scholarly journals Laparoscopic versus open pyeloplasty: an experience at a tertiary care centre

2018 ◽  
Vol 5 (9) ◽  
pp. 3150
Author(s):  
Sunil Krishna M. ◽  
Moideen Nafseer T. A. ◽  
Benakatti Rajendra
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Renal Damage ◽  
Ureteropelvic Junction Obstruction ◽  
Randomized Study ◽  
Tertiary Care ◽  
Care Centre ◽  
Laparoscopic Pyeloplasty ◽  
Tertiary Care Centre ◽  
Open Pyeloplasty

Background: Ureteropelvic junction obstruction can lead to symptoms such as hydronephrosis and progressive renal damage. Authors explain present primary experiences about laparoscopic pyeloplasty and open pyeloplasty in the treatment of UPJO.Methods: A bidirectional non-randomized study from March 2012 to April 2015 was conducted at a tertiary care centre in southern India. A Total 37 cases, 18 patients in laparoscopic pyeloplasty group and 19 patients in open pyeloplasty group were included.Results: A total of 37 patients were included in the study. 18 patients underwent laparoscopic Anderson-Hyne's pyeloplasty, 19 patients underwent open Anderson-Hyne's pyeloplasty patients. Outcomes were measured in terms of pain, surgery duration, postoperative pain, complications which were significant.Conclusions: Laparoscopic pyeloplasty was found to be better in terms of postoperative pain, hospital stay and complications.

scholarly journals Accidental Hijab Pin Ingestion: 10 Years Experience from a Tertiary Care Centre

2018 ◽  
Vol 1 (1) ◽  
pp. 54-59
Author(s):  
Naim Abu Freha ◽  
Muhammad Abu Tailakh ◽  
Doron Schwartz ◽  
Ohad Etzion ◽  
Alex Rosenthal ◽  
...  
Keyword(s):  
Emergency Room ◽  
Hospital Stay ◽  
Clinical Observation ◽  
Tertiary Care ◽  
Muslim Women ◽  
Tertiary Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Duration Of Hospitalization ◽  
Time Of Admission

Background and Aim: Hijab pins ingestion is increasing. Some women hold the pin between their teeth while arranging the Hijab and the inadvertent ingestion of the pin can be the result of any careless movements. The aims of our study were to investigate the clinical outcomes of patients who underwent endoscopic pin removal via gastroscopy as opposed to patients who were treated conservatively with clinical observation, and to compare clinical and endoscopic data pertaining to patients who underwent early versus late gastroscopy.Methods: Muslim women hospitalized in a tertiary hospital from 2005-2015 due to ingestion of Hijab pin ingestion were included. Patients who underwent gastroscopy during 12 hours from the time of admission to Emergency Room (ER) were included in the “early” gastroscopy group, while endoscopy performed at a later time defined the “late” gastroscopy group.Results: During the study period 37 women were included. Twenty four patients (65%, mean age 20 ± 8.9) underwent gastroscopy; and thirteen (35%, mean age 19.9 ± 1.6) were hospitalized for observation. Six patients (25%) had normal gastroscopy; by 8 patients (33%) the pin was located in the antrum, 6 (25%) body, 2 (8.3%) and 1 (4.1%) in the duodenum. Fifteen patients underwent early gastroscopy and nine underwent late gastroscopy. The Duration of hospitalization was significantly shorter among patients who underwent early gastroscopy 1-day (1, 1) median, (IQR) compared with 2 days (1, 3) p < 0.02. Severe complications were found in one patient (2.7%) with stomach perforation which required surgery.Conclusion: Most pins will pass spontaneously, however severe complication may arise inadvertent Hijab pin ingestion. Early gastroscopy shortens the hospital stay.

