scholarly journals A comparative study of two layer versus three-layer repair of mediolateral episiotomy

2020 ◽  
Vol 9 (8) ◽  
pp. 3412
Author(s):  
Manasi V. Gaikwad ◽  
M. Vijaya Sree ◽  
Swapnil V. Bobde
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Wound Complications ◽  
Layer Versus ◽  
Care Hospital ◽  
Suture Materials ◽  
Mediolateral Episiotomy ◽  
Significant Difference

Background: Since majority of the women attending study hospital are belonging to lower socioeconomic strata and active involvement of paramedical staff in providing obstetric care, this study was undertaken to find the utility of a two-layer repair of mediolateral episiotomy and compare it with the standard method of closure in relation to its simplicity, cost-effectiveness and superiority if any, over the traditional three-layered repair of episiotomy.Methods: This was a prospective interventional study comparing 100 women who underwent two-layer closure with 100 women who underwent three-layer closure of episiotomy in a tertiary care hospital in Pune, India over a period of 2 years from October 2012 to October 2014. The parameters assessed were operative time, number of suture materials required, immediate post procedure pain and complications at follow-up. Qualitative and quantitative data was analysed using unpaired t-test, chi square test and Fisher exact test.Results: Both the groups were comparable in terms of hospital stay and wound complications such as oedema, dehiscence, hematoma, requirement of resuturing, cosmesis and long-term complications such as dyspareunia. However, two-layer repair required less operative time, lesser number of suture materials and decreased pain during hospital stay as there was statistically significant difference observed between the two groups.Conclusions: In this study experience, it can be concluded that two-layer repair of episiotomy is faster, with less post-operative pain and more cost effective. Hence it provides mother with better services.

scholarly journals Duration of Hospital Stay and Treatment Pattern among Patients Undergoing Common Operative Procedures at tertiary care hospital in Nepal

2019 ◽  
Vol 7 (2) ◽  
pp. 27-35
Author(s):  
Sanjay Chaudhary ◽  
Lokeshwar Chaurasia ◽  
Jitendra Kumar Singh
Keyword(s):  
Hospital Stay ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Treatment Pattern ◽  
Operative Procedures ◽  
Care Hospital ◽  
Third Generation ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
Significant Difference

Background and Objectives: Appendectomy, cholecystectomy, fistulectomy, and herniotomy or herniorrhaphy are the most common surgical operations in Nepal. Despite the high prevalence and complexity of the patient population served by general and universal surgery services, little has been reported about the services, treatment procedures and outcomes. Therefore, the study is designed to investigate the duration of hospital stay, and treatment pattern among patients undergoing common surgical operative procedures at Janaki Medical College, Janakpur, Nepal. Material and methods: A prospective observational study was conducted among patients undergoing common surgical operative procedures at surgery department of Janaki Medical College (JMC) over a period of one year from January 2018 to December 2018. Patients of all age groups and gender undergoing surgical operative procedures; appendectomy, herniotomy cholecystectomy and fistulectomy were included in the study. The patients were assessed preoperatively, intra-operatively and postoperatively. Results: In a total of 325 patients, 11.1% of patients underwent fistulectomy, 14.5% underwent appendectomy, 35.4% underwent herniorrhaphy and 39.1% underwent cholecystectomy. Mean duration of stay at hospital for cholecystectomy was slightly higher (8.13±2.40 days) than other operating procedures: fistulectomy (5.44 ±1.48 days), appendectomy (7.40±2.00 days), and operative procedure of hernia (6.17±1.59 days). Most commonly used antibiotic for control of preoperative and post operative infection was third generation cephalosporin’s, ceftriaxone and cefixime. Conclusion: The study demonstrates longer duration of hospital stay for cholecystectomy as compared to other operating procedures like fistulectomy, appendectomy, herniorrhaphy, hernioplasty and herniotomy with significant difference by types of surgery. Most commonly used antibiotic for control of infection was third generation cephalosporin, ceftriaxone and cefixime.

