Prevalence of subclinical hypothyroidism in cases of cholelithiasis

Background: This prospective study was carried out to analyse the prevalence of subclinical hypothyroidism in patients of gall stones.Methods: A prospective study was carried out in the Gandhi Medical College and associated Hamidia Hospital Bhopal from 2015 to 2016. Data was collected from patients who were admitted in surgical wards, with a provisional diagnosis of cholelithiasis. Patient was diagnosed cholelithiasis on abdominal ultrasonography and was tested for having subclinical hypothyroidism by testing fasting blood samples for serum TSH.Results: A total of 50 patients of cholelithiasis were included in present study. Females were 42 out of 50 (84%) and males were 8 out of 50 (16%). Most common age group was 41-50 (36%) correct (insignificant at p<0.05). 12 (24%) out 50 patients were hypothyroid. Out of total 42 females 11(26.19 %) were hypothyroid (insignificant at p<0.05). All stones in hypothyroidism patients were >1cm and overall 58% stones were >1cm (statically significant P<0.05). 03 out of 12 hypothyroidisms (25%) patient had single stones while 9 (75%) patient have multiple stone (statically significant P value <0.05). In hypothyroid cases most stones were of cholesterol type (58%) (Statically significant at P value≤0.05).Conclusions: Early diagnosis of hypothyroid state at subclinical level by monitoring TSH level so that they can be treated at early stages and burden of Cholelithiasis thus can be prevented.

Download Full-text

Medial versus Medio-lateral Tympanoplasty in Large Central and Subtotal Perforation – A Prospective Study

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2019.v27i1.224 ◽

2019 ◽

Vol 27 (1) ◽

pp. 44-50

Author(s):

Ajoy Khaowas ◽

Chiranjib Das

Keyword(s):

Prospective Study ◽

Uptake Rate ◽

West Bengal ◽

Age Group ◽

Medical College ◽

Group I ◽

Number Of Patients ◽

Subtotal Perforation ◽

A Prospective Study ◽

Bony Overhang

Introduction: Large central and subtotal tympanic membrane (TM) perforations are difficult to repair because of less vascularity of anterior TM than posterior TM and the anterior bony overhang that blocks visualization. Some studies reported very encouraging results with the medio-lateral tympanoplasty in such cases. We have undertaken this study to find out efficacy of this technique in large central and subtotal perforations and to compare the results of medio-lateral with medial tympanoplasty. Materials and Methods: The present prospective study was conducted in the Department of Otorhinolaryngology of a medical college and hospital, West Bengal from January 2013 to December 2014. Patients were alternatively divided into two groups. Medial technique was used in Group I and medio-lateral technique was used in Group II. Results: Each group comprised of 40 patients each. Maximum number of patients in each group was in the age group of 15-25 years. The overall graft uptake rate in this study was 95% in medio-lateral technique compared to 80% of underlay technique. Conclusion: The medio-lateral tympanoplasty is suitable for reconstruction of large central or subtotal TM perforation. It takes advantage of both medial and lateral grafting methods while avoiding their pitfalls.

Download Full-text

A prospective study of post-operative surgical site infections after abdominal surgeries

International Surgery Journal ◽

10.18203/2349-2902.isj20214000 ◽

2021 ◽

Vol 8 (10) ◽

pp. 3088

Author(s):

Sanjay Jain ◽

Rahul Shivhare ◽

Shoranki Pardhan ◽

Deepti Chaurasiya

Keyword(s):

