scholarly journals Factors predicting difficult laparoscopic cholecystectomy: a single institution experience

2017 ◽  
Vol 4 (5) ◽  
pp. 1743
Author(s):  
Shiv K. Bunkar ◽  
Sushil Yadav ◽  
Amit Singh ◽  
Kalpana Agarwal ◽  
Preeti Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Tertiary Care ◽  
Significant Risk ◽  
General Surgeon ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
College Hospital ◽  
Symptomatic Gallstones ◽  
A Prospective Study

Background: Laparoscopic cholecystectomy is one of the most common operations performed by general surgeon. This study was performed to evaluate pre-operative factors predicting difficult laparoscopic cholecystectomy.Methods: A prospective study was carried out at Jawaharlal Nehru Medical College Hospital, Ajmer, a tertiary care centre in Middle East Rajasthan, India. In present study we included 100 patients diagnosed with symptomatic gallstones disease on the basis of history, clinical examinations and USG findings and underwent laparoscopic cholecystectomy in our hospital by a single surgeon during the period of July 2014 to July 2016. These all patients were evaluated for a group of risk factors and preoperatively these risk factors were given a score between 0-5 labeled as easy, 5-10 as difficult and 11-15 as very difficult. Statistical analysis was done by Fischer’s test and chi square test.Results: BMI >30, previous medical disease like DM, palpable gall bladder, prior hospitalization pericholecystic collection and impacted stone are significant risk factors to predict difficult laparoscopic cholecystectomy.Conclusions: The studied scoring system had a positive prediction value for easy prediction of 94% and for difficult prediction of 100%.

scholarly journals Surgical Site Infections (SSI) and factors associated in a private tertiary care teaching hospital in Raichur, Karnataka, India

2018 ◽  
Vol 5 (8) ◽  
pp. 2899
Author(s):  
Prashanta Swami Pujar ◽  
K. B. Phuleker ◽  
Nagaraj Bhalki
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Research Centre ◽  
Chi Square ◽  
College Hospital ◽  
Factors Associated ◽  
Duration Of Surgery ◽  
Chi Square Test ◽  
A Prospective Study

Background: Prevention of Surgical site infection (SSI) remains a focus of attention because wound infections continue to be a major source of expense, morbidity, and even mortality. Three quarters of deaths of surgical patients with SSIs are attributed to nosocomial infections, nearly all of which are organ/space infections. The objective of the present study was to estimate the incidence of SSI and to study the various risk factors associated with SSI.Methods: This is a prospective study of 180 eligible cases eligible subjects, who underwent various surgeries in the department of General Surgery after applying inclusion and exclusion criteria. The study conducted at the Navodaya Medical College Hospital and Research Centre, Raichur. The tenure for the study was April 2017 to June 2017. Data was collected using pretested proforma. Data was analysed using SPSS version 16. Chi -square test and multiple logistic regression was applied to know the association between various risk factors and occurrence of SSI.Results: Among 180 patients 33 (18.33%) developed surgical site infections (SSI). Among 33 SSIs 25 (75.76%) were grade 3 and 8 (24.24%) were grade 4 infections. SSIs were found more commonly among patients over 50 years, diabetics, HIV infected patients, patients with longer duration of surgery and associations with these factors were found statistically significant.Conclusions: The incidence rate of SSI was quite high, and its end results will have a greater impact on patients as well as on healthcare systems. Prevention of SSI requires multipronged approach targeting both patient related and procedure related risk factors in pre- operative, intra-operative, and post-operative period.

scholarly journals Incidence and risk factors for retinopathy of prematurity at a medical college hospital in rural Tamil Nadu, India

2020 ◽  
Vol 7 (11) ◽  
pp. 2119
Author(s):  
Sengodi Elumalai ◽  
Rajasekaran Kathavarayan ◽  
Venkatesh Govindasamy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Blood Transfusion ◽  
Retinopathy Of Prematurity ◽  
Tamil Nadu ◽  
Care Center ◽  
Tertiary Care ◽  
Significant Risk ◽  
College Hospital

