scholarly journals An original research paper on incidence and risk factors for surgical site infections following major abdominal surgeries in obstetrics and gynaecology

2017 ◽  
Vol 6 (5) ◽  
pp. 1859
Author(s):  
Shalini Mahana Valecha ◽  
Manisha Narayan Saswade
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Significant Risk ◽  
Surgical Site Infections ◽  
Healthcare Services ◽  
Original Research ◽  
Tertiary Care Centre ◽  
Obstetrics And Gynaecology ◽  
Cost Of Health Care

Background: Surgical site infections associated with substantial morbidity and mortality, increase in hospital stay and enhanced cost of health care. Objective of present study is to analyse the incidence of surgical site infections after major abdominal obstetrics and gynaecologic surgeries and risk factors for development SSIs.Methods: It is observational study carried out at Department of Obstetrics and Gynaecology, ESI-PGIMSR at a teaching public hospital Mumbai, Maharashtra, India. It is a tertiary care centre and a teaching hospital. Women who had undergone abdominal surgery for various Obstetrics and Gynaecology indications.Results: 7.3% of operated subjects had SSI. And significant risk factors are anemia, obesity hypoprotenemia, prolonged pre-operative hospital stay, Diabetes mellitus.Conclusions: Post-operative abdominal wound infection represents a substantial burden of disease both for the patients and the healthcare services in terms of the morbidity, mortality and economic costs.

SURGICAL SITE INFECTIONS AT A TERTIARY CARE CENTRE: A CROSS SECTIONAL STUDY

2021 ◽  
pp. 56-58
Author(s):  
G. D. Yadav ◽  
Kuldeep Kumar ◽  
Ashish Varshney ◽  
Himanshu Singh
Keyword(s):  
Tertiary Care ◽  
Surgical Site Infections ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Cost Of Health Care ◽  
One Year

Background: Surgical site infections are associated with substantial morbidity and mortality, increase in hospital stay and enhanced cost of health care. Objective of present study is to identify the etiological pathogens and their antimicrobial susceptibility, resistance and risk factors for development SSIs. Methods: It is observational study carried out at Department of General Surgery at GSVM Medical College, Kanpur, India for a period of one year. It is a tertiary care centre and a teaching hospital. A predesigned and pretested proforma was used to collect data. Surgical sites were examined and culture with sensitivity was done for infected wounds. Results: The most commonly isolated bacteria were: Klebsiella, E. coli and Staphylococcus aureus. Increasing age and associated diabetes showed signicantly higher rates of infection compared to their counterparts. Universal resistance was present to ampicillin, cefoxitin, ceftriaxone and tetracycline, while organism were sensitive to Imipenam, Meropenam and Piperacillin. Conclusions: Post-operative abdominal wound infection represents a substantial burden of disease both for the patients and the healthcare services in terms of the morbidity, mortality and economic costs.

scholarly journals Risk factors, bacteriological profile and outcome of surgical site infections following orthopaedic surgery

2021 ◽  
Author(s):  
Shishir Murugharaj Suranigi ◽  
SR Ramya ◽  
C Sheela Devi ◽  
Reba Kanungo ◽  
Syed Najimudeen
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Antimicrobial Prophylaxis ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Care Hospital ◽  
Chi Square ◽  
Exact Test ◽  
Bacteriological Profile ◽  
Superficial Skin

Background and Objectives: Surgical site infection (SSI) is a challenge for the surgeon. Incidence of SSI reported in literature varies from 0.5% to 15%. Severity of SSI ranges from superficial skin infection to life-threatening condition like septicaemia. It is responsible for increased morbidity, mortality, and economic burden to the hospital in general, and the patient in particular. The aim of this study was to assess the risk factors, bacteriological profile, length of hospitalization, and cost due to orthopaedic SSI in patients admitted to a tertiary care hospital. Materials and Methods: This was a prospective case control study. Cases were diagnosed based on CDC definition of nosocomial SSI. All cases were assessed preoperatively, intraoperatively and postoperatively, according to type of surgery, wound class, duration of operation, antimicrobial prophylaxis, use of drain, preoperative hospital stay, causative micro organism, total hospital stay, re-admission rates and cost incurred. Age, sex and surgical procedure matched controls without SSI, were also assessed. Chi- square test and Fisher's exact test were used for analysis. P= <0.05 was considered significant. Results: Out of 1023 patients, 47 cases had SSI, with a rate of 4.6%. Cigarette smoking was a risk factor for SSI (P = 0.0035). The most common etiologic agents were Acinetobacter baumannii and Staphylococcus aureus. Incidence of re- admission among SSI cases was more compared to controls (P= 0.0001). Costs attributable to SSI (Indian Rupees) was Rs 32,542 (17,054 to 87,514) which was significantly more than those without SSI (P= <0.001). Conclusion: Despite latest surgical amenities, meticulous sterilization protocols and pre-operative antibiotic prophylaxis, SSI continues to be present in healthcare settings. The increase in duration of hospital stay due to SSI adds to additional burden to an already resource-constrained healthcare system.