Laparoscopic Dismembered Pyeloplasty for Ureteropelvic Junction Obstruction: Our Preliminary Experience

2020 ◽  
Vol 19 (2) ◽  
pp. 59-63
Author(s):  
Md Mahfuzur Rahman Chowdhury ◽  
AKM Khurshidul Alam ◽  
AKM Anwarul Islam ◽  
Md Sajid Hasan ◽  
Tms Hossain ◽  
...  
Keyword(s):  
Renal Function ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Operative Time ◽  
Ureteropelvic Junction Obstruction ◽  
Clinical Symptoms ◽  
Ureteropelvic Junction ◽  
Laparoscopic Pyeloplasty ◽  
The Mean ◽  
Urine Leakage

Objective: To evaluate prospectively the results obtained in 16 patients undergoing laparoscopic pyeloplasty through transperitoneal access. Materials and Methods: The study was conducted in the department of urology, BSMMU, Dhaka between the periods of March 2013 and June 2014, sixteen patients between 15 and 48 years old, were treated for ureteropelvic junction obstruction (UPJO) via a transperitoneal laparoscopy. All patients had clinical symptoms of urinary obstruction and hydronephrosis were confirmed by imaging methods. Anderson-Hynes dismembered pyeloplasty was performed in all patients. Patients were clinically and imaging evaluated in the postoperative period at 6 and 12 weeks. Results: Most of the patients were male (68.75%) and female were 31.25%. The mean operative time was 127.37 (±15.67) minutes ranged from 95 to 240 minutes. Pain score in first postoperative day and third postoperative day following pyeloplasty were 20.87 (±6.83) and 4.75 (±3.34) respectively. The mean hospital stay was 4.25 (±1.34) days. Anomalous vessels were identified in 4 patients, intrinsic stenosis in 12 patients. Postoperative urine leakage and UTI were seen 18.75%, 12.50% subject respectively. Split renal function and GFR were significantly improved (p<0.05) and improvement of renal functional outcome was 87.50%. Conclusion: Laparoscopic pyeloplasty had the advantages like less postoperative pain and shorter hospital stay. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.59-63

scholarly journals Comparative evaluation of composite and simplified who partograms in a tertiary care centre in North India

2017 ◽  
Vol 6 (11) ◽  
pp. 5003
Author(s):  
Prachi Sarin Sethi ◽  
Sujata Sharma ◽  
Indu Chawla
Keyword(s):  
Perinatal Outcome ◽  
Randomized Study ◽  
Tertiary Care ◽  
North India ◽  
Routine Practice ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Vaginal Deliveries ◽  
Latent Phase

Background: Early detection of abnormal progress and prevention of prolonged labour can significantly improve the outcome of labour. Partograph is an inexpensive tool which can provide a continuous pictorial overview of labour and is essential to monitor and manage labour. The objectives were to study the course of normal and abnormal labour and to evaluate the maternal and perinatal outcome using simple and composite WHO partogram.Methods: This was a randomized study conducted at Department of Obstetrics and Gynaecology, Government Medical College, Amritsar, a tertiary care centre in North India. 200 women with term, singleton, vertex gestation, in spontaneous labor were included in the study. In 100 cases composite partograph was plotted and in rest 100 cases simple partograph was plotted. The following outcomes were compared: labor crossing the alert and action line, augmentation of labor, rate of cesarean section, perinatal and maternal outcome.Results: The partogram crossed the alert line (p 0.008) and action lines (p 0.017), causing increased need for augmentation (p 0.034) in the composite partogram which was statistically significant. The numbers of vaginal deliveries were high (p<0.001) and decrease number of cesarean sections (p 0.007) and instrumental deliveries (p 0.009) in the simplified group. NICU admissions were also higher in the composite group (p<0.05), though most of the NICU admissions were due to hyperbilirubinemia and low birth weight and was not directly related to monitoring of labour.Conclusions: It was observed in the present study that labour can be managed without the latent phase being plotted on the partograph. The interventions were higher when the latent phase was included, with increased number of labours crossing the alert and action lines, increased no. of augmentations and larger number of caesarean sections. Our study favours the use of the WHO modified partograph, which should become routine practice in monitoring labour for better maternal and perinatal outcome.

scholarly journals A randomized study to determine the efficacy of pregabalin for the treatment of moderate or severe baseline neuropathic pain at a tertiary care centre in Ganjam, Odisha

