scholarly journals Gall bladder stones and the associated histopathology– a tertiary care centre study

2017 ◽  
Vol 5 (4) ◽  
pp. 1368
Author(s):  
Vijayakumaran Pillai ◽  
Renjith Sreekantan ◽  
Meer M. Chisthi
Keyword(s):  
Gallstone Disease ◽  
Tertiary Care ◽  
Gall Stone ◽  
Chronic Cholecystitis ◽  
Premalignant Lesions ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cholesterol Levels ◽  
Gall Stones

Background: Gall stones form one of the main reasons for recurrent upper abdomen pain. Cholecystectomy has turned out to be one of the commonest laparoscopic procedures done all over the world. The objectives of the study were to analyse the histopathological changes in gallstone disease and to study the clinical and biochemical factors that are seen in gall stone disease.Methods: This was a hospital based cross sectional study conducted at a tertiary care centre from January 2013 to December 2014. 108 patients admitted with diagnosis of cholelithiasis and posted for cholecystectomy were studied. Their clinical and biochemical data and post-operative stone analysis results and histopathological reports were collected and analyzed.Results: 63% of the patients were females with a female to male ratio of 1.7:1. Of the group, 64.8% had a BMI between 25 and 29.9. 65.7% patients got operated within one year of the onset of symptoms. Serum cholesterol levels were found elevated in majority of patients. 61% patients had multiple gall stones. 62% had stones composed of cholesterol, bilirubin, calcium carbonate and calcium oxalate. 102 out of the 108 specimens showed histological features of chronic cholecystitis only. One case showed a premalignant change in the form of pyloric metaplasia.Conclusions: Cholelithiasis is seen mostly in females, most of them having elevated cholesterol levels. The commonest histopathological change associated with cholelithiasis is chronic cholecystitis. Premalignant lesions are seen only in a small minority only. Hence early elective cholecystectomy can prevent malignant transformation in asymptomatic gall stones.

scholarly journals CLINICAL EVALUATION OF LAPAROSCOPIC CHOLECYSTECTOMY WITH REFERENCE TO CONVERSION RATE AND COMPLICATIONS- OUR EXPERIENCE IN A TERTIARY CARE CENTRE OF EASTERN INDIA

2020 ◽  
pp. 7-10
Author(s):  
Swapnil Sen ◽  
Sandeep Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conversion Rate ◽  
Gallstone Disease ◽  
Tertiary Care ◽  
Gall Stone ◽  
Injury Rate ◽  
Large Series ◽  
Care Centre ◽  
Eastern India ◽  
Tertiary Care Centre

Cholelithiasis is one of the most common surgical conditions requiring intervention worldwide. Since its introduction nearly four decades ago, laparoscopic cholecystectomy has become the gold standard of treatment for gallstone disease AIM: To critically evaluate our experience of laparoscopic cholecystectomy in a tertiary care centre of eastern India. MATERIALS AND METHODS: Hospital based observational study on 180 patients subjected to elective laparoscopic cholecystectomy with features of gall stone disease and meeting the inclusion and exclusion criteria. RESULTS: Our conversion rate of 10% is somewhat higher than that reported in any other series. This probably reflects that few of our surgeons are in their early learning curve. This can be reduced with the experience of the surgeons. A bile duct injury rate of 0.5% compares favourably with an incidence of 0-1% in several large series. Overall complication rate of 5.5% also compares favourably with an incidence of 1.6-8.6% in several large series. CONCLUSION: Laparoscopic cholecystectomy when performed in properly selected patients is very much effective in the treatment of symptomatic cholelithiasis – in terms of earlier return of bowel function, less postoperative pain, improved cosmesis, shorter length of hospital stay, earlier return of full activity and decreased overall cost. It is vital for the surgeons and patients to understand that conversion to open surgery is not failure; in fact, it implies a safe approach and a sound surgical judgment. The conversion rate is low with experienced surgeons indicating direct relationship between experience and conversion. It should be stressed that conversion if required should be done early rather than after an imminent complication.