Prospective Study ◽

Surgical Site Infections ◽

Emergency Setting ◽

Related Factors ◽

E Coli ◽

Medical College ◽

Contaminated Wound ◽

Male Patients ◽

Gandhi Medical College ◽

A Prospective Study

Background: Surgical site infections have plagued surgeons since time immemorial. There is significant morbidity and mortality associated with surgical site infections. In this study we tried to identify the incidence, various patient and procedure related factors, which could have led to SSIs, the various organism associated with the SSIs and their pattern of sensitivity and resistance to various antibiotics.Methods: This study was conducted in the department of general surgery, Gandhi medical college and Hamidia hospital Bhopal. In this prospective study, we included all patients more than 12 years of age undergoing abdominal surgeries between 2018-2020. Patient data was recorded in a case recording form and all patients were examined post-operatively for soakage along with culture and antibiotic testing.Results: A total of 299 patients were included. Overall incidence of SSI was 23.07%, elective surgeries showed 19.5% incidence and elective showed 26.08% incidence. Higher incidence of SSI was found in, male patients (25.9%), contaminated and dirty surgeries, higher ASA scores, smokers, alcoholics diabetics, anaemics, and malnourished patients. E. coli and klebsiella were the most common organisms isolated in both elective and emergency setting. Organisms isolated were highly sensitive to colistin, meropenem, imipenem, gentamicin and amikacin. Amoxycillin, ceftriaxone, doxycycline were fairly resistant in the current study.Conclusions: Modifiable risk factors like smoking, alcoholism, anaemia, malnourishment, contaminated wound class and emergency surgeries should be addressed systematically along with judicious use of antibiotics and tailoring then according to culture profile whenever possible is needed to reduce SSI rate.

Download Full-text

Role of preoperative nutrition in gastro-intestinal cancer patients: a prospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20164447 ◽

2016 ◽

Vol 4 (1) ◽

pp. 131

Author(s):

Samir Shukla ◽

M. C. Songra ◽

Naveen Kumar Patbamniya ◽

M. Damor ◽

Vijay Tyagi

Keyword(s):

Prospective Study ◽

Clinical Signs ◽

Normal Diet ◽

Control Group ◽

Medical College ◽

Preoperative Nutrition ◽

Total Parentral Nutrition ◽

One Year ◽

Gandhi Medical College ◽

A Prospective Study

Background:This prospective study was carried out to compare outcome and postoperative complication in patients with gastro-intestinal malignancy who received preoperative total parentral nutrition with those whom doesn’t.Methods: The study was a prospective single-centre, two-arm, conducted in department of general surgery, Gandhi Medical College and Associated Hamidia Hospital, Bhopal, Madhya Pradesh, India of one year duration, a total of 60 patients with G. I. malignancy, with or without sign of malnutrition, were included in the study. Patients were randomized and 30 patients were placed in each arm (interventional and control group) patients in the control group were asked to continue their normal feeding while interventional arm were given TPN in addition to their normal diet, for 7 to 10 days before surgery.Results:Infectious complications were more in control group, while one case each of pneumonia and sepsis was observed in patients receiving supplementation. Complications related to nutritional status of the patient like wound infection and anastomotic leak were observed only in patients without supplementation. There was no death observed in interventional group but two deaths occurred in control group.Conclusions:Preoperative nutritional support is beneficial and should be routinely used in abdominal and gastrointestinal cancer patient with or without clinical signs of malnutrition.

Download Full-text

THE SPECTRUM OF MALIGNANT SOLID PEDIATRIC TUMORS IN THE AGE GROUP OF 0-18 YEARS: A PROSPECTIVE STUDY

10.36106/gjra/2800409 ◽

2020 ◽

pp. 1-3

Author(s):

Sandhya Bordia ◽

Praveen Kumar Jain*

Keyword(s):

Prospective Study ◽

Pediatric Tumors ◽

Age Group ◽

Female Ratio ◽

Spindle Cell Neoplasm ◽

Medical College ◽

Pediatric Age Group ◽

Solid Malignancies ◽

Male Female Ratio ◽

A Prospective Study

OBJECTIVE: The purpose of this prospective study is to study the spectrum of pediatric solid malignancies at our institution. METHOD: This study is under taken to evaluate the incidence and morphological features of solid malignant paediatric tumors in eighteen years and below. The material for present study is obtained from FNAC in cytology and biopsy specimen in histology department of RNT Medical college, Udaipur. RESULT: A total number 60 cases of malignant solid pediatric tumors of age group 0-18 years were diagnosed in Department of Pathology RNT Medical college Udaipur, during a period of two years. The number of malignancies diagnosed by Cytology accounted for 53.33% while Histopathology contributed 46.67% respectively. The male: Female ratio of childhood solid malignancies was 1.73:1. In malignant solid pediatric tumors CNS tumors were the commonest constituting 30% followed by Lymphoma 23.33%, Bone tumors 11.67% and neuroblastoma, retinoblastoma & spindle cell neoplasm 3.33% each. CONCLUSION: Our study concluded that solid malignant pediatric tumors contribute also a health problem in Udaipur region affecting all pediatric age group but more prevalent in the age group 6-10 years & 15-18 years.