ASSOCIATION OF HEMATOCRIT-PLATELET INDEX AND HEMATOCRIT SHIFT WITH WARNING SIGNS AND HOSPITAL STAY IN DENGUE PATIENTS AT A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S277-82
Author(s):  
Muhammad Fahd Bin Haider ◽  
Humaira Zafar ◽  
Syed Zubair Hussain Shah ◽  
Mobaila Akram ◽  
Kamran Malik ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Warning Signs ◽  
Care Hospital ◽  
Cross Sectional ◽  
Duration Of Stay ◽  
Platelet Indices ◽  
Significant Difference ◽  
Duration Of Hospitalization

Objective: To determine the relationship between hematocrit, platelet count, warning signs and duration ofhospitalization in indoor dengue patients. Study Design: Analytical, cross sectional study. Place and Duration of Study: Department of Medicine, Pakistan Air Force Hospital Islamabad and Departmentof Biochemistry and Molecular Biology, AM College, Rawalpindi, from Sep 2019 to Jun 2020. Methodology: A total of 100 indoor patients were recruited using convenience sampling. Their platelets, hema-tocrit and warning signs were recorded on arrival in the hospital. First two parameters were checked every day for the whole duration of stay in the hospital. The WHO standard treatment of dengue was given to the patients. Patient were divided into two groups based upon duration of hospitalization using cut-off of 3 days. Linear regression was used to analyze association of hematocrit-platelet index and hematocrit shift with presence of one or more warning signs and duration of hospital stay. Results: There was statistically significant difference in 3rd day Hematocrit Platelet Indices of patients with short and long hospital stay (p=0.003). 3rd day Hematocrit-platelet indices of patients with and without warning signs also showed statistically significant difference when compared with eachother (p=0.0001). It was stronger than Hematocrit Shift (p=0.82) and platelets considered alone. Conclusion: Day 3 Hematocrit Platelet Indexis more strongly associated with warning signs and duration of stay rather than hematocrit alone. It means both need to be taken into account while monitoring dengue patients. Hematocrit platelet index for severity and duration of hospitalization while Hematocrit shift for fluid therapy.

scholarly journals Effect of Carica papaya leaf extract (CPLE) on thrombocytopenia among dengue patients of tertiary care hospital, Chitradurga, India

2018 ◽  
Vol 5 (4) ◽  
pp. 974
Author(s):  
Vijeth S. B. ◽  
Mohamed Murtuza Kauser ◽  
Vijayalaxmi Mangasuli ◽  
Vagesh Kumar S. R. ◽  
Suba Sree ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Leaf Extract ◽  
Carica Papaya ◽  
Tertiary Care ◽  
Specific Treatment ◽  
Public Health Problem ◽  
Study Group ◽  
Care Hospital ◽  
Platelet Counts ◽  
Significant Difference

Background: Dengue is a global public health problem and thrombocytopenia associated with it is a serious complication for which there is no specific treatment available. This study was done to assess the effect of Carica papaya Leaf Extract (CPLE) on thrombocytopenia associated with Dengue and to study other clinical parameters of dengue.Methods: A longitudinal study conducted in Department of General Medicine, BMCH, Chitradurga, from September 2017 to March 2018. All the participants were randomized into two groups by simple randomization by lot method. Study group was given Carica papaya Leaf Extract (CPLE) and routine supportive treatment for other group. The patients were followed from the day of admission till their discharge from hospital. The platelet counts and other baseline hematological investigations, duration of hospital stay in both the groups were compared statistically by unpaired t-test.Results: There were total 127 males and 73 females. Age groups were comparable in both the groups. Most common presenting complaints were fever (100%) followed by headache (85%), myalgia (81.4%), fatigue (75%), arthralgia (65%). On admission baseline investigations were done and mean levels of both groups were compared. It was found that there was only significant difference of mean RBC levels (p=0.045). When followed up with daily platelet counts of both the groups, it was seen that there was increase in platelet counts in study group compared to placebo group and on third day there was significant difference between both (p=0.002). It was also found that discharge rate is earlier in study group than placebo group.Conclusions: Carica papaya leaf extract accelerates the increase in platelet count and reduces the hospital stay. So, it can be used as supplementary drug to reduce complications.

scholarly journals Laparoscopic Appendectomy in Children: Experience in a Single Centre in Chittagong, Bangladesh

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Md. Jafrul Hannan
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Tertiary Care ◽  
Operating Time ◽  
Safe Procedure ◽  
Care Hospital ◽  
Operative Techniques ◽  
Abdominal Abscesses ◽  
Operative Findings

Background. Since the latter half of 1980s laparoscopy has become a well accepted modality in children in many surgical procedures including appendectomy. We present here the experience of laparoscopic appendectomy in children in a tertiary care hospital in Bangladesh.  Subjects & Methods. From October 7, 2005 to July 31, 2012, 1809 laparoscopic appendectomies were performed. Laparoscopy was performed in all the cases using 3 ports. For difficult and adherent cases submucosal appendectomy was performed. Feeding was allowed 6 h after surgery and the majority was discharged on the first postoperative day. The age, sex, operative techniques, operative findings, operative time, hospital stay, outcome, and complications were evaluated in this retrospective study.Results. Mean age was 8.17 ± 3.28 years and 69% were males. Fifteen percent were complicated appendicitis, 8 cases needed conversion, and 27 cases were done by submucosal technique. Mean operating time was 39.8 ± 14.2 minutes and mean postoperative hospital stay was 1.91 days. About 5% cases had postoperative complications including 4 intra-abdominal abscesses.Conclusions. Laparoscopic appendectomy is a safe procedure in children even in complicated cases.

