scholarly journals Relaparotomy in general surgery department of tertiary care hospital of Western India

2016 ◽  
Vol 4 (1) ◽  
pp. 344 ◽  
Author(s):  
Hemil Patel ◽  
Piyush Patel ◽  
D. K. Shah
Keyword(s):  
Tertiary Care ◽  
Patient Characteristics ◽  
Western India ◽  
Anastomotic Site ◽  
Close Monitoring ◽  
Care Hospital ◽  
Case Record ◽  
Primary Surgery ◽  
Initial Surgery ◽  
Operative Care

Background:Relaparotomy has to be performed in case of certain post-operative complications. Incidence of relaparotomy differs according to hospital setup as well as patient characteristics and initial surgery. It also depends on post-operative care given to patient following first surgery and incidence of post-operative sepsis. This study was carried out to know the incidence of relaparotomy and indications of it, so that in the future this factors can be modified and incidence can be further lowered.Methods: This is an observational study in which 75 relaparotomy cases reported during the period of May 2008 to September 2010 were included. All patients irrespective of age and sex, who have undergone re exploration of the abdomen during the period of hospitalization after the first operation and discharge of patients. All the gynaecological and obstetrical laparotomies were excluded. Data were recorded in pre-validated case record form.Results:Incidence of relaparotomy was 2.84%. It was most common in age group of 31 to 40 years; with mean age of 39.25 years. The most common indication of relaparotomy was leak (34 patients); from an anastomotic site (29 patients) or from perforation (5 patients). The mean duration between first Laparotomy and relaparotomy was 6.85 days. The mortality was 34.72% (25 patients). Mean number of days stay in ICU or the patient requires continuous close monitoring was 4.01 days; mean days of hospitalization was 25.72 days.Conclusions:Relaparotomy is lifesaving procedure for patients. Incidence of relaparotomy depends on expertise in primary surgery, proper surgical technique and prevention of post-operative infection.

scholarly journals Current Trends in Etiological Profile of Acute Upper Gastrointestinal Bleeding in Northern India: A Retrospective Analysis of 5-Year Endoscopic Data

2021 ◽  
Vol 12 (01) ◽  
pp. 031-035
Author(s):  
Vishal Bodh ◽  
Brij Sharma ◽  
Rajesh Kumar ◽  
Rajesh Sharma
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
The Other ◽  
Western India ◽  
Anastomotic Site ◽  
Care Hospital ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Etiological Spectrum ◽  
Upper Gastrointestinal

Abstract Introduction The etiological spectrum of acute upper gastrointestinal bleeding (AUGIB) varies from region to region. This study was performed to find out the latest etiological spectrum of the AUGIB in a tertiary care hospital in North India and to compare it with etiological spectra from a previous study from the same center and from the other regions of India. Methods Clinical notes and endoscopic data of all consecutive patients who had presented with AUGIB in Indira Gandhi Medical College Shimla, Himachal Pradesh, from May 2015 to December 2019, were analyzed retrospectively with the objective of finding out the various endoscopic etiologies that lead to AUGIB. The findings were compared with the previous study from the same center and with the data from the other regions of the country. Results A total of 1,513 patients were enrolled and majority were males (74.6%) with male:female ratio of 2.9:1. Majority were 41 to 60 years (46.46%) of age. Melena was the presenting complaint in 93.98% and hematemesis in 46.06%. Peptic ulcer disease (PUD; 46.19%) was the commonest cause of AUGIB followed by portal hypertension (26.23%). Other less common causes were erosive mucosal disease, erosive esophagitis, neoplasm, Mallory–Weiss tear, gastric angiodysplasia, anastomotic site ulcers, and Dieulafoy’s lesion. Conclusion PUD was still the commonest cause of AUGIB followed by portal hypertension. This is in agreement with the previous report from the same center and in contrast to the reports from other studies from Northern and Western India that create the impression that portal hypertension related bleeding is the most common cause of AUGIB in India.

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 Prospective study of midline abdominal incisional hernia repair by component separation technique augmented with prosthetic mesh

2020 ◽  
Vol 7 (10) ◽  
pp. 3273
Author(s):  
Ravi Saroha ◽  
Shivani B. Paruthy ◽  
Sunil Singh
Keyword(s):  
Abdominal Wall ◽  
Tertiary Care ◽  
Component Separation ◽  
Separation Technique ◽  
Close Monitoring ◽  
Care Hospital ◽  
Early Recovery ◽  
Component Separation Technique ◽  
Early Return ◽  
Mesh Augmentation

Background: In our tertiary care hospital, we receive a large number of acute abdomen cases. Raised intra-abdominal pressure (IAP) makes laparostomy mandatory initially and abdominal wall approximation cannot be completed due to compromised state in most cases. Large incisional hernias were seen on complete healing and this study was done to see the feasibility of component separation technique (CST) with mesh augmentation.Methods: 30 patients were subjected to CST with mesh augmentation. Preoperative defect size mapping, Pre- and post-operative monitoring of IAP were done. Pain scoring by visual analogue scale (VAS), early and late complications was noted. Patients were followed up for 60 months.Results: CST with mesh augmentation was found to be feasible with 96.77% success rate as no recurrence was noted in follow up. Preoperative average Basal metabolic index was 26.09. Size of defect varied from 17-20×9-16 cm2 (length X width). Seroma seen in 50% of patients was managed without any intervention. Skin necrosis in 6.6% and wound dehiscence in 3.33%, managed with minimal debridement & local wound care respectively. Respiratory compromise and hematoma were not seen and no patient required any active ICU care. Average length of hospital stay was 5.22 days. Close monitoring of IAP in immediate post-operative period was found to be significant.Conclusion: Physical acceptance of stable abdominal wall gives a psychological boost to patients with early recovery in form of ambulation and early return to work.