Background: The objective of the research was to evaluate the incidence of retinopathy of prematurity (ROP), association of prenatal and postnatal risk factors, pattern of ROP and treatment outcomes among infants admitted to neonatal intensive care unit (NICU) of tertiary care center located in Thiruvannamalai, Tamil Nadu.Methods: A retrospective study done in all infants admitted between April 2019 and March 2020 who met the criteria for ROP screening with gestational age (GA) less than or equal to 36 weeks or birth weight less than 2000 grams or with GA more than 36 weeks and birth weight more than 2000 gram with significant risk factors like intrauterine growth restriction, respiratory distress syndrome, sepsis, long term oxygen use, phototherapy, blood transfusion and maternal anemia. Treatment was offered to infants with stage 3 ROP and stage 2 in zone 2 with or without plus disease. Qualified infants were treated with argon laser photocoagulation within 72 hours of diagnosis. They were followed until the disease was successfully treated.Results: Out of total 3121 neonates, 717 neonates met the screening criteria. Incidence of ROP was found to be 33% (n=237). 46.4% (n=110) of ROP belongs to 32-36 weeks GA. 42.6% (n=101) of ROP belongs to 1500-2000 gm birth weight.Conclusions: Incidence of ROP is quite high in high risk neonates in our unit. Significant risk factors are long term oxygen use, blood transfusion and sepsis.

scholarly journals Immediate outcome and risk factors determining the outcome of status epilepticus in children attending tertiary care centre

2017 ◽  
Vol 4 (4) ◽  
pp. 1289
Author(s):  
Murali Thandavarayan ◽  
Sureshkumar Ramaswamy ◽  
Priyadarsini Bose ◽  
Sivaraman Thirumalaikumarasamy
Keyword(s):  
Risk Factors ◽  
Status Epilepticus ◽  
Tertiary Care ◽  
Medical Emergency ◽  
Time Of Arrival ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Medical College

Background: Status epilepticus (SE) is a paediatric and neurological medical emergency, continuous seizure lasting more than 30 min, or two or more seizures without full recovery of consciousness between any of them. Determination of immediate outcome of SE in children in a tertiary care hospital and to identify the risk factors influencing the outcome was the objectives of the present study.Methods: A study was conducted in Dept of Pediatrics, Tirunelveli Medical College Hospital among the children from 1 month to12 years of age, who had admitted for SE in hospital’s pediatric causality from October 2009 to October 2010 were selected for the study.Results: Out of 92 patients, total 87 patients completed the study and out of those 74 have recovered and 13 have died. The risk factors significantly affecting the outcome were hypoxia at the time of arrival, decompensated shock, respiratory failure requiring intubation and acidosis.Conclusions: Proper prehospital therapy, early referral, proper care while transporting, anticipitating risk factors involved, and protocol based approach uniformly at all hospital can reduce the mortality due to status epilepticus in children. 

scholarly journals Important risk factors for gallstones after laparoscopic gastrectomy: A retrospective study

2020 ◽  
Author(s):  
Shohei Fujita ◽  
Masaru Kimata ◽  
Kenji Matsumoto ◽  
Yuichi Sasakura ◽  
Toshiaki Terauchi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Gastrectomy ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Gallstone Formation ◽  
Abdominal Ultrasonography ◽  
Symptomatic Gallstones ◽  
Male Sex ◽  
Observation Period

Abstract Background: The frequency of gallstones is higher in patients who have undergone gastrectomy than in the general population. While there have been some studies of gallstone formation after open gastrectomy, there are few reports of gallstones after LG. This study aimed to evaluate the incidence of gallstones after laparoscopic gastrectomy. Methods: We retrospectively reviewed the records of 184 patients who underwent laparoscopic gastrectomy between January 2011 and May 2016 at Saiseikai Utsunomiya Hospital. After gastrectomy, abdominal ultrasonography was generally performed every 6 months until 5 years later. Patients who underwent simultaneous cholecystectomy or with an observation period of < 24 months were excluded from the study. Ninety patients were ultimately analyzed. Laparoscopic cholecystectomy was performed whenever biliary complications occurred.Results: Gallstones were detected after laparoscopic gastrectomy in 27 of the 90 (30%) cases. Multivariate analysis identified Roux-en-Y reconstruction and male sex as significant risk factors for gallstones after gastrectomy. Symptomatic gallstones after laparoscopic cholecystectomy were found in 6 cases (6/27, 22%), and all patients underwent laparoscopic cholecystectomy.Conclusion: Roux-en-Y reconstruction was identified as a significant risk factor for gallstones after laparoscopic gastrectomy.

scholarly journals A prospective study on cardiac changes (electrocardiographic, enzymatic and echocardiographic) in birth asphyxiated neonates admitted in tertiary care centre

