scholarly journals Evaluation of postoperative pain in closure versus non-closure of parietal peritoneum at caesarean section

Author(s):  
Avantika Sharma ◽  
Nupur Hooja ◽  
Apoorv Shastri ◽  
Brijesh Dadhich ◽  
Richa Manish

Background: Pain is one of the major discomfort which drives post caesarean mothers to seek help. Thus, it is important to know if any change in surgical technique could have effect on the post-operative pain which affects all the woman’s activities. Hence, the study was undertaken to study the effect of closure and non-closure of parietal peritoneum on postoperative pain.Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Detailed history, investigations, operative details, postoperative outcome in terms of pain were recorded and analysed.Results: Women in the closure group had more postoperative pain. P value was highly significant at 8h (P=0.0001), 16h (P=0.0001), 24h (P=0.00001) and 32h (P=0.000001), 40 hour (P=0.00001) and 48h (P=0.0001).Conclusions: Peritoneal should not be closed routinely in caesarean sections as it is shown to cause less postoperative pain.

Author(s):  
Prem Singh ◽  
Achyut Kumar Pandey

Background: The quality of life (QOL) evaluation is a relatively new measure to evaluate the outcome of epilepsy. Many factors influence the quality of life of people with epilepsy, including seizure severity, stigma, fear, and the presence of cognitive or psychiatric problems. QOL is influenced by biological factors as well as cultural, social and religious beliefs and values. This study was planned to find out the impact of epilepsy on quality of life of epileptic patients.Methods: The study was conducted in the epilepsy clinic of department of neurology at a tertiary care hospital over a period of one year.101 patients were included after fulfilling the inclusion criteria. All the patients seeking treatment in the OPD were screened, assessed and then all procedures were fully explained to them. History regarding name, age sex, socio-demographic profile and detailed history regarding seizure disorder was taken from both the patient and the reliable informant. Bengali version of QOLIE-9 was used to assess the quality of life.Results: One hundred and one patients with epilepsy consisting of 70 men (69.3%) and 31 women (30.7%) were included. Their ages ranged from 15 to 52, the mean age being 26.17 (SD = 7.84). Out of the 101 patients, 65 patients (64.4%) were suffering from partial epilepsies and 36 patients (35.6%) were suffering from generalized epilepsies. Mean QOLIE-9 total scores were 16.66, 19.74, 20.13 and 24.00 in married, widows, unmarried and separated individuals respectively. The differences in the means were statistically significant on ANOVA (p value 0.002). Mean QOLIE-9 total scores were 27.75, 19.64, 19.65, 18.14 and 18.00 in primary, secondary, higher secondary, graduate and postgraduate individuals respectively. The differences were highly significant statistically on ANOVA (p value<0.001). Frequency of seizures per month was positively correlated with QOLIE-9 total scores (Pearson Correlation 0.622) and was highly statistically significant (p value<0.001).Conclusions: Frequent seizures, lower education level and single status are associated with lower quality of life in persons with epilepsy.


2019 ◽  
Vol 6 (5) ◽  
pp. 1893
Author(s):  
Sarvepalli Vijaya Kumar ◽  
Krishnan Ramalingam

Background: Intestinal parasitic infections are one of the neglected tropical diseases listed by world health organization. Parasitic infections among school going tribal children cause significant anaemia and malnutrition. Our study mainly focused on estimating the prevalence of intestinal parasitic infections and focused on iron deficiency anaemia among the tribal school going children.Methods: A prospective study for one year was conducted at a tertiary care hospital and study group was tribal children from hostels and schools. Ethical committee approval was obtained and study included collection of socio demographic data, anthropometric data, stool examination for intestinal parasitic infections, Hb% estimation by “Hemocue globinometer Hb 301 System” a portable hemometer for Hb estimation. S. iron, S. transferrin and Total iron binding capacity were also estimated. Statistical analysis was performed by using SPSS version 20 and analyzed. P value <0.05 was considered significant.Results: This 428 study participants with 66.36% boys and 33.64% girls were enrolled. The prevalence of parasitic infections was 42.06%. Protozoal infections were 41.11% when compared to helminthic infections (26.67%) and mixed infections in 32.22%.  Entamoeba histolytica was the predominant protozoal parasite identified (30%) and Ascaris lumbricoides among the helminthic infection (13.3%). Presence of anaemia in the present study population was 11.21% and among the study group with parasitic infections it was 66.67%.Conclusion: To conclude, regular deworming practices, awareness regarding hand washing practices, iron and folic acid supplementation irrespective of nutritional status and health education could significantly reduce the incidence of anaemia associated with intestinal parasitic infections. 


2016 ◽  
Vol 47 (2) ◽  
pp. 145-149 ◽  
Author(s):  
Archan Sil ◽  
Tamoghna Biswas ◽  
Moumita Samanta ◽  
Mithun Chandra Konar ◽  
Arun Kumar De ◽  
...  

Ours was a descriptive observational cross-sectional study carried out in a tertiary care hospital in eastern India over a period of one year to study the profile of neurological involvement in paediatric dengue patients. Of 71 laboratory-confirmed cases, 20 (28.17%) had neurological involvement. Common forms observed were acute encephalopathy (40%), encephalitis (30%), pure motor weakness (15%), transverse myelitis (5%), acute disseminated encephalomyelitis (5%) and Guillain–Barré syndrome (5%). The dengue IgM antibody could be detected in the cerebrospinal fluid of only two patients with encephalitis. Neurological involvement was present in all four patients who died during the study period (two-tailed P value = 0.005).