2020 ◽  
Vol 10 (3) ◽  
pp. 295-298
Author(s):  
Sambit Kumar Panda ◽  
◽  
Pradyut Kumar Pradhan ◽  
Sanjay Kumar Behera ◽  
Chinmaya Debasis Panda ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Randomized Study ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre

Extraperitoneal versus transperitoneal cesarean section in surgical morbidity in a tertiary care centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3397 ◽  
Author(s):  
Bebincy D. S. ◽  
Chitra J.
Keyword(s):  
Postoperative Pain ◽  
Cesarean Section ◽  
Prospective Study ◽  
Tertiary Care ◽  
Bowel Function ◽  
Government Medical College ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Surgical Morbidity ◽  
Medical College

Background: To test the advantages of extraperitoneal cesarean section over transperitoneal cesarean section.Methods: It is a single blinded prospective study. Women who were planned for emergency LSCS in the department of OG, Kanyakumari Government Medical College, Asaripallam were randomly allocated into extraperitoneal cesarean section (ECS) (n=80) or transperitoneal cesarean section (TCS) (n=80) from November 2015 to January 2017 and evaluated.Results: Even though the time taken to deliver the baby was more in ECS group (Average 4:57 minutes) than TCS group (Average 2:05 minutes, there is no change in Apgar score at 1 minute. The postoperative pain measured by VAS was lesser (4.28) in ECS than TCS (7.06). Bowel function returned early in ECS (8.687 hours) than in TCS (16.487 hours) group. None of the cases in ECS group had peroperative vomiting or post-operative wound infection.Conclusions: So, we can conclude that ECS is a better method in experienced hands than the TCS in selected cases.

A COMPARATIVE STUDY OF DEEP NECK SPACE INFECTIONS (DNSI) IN DIABETIC VERSUS NON-DIABETIC PATIENTS: OUR EXPERIENCE IN A TERTIARY CARE CENTRE

2021 ◽  
pp. 32-34
Author(s):  
Arijit Chatterjee ◽  
Rajarshi Chakraborty
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Treatment Protocol ◽  
Vascular Complications ◽  
Older Age ◽  
Diabetic Patients ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Airway Infections ◽  
Deep Neck Space Infections

Background:The term deep neck space infections (DNSIs) encompasses infections of several different areas of the neck formed by the potential spaces formed by different fascial layers of the neck. The etiology of DNSI include pharyngo-tonsillar infections (most commonly in children), odontogenic infections, sialolithiasis and sialadenitis, congenital anomalies like cysts and sinuses of the neck. Predisposing factors may include Extremes of age, Immunodeciency, Diabetes mellitus and Intravenous drug abuse. The microbiology of deep neck infections usually reveals mixed aerobic and anaerobic organisms, often with a predominance of oral ora. Both gram-positive and gram-negative organisms may be cultured. DNSI usually mandate early intervention on an urgent basis because of the risk of potentially fatal complications such as airway obstruction, mediastinitis and vascular complications. Airway assessment and intervention plays a pivotal role in the management of DNSI. Aims and Objectives: The present study aims to compare the clinical presentation, complications, treatment outcomes and microbiology of DNSIs in diabetic vs non-diabetic patient populations.The objective is to have a proper understanding of the disease so that a much organized treatment protocol can be established. 70 patients were enrolled for this comparative st Materials and Method: udy in Indoor wards of a Tertiary care centre. The study was conducted from January 2019 to December 2019 for 1year. Patients diagnosed with DNSI (by imaging studies) and admitted in ward of ENT and Head Neck Surgery were selected. Parapharyngeal Space was mos Results: t common involved space in both Diabetics (52.38%) and Non Diabetics (41.46%), followed by Submandibular Space. Most common organism in both groups was Klebsiella pnemoniae. Odontogenic infection and Upper airway infections were 2 leading causes of DNSI in both Diabetics and Non Diabetics in this study. The Diabetic groups affected had much older age with longer hospital stay and had more frequent complications than Non Diabetic group. Diabetics also needed more frequent tracheostomy (28.57%) than Non Diabetics (2.44%). Diabetic patients as a subgroup Conclusion: of DNSIs pose many unique problems including older age at presentation, involvement of multiple neck spaces, prolonged hospital stay and operative interventions. As these patients have higher rate of complications and poorer prognosis, early institution of therapy, strict glycemic control and operative interventions are more often required.

