scholarly journals Incidence, clinical manifestations and outcome of TUR (transurethral resection) syndrome in patients undergoing TURP under spinal anaesthesia: results from clinical observations in a cohort of 50 patients at a tertiary care centre in North India

2017 ◽  
Vol 5 (1) ◽  
pp. 243
Author(s):  
Christina George ◽  
Parvez David Haque ◽  
Kim J. Mammen
Keyword(s):  
Spinal Anaesthesia ◽  
Serum Sodium ◽  
Transurethral Resection ◽  
Clinical Symptoms ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
North India ◽  
Spinal Block ◽  
Transurethral Resection Of Prostate ◽  
Turp Syndrome

Background: ‘TUR syndrome’ is clinically detectable in 2% of patients undergoing an otherwise safe operation. Currently, spinal anaesthesia is the most widely anaesthetic technique for TURP as it is easier to detect signs of TUR syndrome in an awake patient. This study aimed at looking at the clinical spectrum and outcomes of TUR syndrome in patients undergoing TURP under spinal anaesthesia.Methods: This clinical study was conducted over a period of 6 months in the departments of anesthesiology and urology at the Christian medical college and hospital Ludhiana in a cohort of 50 male patients electively admitted for TURP under spinal block belonging to ASA I or II groups. Patients received intermittent irrigation with 1.5% glycine, and monitored for TUR symptoms and electrolyte estimations perioperatively.Results: In our study the incidence of TURP syndrome was 10 %. Under spinal block clinical manifestations along with serum sodium values monitored perioperatively helped diagnose and manage the patients. All patients successfully completed resection, with no mortality related to TURP syndrome.Conclusions: In patients undergoing transurethral resection of prostate under spinal anaesthesia, monitoring clinical symptoms for the rare TURP syndrome and additional serum sodium levels act as an adjunct in diagnosis. In both situations diagnosis and early intervention prevents extreme neurological symptoms and reduces mortality.

scholarly journals Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

2021 ◽  
Vol 12 (8) ◽  
pp. 60-64
Author(s):  
Rajesh Kumar Maurya ◽  
Vinay Kumar ◽  
Kumar Vineet
Keyword(s):  
Energy Source ◽  
Transurethral Resection ◽  
Surgical Procedure ◽  
Tertiary Care ◽  
North India ◽  
Transurethral Resection Of Prostate ◽  
Care Hospital ◽  
Operative Morbidity ◽  
Bipolar Energy ◽  
Turp Syndrome

Background: Transurethral resection of prostate is considered as gold standard surgical procedure for treatment of benign enlargement of prostate. It can be performed in two forms- monopolar transurethral resection and bipolar transurethral resection. Aims and Objective: This study was conducted to know which energy source among monopolar and bipolar energy leads to more post-operative morbidity after performing transurethral resection of prostate. Materials and Methods: In this study, total eighty (80) cases were included. They were suffering from lower urinary tract symptoms which were diagnosed to be due to benign enlargement of prostate after careful clinical and radiological examination. In forty cases, transurethral resection of prostate was performed by using monopolar energy source and in another forty cases, resection of prostate by transurethral route was done using bipolar energy source. Results: In our study, we found that development of TURP syndrome was more in monopolar TURP group in which pre-operative weight of prostate was more than 50 grams in comparison to bipolar TURP group in which there was no incidence of development of TURP syndrome in same class. Further, post-operative hospital stay and post-operative urethral catheter in situ was less in bipolar TURP group in terms of days as compared to monopolar TURP group. Conclusion: Our study concludes that Bipolar TURP is better in terms of development of less post-operative morbidity as compared to monopolar TURP. Bipolar TURP must be used extensively in teaching hospitals where students take more time than a seasoned surgeon to perform a surgical procedure and bipolar TURP will come handy in that situation.

scholarly journals Role of preoperative assessment of serum sodium in transurethral resection of prostate to avoid transurethral resection of prostate syndrome: a comparative study

2020 ◽  
Vol 7 (8) ◽  
pp. 2630
Author(s):  
Bhavesh Gamit ◽  
Nimesh Bharatkumar Thakkar
Keyword(s):  
Serum Sodium ◽  
Transurethral Resection ◽  
Tertiary Care ◽  
Prostate Gland ◽  
Preoperative Assessment ◽  
Transurethral Resection Of Prostate ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Group 13 ◽  
Prostate Size

