scholarly journals Total laparoscopic hysterectomy: an experience at a tertiary care hospital

2019 ◽  
Vol 8 (11) ◽  
pp. 4341
Author(s):  
Fatma M. Rentiya ◽  
Ajesh N. Desai
Keyword(s):  
Blood Loss ◽  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Tertiary Care ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Safe Procedure ◽  
Care Hospital ◽  
Duration Of Surgery

Background: This study is aimed to review indications, demographic data of patients, clinical outcomes and safety of total laparoscopic hysterectomy.Methods: This is a prospective observational study of total 150 patients who underwent total laparoscopic hysterectomy (TLH) from 1st June 2017 to 30th November 2018 in GMERS Civil Hospital Sola.Results: ~45% patients were between 40-50 years age group; 60% patients had 2 or more deliveries; commonest indication was symptomatic adenomyosis ; uterine size in ~57% of patients were up to 6 weeks; duration of surgery in ~91% of patients <120 minutes; intraoperative blood loss in all cases <200ml; no intra-operative and postoperative complications were encountered.Conclusions: TLH is safe procedure with minimal blood loss, minimal postoperative pain and discomfort and shorter duration of hospital stay when performed via expert hands.

scholarly journals Trends and patterns in total laparoscopic hysterectomy in tertiary care hospital

2018 ◽  
Vol 7 (6) ◽  
pp. 2170
Author(s):  
Sonali Ingole ◽  
Sameer Darawade
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Bladder Injury ◽  
Care Hospital ◽  
Estimated Blood Loss ◽  
The Mean

Background: Due to technical advances in the field of laparoscopy, there has been an increase in total laparoscopic hysterectomies all over the world in last decade. This study was conducted to analyse the technique and surgical outcome of total laparoscopic hysterectomy in tertiary care hospitalMethods: This is a retrospective cohort (observational) study, which included all patients who underwent Total Laparoscopic Hysterectomy (TLH) for benign conditions from January 2012 to December 2017 at the tertiary Care Hospital. The data so obtained was analysed for various parameters like indication for surgery, mean operating time, length of hospital stay, complications and conversion to abdominal route.Results: Total number of 2307 hysterectomies were performed over a period of 5 years. Of these, TLH were 270 (11.70%). Amongst those undergoing TLH, the mean age was 45±7.84 years. The most common indication for the surgery was fibroid uterus (38.14%), followed by dysfunctional uterine bleeding (28.88%), and adenomyosis (15.1%). The mean estimated blood loss was 106±4.34 ml. Hemorrhage (n = 2) and bladder injury (n = 4) were most common surgical complications.Conclusions: TLH is safe and effective procedure for most of the benign pelvic conditions. With adequate training TLH can be used more widely in tertiary care hospital and teaching institute.

scholarly journals Assessment of adverse drug reaction profile of the disease-modifying anti-rheumatic drugs at the department of orthopaedics in a tertiary care hospital, Silchar, Assam, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1007
Author(s):  
Vijoy S. Kairi ◽  
Pinaki Chakravarty ◽  
Arun Kumar Sipani
Keyword(s):  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Case Record ◽  
Medical College ◽  
Disease Modifying ◽  
Reaction Profile

Background: The mainstay of treatment of Rheumatoid Arthritis (RA) is the use of the disease-modifying anti-rheumatic drugs (DMARDs). Methotrexate, sulfasalazine and hydroxychloroquine are some of the DMARDs which are used in combination for the treatment of RA. The current study was undertaken to assess the adverse drug reactions (ADRs) of DMARDs that are commonly encountered with the treatment of RA.Methods: The present study was designed as a prospective, observational study on newly diagnosed patients with RA. Patients diagnosed with RA above 18 years (excluding pregnant women) of either sex who were prescribed DMARDs in combination were included. ADRs reported spontaneously by the patients and also responses obtained in a questionnaire related to likely ADRs from the patients was recorded in the case record form. Statistical analysis was done using graph pad and p value <0.05 was considered to be statistically significant.Results: A total of 47 patients attending the Outpatient Department of Orthopaedics, Silchar Medical College and Hospital, Silchar, Assam, India were screened for the study. ADRs were monitored up to the last visit on 41 patients excluding the patients who were lost and who were not able to adhere to the treatment. A total of 27 ADRs were reported from 19 ADR forms. Gastrointestinal manifestations were the most common adverse effects of combination DMARDs seen in 10 patients (24.39%). Severity assessment done using modified Hartwig and Siegel scale that showed majority of the ADRs were mild (74.07%).Conclusions: Present study showed that DMARDs are well-tolerated and have an acceptable toxicity profile as majority of ADRs seen were mild. It was however difficult to prevent the occurrence of ADRs. Proper monitoring of therapy is needed for early recognition of ADRs.

scholarly journals EFFECTIVENESS OF AUTOLOGOUS SERUM THERAPY IN CHRONIC URTICARIA: A PROSPECTIVE OBSERVATIONAL STUDY IN TERTIARY CARE HOSPITAL

2016 ◽  
Vol 5 (17) ◽  
pp. 822-827
Author(s):  
Rakesh Kumar Patel ◽  
Anil Kumar Gupta ◽  
Santosh Kumar Singh ◽  
Harleen Chhachhi ◽  
Pawan Kumar Patel ◽  
...  
Keyword(s):  
Observational Study ◽  
Chronic Urticaria ◽  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Autologous Serum ◽  
Care Hospital ◽  
Serum Therapy

scholarly journals Solitary thyroid nodule: an overview of one year study at a tertiary care hospital

