scholarly journals A comparative study of two different techniques of subcutaneous tissue closure in abdominal surgery

2017 ◽  
Vol 6 (12) ◽  
pp. 5512
Author(s):  
Jyotsna S. Dwivedi ◽  
Alka S. Gupta ◽  
Sachin H. Pardeshi
Keyword(s):  
Subcutaneous Tissue ◽  
Tertiary Care ◽  
Total Duration ◽  
Wound Complications ◽  
Control Group ◽  
Tertiary Care Centre ◽  
Surgical Access ◽  
Suction Drain ◽  
The Difference

Background: Surgical access to abdomen is required for many operative procedures. The subcutaneous tissue of the anterior abdominal wall can either be sutured or left unsutured with drain in situ. The purpose of this study was to compare the two methods of closure of the subcutaneous tissue and determine the benefit of one over the other.Methods: The study was conducted in a tertiary care centre with sample size of 30 each in study and control group. Patients fulfilling the inclusion criteria were selected and depending on the randomisation the closure of subcutaneous tissue was done either by polyglactin 910, 2-0 or left unsutured with indigenously designed syringe suction drain kept in situ. The patients were followed up till the day of suture removal and further in case of any complications.Results: Total duration taken for the procedure was significantly increased in the study group. There was a significant level of discomfort among the participants due to drain. The rate of surgical site infection, hospital readmission morbidity was significantly higher in the study group.Conclusions: The type of drain studied was indigenously designed where the closed system was not maintained during charging the drain, hence further studies need to be conducted which will compare this with the other closed suction drains to determine the difference in the risk of wound complications.

Carnitine deficiency in chronic obstructive lung disease: A study in a tertiary care centre

2021 ◽  
Vol 6 (3) ◽  
pp. 183-187
Author(s):  
M Ravindranath ◽  
C H Raju
Keyword(s):  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Tertiary Care ◽  
Chronic Obstructive Lung Disease ◽  
Carnitine Deficiency ◽  
Control Group ◽  
Chronic Obstructive ◽  
X Rays ◽  
Tertiary Care Centre ◽  
Regular Diet

Chronic Obstructive Lung Disease (COPD) is a condition where there is poor airflow to the lungs and over a period of time this condition worsen, resulting in severe morbidity. L-carnitine (LC) is a soluble qaurtenary amine and is essential for the tissues and lung tone to function normally. This study was therefore find out the association of L-carnitine in patients with chronic Obstructive Pulmonary Disease. 75 patients who came to the Department of Pulmonology of either sex between 40 to 75 years with confirmed COPD were included into patients group and 75 healthy patients were included into the control group. Blood was collected for Fasting blood sugar, AST, ALP, ALT, Urea, Creatinine, Albumin, pre-albumin, iron , magnesium, sodium, phosphorous, calcium, Acylcarnitines, total and free carnitine levels. X-rays were taken and pulmonary function test was done for all the patients. The mean age of the patients in our study was 62.53 and 61.86 years among the patients and controls respectively. Among the controls the Ph and Fe levels were 3.1 ± 0.9mmol/L and 21.69 ± 3.19 mcg/dL respectively and among the patients the same levels were 2.6 ± 1.9mmol/L and 43.82 ± 8.22mcg/dL respectively. The albumin and the prealbumin in the patients were significantly lower in the patients with 21.81 ± 2.88 and 23.53 ±2.58 mg/dL and in controls they were 32.61 ±3.87 and 26.87 ± 1.93 mg/dL respectively. There was a considerable carnitine deficiencies in COPD patients when compared to the controls and since carnitine can be found in regular diet, people can be educated to have a proper intake of foods containing carnitine in their regular diet.

scholarly journals Cutaneous manifestations in obese patients and non-obese controls in a tertiary care centre: a case-control study