2019 ◽  
Vol 6 (2) ◽  
pp. 269
Author(s):  
A. Muhammed Shadique ◽  
Madhivanan Sailavasan
Keyword(s):  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Myocardial Damage ◽  
Organ Damage ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Medical College ◽  
Perinatal Management ◽  
High Index Of Suspicion ◽  
A Prospective Study

Background: Reduced myocardial performance and cardiac output following perinatal asphyxia may significantly complicate perinatal management and may contribute to increased end-organ damage and mortality. Hence the present study was done with the aim to assess the usefulness of echocardiography, electrocardiography (ECG), and cardiac enzymes in evaluating myocardial damage in perinatal asphyxia neonates and to assess their correlation with different stages of hypoxic-ischemic encephalopathy (HIE) and outcome.Methods: The study was conducted in the NICU, Department of Pediatrics, Government Chengalpattu Medical college hospital between August 2017 and August 2018 using 70 birth asphyxiated term babies. The asphyxiated babies were resuscitated as per NRP guidelines and were stratified into HIE stages as per Levene system of classification and were managed as per clinical condition. ECG grading, echo changes were noted. Creatinine kinase-MB (CKMB) levels were measured and documented after 12 hours of life among these babies and were analysed.Results: Of 70 cases, 36 (51.4%) had mild, 26 (37.1%) moderate and 8 (11.4%) severe HIE. Abnormal ECG was observed in 63 cases. Raised CKMB levels were found in 67 (95.7%) and abnormal echo findings were noted in 46 (65.7%) babies. ECG, echo changes and CKMB levels showed increasing abnormalities with increasing severity of HIE (p=0.000, 0.030 and 0.001 respectively). 8 babies in present study expired.Conclusions: Cardiac abnormalities among asphyxiated neonates requires high index of suspicion. ECG abnormalities, echo changes, elevated CK-MB levels in babies with HIE can help us identify neonates at risk of complications and guide in timely intervention that can prevent mortality of these babies and help us achieve better neurological outcome in these babies.

scholarly journals 1382. A Prospective Epidemiological Study BK Polyomavirus DNAuria and DNAemia within the First Year after Kidney Transplantation

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S777-S777
Author(s):  
Pannawat Mongkolrattanakul ◽  
Jackrapong Bruminhent ◽  
Tanaya Siripoon ◽  
Punlop Wiwattanathum ◽  
Suchin Worawichawong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Chi Square ◽  
Low Level ◽  
Resource Limited ◽  
Kaplan Meier ◽  
Bk Polyomavirus ◽  
Student’S T ◽  
High Level ◽  
A Prospective Study

Abstract Background Screening and early detection for the preceding BK polyomavirus (BKV) DNAuria and DNAemia to prevent the occurrence of BK polyomavirus BKV-associated nephropathy (BKPyVAN) among kidney transplant (KT) recipients has not been universally utilized and never assessed in a setting where the resource is limited. Therefore, we aimed to investigate this entity’s incidence, risk factors, and outcome with this intervention at our institution. Methods A prospective study of KT recipients at a tertiary care transplant center in Bangkok, Thailand, was conducted between January 2019 and March 2020. All patients underwent preemptive monitoring of urine and plasma BKV DNA load, measured by quantitative real-time PCR at 1, 2, 3, 6, 9, and 12 months post-KT. Low- and high-level BKV DNAuria was defined as urine BKV DNA load of &lt; and &gt; 7log10 copies/mL, respectively. Low- and high-level BKV DNAemia was defined as plasma BKV DNA load of &lt; and &gt; 4log10 copies/mL, respectively. The incidences were calculated by Kaplan-Meier analysis. The chi-square or student’s T-test compared clinical characteristics between those with and without high-level BKV DNAuria as appropriate. Risk factors of high-level BKV DNAuria were analyzed using Cox proportional hazard model. Results Among 99 evaluable KT recipients, a mean (SD) age was 42 (11) years, 64.6% were male, and 69.6% received an induction immunosuppressive therapy. Within 12 months post-KT, the incidences of low-level BKV DNAuria, high-level BKV DNAuria, low-level BKV DNAemia, and high-level BKV DNAemia were 22.63%, 13.14%, 9.49%, and 5.11%, respectively. High panel reactive antibody (PRA) was associated with high-level BKV DNAuria at 6 and 12 months, (HR 1.02 [95% CI (1.00-1.04)], P=0.019) and (HR 1.02 [95% CI (1.00-1.04)], P=0.023), respectively. Underlying diabetes mellitus was associated with high-level BKV DNAuria (HR 3.49 [95% CI (1.28-9.51)], P=0.015) at six months; however, not at 12 months. There was no allograft rejection directly related to a reduction of immunosuppression for BKV infection observed. Conclusion BKPyV infection is also prevalent among KT recipients in a resource-limited setting, however, without unfavorable consequence. Those with high-level PRA and underlying diabetes could be at risk of high-level BKV DNAuria after KT. Disclosures All Authors: No reported disclosures