scholarly journals Complications following central corpectomy in 468 consecutive patients with degenerative cervical spine disease

2016 ◽  
Vol 40 (6) ◽  
pp. E10 ◽  
Author(s):  
Sauradeep Sarkar ◽  
Bijesh R. Nair ◽  
Vedantam Rajshekhar
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Hospital Stay ◽  
Perioperative Complications ◽  
Statistical Significance ◽  
Significant Risk ◽  
Surgical Site Infections ◽  
Posterior Longitudinal Ligament ◽  
Recurrent Laryngeal Nerve Injury ◽  
Dural Tear

OBJECTIVE This study was performed to describe the incidence and predictors of perioperative complications following central corpectomy (CC) in 468 consecutive patients with cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL). METHODS The authors performed a retrospective review of a cohort of patients who had undergone surgery for CSM (n = 338) or OPLL (n = 130) performed by a single surgeon over a 15-year period. All patients underwent uninstrumented CC with autologous iliac crest or fibular strut grafting. Preoperative clinical and imaging details were collected, and the type and incidence of complications were studied. Univariate and multivariate analyses were performed to establish risk factors for the development of perioperative complications. RESULTS Overall, 12.4% of patients suffered at least 1 complication following CC. The incidence of major complications was as follows: C-5 radiculopathy, 1.3%; recurrent laryngeal nerve injury, 0.4%; dysphagia, 0.8%; surgical-site infection, 3.4%; and dural tear, 4.3%. There was 1 postoperative death (0.2%). On multivariate analysis, patients in whom the corpectomy involved the C-4 vertebral body (alone or as part of multilevel CC) were significantly more likely to suffer complications (p = 0.004). OPLL and skip corpectomy were risk factors for dural tear (p = 0.015 and p = 0.001, respectively). No factors were found to be significantly associated with postoperative C-5 palsy, dysphagia, or acute graft extrusion on univariate or multivariate analysis. Patients who underwent multilevel CC were predisposed to surgical-site infections, with a slight trend toward statistical significance (p = 0.094). The occurrence of a complication after surgery significantly increased the mean duration of postoperative hospital stay from 5.0 ± 2.3 days to 8.9 ± 6 days (p < 0.001). CONCLUSIONS Complications following CC for CSM or OPLL are infrequent, but they significantly prolong hospital stay. The most frequent complication following CC is dural tear, for which a diagnosis of OPLL and a skip corpectomy are significant risk factors.

scholarly journals Factors predicting difficult laparoscopic cholecystectomy: a single institution experience

2017 ◽  
Vol 4 (5) ◽  
pp. 1743
Author(s):  
Shiv K. Bunkar ◽  
Sushil Yadav ◽  
Amit Singh ◽  
Kalpana Agarwal ◽  
Preeti Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Tertiary Care ◽  
Significant Risk ◽  
General Surgeon ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
College Hospital ◽  
Symptomatic Gallstones ◽  
A Prospective Study

Background: Laparoscopic cholecystectomy is one of the most common operations performed by general surgeon. This study was performed to evaluate pre-operative factors predicting difficult laparoscopic cholecystectomy.Methods: A prospective study was carried out at Jawaharlal Nehru Medical College Hospital, Ajmer, a tertiary care centre in Middle East Rajasthan, India. In present study we included 100 patients diagnosed with symptomatic gallstones disease on the basis of history, clinical examinations and USG findings and underwent laparoscopic cholecystectomy in our hospital by a single surgeon during the period of July 2014 to July 2016. These all patients were evaluated for a group of risk factors and preoperatively these risk factors were given a score between 0-5 labeled as easy, 5-10 as difficult and 11-15 as very difficult. Statistical analysis was done by Fischer’s test and chi square test.Results: BMI >30, previous medical disease like DM, palpable gall bladder, prior hospitalization pericholecystic collection and impacted stone are significant risk factors to predict difficult laparoscopic cholecystectomy.Conclusions: The studied scoring system had a positive prediction value for easy prediction of 94% and for difficult prediction of 100%.