2019 ◽  
Vol 5 (4) ◽  
pp. 695
Author(s):  
Raghuveer Chekuri ◽  
Thameena Mohamed
Keyword(s):  
Acanthosis Nigricans ◽  
Tertiary Care ◽  
Control Group ◽  
Obese Patients ◽  
Striae Distensae ◽  
Tertiary Care Centre ◽  
Cutaneous Manifestations ◽  
High Prevalence ◽  
Skin Conditions ◽  
And Function

<p class="abstract"><strong>Background:</strong> Obesity has emerged as one of the most serious public health concerns in the 21<sup>st</sup> century. It is responsible for varied changes in structure and function of different components of skin. Skin care of obese patients deserves particular attention, not only because of high prevalence of cutaneous alteration but mainly because many of these disorders are preventable and could be treated, improving patient’s quality of life.</p><p class="abstract"><strong>Methods:</strong> Two hundred patients with BMI ≥30 kg/m<sup>2</sup> and two hundred age and sex matched controls (BMI: 18.5-24.9 kg/m<sup>2</sup>) were included in this study.<strong></strong></p><p class="abstract"><strong>Results:</strong> Compared to the control group, obese patients were having higher prevalence of various skin conditions of which most common were acanthosis nigricans, acrochordons, striae distensae, frictional hyperpigmentation and infections.</p><p class="abstract"><strong>Conclusions:</strong> There is increased incidence and severity of cutaneous manifestations like acanthosis nigricans, acrochordons, striae distensae, frictional hyperpigmentation and infections in obese patients than control subjects. These can be used as markers for the early detection of various components of metabolic syndrome.</p>

MANAGEMENT AND OUTCOME OF ABDOMINAL WALL CLOSURE IN EMERGENCY LAPAROTOMY AT A TERTIARY CARE CENTRE

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Mohit Badgurjar ◽  
Poojan Thakor ◽  
Pankaj Saxena ◽  
Suman Parihar ◽  
Giriraj Prajapati ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Tertiary Care ◽  
Wound Complications ◽  
Emergency Laparotomy ◽  
Abdominal Wall Closure ◽  
Suture Materials ◽  
Tertiary Care Centre ◽  
Mass Closure ◽  
Continuous Methods ◽  
Closure Group

Objective: Abdominal wall closure of an emergency laparotomy involves a great deal of consideration. An ideal laparotomy wound closure should be efficient. provide strength and serve as a barrier to infection. The aim of this study is to compare and evaluate the advantages of layered closure in comparison with the mass layered closure, the types of suture materials used in the closure, absorbable/nonabsorbable and its correlation with post operative complications such as wound sepsis, burst abdomen and incisional hernia. Methods: This prospective study was carried out over a period of 18 months enrolling a total of 90 patients split into two groups with group 1 undergoing mass closure using both interrupted and continuous methods and group 2 undergoing layered closure using both interrupted and continuous methods of suturing. Results: A higher rate of wound complications was noted in the layered closure group (37.7%) than the mass closure group (17%). Wound complications were also noted to be higher in closures done with prolene suture (37.7%) than PDS (20%). As far as techniques were concerned, interrupted and continuous suturing had a similar rate of complications. Of all the comorbidities, considered in the study, the highest rate of wound related complications were seen in patients with pulmonary complications (13.3%). Conclusion: Although the ideal way to close an abdomen post laparotomy has not yet been discovered, our study shows that mass closure with PDS suture to close the abdominal wall should be advocated as there is decreased early and late post operative wound complications Keywords: PDS.

scholarly journals Physical activity during pregnancy and its influence on delivery time: a randomized clinical trial

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6370 ◽  
Author(s):  
Raquel Rodríguez-Blanque ◽  
Juan Carlos Sánchez-García ◽  
Antonio Manuel Sánchez-López ◽  
María José Aguilar-Cordero
Keyword(s):  
Physical Exercise ◽  
Pregnant Women ◽  
Intervention Program ◽  
Total Duration ◽  
Perinatal Outcomes ◽  
Exercise Group ◽  
University Hospital ◽  
Control Group ◽  
Beneficial Effects ◽  
The Difference