Download Full-text

FAILURE OF THROMBOLYSIS WITH STREPTOKINASE IN ACUTE MYOCARDIAL INFARCTION USING ECG CRITERIA: AN OBSERVATIONAL STUDY

10.36106/ijsr/0227307 ◽

2020 ◽

pp. 1-3

Author(s):

Prabhat Kumar Sinha ◽

Kumari Suruchi ◽

Pradeep Kumar Sharma ◽

Debarshi Jana

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Observational Study ◽

Prospective Study ◽

Diabetic Patients ◽

Age Group ◽

Medical College ◽

One Year ◽

A Prospective Study ◽

Ecg Criteria

To Study failure of thrombolysis with streptokinase in acute myocardial infarction using E.C.G criteria a prospective study of patients presenting with acute myocardial infarction in Department of Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Bihar for a period of one year from December 2018 to November 2019. A total of 220 patients who presented with acute myocardial infarction were included in the study. Out of 220 patients 193(87.7%) males and 27 (12.3%) females participated in the study. All the patients underwent thrombolysis with streptokinase. Out of 220 patients who were being thrombolysed with streptokinase, most of them (97; 41.1%) were in the age group of 56-65 years. Out of all the patients who underwent thrombolysis (n=220), thrombolytic failure was observed in 121 (55%) patients. Failure rate was significantly higher in the age group of 56-65 years (88; 72.7%). Significantly higher prevalence of thrombolytic failure with streptokinase was observed among diabetic patients (65.2% ) as compared to non diabetics (52.3%).

Download Full-text

A prospective study of assessment of prognostic factors in early and late wound dehiscence in midline vertical incision

International Surgery Journal ◽

10.18203/2349-2902.isj20203238 ◽

2020 ◽

Vol 7 (8) ◽

pp. 2578

Author(s):

Ramashankar Gupta ◽

Surendra Kumar Shrivastava ◽

Prateek Malpani ◽

M. C. Songra

Keyword(s):

Prognostic Factors ◽

Prospective Study ◽

Respiratory Infections ◽

Wound Dehiscence ◽

Emergency Laparotomy ◽

Contributing Factors ◽

Medical College ◽

Elective Setting ◽

Gandhi Medical College ◽

A Prospective Study

Background: Wound dehiscence is separation of some or all layers of incision. It may be partial or complete. It is called as complete when all layers of the abdominal wall have been separated with or without evisceration of viscous. The study aims to find out and record the prognostic factors for wound dehiscence in vertical midline laparotomy.Methods: This was a prospective study in 1400 laparotomies that developed wound dehiscence operated in Gandhi Medical College, Bhopal from august 2017 to august 2019. All the patients with burst abdomen operated during emergency or elective setting by midline vertical laparotomy were included.Results: Wound dehiscence was most common in 51-60 years age group (26%). Majority patients were males (62%). Emergency laparotomy showed maximum incidence (71%). Bursts were seen mostly during 6th to 10th postoperative day. 78% patients presented as partial wound dehiscence and remaining as complete wound dehiscence. 46% presented as early wound dehiscence (7 days).Conclusions: Post laparotomy wound dehiscence has multifactor etiology. Respiratory infections, anemia, and hypoproteinaemia are the contributing factors. Improper haemostasis during surgery and poor surgical technique are the predisposing factors.

Download Full-text

Association between cholelithiasis and hiatus hernia in patients with dyspepsia: a prospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20191058 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1131

Author(s):

Shishir Sudhakar Jadhav ◽

Pravin Namdev Shingade ◽

Dakshayani Satish Nirhale ◽

Abhijeet . ◽

Anshu Rawat ◽

...