scholarly journals Risk Factors of COVID-19 among Patients Attending a Tertiary Care Centre in Delhi: A Case Control Study

2020 ◽  
Vol 05 (04) ◽  
pp. 5-11
Author(s):  
Aakanksha Bharti ◽  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Tertiary Care ◽  
Significant Risk ◽  
P Value ◽  
Rt Pcr ◽  
Tertiary Care Centre ◽  
Case Record ◽  
Significant Difference ◽  
Contact Data

Introduction: COVID-19 is an infectious disease caused by a newly discovered coronavirus Severe Acute Respiratory Syndrome Corona Virus-2 (SARS CoV-2). Therefore, there is paucity of data on risk factors of COVID-19 in India which will help in designing preventive measures. Objective: To determine the risk factors of COVID-19 patients attending a tertiary care institution. Methods: The study was conducted at tertiary care hosipital in South Delhi, India among the patients admitted in Covid-19 wards or visiting the hospital for testing of SARS CoV-2 infection. Contact data of test results was collected from the medical record and detailed information was collected through telephone calls. 103 cases were selected who were found test positive by RT PCR and 103 negatives were selected as controls. Data was collected using pre-tested Questionnaire. The data were first captured in paper-based case record form and then entered in a Microsoft Excel and analyzed in SPSS Software version 21.0. Result: The mean age of all the participants was 37.63±15.32 years. On comparing cases and controls, it was found that symptoms like fever, general weakness, cough, sore throat, breathlessness and headache were significantly associated with cases, having an odds ratio of greater than 1 and p value< 0.05. On analysing various underlying medical conditions amongst controls and cases, it was found that there was a significant difference among cases and controls who had Diabetes Mellitus (DM) and Hypertension (p-value: 0.001) with a high odds ratio of 6.130 and 5.964 respectively. Around half of the cases (54.4%) and 23.3% of controls reported to have faced discrimination or changed attitude of their neighbours after revealing their RT-PCR report and this difference was statistically significant (p-value 0.001). Conclusion: Study revealed that majority of symptoms were not predictors of COVID-19 and only occupations and history of contact remained significant risk factors of COVID-19 in multivariate analysis. A multicenter research study is required to learn more about risk factors.

scholarly journals Antepartum haemorrhage: a retrospective analysis in a tertiary care centre

2020 ◽  
Vol 9 (11) ◽  
pp. 4531
Author(s):  
Mohini Rajoriya ◽  
Saurabh Dubey ◽  
Sanju Agarwal
Keyword(s):  
Risk Factors ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
Induced Hypertension ◽  
Very High

Background: Aim of the present study was to found the incidence of APH, demographic profile risk factors and maternal outcome.Methods: This was a retrospective study carried out in Department of Obstetrics and Gynaecology, MGM Medical College and associated M.Y., Hospital, Indore from August 2019 to July 2020.Results: The incidence of APH was 3.27%. 68.7% cases of APH were associated with pregnancy induced hypertension suggesting PIH is one of the major risk factors. Maternal morbidity was very high with increased rates cesarean section 91.7%, postpartum hemorrhage (32.6%), need of blood transfusion (86%). There were 2 mortalities and 3.1 % patients underwent Obstetric Hystrectomy and 24% required CCU admission.Conclusions: There is very high maternal morbidity and mortality in APH. 

scholarly journals Incisional surgical site infections in obstetric and gynecological procedures in a tertiary care hospital in Northern India

2020 ◽  
Vol 9 (12) ◽  
pp. 4946
Author(s):  
Savita Chandra ◽  
Shodashi Saxena
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Surgical Site Infections ◽  
Current Status ◽  
Care Hospital ◽  
Incisional Surgical Site Infection ◽  
The Impact ◽  
Microbial Spectrum

Background: To find the incidence of incisional surgical site infection (ISSI) in obstetric and gynecological procedures, the risk factors, the microbial spectrum, the antibiotic sensitivity and the impact on the hospital stay. Methods: A prospective observational study was done under the department of obstetrics and gynecology, Era’s Lucknow medical college and hospital. All consecutive patients who underwent caesarean section, vaginal delivery with episiotomy, laparotomy, and hysterectomy were included in this study. Laparoscopic surgeries were excluded. Results; In this series of 646 surgeries, 6.18% developed ISSI. In the category of major surgeries, the ISSI rate was 8.89%. Amongst the 185 episiotomies 1.6% gaped. Anemia, diabetes mellitus, excess body weight, emergency or elective surgery, rapid built up of hemoglobin with blood transfusion, previous caesarean scar and tobacco intake were the risk factors identified. Coagulase negative staphylococcus was the dominant microbe. Antibiotic sensitivity to linezolid was found in 50% of the ISSI cases followed by amikacin, clindamycin and some others. The mean hospital stay was 13 days while the maximum was 26 days.Conclusions: The study established the current status of incisional surgical site infections, identified the risk factors, the microbial spectrum, the antibiotic sensitivity and the need for further studies using a preventive approach. 