scholarly journals A clinical study of risk factors of acute pancreatitis in a tertiary care centre in north India

2017 ◽  
Vol 4 (6) ◽  
pp. 1878 ◽  
Author(s):  
Pawan Kumar Jha ◽  
Rajnish Chandran ◽  
Pradeep Jaiswal ◽  
Kumari Seema
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Tertiary Care ◽  
Gall Stone ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Organ Systems ◽  
Mild Acute Pancreatitis ◽  
A Prospective Study

Background: According to Atlanta Symposium, acute pancreatitis (AP) was defined as an acute inflammatory process of the pancreas that may also involve peri-pancreatic tissues and/or remote organ systems. The objective of this study was to know the risk factors of acute pancreatitis in patients admitted in a tertiary care centre in north IndiaMethods: A prospective study was performed with admitted cases of patients with acute pancreatitis over 2 years period. Total 104 patients were selected for study. All data concerning aetiology were recorded and analysed in all patients forming study groups.Results: Among 104 patients with acute pancreatitis 68 (65%) were females and 36 (35%) were males. Mean age of our study group was 40.9 years and maximum incidence was seen in 36-45 years. Most common cause was biliary pancreatitis (63%) followed by alcohol (27%), idiopathic (6%), trauma (3%), infections (1%). In females, most common aetiology was gall stone (88%), in males most commonly by alcohol (78%). As per Atlanta classification 81 patients (77.8%) had acute mild pancreatitis and 23 patients (22.2%) had acute severe pancreatitis. Majority females (66.7%) were admitted in mild acute pancreatitis. The mean age of patients in mild acute pancreatitis was 39.6 years and in severe group was 45.4 years. Gall stone were the leading cause in both mild and severe acute pancreatitis.Conclusions: Females were more commonly affected than men by acute pancreatitis. The most common aetiology was gall stone followed by alcohol which was leading cause in the males.

scholarly journals An original research paper on incidence and risk factors for surgical site infections following major abdominal surgeries in obstetrics and gynaecology

2017 ◽  
Vol 6 (5) ◽  
pp. 1859
Author(s):  
Shalini Mahana Valecha ◽  
Manisha Narayan Saswade
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Significant Risk ◽  
Surgical Site Infections ◽  
Healthcare Services ◽  
Original Research ◽  
Tertiary Care Centre ◽  
Obstetrics And Gynaecology ◽  
Cost Of Health Care

Background: Surgical site infections associated with substantial morbidity and mortality, increase in hospital stay and enhanced cost of health care. Objective of present study is to analyse the incidence of surgical site infections after major abdominal obstetrics and gynaecologic surgeries and risk factors for development SSIs.Methods: It is observational study carried out at Department of Obstetrics and Gynaecology, ESI-PGIMSR at a teaching public hospital Mumbai, Maharashtra, India. It is a tertiary care centre and a teaching hospital. Women who had undergone abdominal surgery for various Obstetrics and Gynaecology indications.Results: 7.3% of operated subjects had SSI. And significant risk factors are anemia, obesity hypoprotenemia, prolonged pre-operative hospital stay, Diabetes mellitus.Conclusions: Post-operative abdominal wound infection represents a substantial burden of disease both for the patients and the healthcare services in terms of the morbidity, mortality and economic costs.

scholarly journals Magnitude, risk factors and outcome of low birth weight babies admitted to neonatal intensive care unit of a tertiary care centre in Puducherry, India

2020 ◽  
Vol 7 (6) ◽  
pp. 1389
Author(s):  
Maheswari K. ◽  
Neha Sharma
Keyword(s):  
Risk Factors ◽  
Teenage Pregnancy ◽  
Tertiary Care ◽  
Research Centre ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Maternal Risk ◽  
Feeding Difficulties ◽  
Preterm Babies ◽  
Pregnancy Avoidance

