Concurrent surgeries in ENT: a cost-effective and safe approach in patients requiring multiple definitive procedures

2004 ◽  
Vol 118 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Achamma Balraj ◽  
Mary Kurien ◽  
Anand Job
Keyword(s):  
Surgical Procedures ◽  
Tertiary Care ◽  
Case Series ◽  
Cost Effective ◽  
Definitive Treatment ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Average Hospital ◽  
Duration Of Surgery

Treatment of the predisposing factors that are identified in the nose and throat in several ENT diseases is mandatory prior to the definitive management of the latter. When surgical management is indicated it has been traditional to use staged procedures. This study was undertaken to assess the role of concurrent surgical procedures in ENT and evaluate their cost-effectiveness compared to similar staged procedures. This was a retrospective case series of 100 consecutive patients undergoing concurrent and similar staged ENT surgical procedures. On analysis, it was noted that the average duration of surgery, anaesthesia and hospital stay was significantly less in the concurrent procedures group than in the staged procedures (2.35/3.1.hours; 3.05/3.30.hours and 2.5/6.5 days, respectively). The average hospital bill for the concurrent procedures was also lower than for the staged procedures. Hence, in patients requiring multiple ENT surgical procedures for definitive treatment, concurrent procedures are more cost-effective than staged procedures and should be considered the treatment of choice in a tertiary care centre.

scholarly journals Peripartum hysterectomy: a five year review at a tertiary care centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3590
Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
College Hospital ◽  
Peripartum Hysterectomy ◽  
Medical College ◽  
Obstetric Haemorrhage ◽  
Suboptimal Care

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 

scholarly journals Transcanal Endoscopic Antrostomy Hole : Its Utility in Restoring Ventilation Pathway to Epitympanum and Mastoid Antrum During Tympanoplasty

2014 ◽  
Vol 2 (1) ◽  
pp. 9-14
Author(s):  
Sheikh Shawkat Kamal
Keyword(s):  
Middle Ear ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Retrospective Case ◽  
Middle Ear Mucosa ◽  
Case Series Study ◽  
Temporal Bones ◽  
Mastoid Antrum

Aim: To evaluate the role of newly created transcanal endoscopic antrostomy hole as a passage in restoring the aeration of epitympanum and mastoid antrum.Materials & Methods: Study design: Retrospective case series study. Study duration: From January 2013 to January 2014. Study place: Private tertiary care hospital. Patients: 27  ears of 23 adult patients (age ranging from 15years to 54years) underwent transcanal endoscopic tympanoplasty for their chronic middle ear diseases in presence of inflamed middle ear mucosa along with radiological shadows of stagnant fluid in their epitympanum and mastoid antrum. Structured three months follow-up was ensured in every case. Intervention: A hole was created at a selected site of posterior meatal wall purely through transcanal endoscopic approach that established direct communication between mastoid antrum and external auditory canal. Thereafter this newly created passage was used for three purposes- assessment of the condition of mastoid antrum, performing the water test for checking epitympanic patency and in few cases placement of temporary tube for postoperative ventilation and drainage of middle ear. Main out come measures: The feasibility, performance and management of transcanal endoscopic antrostomy hole as passage for reestablishing the aeration of epitympanum and mastoid antrum.Results: The chosen site for antrostomy hole was found effective and safe in providing convenient entrance into the mastoid antrum in every case in this study with out facing technical complexity and failure. Postoperative healing of skin over antrostomy hole was found complete in all ears without any inward growth of skin in to mastoid antrum. Available post operative CT scan imaging of temporal bones showed improved aeration in their epitympanum and mastoid antrum.Conclusions: The role of transcanal antrostomy hole has been proved worthy in restoring ventilation pathway to epitympanum and mastoid antrum during tympanoplasty. This antrostomy hole has the potentiality to be considered in future for placement of long term mastoid ventilation tube in order to treat persistent atelectatic middle ear.