scholarly journals Assessment of knowledge, attitudes and practice among the post graduate students of dentistry and physiotherapy towards adverse drug reactions reporting and pharmacovigilance at a tertiary care centre at Indore, India

2018 ◽  
Vol 7 (4) ◽  
pp. 626
Author(s):  
Gopal Gudsurkar ◽  
Vikalp Tiwari ◽  
Pooja Solanki Mishra
Keyword(s):  
Graduate Students ◽  
Graduate Student ◽  
Single Point ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Post Graduate ◽  
Adr Reporting ◽  
Post Graduate Student

Background: Pharmacovigilance knowledge and training in post graduate student doctors is key factor for proper implementation of PvPI. Often the dentists and physiotherapists who are also one of the main stakeholders for ADR reporting are neglected for training and knowledge regarding pharmacovigilance. This study was planned to evaluate the knowledge and awareness of pharmacovigilance in post graduate students in tertiary care centre in Indore.Methods: It was a single point cross sectional questionnaire-based study conducted in a tertiary care Institute MGM Medical College and M.Y. Hospital in the state of Madhya Pradesh at Indore. It was conducted among post graduate student doctors from dentistry and physiotherapy. Total of 55 questionnaires were distributed, 50 of them were returned back and were analysed.Results: Overall knowledge level was average. 90% knew about ADR while 80% were aware about PVPI. 10% knew about local AMC at Indore while only 04% knew global centre for Pharmacovigilance is at Sweden Uppsala. 88% thought Med watch as global database for ADR against only 12% knew its Vigibase. 90% thought ADR reporting is necessary. 96% thought it should be included in UG curriculum. 98% had not reported any ADR till date while 84% had not seen an ADR form.Conclusions: Post graduate doctors are the prime candidates to impart the importance of pharmacovigilance. The study strongly suggested that there was a great need to create awareness and impart training among the post graduate doctors to improve the reporting of ADRs.

scholarly journals Magnitude of hypothyroidism among patients of cholelithiasis in a tertiary care centre in rural West Bengal: a prospective study

2021 ◽  
Vol 8 (11) ◽  
pp. 3375
Author(s):  
Jaganmoy Maji ◽  
Debjyoti Mandal
Keyword(s):  
Stone Formation ◽  
Tertiary Care ◽  
Gall Stone ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Elder Patients ◽  
A Prospective Study

Background: Cholelithiasis is a common pathology of the gall bladder affecting about 10 to 15% of the adults in western countries and 2 to 29% in India. More than 80% of the patients with cholelithiasis are asymptomatic. Hypothyroidism may cause gall stone formation due to the hyperlipidemia, motility disorders affecting the bile duct and sphincter of Oddi.Methods: This was a descriptive cross-sectional study conducted at Department of Surgery, Bankura Sammilani Medical College and Hospital, Bankura from March 2019 to February 2020 for duration of one and half year. The sample size was 54 and consecutive non-probability sampling technique was used for the sampling. All the collected data were recorded in a pre-designed proforma and analyzed in MS excel.Results: Out of 54-patients with cholelithiasis, 28% patients were from the age group 45-54 years.40% patients were hypothyroid pre-dominantly females. Among 30-female patients 11 (26.82%) were hypothyroid and among 11-male patients 2 (15.38%) were hypothyroid. Hypothyroidism in male and female was statistically significant.Conclusions: This study was introduced to determine the relationship between hypothyroidism and cholelithiasis. It was concluded that hypothyroidism was more common in female, obese and elder patients. The gender distribution of the hypothyroidism in patients with cholelithiasis was statistically significant while all other variables were statistically not significant.  

scholarly journals Case reports on erosive pustular dermatosis of scalp: a cross sectional study at a tertiary care centre

2020 ◽  
Vol 6 (2) ◽  
pp. 260
Author(s):  
Avanitaben D. Solanki ◽  
Neha S. Nagrani ◽  
Dhara V. Patel ◽  
Neela M. Patel ◽  
Jigna P. Barot ◽  
...  
Keyword(s):  
Case Reports ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Neutrophilic Dermatosis ◽  
Repeated Treatment ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Proper Diagnosis ◽  
Folliculitis Decalvans