Keyword(s):

Prospective Study ◽

Hiatus Hernia ◽

P Value ◽

Chi Square ◽

Medical College ◽

Obvious Association ◽

Long Time ◽

Study Association ◽

A Prospective Study ◽

Asymptomatic Disease

Background: An association between hiatus hernia and cholelithiasis has been suspected for a long time but has never been adequately documented. Cholelithiasis is an asymptomatic disease. The precise incidence of hiatus hernia is not known. In current era as the practise is getting result oriented not diagnosing Hiatus hernia and persistence of symptoms is considered as failure in case of surgery. Coexistence if diagnosed preoperatively is of great help in management of the patient. The purpose of the study is to study association of Hiatus hernia with cholelithiasis in patients with dyspepsia.Methods: This is a prospective study conducted in DR. D. Y. Patil Medical College, Pune, Maharashtra for a period of two years. 100 patients of dyspepsia were enrolled in the study. All patients of dyspepsia were subjected to USG- abdomen. Patients were divided into diagnosed cholelithiasis (A) and non-cholelithiasis (B) as per USG findings. Both groups were subjected to upper gastro intestinal scopy. Appropriate statistical method was applied to know the incidence of hiatus hernia in cholelithiasis and non -cholelithiasis patients. Comparison was done to know the association between hiatus hernia and cholelithiasis in the patients with dyspepsia.Results: Total 24% patients had both hiatus hernia and cholelithiasis. Whereas 23% patients had neither hiatus hernia nor cholelithiasis on applying chi-square, p-value is 0.58. This is statistically insignificant.Conclusions: There is no obvious association between hiatus hernia and cholelithiasis in patients with complains of dyspepsia.

Download Full-text

A study of clinical patterns in benign breast disorders

International Surgery Journal ◽

10.18203/2349-2902.isj20180343 ◽

2018 ◽

Vol 5 (2) ◽

pp. 518

Author(s):

Trupti P. Tonape ◽

Akriti R. Tulsian ◽

Debabrata D. Gope ◽

Jyotsna C. Gogineni

Keyword(s):

Prospective Study ◽

Left Breast ◽

Age Group ◽

Medical College ◽

Increased Risk ◽

Proven Case ◽

Clinical Patterns ◽

Breast Lumps ◽

The Right ◽

A Prospective Study

Background: This is a prospective study aimed at evaluating patients presenting with breast related complaints at Dr. D.Y. Patil Medical College, Pimpri, Pune. It outlines various clinical patterns in benign breast disorders; this includes age, type of presentation, side and quadrant of breast involved, size of breast lump and the eventual diagnosis.Methods: A prospective study was conducted at Dr. D.Y. Patil Medical College, Pimpri, Pune, between July 2016 and July 2017. Author evaluated 50 patients, male and female, of all ages, presenting with complaints suggestive of a benign breast disorder. Patients that were a proven case of carcinoma of breast and those diagnosed with a malignant condition of the breast during evaluation were excluded from the study.Results: The incidence of benign breast disorders is the highest in the age group of 21 to 30 years (42%). Most common presentation of benign breast disorder in the series was found to be lump in the breast (58%). The Left breast (44%) was noted to be more commonly involved than the Right breast (40%). Most commonly involved quadrant of breast was the upper inner quadrant (30%), followed by the upper outer quadrant (24%).Most of the breast lumps were of size ranging from 3 to 3.9cm (36.58%) followed by those of size ranging from 2 to 2.9cm. (21.95%). Fibroadenoma (42%) was the most common benign breast disorder in present study, followed by fibro-adenosis (18%).Conclusions: Every benign breast disorder presents in a certain age group and follows a certain clinical pattern as outlined in this study. Detailed history taking and clinical examination while keeping in mind these clinical patterns, along with ultrasound and FNAC (triple test), aids in establishing the diagnosis of a benign breast disorder within 72 hours. Hence, the anxiety caused by breast lumps and nodularity can be alleviated by excluding the diagnosis of carcinoma breast. And since majority of benign lesions are not associated with an increased risk for subsequent breast cancer, unnecessary surgical procedures can be avoided.