scholarly journals Assessment of Post-Covid Symptoms in Covid-19 Recovered Patients: A Prospective Cohort Study in a Tertiary Care Centre of South India

2021 ◽  
Author(s):  
Chithira V Nair ◽  
Merlin Moni ◽  
Fabia Edathadathil ◽  
A Appukuttan ◽  
Preetha Prasanna ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hospital Stay ◽  
South India ◽  
Tertiary Care ◽  
Care Centre ◽  
Persistent Symptom ◽  
Tertiary Care Centre ◽  
Steroid Administration ◽  
Female Sex

Abstract Background: The post-Covid symptoms among patients hospitalised with covid has to be determined for elucidating the spectrum of illness which persists even after the apparent recovery. The understanding of the post-Covid symptoms will help us to better manage aftermath of the pandemic.Aim: To determine the incidence of post-Covid symptoms in a cohort of inpatients who recovered from COVID-19 from a tertiary care centre in South India.Method: 120 survivors from patients admitted with COVID 19 were prospectively followed up for 6 weeks after their discharge from the hospital. The cohort included 50 patients requiring Intensive care unit (ICU) care and 70 ward patients. The follow-up was conducted on the second and sixth week after discharge with a structured questionnaire. The questionnaire was filled by the patient/bystanders during their visit to the hospital for follow-up at 2 weeks and through telephone follow up at 6 weeks.Results: Mean age of the cohort was 55 years and 55% were males. 58.3% had mild covid and 41.7% had moderate to severe covid infection. 60.8% (n=73) of patients had at least one persistent symptom at sixth week of discharge. 50 (41.7%) patients required intensive care during their inpatient stay. Presence of persistent symptoms at 6 weeks was not associated with severity of illness, age or requirement for intensive care. Fatigue was the most common reported persistent symptom with a prevalence of 55.8% followed by weight loss (22.5%) and dyspnoea (20%). Female sex (OR 2.4, 95% CI: 1.03–5.58, p = 0.041) and steroid administration during hospital stay (OR: 4.43; 95% CI: 1.9–10.28, p = 0.001), were found to be significant risk factors for the presence of post-Covid symptoms at 6 weeks as revealed by logistic regression analysis.Conclusion: 60.8% of inpatients treated for covid had post-Covid symptoms at 6 weeks post- discharge from hospital. Female sex and steroid administration during hospital stay were identified as predictors of persistence of post-Covid symptoms at 6weeks.

scholarly journals Morbidly adherent placenta –A burden on tertiary care centre.

2020 ◽  
Vol 27 (09) ◽  
pp. 1795-1798
Author(s):  
Zahra Safdar ◽  
Sumera Zaib ◽  
Sumera Fatima
Keyword(s):  
Caesarean Section ◽  
Hospital Stay ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Prolonged Stay ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta

Objectives: To determine the burden of Morbidly Adherent Placenta on tertiary care centre in terms of prolonged hospital stay, multiple blood transfusions, Intensive care unit stay, involvement of surgical urological colleges. Study Design: Descriptive Case Series. Setting: Department of Obstetrics and Gynaecology, Unit I Lahore, General Hospital Lahore LGH. Period: 06 months (1st August 2017-28th February 2018). Material & Methods: Total Obstetrical patients admitted in this period were 2754 total births 2567, lower segment caesarean 1184 patients, with Morbidly Adherent Placenta were 28. Date was analysed regarding maternal age, parity, previous surgeries and diagnosis prior to admission. The complications analysed were hospital stay >10 days, multiple transfusions>04 days, ICU admission>72hours, requirement of surgical and urological colleges. Patients fulfilling inclusion and exclusion criteria were studied. Results: Morbidly Adherent Placenta results in patient’s prolonged stay in hospital and ICU which results in high consumption of hospital resources. Conclusion: Morbidly Adherent Placenta is directly related with caesarean section rate. Every effort should be made to reduce the %age of primary caesarean section so that incidence of Morbidly Adherent Placenta can be minimised.

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