<p class="abstract">Erosive pustular dermatosis of the scalp (EPDS) has been reported as a rare chronic and progressive non-infectious inflammatory condition of the actinically damaged scalp characterized by crusts, erosions and pustules. It tends to occur on the scalp of older people who have usually been treated for diffuse actinic damage and actinic keratoses. The list of possible differential diagnosis is long and includes tinea capitis, folliculitis decalvans, neutrophilic dermatosis, autoimmune vesiculobullous disorders, malignancy etc. Notoriously difficult to treat, these cases tend to be chronic and progressive. These patients often present after repeated treatment to various scalp dermatosis that doesn’t result in clearing instead persistence and perpetuation of the process. A cross sectional prospective study was conducted in department of dermatology in a tertiary care centre in which six cases of EPDS attending outpatient department from 2017 to 2019 were included. EPDS is more common but under recognized condition, hence less cases are reported till date. Increased awareness of and proper diagnosis of this condition changes the approach towards these patients, protects the scalp from involuntary insults and other precipitating factors that hinders with a better outcome.</p>

CLINICOEPIDEMIOLOGICAL STUDY OF CHILDHOOD PSORIASIS PATIENTS AND ITS ASSOCIATION WITH HLA-CW6 IN A TERTIARY CARE CENTRE OF EASTERN INDIA

2021 ◽  
pp. 10-11
Author(s):  
Akhilesh Behra
Keyword(s):  
Tertiary Care ◽  
Epidemiological Data ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Eastern India ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Plaque Type ◽  
Worldwide Population

BACKGROUND- Psoriasis is chronic common papulosquamous disorder. Its aetiology included various environmental and genetic factors. In genetics, HLA-Cw6 is most commonly associated with psoriasis. Childhood psoriasis is also common in worldwide population. However, very few studies done on epidemiological data and HLA-Cw6 analysis in childhood psoriasis patients. AIMS AND OBJECTIVE- Clinicoepidemiological study of childhood psoriasis patients and its association with HLA-Cw6 in a tertiary care centre of Eastern India MATERIALAND METHOD- We conducted a cross-sectional study in a tertiary care centre and recruited 20 patients of psoriasis with age group below 18 years after taking proper consent. Clinical history and blood was taken from them and HLA-Cw6 analysis was done by PCR method. Data compilation was done by Microsoft excel using SPSS software. RESULTS- A total of the 20 childhood psoriasis patients, 9 were males and 11 were females. Generalized plaque type psoriasis (N=19) is commonest followed by guttate psoriasis (N=1). None of the patients had arthalgia. Family history was present in only 3 patients. Higher numbers of childhood psoriasis patients (N=14) were positive for HLA-Cw6. Also Higher numbers of females (N=10) were positive for HLA-Cw6. ve patients had nail changes. CONCLUSION- We found HLA-Cw6 is strongly associated with childhood psoriasis and also HLA-Cw6 frequency is higher in female than male childhood psoriasis patients.

scholarly journals Towards more patient-centred endometriosis care: a cross-sectional survey using the ENDOCARE questionnaire

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
A M F Schreurs ◽  
M van Hoefen Wijsard ◽  
E A F Dancet ◽  
S Apers ◽  
W K H Kuchenbecker ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Diagnostic Delay ◽  
Care Centre ◽  
Cross Sectional Survey ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Tertiary Centre ◽  
Validated Questionnaire ◽  
Physical Comfort ◽  
Patient Centredness