Background: Transurethral resection of prostate syndrome (TURP) syndrome is an iatrogenic complication caused by absorption of the irrigating fluid which is used to distend the bladder during surgery.Methods: A total of 100 patients with benign prostatic hyperplasia (BPH) were taken for study. Study was done in tertiary care centre in Gujarat from January 2016 to December 2017. They were evaluated pre-operative and post-operative for sodium concentration.Results: In this study most of the patients i.e. 32 were seen in age group 61- 65 years.31% cases have developed hyponatremia out of 6% were having serum sodium level <125 mEq/l. 56% of cases were having prostate gland <40 cc. In 70% cases, TURP was completed within 60 minutes, while 30% cases required more than 60 minutes time. 13 were seen in age group 51 to 60 years, means 40.62% patients of this age group (13/32) and 12 patients were seen in age group 71-80 years, means 52.17% patients of this age group (12/23) were having post-operative hyponatremia. Out of 31 patients, 20 patients (64.52%) were having prostate size more than 60 cc and 11 patients (35.48%) were having prostate size between 46 to 60 cc.Conclusions: From present study, it is concluded that electrolyte derangement occurs in older patients, with larger amount of tissue and longer time of resection and higher volume of irrigation fluid. It was also noticed that chances of electrolyte derangement are higher in patients with co-morbid conditions.

scholarly journals Correlation between Clinical Symptoms of Coeliac Disease, Serum IgA Anti TTG and Biopsy in Pediatric Population of Northern India

2020 ◽  
Vol 8 (1) ◽  
pp. 65-68
Author(s):  
Sumit Jeena ◽  
Jaswinder Kaur ◽  
Nishant Wadhwa
Keyword(s):  
Coeliac Disease ◽  
Clinical Symptoms ◽  
Tissue Transglutaminase ◽  
Pediatric Population ◽  
Clinical Manifestations ◽  
North India ◽  
P Value ◽  
Serum Iga ◽  
Significant Difference ◽  
The Mean

Background: Celiac disease is basically an immune-mediated enteropathic condition produced by permanent sensitivity to gluten in genetically susceptible subjects. There is paucity of data in north India regarding clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population. The present study was conducted with the aim to determine the correlation between clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population of northern India.Materials and Methods: The present study was conducted in prospective including 73 pediatric patients at Department of Pediatric Gastroenterology, Institute of Child Health, Sir Gangaram Hospital, New Delhi, India. Esophagogastroduodenoendoscopy and serum anti Ig A tissue transglutaminase were performed. The characteristic scalloping of the folds were looked for in endoscopy followed by four duodenal biopsies performed from second part of duodenum and histological grading was performed as per modified marsh system. Patients with Serum IgA anti tTG>20 U/ml were confirmed to be at risk. Complete histological work up was done including hemoglobin, RBC indices and peripheral blood smear examination. The association of clinical manifestations with disease grade was also established with correlation coefficient. All the data thus obtained was arranged in a tabulated form and analyzed using SPSS software. Probability value of less than 0.05 was regarded as significant.Results: There were 4 males and 16 females with marsh grade 1 and 2 and mean age of 7.3±1.9 years. There were 5 males and 8 females with marsh grade 3a and mean age of 6.8±2.3 years. The mean weight of 18.11±3.89, height of 103.17±8.73 and BMI of 16.26±3.78 was observed amongst subjects with Marsh grade 1 and 2. The mean weight of 15.12±3.17, height of 99.28±9.19 and BMI of 15.02±3.20was observed amongst subjects with Marsh grade 3a. Diarrhoea was maximum amongst subjects with grade 3c and 4(70%) and minimum amongst Grade 1 and 2 (40%). There was a significant difference between the frequency of anemia amongst different grades as the p value was less than 0.05.Conclusion: The most common presenting signs and symptoms were diarrhea and abdominal pain. The study also concluded that the incidence of anemia increases with higher marsh grades.

scholarly journals Clinico-Epidemiological Profile of Viral Sexually Transmitted Infections in Seropositive Patients Attending a Tertiary Care Hospital in North India

2017 ◽  
Vol 16 (4) ◽  
pp. 331-337 ◽  
Author(s):  
Shikha Chugh ◽  
Vijay Kumar Garg ◽  
Rashmi Sarkar ◽  
Kabir Sardana
Keyword(s):  
Sexually Transmitted Infections ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Developed Countries ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Sexually Transmitted ◽  
Hiv Seropositive

Sexually transmitted diseases are a major public health problem both in developing and in developed countries, and especially with the co-synergy with HIV infection, there is an increasing need to have a proper understanding of the clinicodemographic patterns of sexually transmitted infections (STIs) for planning and implementing control strategies. Worldwide, there is an increased preponderance of viral STIs. Increasing incidence and altered clinical presentation of viral STIs in patients with HIV pose a diagnostic challenge; thereby, we studied the demographic profile of HIV-seropositive patients and compared clinical manifestations of viral STIs in HIV-seropositive patients to those in seronegative individuals. Twenty-seven HIV-seropositive patients with viral STI (herpes/molluscum/warts) and same number of age-, sex-, and STI-matched seronegative patients were studied for variability in clinical profile. There were significant differences in the demographic factors (education, income, and migration) and sexual practices (number of contacts and source of infection) in the 2 groups. Lesional symptoms, increased extent of lesions, and resistance to treatment were significantly more common in HIV-seropositive patients.

