Study of bacteriological profile and sensitivity to various drugs in a case of wound dehiscence in tertiary care centre

Background: Surgical wound infection is a common post-operative complication causing significant post-operative morbidity and mortality, prolonged hospital stays and adds between 10-20% to hospital cost.Methods: This is a prospective study conducted in Department of General Surgery and Department of Microbiology, M.L.N. Medical College and Swaroop Rani Nehru Hospital, Allahabad. The study group comprised of all patients who underwent surgery during the period from October 2017 to September 2018 and were diagnosed with postoperative surgical site infection and wound dehiscence.Results: A total of 1640 patients were followed during one year of study. 540 (32.92%) patients were operated as emergency cases while 1100 (67.08%) were operated as elective cases.Conclusions: Wound dehiscence is a common surgical complication occurring in about 6.5% of surgical procedures. Emergency operative procedures are associated with higher incidence (16.67%) of wound dehiscence as compared to elective surgical procedures (1.67%). Male gender is more commonly associated with wound dehiscence especially in case of emergency surgical procedures with male to female ration of 1.67:1.Incidence of wound dehiscence increases with increasing age being maximum in older age group. Malnutrition is the most common risk factor present in surgical patients predisposing to wound dehiscence.

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Pattern of Ear Diseases among Paediatric ENT Patient: An Experience from Tertiary Care Centre, Pokhara, Nepal

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v32i2.5673 ◽

2012 ◽

Vol 32 (2) ◽

pp. 142-145 ◽

Cited By ~ 2

Author(s):

B Sigdel ◽

R Nepali

Keyword(s):

Tertiary Care ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Suppurative Otitis Media ◽

Ear Diseases ◽

Paediatric Age ◽

One Year ◽

A Prospective Study ◽

Nose And Throat

Introduction: Ear diseases are common in children mainly due to altered anatomy of Eustachian tube which is straighter in children as compared to that in adults. However, the cause of hearing loss in children is more varied, including the etiologies. This study was done to find out the pattern of ear diseases in paediatric age group attending ear, nose and throat OPD in a tertiary care centre in Pokhara, Nepal. Materials and Methods: This is a prospective study done in paediatric patients attending ENT OPD over a period of one year from January 2010 to January 2011. The diagnoses were made on the basis of history and clinical examination. Results were expressed in numbers and percentages. Results: Out of 1632 Pediatric ENT patients, 944 had ear diseases, 59.2% were males and 40.8% females. Wax (33.4%) was the commonest diagnosis followed by Chronic suppurative otitis media (24.3%) and Acute ottitis media (13%). Conclusion: Ear diseases are most common condition in ENT OPD among paediatric age group. Wax, CSOM and ASOM were the three most common ear diseases. J. Nepal Paediatr. Soc. 32(2) 2012 142-145 doi: http://dx.doi.org/10.3126/jnps.v32i2.5673

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Magnitude of hypothyroidism among patients of cholelithiasis in a tertiary care centre in rural West Bengal: a prospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20214374 ◽

2021 ◽

Vol 8 (11) ◽

pp. 3375

Author(s):

Jaganmoy Maji ◽

Debjyoti Mandal

Keyword(s):

Stone Formation ◽

Tertiary Care ◽

Gall Stone ◽

Sampling Technique ◽

Cross Sectional Study ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Medical College ◽

Elder Patients ◽

A Prospective Study

Background: Cholelithiasis is a common pathology of the gall bladder affecting about 10 to 15% of the adults in western countries and 2 to 29% in India. More than 80% of the patients with cholelithiasis are asymptomatic. Hypothyroidism may cause gall stone formation due to the hyperlipidemia, motility disorders affecting the bile duct and sphincter of Oddi.Methods: This was a descriptive cross-sectional study conducted at Department of Surgery, Bankura Sammilani Medical College and Hospital, Bankura from March 2019 to February 2020 for duration of one and half year. The sample size was 54 and consecutive non-probability sampling technique was used for the sampling. All the collected data were recorded in a pre-designed proforma and analyzed in MS excel.Results: Out of 54-patients with cholelithiasis, 28% patients were from the age group 45-54 years.40% patients were hypothyroid pre-dominantly females. Among 30-female patients 11 (26.82%) were hypothyroid and among 11-male patients 2 (15.38%) were hypothyroid. Hypothyroidism in male and female was statistically significant.Conclusions: This study was introduced to determine the relationship between hypothyroidism and cholelithiasis. It was concluded that hypothyroidism was more common in female, obese and elder patients. The gender distribution of the hypothyroidism in patients with cholelithiasis was statistically significant while all other variables were statistically not significant.