Abstract STUDY QUESTION What is the performance of the patient-centredness of endometriosis care in a secondary and a tertiary care setting and how can it be improved? SUMMARY ANSWER Overall, patient-centredness was comparable in the two endometriosis care centres, but differed regarding ‘physical comfort’ and ‘continuity and transition’; both centres can learn how to improve several of their targets from the other’s strengths. WHAT IS KNOWN ALREADY The ENDOCARE questionnaire (ECQ) is a validated questionnaire for assessing the important quality dimension ‘patient-centredness’. Patient-centredness is associated with quality of life, although this should be explored further by larger-scale studies. STUDY DESIGN, SIZE, DURATION A cross-sectional survey, relying on the ECQ, was performed (during 2015 and 2016) among 407 women with surgically diagnosed endometriosis. PARTICIPANTS/MATERIALS, SETTING, METHODS This study was conducted in a secondary and a tertiary care centre in the Netherlands. A total of 209 Dutch-speaking women who had endometriosis surgery (2013–2014), completed the ECQ after a postal invitation and, if needed, postal reminders. The assessed outcomes were: overall patient-centredness, the patient-centredness for each of its 10 dimensions, and the patient-centred strengths and targets for improvement. Case-mix adjusted patient-centredness scores (PCS) were compared and strengths and targets for improvement were identified with a matrix modelling importance against experience. The need to improve the targets was quantified with quality impact indices. MAIN RESULTS AND THE ROLE OF CHANCE No difference was demonstrated between the overall PCS of the secondary and tertiary centres (respectively: 4.8 and 4.5; P = 0.15). No difference was found in PCS per dimension between the two clinics except for the secondary care centre performing better regarding ‘physical comfort’ (respectively: 4.5 and 3.0; P = 0.01) and ‘continuity and transition’ (respectively: 6.0 and 4.2; P = 0.01). The two centres had nine targets for improvement in common. The secondary and tertiary centres, respectively, had five and seven additional centre-specific targets for improvement. Cross-centre learning is encouraged as 9 out the 12 additional centre-specific targets were strengths in the other centre. The main improvement targets were being able to contact the centre in case of emergency (both centres), the involvement of a significant other (secondary centre), diagnostic delay (secondary centre), personal follow-up (tertiary centre) and disclosing the level of competence of healthcare providers (tertiary centre). LIMITATIONS, REASON FOR CAUTION Responders did not differ from non-responders in their stage of endometriosis, educational level, rating of endometriosis care and degree to which their complaints are suppressed. Endometriosis is a chronic condition and patient-centredness might be experienced differently at other points of the endometriosis care trajectory. WIDER IMPLICATION OF THE FINDINGS The ECQ is a useful tool to assess patient-centredness in both secondary and tertiary care centres. Further research should focus on how to improve endometriosis care. STUDY FUNDING/COMPETING INTEREST(S) No external funding was used. V.M. and C.B.L. report grants from Guerbet, grants from Merck and grants from Ferring outside the submitted work. All authors declare that they have no competing interests concerning this publication.

scholarly journals Epidemiology of Gall Stone Diseases among Patients attending Surgical Department of a Tertiary Care Hospital in Nepal

2020 ◽  
Vol 8 (1) ◽  
pp. 50-55
Author(s):  
Sanjay Chaudhary
Keyword(s):  
Large Scale ◽  
Gallstone Disease ◽  
Tertiary Care ◽  
Gall Stone ◽  
College Teaching ◽  
P Value ◽  
Cholesterol Stone ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Surgical Department

Background and Objectives: Gallstone disease (GSD) is a chronic disease that consumes a lot of economic and medical resources. It not only affects patients’ life quality, but also is associated with the potential risks of the development of consequences of gallstone diseases. Therefore, the study is aimed to investigate the epidemiology and risk factors of gall stone diseases among patients attending tertiary care centre in Nepal. Material and Methods: A cross sectional study was conducted among patients attending surgical department of Janaki Medical College Teaching Hospital (JMCTH) over a period of one year from January 2019 to December 2019. Chi-square test was applied to show the association between the two groups. P-value < 0.05 was considered statistically significant. Results: In a total of 148 patients, 69.59% had mixed gallstone, 17.57% had cholesterol stone and 12.84% had pigment gallstone. Types of gallstone was found significant for age group (p=0.006), gender (p=0.027) and presence of diabetes (p=0.003) but insignificant with presence of hypertension (p=0.992). Conclusion: Age of the patients, gender and presence of diabetes were found significant for the all types of gall stone. Further large scale research need to be conducted.

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