Download Full-text

Sonographic Measurement of Spleen in Relation to Age: A Prospective Study among Adult Nepalese People in Western Nepal

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v10i1.17904 ◽

2017 ◽

Vol 10 (1) ◽

pp. 11-16

Author(s):

Keshab Sharma ◽

PS Lamichhane ◽

B Sharma ◽

BK Sharma

Keyword(s):

Prospective Study ◽

Age Group ◽

Medical College ◽

Splenic Enlargement ◽

Clinical Disorders ◽

Males And Females ◽

A Prospective Study ◽

Splenic Size ◽

Normal Dimension

Introduction: Splenomegaly is an enlargement of the spleen which is a quite common problem in any part of the world. Spleen is enlarged in various clinical disorders e.g. infections, metabolism or storage disorders and hematological abnormalities. Splenomegaly is an indicator of pathologic process that may be of primary splenic origin but also may be a reflection of disease in virtually any other organ system. Thus, it is important to estimate the splenic size in vivo in the diagnosis, treatment and prognosis of a variety of disorders.Objective: The objective of this study was to determine the normal dimension of the spleen in the adult Nepalese people.Methods: This is a prospective study in which 320 adults subjects were scanned by using 3.5 MHz curvilinear probe. We used ultrasonography to examine 160 males and 160 females, not to have any condition likely to be associated with splenic enlargement. The measurement for the length and thickness of spleen were obtained in right lateral position.Results: This study revealed the splenic dimensions for males were greater than in females. The men spleen length were (10.07 ±0.7 cm, 10.1 ±0.54 cm, 9.5 ±0.7 cm and 9.0 ±0.43 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively). The females spleen length were (9.83 ±0.53 cm, 9.58 ±0.58cm, 9.2 ±0.64 cm and 8.8 ±0.36 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively). The men spleen thickness were more (4.1 ±0.5 cm, 4.05 ±0.58 cm, 3.43 ±0.38 cm and 3.0 ±0.36 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively). The females splenic thickness were 4.06 ±0.47 cm, 3.78 ±0.48 cm, 3.38 ±0.35 cm and 2.29 ±0.23 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively. Thus significant differences between male and female splenic dimensions were found for each age group chosen (P <0.05).Conclusions: The results show that the splenic length and thickness decreased with increase in age in both males and females and all the dimensions were greater in males than in females. This study established normogram that can be more reliably used as both a complementary modality to clinical evaluation and as a more sensitive means of evaluating and screening patients for splenic disorders for any pathological enlargement or reduction of size in clinical practice in a Nepalese populations.Journal of Gandaki Medical College Vol. 10, No. 1, 2017, page: 11-16

Download Full-text

Pattern and Etiology of Mandibular Fractures Reported at Nepalgunj Medical College: A Prospective Study

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v13i2.16540 ◽

2017 ◽

Vol 13 (2) ◽

pp. 21-24

Author(s):

Niva Kansakar ◽

Bikram Budhathoki ◽

Namdev Prabhu ◽

Anjani Kumar Yadav

Keyword(s):

Prospective Study ◽

Traffic Accidents ◽

Road Traffic ◽

College Teaching ◽

Mandibular Fracture ◽

Mandibular Fractures ◽

Age Group ◽

Road Traffic Accidents ◽

Medical College ◽

A Prospective Study

Background: Mandibular fracture is one of the most common fractures of the maxillofacial region. The pattern of mandibular fractures varies from country to country and these variations can be due to social, cultural, and environmental factors. Objectives: This study was conducted to evaluate the etiology, incidence and pattern of mandibular fractures in western region of Nepal, reported at Nepalgunj Medical College Teaching Hospital.Methodology: A prospective study of 130 patients with mandibular fractures was conducted in Department of Dentistry, Nepalgunj Medical College Teaching Hospital from November 2013 to November 2014. These patients were examined both using clinical and radiographic parameters for mandibular fracture. Data concerning age, gender, causes of fracture and sites of fracture were analyzed.Result: Out of 130 patients, 104(80%) were male patients and 26(20%) were female patients. Most common age group was between 21-30 years. Most common cause of mandibular fracture was road traffic accidents accounting for 66(50.77%) cases followed by fall injury in 30(23.08%) cases. Most common site involved was parasymphysis 46(30.47%) followed by angle 27(17.89%). Road traffic accidents due to alcohol consumption 40(68.97%) was the leading cause followed by assault 10(17.24%) and fall 8(13.79%).Conclusion: Mandibular fractures are more frequent in male than female with higher frequency in 21-30 years age group. The most commonly fractured site was the parasymphysis. Road traffic accidents were the most common etiology and significantly associated with alcoholism. JNGMC Vol. 13 No. 2 December 2015

Download Full-text