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A PROSPECTIVE HISTOPATHOLOGICAL STUDY OF MENINGIOMAS IN A TERTIARY CARE CENTRE OF VIJAYAWADA

10.36106/gjra/9100428 ◽

2021 ◽

pp. 11-13

Author(s):

C.Bhanu Sree ◽

P. Annapurna ◽

M. Rajani

Keyword(s):

Surgical Resection ◽

Tertiary Care ◽

Histopathological Study ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Medical College ◽

Histological Appearance ◽

Classi Cation ◽

A Prospective Study

Background: Meningiomas are neoplasms arising from the arachnoidal cap cells in the meningeal coverings of the spinal cord and brain. These are the most common benign intracranial tumours and account for about 13-26% of all primary brain neoplasms. These are generally benign neoplasms of adults most often seen in middle age, but about 10% are atypical or malignant. These neoplasms are graded by WHO as Grade I , II and III . Benign meningiomas can be cured by surgical resection where as higher grade meningiomas require radiotherapy after surgical resection as these higher grade meningiomas have greater recurrence and aggressive behavior. Aims and Objectives: To study the variants and histopathological spectrum of meningioma and prognosis of variants. Material & Methods: The present study is a prospective study conducted in the department of Pathology, Siddhartha medical college from June 2019-May 2020. During this study, 16 cases of meningiomas were diagnosed and reviewed. Result:In our study of 16 cases females were 62.5%. The most common age group is 41-60 yrs (68.75%). Most common variant was noted to be transitional meningioma followed by meningothelial meningioma. Out of the 16 cases, grade I were 81.25%. Conclusion: Meningiomas account for 28-30% of primary central nervous system tumors and unveil a heterogeneous histopathology. The histological appearance of meningioma determines the grading for the management of the various subtypes and also associated with patient's prognosis. Hence a continuous revision of histopathological classication systems is required to improve the diagnostic accuracy. Benign meningiomas are the most common type. From our study, we conclude that transitional meningioma is the most common benign variant.

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Study of maternal and fetal outcome in antepartum eclampsia in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180902 ◽

2018 ◽

Vol 7 (3) ◽

pp. 1108

Author(s):

Aruna Rani R. ◽

Dheeba Jayanthi R. ◽

Eswari S.

Keyword(s):

Gestational Age ◽

Tertiary Care ◽

Mode Of Delivery ◽

Fetal Outcome ◽

Care Hospital ◽

College Hospital ◽

Medical College ◽

Obstetric Emergencies ◽

One Year ◽

A Prospective Study

Background: In modern obstetrics, the prevalence of Eclampsia and its complications are high, so we decided to study pregnancy outcome in all Antepartum Eclampsia patients. The present study was carried out to investigate the maternal and fetal outcome in patient with Antepartum eclampsia.Methods: A prospective study was conducted in Government Mohan Kumaramangalam Medical College Hospital, Salem, India over a period of one year from January 2016 to December 2016 in all Antepartum Eclampsia patients. Analysis was done regarding the age of women, parity, gestational age, imminent symptoms, mode of delivery, fetal outcome and maternal morbidity and mortality.Results: Incidence of Antepartum Eclampsia in our hospital is 0.7%. It is more common in age group of 20 to 25years (68.5%) and primigravida (56%) and gestational age >37 weeks (51.85%). Commonest mode of delivery was by caesarean section (72%). Out of 54 patients of Antepartum Eclampsia 3 (5.5%) died and 18 (33%) had complications. Out of 50 live babies, 16 (32%) died.Conclusions: Eclampsia is still one of the important and common obstetric emergencies and it has a significant role in maternal and fetal outcome. The early identification of risk factors and timely intervention is needed to improve maternal and perinatal outcome.