Management and Outcomes of Interstitial Ectopic Pregnancies at a Tertiary Care Centre: a Retrospective Case Series

2018 ◽  
Vol 40 (6) ◽  
pp. 852
Author(s):  
Angel Shan ◽  
Mary Ellen Conway ◽  
Lindsay Machan ◽  
Laura Cormack ◽  
Nadia Branco ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Ectopic Pregnancies

scholarly journals Observational Study on Clinical Features, Treatment and Outcome of COVID 19 in a tertiary care Centre in India- a retrospective case series

2020 ◽  
Author(s):  
Raja Bhattacharya ◽  
Rohini Ghosh ◽  
Manish Kulshrestha ◽  
Sampurna Chowdhury ◽  
Rishav Mukherjee ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Standard Of Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Demographic Profile ◽  
Acetyl Cysteine

ABSTRACT Objective: This study will attempt to explore the demographic profile and outcome in the patients receiving multidisciplinary, personalised approach including use of Broad Spectrum Antivirals - Ivermectin, anti-inflammatory and antioxidants roles of Statins and N-acetyl-cysteine along with Standard of Care (SOC) in hospitalised COVID19 patients in a tertiary care centre. Setting: Inpatient department Participants: 191 COVID-19 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the year 2020 between June 14- 28, 2020 Main outcome measures: The outcome of Interests are : Studying the demographic profile of COVID 19 cases Study the treatment outcomes in terms of death or discharge in patients receiving Ivermectin+N-acetyl-cysteine+Statin along with Standard of care. Results: 148 patients were included in the study. All of them had confirmed COVID19 infection by the rtPCR method. Average age of the patients was 57.57 years ( Range = 17 - 88), 49% were male, 51% female. 81% of the patients had at least one or more comorbidities. Most common comorbidities included diabetes( 32%), Hypertension (27%),Ischaemic Heart Disease (8%). More comorbidities. The in hospital, Case Fatality Rate was therefore, 1.35 %. The remaining 144 were discharged from the facility after an average 12 days duration of stay. Conclusions: Triple therapy with ivermectin + atorvastatin + N-acetylcysteine can be an useful adjunct to standard of care. Keywords: SARS-CoV-2, COVID-19, outpatients, treatment, zinc, hydroxychloroquine, azithromycin

scholarly journals Secondary Abnormal CSF Neurotransmitter Metabolite Profiles in a Pediatric Tertiary Care Centre

2017 ◽  
Vol 45 (2) ◽  
pp. 206-213 ◽  
Author(s):  
Clara D.M. van Karnebeek ◽  
Mary Dunbar ◽  
Csilla Egri ◽  
Bryan Sayson ◽  
Janetta Milea ◽  
...  
Keyword(s):  
Movement Disorders ◽  
Tertiary Care ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Epileptic Encephalopathy ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Chi Square ◽  
Number Of Patients ◽  
Patients With Epilepsy

AbstractBackground:Secondary neurotransmitter deficiencies have been reported in several reviews. Our primary aim was to assess the relationship among epilepsy, antiseizure medications, and specific neurotransmitter abnormalities. We also evaluated movement disorders and brain abnormalities via magnetic resonance imaging scans in patients with secondary neurotransmitter defects.Methods:This is a retrospective case series of 376 patients who underwent neurotransmitter analysis at BC Children’s Hospital between 2009 and 2013, for a variety of neurological presentations. The biochemical genetics laboratory database was interrogated for results of cerebrospinal fluid neurotransmitter analyses. Clinical data for patients with abnormal results were collected from the hospital charts. Statistical analysis included one-way analysis of variance, chi-square, and a two-way contingency table.Results:Abnormal neurotransmitter values were identified in 67 (17.8%) patients, two (0.53%) of which were attributable to a congenital neurotransmitter disorder and 11 (16.9%) secondary to other genetic diagnoses. Of 64 patients with secondary abnormal neurotransmitter values, 38 (59%) presented with epilepsy and 20 (31%) with movement disorders. A combination of epilepsy and movement disorder was less frequent.Discussion:Acknowledging the limitations of this retrospective chart review, we conclude that, in our cohort, in addition to patients with movement disorders, a considerable number of patients with epilepsy and epileptic encephalopathy also showed secondary neurotransmitter mono-amine abnormalities. There is no clear relation, however, between clinical phenotype and type of neurotransmitter affected. In addition, no association was identified between the type of antiseizure medications and affected neurotransmitter type. We outline the need for prospective studies to further enrich our understanding of the relation between epilepsy and neurotransmitters with a focus on improving treatments and patient outcomes.