Background: This study was undertaken to know the magnitude, risk factors and outcome of LBW babies admitted in NICU in a tertiary centre.Methods: This is a hospital based, retrospective study, of LBW babies admitted to NICU of Sri Venkateshwara Medical College hospital and research centre, Puducherry, from Jan 2019 - Dec 2019.Results: About 340 babies were admitted to NICU and 56 were LBW babies, 5 were excluded and 51 LBW babies analysed. Magnitude of LBW babies, 51 (15%). Socio demographic pattern showed, IUGR (62.7%). Term IUGR (52%) and preterm IUGR (9.8%). Preterm babies (37.2%). Preterms <28 weeks of gestation (7.8%), 28-34 weeks (9.8%) and 34 to < 37 weeks (19.6%). LBW babies <1kg (7.8%), 1-1.5kg (1.9%) and 1.5 to 2.49 kg (90.1%). Male (52.9%), female babies (47%). LBW babies from rural area (62.7%), urban area (37.2%). Among the maternal risk factors, maternal anemia was common (31.3%). Elderly primi (13.7%), PROM and twin pregnancy in (9.8%) each, bad obstetric history (7.8%). PIH, APH, GDM and oligohydramnios in (3.9%) each. Rh negative pregnancy, grand multipara, teenage pregnancy, ART with hypothyroidism and unbooked pregnancy seen in (1.9%) each. Fetal distress (19.6%). Morbidity was (92.1%). Most common was jaundice (31.9%), sepsis (21.2%). Feeding difficulties (19.1%), TTNB (17%), apnea of prematurity (14.8%). Hypoglycemia and HIE in (12.7%) each. Hypothermia and HMD in (10.6%) each. Seizures in (8.5%) MAS and NEC (4.2%) each, congenital anomalies and hypocalcemia in (2.1%) and mortality in (7.8%). Extreme prematurity, ELBW with sepsis and RDS being common cause of mortality.Conclusions: Iron tablets intake, nutritional care, regular antenatal checkup, spacing pregnancy, avoidance of teenage and elderly pregnancy is important. Improving the infrastructure, manpower in NICU to manage preterm babies, when surfactant and ventilation is given.

scholarly journals Risk Factors of COVID-19 among Patients Attending a Tertiary Care Centre in Delhi: A Case Control Study

2020 ◽  
Vol 05 (04) ◽  
pp. 5-11
Author(s):  
Aakanksha Bharti ◽  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Tertiary Care ◽  
Significant Risk ◽  
P Value ◽  
Rt Pcr ◽  
Tertiary Care Centre ◽  
Case Record ◽  
Significant Difference ◽  
Contact Data

Introduction: COVID-19 is an infectious disease caused by a newly discovered coronavirus Severe Acute Respiratory Syndrome Corona Virus-2 (SARS CoV-2). Therefore, there is paucity of data on risk factors of COVID-19 in India which will help in designing preventive measures. Objective: To determine the risk factors of COVID-19 patients attending a tertiary care institution. Methods: The study was conducted at tertiary care hosipital in South Delhi, India among the patients admitted in Covid-19 wards or visiting the hospital for testing of SARS CoV-2 infection. Contact data of test results was collected from the medical record and detailed information was collected through telephone calls. 103 cases were selected who were found test positive by RT PCR and 103 negatives were selected as controls. Data was collected using pre-tested Questionnaire. The data were first captured in paper-based case record form and then entered in a Microsoft Excel and analyzed in SPSS Software version 21.0. Result: The mean age of all the participants was 37.63±15.32 years. On comparing cases and controls, it was found that symptoms like fever, general weakness, cough, sore throat, breathlessness and headache were significantly associated with cases, having an odds ratio of greater than 1 and p value< 0.05. On analysing various underlying medical conditions amongst controls and cases, it was found that there was a significant difference among cases and controls who had Diabetes Mellitus (DM) and Hypertension (p-value: 0.001) with a high odds ratio of 6.130 and 5.964 respectively. Around half of the cases (54.4%) and 23.3% of controls reported to have faced discrimination or changed attitude of their neighbours after revealing their RT-PCR report and this difference was statistically significant (p-value 0.001). Conclusion: Study revealed that majority of symptoms were not predictors of COVID-19 and only occupations and history of contact remained significant risk factors of COVID-19 in multivariate analysis. A multicenter research study is required to learn more about risk factors.

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