scholarly journals A Comparative Study of Endoscopic Versus Navigation Guided Microscopic Transsphenoidal Pituitary Surgery at Tertiary Care Centre in India

2018 ◽  
Vol 32 (3) ◽  
pp. 443-457
Author(s):  
Anurag Sahu ◽  
Sharad Pandey ◽  
Kulwant Singh ◽  
Vivek Sharma
Keyword(s):  
Operative Time ◽  
Tertiary Care ◽  
Pituitary Surgery ◽  
Controlled Study ◽  
Complication Rates ◽  
Care Hospital ◽  
Significant Difference ◽  
Transsphenoidal Pituitary Surgery ◽  
Group A ◽  
Group B

Abstract Introduction: The transsphenoidal route for pituitary surgery is considered the standard treatment for pituitary adenomas. The disadvantage of the smaller exposure of this route is partially compensated for by the introduction of the microscope with its coaxial illumination, stereoscopic view, adequate magnification, and microsurgical instruments. However, there are only few reports about the outcome of endonasal endoscopic transphenoidal technique. Aims & Objectives: Current study has been conducted to compare the efficacy, advantages and dis advantages of endoscopic versus navigation guided microscopic transsphenoidal Pituitary surgery. Material and methods: A controlled study was done in the department of neurosurgery, at tertiary care hospital in India, from the period of August 2012 to December 2017 prospectively. In Group A- 30 patients in whom endoscopic transnasal trans Sphenoidal pituitary surgery and in Group B - 30 patients, intraoperative neuronavigation was used. Observations and Results: Both the groups were similar in demographic variables. The most common age group of pituitary tumor patients was 30-40 years. Fourteen (46.6 %) patients in group A and fifteen (50 %) of the patients in group B had tumor volume less than 5 ml. In group A, thirteen (43%) patients had intrasellar tumors with no suprasellar extension, while in group B, fifteen (50%) patients had intrasellar tumors with no extension. Operative time was noted from incision to closure and average time taken in both the groups was compared. Twenty five (83%) cases of group A took between 2-3 hours and only four cases (13%) took more than 3 hours. While in group B, twenty (66%) cases took between 4-5 hours. This shows a significant difference by fisher extact test (p<0.001) in the operative time required in both the groups. Eighteen (60%) patients in group B had a residual volume between 1-1.5 ml while only two patients in group A had so. This difference is also significant Fischer Exact test (p<0.001). Four (13.3%) patients in group A had diabites insipidus while only half of this, i.e. two (6.6%) had so in group B. however this difference in postoperative complication rate is not statistically significant between two groups. Conclusion: The results of our study correlate with many previous studies to compare endoscopic and microscopic transsphenoidal surgery. These two approaches are equally efficacious in oncological outcomes and the complication rates are comparable.

Uterine Exteriorization vs. In situ Repair of Cesarean Section: A Comparative Study at a Tertiary Care Hospital

2020 ◽  
Author(s):  
Reeta Kumari
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Abdominal Cavity ◽  
Tertiary Care ◽  
Elective Cesarean Section ◽  
Bowel Sound ◽  
Care Hospital ◽  
Uterine Incision ◽  
Significant Difference ◽  
Abdominal Repair

Background: Exteriorization, a valuable repair of uterus technique during cesarean section, requires removal of uterus temporarily from the abdominal cavity to repair the incision. The objective of this study was to compare the postoperative symptoms of intra-abdominal to extra-abdominal repair of the uterine incision during caesarean procedure. Methods: A quasi experimental study done in the Obstetrics and Gynecology unit of Ziauddin University Hospital, Kamari and Clifton Campus, Karachi from 1st January 2017 to 30th June 2017. A total of 190 patients were divided into two groups (95 patients in each). In group A Uterine incision was closed extra abdominally and in Group B the closure was done intra-abdominally. The rate of nausea, vomiting, hospital stay, wound infection, fever, returns of bowel sounds, blood loss, and uterine trauma was measured between the two groups. Statistical analyses were done by applying independent sample t-test and chi-square tests. Results: Exteriorization was better option above age 35 years and elective cesarean section(C/S) patients with less Intensity of pain and hospital stay (3 days) but the results were not statistically significant. Caesarean Section, hemoglobin both pre and post-operative, blood transfusion, the return of bowel sound after surgery, surgical site infection and uterine trauma between the two groups showed no significant difference. Conclusion: The postoperative management of Exteriorization was better compared to intra-abdominal repair but the results were not significant. Exteriorization is an easy, convenient and valid option without complications and can be used especially in cases where difficulty in visualization of uterine scar and hemostasis is at stake.