scholarly journals Effectiveness of bundled interventions in reducing surgical site infections in elective caesarean sections and caesarean hysterectomies in a tertiary care centre

2020 ◽  
Vol 9 (7) ◽  
pp. 2823
Author(s):  
Gunjan Yadav ◽  
Kalpana Yadav ◽  
Parasuram Waddar
Keyword(s):  
Risk Factors ◽  
Treatment Outcomes ◽  
Tertiary Care ◽  
Intervention Group ◽  
Surgical Site Infections ◽  
Routine Care ◽  
Care Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Factors Associated

Background: Surgical site infections are the most common and easily preventable infections complicating surgeries. CDC recommends certain bundle interventions for the prevention of SSIs. Hence the present study was undertaken to see the effectiveness and feasibility of the bundle interventions in the elective caesarean sections and caesarean hysterectomies.Methods: A total of 600 patients were taken. Bundled interventions were applied in 278 caesarean sections and 26 caesarean hysterectomies. Routine care was implemented in 262 caesarean sections and 34 caesarean hysterectomies. Rate of SSI, risk factors associated and treatment outcomes were studied.Results: 8 out of 304 cases of the bundled intervention group developed SSI, giving a rate of 2.6%. 52 cases out of 296 in the routine care group developed SSI, the SSI rate being 17.5%. Anemia and diabetes were the most common risk factors.Conclusions: Adherence to bundled interventions can significantly and easily reduce the incidence of SSI.

scholarly journals Clinical and Etiological Profile of Mycotic Keratitis from a Tertiary Care Centre in South India

2021 ◽  
Vol 10 (27) ◽  
pp. 2001-2006
Author(s):  
John Britto Augustin ◽  
Sureshbaboo Variamkandi
Keyword(s):  
Risk Factors ◽  
Corneal Ulcer ◽  
Fusarium Species ◽  
Tertiary Care ◽  
Government Medical College ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Corneal Ulcers ◽  
Prompt Treatment

BACKGROUND Corneal ulcer is the leading cause of ocular morbidity and monocular blindness worldwide. To effectively prevent blindness in patients with corneal ulcer, a proper understanding of the risk factors predisposing to ulceration, its clinical and microbiological characteristics are essential. Timely identification of aetiological agents causing corneal ulcers and their prompt treatment helps to save the vision. We wanted to detect aetiological agents of corneal ulcer with special references to fungal causes and characterize the fungal aetiological agents to species level. METHODS This is a cross sectional study, conducted in Government Medical college, Kozhikode, between January 2016 and June 2017. All patients who were clinically diagnosed as cases of infectious corneal ulcer in the Ophthalmology department, Government Medical College, Kozhikode were included in the study. Corneal scrapings collected from the infected eye were subjected to microbiological examination and culture. A total of 120 cases were analysed. Each patient was examined with the slit lamp bio microscope after staining with fluorescein. Scrapings from cornea at the site of corneal ulcer were collected by ophthalmologist after a detailed clinical history and examination of the affected eye. The laboratory procedures used in the diagnosis of infectious keratitis were based on direct visualization of organisms by subjecting corneal scrapings to Gram stain and KOH wet mount and inoculation of material on to blood agar and Sabouraud dextrose agar. RESULTS Among the 120 cases, a total of 49 cases were culture positive. Twenty-one [17.5 %] were bacterial, twenty-two [18.34 %] were fungal and six [5.0 %] were poly microbial [bacteria and fungus]. Among the fungal aetiology, fusarium species was most common [32.14 %], followed by aspergillus species - 25.0 %. Trauma was the major risk factor. Diabetes mellitus, exposure keratitis were the other comorbidities / risk factors. CONCLUSIONS This study shows majority of infected corneal ulcers are associated with risk factors and the aetiology are mainly fungi. Microscopy, culture, and clinical correlation helped in adequate management. Thus, prognosis and outcome of corneal ulcers rely on timely identification of their aetiology and prompt treatment. KEY WORDS Corneal ulcer, Fungal Keratitis

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