2019 ◽  
Vol 6 (9) ◽  
pp. 3117
Author(s):  
Shyam Sundar Tandri ◽  
Ayathu V. S. Sai Mahesh
Keyword(s):  
Thyroid Nodule ◽  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Tertiary Care ◽  
Common Finding ◽  
Clinical Approach ◽  
Care Hospital ◽  
Cross Sectional ◽  
Solitary Thyroid Nodule ◽  
One Year

Background: Thyroid nodules are a common finding in general practice. These nodules are either solitary or multinodular. In the present study thorough evaluation of all the cases presenting with a solitary thyroid nodule (STN) is done. The clear overview of prevalence of STN, associated risk factors, its distribution and its percentage of malignancy, clinic-pathological correlation and findings on ultra-sonogram.Methods: A one year cross sectional study at a tertiary care hospital was done after ethical committee approval. All cases of thyroid with solitary thyroid nodule were included and socio demographic data, clinical examination and USG data was noted. Thyroid hormone profile, FNAC and HPE was performed for every case enrolled and data was noted. The data was analyzed using SPSS version 22.Results: 350 cases were enrolled with 44.42% prevalence and 61.43% were females. Maximum age group was 31-40 years with swelling as the most common sign. 81.14% were euthyroid, 6.3% of cases had lymph node involvement. Micro calcification in 69.7% of nodules and 78.65 were solid. 40.3% of the STN were of colloid on FNAC and 6% were malignant. Malignancy on HPE was 14.6% and papillary carcinoma was the most commonest and follicular least.Conclusions: All cases of STN require a thorough clinical approach supported by ultra-sonogram, FNAC and detailed HPE after surgery for evaluation of benign and malignant lesions. Fine needle aspiration cytology has become an invaluable, minimally invasive and reliable tool in the preoperative assessment of patients with suspicion of malignancy.

scholarly journals Prevalence of Carbapenem Resistant Enterobacteriaceae in a Tertiary Care Hospital of Gujarat, India

2021 ◽  
Author(s):  
Chirag Manojkumar Modi ◽  
Suman Praveen Singh ◽  
Yagnesh Gajanand Pandya ◽  
Chirag Premjibhai Patel ◽  
Rupal Minesh Patel
Keyword(s):  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Treatment Options ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Defined Daily Dose ◽  
Sample Type ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Introduction: Carbapenem Resistant Enterobacteriaceae (CRE) are major cause of community as well as healthcare associated infections and have limited treatment options. Measuring the magnitude of the problem of CRE, it is important for making strategies to lower its spread. Aim: To assess the incidence and prevalence rate of CRE in a tertiary care hospital of Gujarat, India. Materials and Methods: Retrospective data was collected for a period from 2014 to 2018 using Laboratory Information System (LIS). Prevalence of CRE was determined as number of CRE isolated per 100 Enterobacteriaceae isolated during the study period whereas incidence rate was determined as number of CRE cases per 1000 patient-days. Consumption of Carbapenems was calculated as Defined Daily Dose (DDD) per 1000 patient-days. Demographic data including age, gender, location in the hospital and sample type from which CRE was isolated was also analysed using Microsoft Excel. Results: The incidence of CRE cases per 1000 patient-days in 2014 to 2018 was 1.66, 2.11, 1.90, 2.26 and 1.91, respectively with an overall incidence of 1.99 per 1000 patient-days. The overall prevalence of CRE over a period of five years was found to be 29.07%. Klebsiellasp. was the most common CRE and had the highest percentage of Carbapenem resistance among all Enterobacteriaceae. Conclusion: The rate of CRE in present study was high and worrisome. Screening of the patient for CRE, source isolation and stringent implementation of infection control practices is required to confine the spread of CRE in this institute.

scholarly journals Brucellosis, Unravelling an Enigma: Eight Years of Experience from a Tertiary Care Hospital in Central Kerala, India

2020 ◽  
Author(s):  
M Ardra ◽  
Chithra Valsan ◽  
KA Sathiavathy
Keyword(s):  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Unknown Origin ◽  
Personal Contact ◽  
Human Brucellosis ◽  
Care Hospital ◽  
Laboratory Findings ◽  
Middle East Countries

Introduction: Various emerging and re-emerging infectious diseases have made the existence of mankind in this world a great challenge. In the midst of these havocs, some important diseases has undermined in the dark. Brucellosis is an endemic zoonotic disease in most of the developing world and it has far-reaching and deleterious effects on humans and animals alike. In humans, brucellosis shows a variety of non-specific clinical signs. To recognise and diagnose this neglected but debilitating disease, the awareness and alertness of medical personnel has to be enhanced. Aim: To determine the prevalence of brucellosis in Tertiary Care Hospital. Materials and Methods: A retrospective study was conducted from June 2011 to May 2019, all culture proven cases of human brucellosis admitted in a Tertiary Care Hospital in central Kerala, India were reviewed. Demographic data, clinical presentations, laboratory parameters, treatment and outcomes of the same were analysed in Microsoft excel sheets as percentages. Results: Of the 12 culture proven Brucella cases, 11 presented as Pyrexia of Unknown Origin (PUO) cases and one was a soft tissue infection. Eleven patients had history of either consumption of unpasteurised milk products or had contact with animals before the symptoms developed. A 75% cases were imported cases from middle-east countries. In one case the route of entry was by close personal contact probably sexual transmission. All the patients complained of fever and malaise (100%), while low backache and arthralgia was noted in 83%. Most common clinical and laboratory findings associated with brucellosis were hepatosplenomegaly (41.7%) and anaemia (66.6%). Oral doxycycline for six weeks combined with either aminoglycoside or rifampicin was used for treatment. There was no death or relapses noted. Conclusion: This study emphasises the close collaboration of an alert clinician and an experienced microbiologist to correctly diagnose and treat an infection with multiple presentations as brucellosis, in endemic areas also.

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