scholarly journals Laparoscopic Treatment of Hydatid Cyst of Liver: Outcome at Tertiary Care Hospital

2020 ◽  
pp. 164-168
Author(s):  
Shahida Khatoon ◽  
Altaf Talpur ◽  
Aijaz Ahmed Shaikh ◽  
Mujeeb-ur- Rehman
Keyword(s):  
Hydatid Cyst ◽  
Hospital Stay ◽  
Hydatid Disease ◽  
Operative Time ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Bile Leak ◽  
Care Hospital ◽  
Laparoscopic Treatment ◽  
Cross Sectional

Objective: To determine the outcome of laparoscopic treatment of hydatid cyst of liver at tertiary care Hospital. Methodology: This cross sectional, study was conducted at public and private sector Hospitals of Jamshoro/Hyderabad from June 2017 to Sept 2019. It includes all diagnosed patients of Hydatid cyst of liver with either of gender and age range from 15 to 65 years who were operated laparoscopically. Patient’s demographic information, postoperative complications, operative time and hospital stay were recorded via self-made proforma and data was analyzed by using SPSS version 20. Results: Total 29 patients were admitted with hydatid disease of liver and out of them 21 patients underwent laparoscopic treatment during study period; their mean age was 46.7±13 years. Males were commonest 71.42% and 28.57% were female. Mean operative time was 98.3±18 minutes. According to postoperative pain, the average of visual analog score was 07.85±1.38 at 24 hours and 3.42±1.50 at 72 hours. VAS mean was 07.8 and 3.4 respectively. Cavity related infection was noticed in 3 cases; port site infection in two cases, bile leak in two and residual cyst was also found in two patients. Mean postoperative Hospital stay was 6.6 days. Conclusion: Laparoscopic surgery for hepatic hydatid disease can be conducted safely as it provides advantages of minimal invasive surgery. Careful selection of the patient is utmost important to achieve good results especially in initial phases.

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Sarwat Memon
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Class Iii ◽  
Chi Square ◽  
Cross Sectional ◽  
Skeletal Malocclusion ◽  
Palatal Rugae ◽  
Significant Difference ◽  
Orthodontic Patients

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

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)

scholarly journals A Study of Factors Affecting the Length of Hospital Stay of COVID-19 Patients by Cox-Proportional Hazard Model in a South Indian Tertiary Care Hospital

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Gayathri Thiruvengadam ◽  
Marappa Lakshmi ◽  
Ravanan Ramanujam
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hazard Model ◽  
Cox Proportional Hazard Model ◽  
Care Hospital ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
South Indian

Background: The objective of the study was to identify the factors that alter the length of hospital stay of COVID-19 patients so we have an estimate of the duration of hospitalization of patients. To achieve this, we used a time to event analysis to arrive at factors that could alter the length of hospital stay, aiding in planning additional beds for any future rise in cases. Methods: Information about COVID-19 patients was collected between June and August 2020. The response variable was the time from admission to discharge of patients. Cox proportional hazard model was used to identify the factors that were associated with the length of hospital stay. Results: A total of 730 COVID-19 patients were included, of which 675 (92.5%) recovered and 55 (7.5%) were considered to be right-censored, that is, the patient died or was discharged against medical advice. The median length of hospital stay of COVID-19 patients who were hospitalized was found to be 7 days by the Kaplan Meier curve. The covariates that prolonged the length of hospital stay were found to be abnormalities in oxygen saturation (HR = 0.446, P < .001), neutrophil-lymphocyte ratio (HR = 0.742, P = .003), levels of D-dimer (HR = 0.60, P = .002), lactate dehydrogenase (HR = 0.717, P = .002), and ferritin (HR = 0.763, P = .037). Also, patients who had more than 2 chronic diseases had a significantly longer length of stay (HR = 0.586, P = .008) compared to those with no comorbidities. Conclusion: Factors that are associated with prolonged length of hospital stay of patients need to be considered in planning bed strength on a contingency basis.

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