scholarly journals Serum sodium level in dengue infected children: a retrospective study

2018 ◽  
Vol 5 (5) ◽  
pp. 1801
Author(s):  
Reshma Raj ◽  
Rashmi Alva
Keyword(s):  
Dengue Fever ◽  
Serum Sodium ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Severe Dengue ◽  
Dengue With Warning Signs ◽  
Group B

Background: Dengue fever is one of the most common arbo virus mediated outbreaks, being reported from different parts of the world. Now as the outbreaks are hitting different geographic locations, different clinical manifestations are being reported recently. Aim of this study is to document the serum Sodium level in dengue infected children in a tertiary care centre.Methods: A total 128 cases of NS1 antigen, IgM positive or ELISA positive dengue patients were included in this observational study and analyzed.Results: The serum Sodium level in dengue varies according to the different groups. In group A (dengue with no warning signs) the serum Sodium level was normal, whereas in case of group B (dengue with warning signs), there was significant hyponatremia. In group C, severe dengue the serum Sodium was normalConclusions: Mild hyponatremia is a common electrolyte disturbance in patients with dengue with warning signs. Hence, the lower the serum Sodium levels the higher is the incidence of complications associated with dengue fever.

scholarly journals Comparison of hemodynamic effect between the spinal anesthesia and saddle block during transurethral resection of the prostate

2021 ◽  
Vol 23 (09) ◽  
pp. 817-828
Author(s):  
Dr. Farooq Taher Abdulqader ◽  
◽  
Dr. Ali Abd-Alhameed Mohammed ◽  
Keyword(s):  
Spinal Anesthesia ◽  
Transurethral Resection ◽  
Major Complication ◽  
Hemodynamic Effect ◽  
Spinal Block ◽  
Transurethral Resection Of Prostate ◽  
Hyperbaric Bupivacaine ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The best technique for transurethral resection of prostate (TURP) is regional anesthesia. The hypotension is the major complication following spinal anesthesia. The hemodynamic changes is less with saddle block than spinal block. Aim and Objective: To compare hemodynamic effect between the spinal block and saddle block in TURP. Patients and methods: 50 patients between 50-70 years old ASA I – II prepared for TURP, divided randomly in two groups 25 pt. in each group. Group A received spinal 10 mg of hyperbaric bupivacaine (2 ml of 0.5%), were group B received saddle block 10 mg of hyperbaric bupivacaine (2 ml of 0.5%). The blood pressure, oxygen saturation, heart rate measured and recorded subsequently. The hypotension treated by 100 mcg bolus of phenylephrine. Results: In our study there was statically significant difference (p < 0.05) between group A which received spinal anesthesia and group B which received saddle block in hemodynamic effect. In which the incidence of hypotension and vasopressor requirement more in group A. Conclusion: Under saddle block the TURP can safely performed with low risk of hypotension and less requirement of vasopressor.

scholarly journals Clinical profile and seroepidemiology of scrub typhus and its concurrent infections associated with other tropical fevers: a two-year study from a tertiary care centre in North India

2020 ◽  
Vol 7 (11) ◽  
pp. 4440
Author(s):  
Monika Matlani ◽  
Supriya Maheshwari ◽  
Neha Dubey ◽  
Shyam S. Mina ◽  
Vinita Dogra
Keyword(s):  
Clinical Presentation ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Clinical Profile ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Igm Elisa ◽  
Concurrent Infections

Background: The study showed epidemiological aspects, clinical profile and laboratory features of patients presenting with scrub typhus alone and scrub typhus along with concurrent infections namely typhoid, malaria, leptospira, chikungunya and dengue.Methods: A total of 383 suspected cases of Scrub typhus were tested by IgM ELISA from January 2017 to October 2018. Appropriates tests were performed to determine the coinfections of scrub typhus with dengue, chikungunya, malaria, leptospirosis and typhoid fever.Results: Of the 383 samples received, 68 were positive for scrub typhus. Commonest clinical manifestations were fever, shortness of breath, myalgia, headache and jaundice. Maximum number of co infection cases were observed along with dengue.Conclusions: With the rapidly changing epidemiology of scrub typhus, it is very important to become familiar with its clinical presentation when presenting alone and as a concurrent infection with other acute febrile infections. 

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