scholarly journals Bacteriological profile of neonatal and pediatrics sepsis in intensive care unit at a tertiary care hospital in western India

2021 ◽  
Vol 8 (3) ◽  
pp. 460
Author(s):  
Ajit Kumar Shrivastava ◽  
Prema Ram Choudhary ◽  
Santosh Kumar Roy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bacterial Species ◽  
Tertiary Care ◽  
Bacterial Pathogen ◽  
Pediatric Intensive Care ◽  
Western India ◽  
Care Hospital ◽  
Older Children ◽  
Bacteriological Profile

Background: Neonatal and pediatrics sepsis are one of the main causes of mortality in neonatal and pediatric intensive care units of developing countries. This study was conducted to determine bacteriological profile of neonatal and pediatrics sepsis in the intensive care unit. Methods: A prospective cross-sectional study was conducted in the neonatal and pediatric intensive care unit, for the period of two years. All 400 neonates and pediatrics patients admitted with suspected clinical sepsis were included. Sepsis screens and cultures were sent under aseptic conditions. Isolation of microorganisms and their identification was done according to standard microbiological techniques bacteriological profile was analyzed with descriptive statistics.Results: Incidence of septicemia is 35.34% in neonates, 9.83% in post neonates and 22.95% in older children. Most common associated factor in neonates were preterm 41.46% in neonates, fever of unknown origin 50% and 78.57% in post neonates and children respectively. Out of 232 suspected cases on neonates in 36.07% cases bacterial pathogen were isolated, 62 suspected cases on post neonates in 9.83% cases bacterial were isolated and 106 suspected cases of older children in 22.95% cases bacterial pathogen were isolated. Common bacterial species isolated were Klebsiella sp. 39.02% in neonates, S. aureus 50% and 35.71% in post neonates and older children respectively.Conclusions: There is entail prevention of infection control measures and rational antibiotic strategy to decrease the economic burden of hospital and community. 

Etiology of primary amenorrhea: Experience from a tertiary care hospital in Western India

2021 ◽  
Vol 14 (6) ◽  
pp. 674
Author(s):  
RajeshKumar Mishra ◽  
UttaraAiyer Kohli ◽  
Atul Seth ◽  
SumeetRanjan Tripathy
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Primary Amenorrhea ◽  
Western India ◽  
Care Hospital

A PROSPECTIVE STUDY ON CLINICAL PROFILE AND OUTCOME OF PATIENTS WITH TUBERCULOUS MENINGITIS AT A TERTIARY CARE CENTRE IN MAHARASHTRA

2021 ◽  
pp. 7-10
Author(s):  
Nupoor Vaghasia ◽  
Bharatsing D. Rathod ◽  
Vidya Nagar
Keyword(s):  
Tuberculous Meningitis ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Acute Onset ◽  
P Value ◽  
Western India ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Altered Sensorium ◽  
Low Sensitivity

BACKGROUND: Tuberculous meningitis (TBM) is one of the most fatal forms of tuberculosis, early diagnosis and treatment of which can reduce morbidity and mortality. This study was undertaken to achieve data regarding clinical prole and outcome of patients from western India as epidemiological data is lacking from this region. METHODS: This prospective observational study was conducted on 136 patients admitted in medical ward and critical care unit of a tertiary care hospital in Maharashtra over 18 months. Clinical, biochemical, radiological and microbiological evaluation was done. Data was analyzed using SPSS 22 version software and p value of <0.05 as signicant. RESULTS: The mean age of cases was 35.2 ± 14.69 years, majority from age group of 18 - 40 years. Out of 136 cases, 62 (45.6%) were males and 74 (54.4%) females. Commonest clinical features were fever and headache, followed by altered sensorium and seizure. Symptoms were mostly of acute onset (<14 days). 42 cases (30.9%) were associated with present or past pulmonary tuberculosis and 34 (25%) with retroviral disease. 7 cases (5.2%) had hemiparesis and 3 (2.2%) had ophthalmoplegia. Mean ESR was 56.59 + 22.87. CSF showed lymphocytosis (mean 88.4 + 18.09 %), low glucose percentage (mean 39.57 + 0.2 %) and high protein (mean 146.02 + 106.62 mg/dl). 117 cases (86%) showed positive neuroimaging. Outcome was poor in stage III disease. CONCLUSION: Tuberculous meningitis usually presents as acute onset illness with fever, headache or altered sensorium. CSF Gene Xpert has low sensitivity as compared to neuroimaging. Advanced disease was associated with poor outcome.

Sphenoid Wing Meningiomas: Experience from a Tertiary Care Hospital in Western India

2017 ◽  
Vol 9 (2) ◽  
pp. 104-109
Author(s):  
Bandlish Deepak ◽  
◽  
Salgotra Bhagwati ◽  
Somil Jaiswal ◽  
Jadhav Prashant ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Western India ◽  
Care Hospital
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