scholarly journals OBSERVATIONAL STUDY ON CLINICAL FEATURES, TREATMENT AND OUTCOME OF COVID 19 IN A TERTIARY CARE CENTRE IN INDIA - A RETROSPECTIVE CASE SERIES

2020 ◽  
pp. 1-3
Author(s):  
Raja Bhattacharya ◽  
Indranil Ray ◽  
Rishav Mukherjee ◽  
Sampurna Chowdhury ◽  
Manish Kulasreshtha ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Standard Of Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Demographic Profile ◽  
Acetyl Cysteine

Till date, no proven therapy exists for treatment of SARS-coV-2 infections which has been de-clared a pandemic by WHO in March, 2020. Objective: This study will attempt to explore the demographic profile and outcome in the pa-tients receiving multidisciplinary, personalised approach including use of Broad Spectrum Antivi-rals - Ivermectin, anti-inflammatory and antioxidants roles of Statins and N-acetyl-cysteine along with Standard of Care (SOC) in hospitalised COVID19 patients in a tertiary care centre. Setting: Inpatient department (designated COVID ward) Participants: COVID-19 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the year 2020 between June 14- 28, 2020. Main outcome measures: The outcome of Interests are : a. Studying the demographic profile of COVID 19 cases b. Study the treatment outcomes in terms of death or discharge in patients receiving Ivermectin+N-acetyl-cysteine+Statin along with Standard of care. Results: 148 patients were included in the study. All of them had confirmed COVID19 infec-tion by the rtPCR method. Average age of the patients was 57.57 years ( Range = 17 - 88), 49% were male, 51% female. 81% of the patients had at least one or more comorbidities. Most com-mon comorbidities included diabetes( 32%), Hypertension (27%),Ischaemic Heart Disease (8%). More comorbidities. The in hospital, Case Fatality Rate was 1.35 %. The remaining 146 were dis-charged from the facility after an average 12 days duration of stay. Conclusions:. Triple therapy with Ivermectin, N-acetyl-cysteine and Atorvastatin along with standard of care is safe and effective in SARS-coV-2 infection.

scholarly journals Supracondylar humerus fracture in children: K wire pinning with minimal sterile technique

2021 ◽  
Vol 7 (4) ◽  
pp. 840
Author(s):  
Girish H. R. ◽  
Mahendranath . ◽  
Deepak Malik ◽  
Gowthama Pradhban N.
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Cost Effective ◽  
Supracondylar Fracture ◽  
Oral Antibiotic ◽  
Tertiary Care Centre ◽  
Sterile Technique ◽  
Prospective Case Series

<p class="abstract"><span lang="EN-US">A minimal sterile technique to assess the outcome of K wire pinning of Supracondylar fracture of humerus in children. A prospective case series between 2018 to 2020 was conducted on 10 supracondylar fracture of humerus operated at a tertiary care centre. Gartland type 2 and 3 were included and all the patients were treated with minimal sterile K-wire pinning technique. After 18 weeks follow up with mean age of 7.3 years, all patients were found to have excellent results. In our study no patients received antibiotic except in one patient where 5 days of oral antibiotic cefixime was given. Less complications, reduced time of surgery of average 24.3 minutes, reduction in cost factor and patient compliance was better. Supracondylar fracture of humerus can be fixed by K-wire fixation with minimal sterile technique either by cross pinning or lateral pinning which has same outcome as sterile technique and minimal sterile technique is cost effective and time sparing.</span></p>

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