Introduction During pregnancy, women often change their lifestyle for fear of harmful effects on the child or themselves. In this respect, many women reduce the amount of physical exercise they take, despite its beneficial effects. Objective To determine the duration of labor in pregnant women who completed a program of moderate physical exercise in water and subsequently presented eutocic birth. Methods A randomized trial was performed with 140 healthy pregnant women, divided into an exercise group (EG) (n = 70) and a control group (CG) (n = 70). The women who composed the study population were recruited at 12 weeks of gestation. The intervention program, termed SWEP (Study of Water Exercise during Pregnancy) began in week 20 of gestation and ended in week 37. Perinatal outcomes were determined by examining the corresponding partographs, recorded by the Maternity Service at the Granada University Hospital Complex. Results The intervention phase of the study took place from June through October 2016, with the 120 women finally included in EG and CG (60 in each group). At term, 63% of the women in EG and 56% of those in CG had a eutocic birth. The average total duration of labor was 389.33 ± 216.18 min for the women in EG and 561.30 ± 199.94 min for those in CG, a difference of approximately three hours (p < 0.001). Conclusions The women who exercised in water during their pregnancy presented a shorter duration of labor than those who did not. The difference was especially marked with respect to the duration of the first and second stages of labor.

scholarly journals Epidural analgesia during labour: its influences on pain relief, progress of labour, mode of delivery, maternal and foetal

2020 ◽  
Vol 9 (2) ◽  
pp. 555
Author(s):  
M. Suneetha ◽  
A. Saritha
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Obstetric Care ◽  
Fetal Outcome ◽  
Control Group ◽  
Sitting Position ◽  
Tertiary Care Centre ◽  
Group 2

Background: Today, the availability of regional anaesthesia for labour is considered a reflection of standard obstetric care. This study is to be conducted in a tertiary care centre with all facilities available for proposed end of proving that epidural analgesia is a safe and effective method for both parturient and the foetus in abolishing pain during labour.Methods: A total of 60 parturients were studied. they were randomly divided into two groups Group 1 includes 30 parturients. In this group parturient received epidural analgesia. The loading dose consisted of 10 ml of Bupivacaine 0.1% and Fentanyl 0.0002% (20 mcg). The top up doses were 10 ml of 0.1% Bupivacaine and Fentanyl 0.0002%, administered whenever the parturient complained of pain. When parturients enters into second stage a further 12-15 ml was injected with parturient in sitting position or semi-sitting position. Group 2 - (control group) Includes 30 parturients. In this group parturient was monitored without any analgesia.Results: This prospective study was done to assess the effect of epidural analgesia on the progress of labour and its outcome, to evaluate its efficacy as an analgesic technique and to study the maternal and fetal outcome. The total number of 60 parturients were selected and randomly categorized into two groups. CASE-Those who received epidural analgesia, CONTROL-Those who did not receive any analgesia.Conclusions: Epidural analgesia provides a versatile method of administering effective and satisfactory pain relief to parturient women. The technique should not be considered as a single entity, because the type and the dose of epidural medication can be altered as needed.

scholarly journals Langerhans Cells Express IL-17A in the Epidermis of Chromoblastomycosis Lesions

2017 ◽  
Vol 2 (2) ◽  
pp. 1-8 ◽  
Author(s):  
Aline Alves de Lima Silva ◽  
Paulo Ricardo Criado ◽  
Ricardo Spina Nunes ◽  
Luciane Kanashiro-Galo ◽  
Maria Irma Seixas Duarte ◽  
...  
Keyword(s):  
Langerhans Cells ◽  
Subcutaneous Tissue ◽  
Innate Immune ◽  
Lesion Group ◽  
Control Group ◽  
Histopathological Diagnosis ◽  
Immunofluorescence Technique ◽  
Double Immunostaining ◽  
First Time