Author(s):  
Lata Rajoria ◽  
Manisha Kala ◽  
Nupur Hooja ◽  
Smriti Bhargava ◽  
Brijesh Dadhich

Background: Caesarean section is the most commonly performed obstetric surgery. A change in the operative technique affects the postoperative outcome. The study was undertaken to study the postoperative outcome of the patient who underwent caesarean section by Pfannensteil Kerr and Misgav Ladach method of lower segment caesarean section.Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Postoperative condition of the women was assessed after caesarean section in women with Pfannensteil Kerr and Misgav Ladach method and compared.Results: Most cases in the Misgav Ladach method had breast fed early, had quicker return of bowel activity and earlier ambulation in comparison to the Pfannensteil Kerr method. This difference was statistically significant. Women with the Pfannensteil Kerr method had more postoperative pain, nausea and vomiting. The duration of hospital stay was less in Misgav  technique.Conclusions: Since Misgav Ladach method was a better technique than Pfannensteil Kerr, adopting it routinely would result in considerable reduction in maternal morbidity, decreased hospital stay, better patient satisfaction level and more cost effective.


Background: Epilepsy is fairly a frequent occurrence in the elderly. It is commonly diagnosed after the episode of two or more unprovoked seizures. Unprovoked seizures in elderly are recurrent rather than younger individuals. This study was designed to estimate the concrete burden of frequent causes of epilepsy. Methods: A descriptive cross-sectional study with a total of 153 patients diagnosed case of epilepsy were included in this study at Jinnah Medical College Hospital from February 2018-August 2018. Mean was calculated for age, duration of disease of the patients. Causes of epilepsy, gender, and education was calculated and presented as percentages. Electrolyte readings were taken i.e., Sodium, Calcium and Magnesium levels and imaging was planned to rule out stroke, primary neurodegenerative disorders and tumors. Post stratification Chi square test was applied and p-value less than or equal to 0.05 was considered significant. Results: The mean age of the patients was 63.91±5.68 years and mean duration of the disease was 4.61± 1.07 months. The common causes of epilepsy were found to be cerebrovascular disease 56.9%, cryptogenic 54.2%, neurodegenerative disorder 20.3%, traumatic head injury 11.8%, metabolic abnormalities or electrolyte disturbances 10.5% and brain tumor 7.8%. Conclusion: Elderly patients with first seizure should present to a facility designed in a way that neurologist, cardiologist, rehabilitation and geriatrics work together to identify and treat the condition in a better way. Keywords: Epilepsy; Seizures; Cerebrovascular Disease; Neurodegenerative Disorder.


2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)


Author(s):  
Amit Kumar ◽  
Surender Kumar ◽  
Anand Krishnan ◽  
Manish Verma ◽  
Uma Garg ◽  
...  

AbstractTonsillectomy is one of the commonest ENT procedures done in paediatric population, the technique of which has evolved over years to decrease the morbidity associated with the surgery. This prospective randomized comparative study is done to evaluate the efficacy of two different techniques of this surgery, conventional cold dissection and laser tonsillectomy based on operative time, blood loss, post-operative pain and occurrence of secondary complications. The study was done in 68 patients of paediatric age group, 34 in each group underwent cold dissection and laser tonsillectomy. Operative time and bleeding were significantly low for laser group. Pain score was comparable in early post-operatives days, but was high towards the end of first week. Our study reported only one incidence of complication in the form of a secondary bleeding.


2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27


Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Farzana Latif ◽  
Sadia Ilyas ◽  
Saeed Mehmood ◽  
Hammad Arif ◽  
Nuzhat Parveen Khawaja ◽  
...  

Objectives: To audit the obstetric hysterectomies in a tertiary care hospital during one year. Methods: It was an observational retrospective study design, where all the pregnant women were assessed for fetomaternal outcomes, indications and complications for peripartum hysterectomy. The records were retrieved from Jan 2015 to Dec 2015 by using hospital record system. The study duration was of one year. The venue of the study was Lahore General hospital, Lahore. The exclusion criteria included all unmarried women, women with chronic kidney disease or renal failure, past surgical history of heart disease, whereas all the women who delivered in hospital, private clinic or at home after atleast 28 weeks of gestational age and experience hysterectomy at the time of delivery or after delivery in the puerperium, were included in the study. Results: The data over 32 women were retrieved from the hospital record system. The mean age of the women was 30.34+2.23 with range 26-34. The average number of parity was 3 of all females. The range of parity was 2 to 7. The average gestational age was 36.18 weeks. All the deliveries were done by cesarean section whereas 4 (12.5%) were elective and 28 (87.5%) were with emergency indications. 13 (40.6%) of the deliveries were in private clinic, 9 (28.1%) were done by LHV/ mid wife, 5(15.6%) were in private hospitals, 4(12.5%) were in LGH and only 1(3.1%) was at home. 18(56.3%) of the women were having at least one abortion in previous history. Conclusion: We concluded that emergency peripartum hysterectomy is very vital procedure that saves lives and manage life threatening obstetrical hemorrhage when other methods failed to control it.The major indications for emergency peripartum hysterectomy were placental abruption, placenta praevia/accrete, uterine atony and ruptured uterus. Key Words: Uterine artery embolization, Emergency peripartum hysterectomy, maternal morbidity and mortality, healthcare providers How to Cite: Latif F, Ilyas S, Mehmood S. Arif H. Khawaja P. Nuzhat. Jawad Z. J Clinical audit of obstetrical hysterectomies for a period of one year in a tertiary care hospital. Esculapio.2020;16(04):50-53.


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