Chromoblastomycosis (CBM) is a chronic fungal infection that affects skin and subcutaneous tissue, and little is known about the immunological aspects of such lesions. We have previously described the high expression of IL-17 in this group. Understanding the innate immune response of patients with CBM would improve the knowledge of its immunopathogenesis and contribute to the most appropriate therapies. Nineteen biopsies of verrucous form were obtained from patients with clinical and histopathological diagnosis of CBM, without treatment. This was done with a double immunostaining with conventional immunohistochemistry and immunofluorescence technique as well as confocal microscopy to detect Langerin and IL-17 expression. All of the specimens that were analyzed showed expression of Langerin in the epidermis - the same as the control group. However, only the CBM group presented cells expressing CD207 in the dermis. Interestingly, the coexpression of IL-17 and Langerin was visualized along the epidermis and dermis in 100% of the lesion group. We demonstrated for the first time in situ coexpression of IL-17 and Langerin (CD207) in epidermal cells of patients with CBM and speculated on their role as IL-17-producing cells or whether they could be a new subpopulation of dendritic cells distinct from Langerhans cells.

scholarly journals A prospective study of cases with necrotising fasciitis: our experience at a tertiary care teaching hospital

2017 ◽  
Vol 4 (10) ◽  
pp. 3326
Author(s):  
S. Mittal ◽  
B. Singh ◽  
R. Mittal ◽  
K. Singh
Keyword(s):  
Clinical Features ◽  
Teaching Hospital ◽  
Subcutaneous Tissue ◽  
Tertiary Care ◽  
Total Duration ◽  
Necrotising Fasciitis ◽  
Comorbid Condition ◽  
Surgical Interventions ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching

Background: Necrotising fascitis is a life-threatening infection involving fascia and necrosis of subcutaneous tissue. The portal of entry usually is trivial trauma. It requires immediate diagnosis and intervention to reduce mortality. The objective of this study was to study clinical profile, predisposing risk factors and to formulate a protocol for management of necrotising fasciitis.Methods: The study was conducted at tertiary care teaching hospital in Punjab, India catering to a semi-urban and rural (agricultural based) population over a period of three years between January 2014 to January 2017. All the consecutive patients who came to the emergency department (ER) of the institute presenting early with clinical features suggestive of NF were included in the study. The study included total 50 cases. The cases were studied in detail according to study plan that included age, sex, clinical features, results of blood and wound cultures, the number of surgical interventions, total duration of hospitalization and the mortality rate.Results: The most common age group was between 40-60yrs and there were 48 males. There was history of trivial trauma or insect bite in majority of cases. Mostly patients presented with bullae formation, induration, edema. Diabetes was the commonest comorbid condition associated. All the patients were thoroughly investigated, swab cultures were taken. Debridements were done followed by grafting. In 10 patients, we could not salvage the limb and 10 patients expired after debridement.Conclusions: Necrotising fasciitis is more common in middle aged males with diabetes. Early diagnosis and aggressive treatment is required to reduce the mortality.

scholarly journals The impact of the COVID-19 pandemic on microbial keratitis presentation patterns

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256240
Author(s):  
Gibran F. Butt ◽  
Alberto Recchioni ◽  
George Moussa ◽  
James Hodson ◽  
Graham R. Wallace ◽  
...  
Keyword(s):  
Time Windows ◽  
Tertiary Care ◽  
Patient Characteristics ◽  
Microbial Keratitis ◽  
Tertiary Care Centre ◽  
Culture Positivity ◽  
Equivalent Time ◽  
Sight Loss ◽  
The Difference ◽  
The Impact

Background Microbial keratitis (MK) is the most common non-surgical ophthalmic emergency, and can rapidly progress, causing irreversible sight-loss. This study explored whether the COVID-19 (C19) national lockdown impacted upon the clinical presentation and outcomes of MK at a UK tertiary-care centre. Methods Medical records were retrospectively reviewed for all patients with presumed MK requiring corneal scrapes, presenting between 23rd March and 30th June in 2020 (Y2020), and the equivalent time windows in 2017, 2018 and 2019 (pre-C19). Results In total, 181 and 49 patients presented during the pre-C19 and Y2020 periods, respectively. In Y2020, concurrent ocular trauma (16.3% vs. 5.5%, p = 0.030) and immunosuppression use (12.2% vs 1.7%, p = 0.004) were more prevalent. Despite proportionately fewer ward admissions during the pandemic (8.2% vs 32.6%, p<0.001), no differences were observed in baseline demographics; presenting visual acuity (VA; median 0.6 vs 0.6 LogMAR, p = 0.785); ulcer area (4.0 vs 3.0mm2, p = 0.520); or final VA (0.30 vs 0.30 LogMAR, p = 0.990). Whilst the overall rates of culture positivity were similar in Y2020 and pre-C19 (49.0% vs. 54.7%, p = 0.520), there were differences in the cultures isolated, with a lower rate of poly-microbial cultures in Y2020 (8.3% vs. 31.3%, p = 0.022). Conclusions Patient characteristics, MK severity and final visual outcomes did not appear to be affected in the first UK lockdown, despite fewer patients being admitted for care. Concurrent trauma and systemic immunosuppression use were greater than in previous years. The difference in spectra of isolated organisms may relate to behavioural changes, such as increased hand hygiene.

scholarly journals Evaluation of the effectiveness of the use of low-traumatic surgical access in the reverse shoulder arthroplasty

2021 ◽  
Vol 28 (2) ◽  
pp. 21-28
Author(s):  
Gurgen A. Kesyan ◽  
Grigoriy S. Karapetyan ◽  
Artem A. Shuyskiy ◽  
Rashid Z. Urazgil'deev ◽  
Igor' G. Arsen'ev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Shoulder Arthroplasty ◽  
Shoulder Joint ◽  
Subcutaneous Tissue ◽  
Reverse Shoulder Arthroplasty ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Surgical Access

BACKGROUND: The number of reversible shoulder joint endoprostheses installed in the world at the present stage is several times greater than the number of hemiarthroplasty performed. Nevertheless shoulder arthroplasty is considered a traumatic operation and can be accompanied by a number of complications, both from the side of implants and due to the traumatic nature of the surgical technique. During surgical interventions on the shoulder joint with a wide dissection of the skin and subcutaneous tissue, iatrogenic damage to structures such as the axillary nerve, posterior and anterior arteries and veins surrounding the humerus can often be detected, which triggers a whole cascade of pathophysiological and regulatory processes in which Interventions immediately release inflammatory mediators. Therefore, orthopedic traumatologists strive to reduce the risk of intra- and postoperative complications, and it is necessary to improve the surgical technique of surgical interventions towards their less traumatic performance. AIM: Development and evaluation of the effectiveness of the use of low-traumatic surgical access when performing reverse shoulder arthroplasty. MATERIALS AND METHODS: In the period 20172020, 169 patients with various diseases, injuries of the shoulder joint and their consequences were operated on in the Department of Adult Orthopedics of the N.N. Priorov National Research Medical Center of the Russian Federation, who underwent reverse shoulder arthroplasty according to generally accepted indications. In the main group (84 patients), surgical treatment was performed using a low-traumatic surgical approach, while the control group (85 patients) underwent standard procedures. Functional, clinical and radiological results of surgical treatment of patients of the main and control groups were evaluated and compared after 3, 6 and 12 months. RESULTS: In the main group, excellent results (25 points on DASH) were observed in 73 patients, good results (2650 points) in 10 patients. In 1 patient, the results were assessed as satisfactory (5175 points). In the control group of observation, the clinical result was worse (68 excellent, 16 good and 1 satisfactory result). CONCLUSION: On the basis of the performed study, taking into account the better results in the main group of patients, the technique of low-traumatic surgical access for reverse shoulder arthroplasty can be recommended for wide use in clinical practice.

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