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LIMBERG FLAP A BETTER METHOD OF CLOSURE OF LUMBAR MYELOMENINGOCELE DEFECTS: A PROSPECTIVE STUDY

10.36106/ijar/8312981 ◽

2021 ◽

pp. 3-4

Author(s):

Prem Shanker ◽

Raghavendra Gupta ◽

Rajesh Kumar ◽

Adiveeth Deb

Keyword(s):

Tertiary Care ◽

Wound Dehiscence ◽

Patient Characteristics ◽

Csf Leak ◽

Controlled Study ◽

Limberg Flap ◽

Tertiary Care Centre ◽

Direct Repair ◽

Group B ◽

A Prospective Study

Background: Myelomeningocele is the most common and complex congenital malformation of the central nervous system with an incidence of approximately 1 in 1000 live births. The lumbosacral area is the commonest site for defect. Early closure of a myelomeningocele defect is advocated because it reduces infection rates even though it is not associated with an improved neurological outcome. Aims & objectives: The aim of this study was to evaluate the effectiveness and outcome of direct repair and a Limberg ap repair for skin defects that occur in myelomeningocele. Settings and Design: This was a prospective, randomized controlled study. Material and methods: A tertiary care centre based, non-randomized, prospective, comparative study was conducted in the Department of Neurosurgery, GSVM Medical College, Kanpur, from January 2018 to October 2019, in 22 patients with lumbar myelomeningocele. 7 patients who underwent Limberg ap repair constituted Group A and 15 patients who underwent direct repair constituted Group B. Post operatively the outcomes were compared at 6 months, on the basis of cosmetic appearance and complications such as wound dehiscence, CSF leak, neurological decit, hydrocephalus, necrosis and wound infection. Results : Lesser complications and a better cosmetic outcome were seen post operatively at 6 months with Limberg ap technique compared to direct repair. Our study show better result with Limberg ap over direct repair of myelomeningocele defect closure up to the follow up period of 6 months. Conclusion: Because of various defect sizes and patient characteristics, no single protocol exists for the reconstruction of myelomeningocele defects. Most lumbar myelomeningocele defects can be managed by direct skin repair alone. In cases of large defects, in which direct repair is not possible, local aps may be used to cover the defect. Overall, Limberg ap is a better technique for closure in these patients.

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A PROSPECTIVE STUDY OF THE PATTERN OF USE OF ANTIMICROBIAL AGENTS IN SURGICAL PROPHYLAXIS IN A TERTIARY CARE CENTRE

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2017v9i1.15803 ◽

2016 ◽

Vol 9 (1) ◽

pp. 283

Author(s):

C. S. Brethis ◽

S. Thamizharasan ◽

S. A. Sridevi ◽

B. Kalaiselvi ◽

M. Balaji Singh ◽

...

Keyword(s):

Antimicrobial Agent ◽

Antimicrobial Agents ◽

Tertiary Care ◽

Cost Effective ◽

Surgical Prophylaxis ◽

Tertiary Care Centre ◽

Medical College ◽

The Mean ◽

A Prospective Study ◽

Induction Of Anaesthesia

Objective: To evaluate the most common class of antimicrobial agents used in surgical prophylaxis. To evaluate the timing, dosage, route and duration of use of antimicrobial agents in surgical prophylaxis.Methods: The study subjects were 214 patients who underwent general surgical procedures at Vinayaka Missions Kirupananda Variyar Medical College from July 2013 to June 2014. The use of antimicrobial agents was noted from the first dose of antibiotic given before the induction of anaesthesia. After surgery was completed the duration of antibiotic in the post-operative ward was noted. Results: Majority of the patients were males of age group 50-60 y and the most common surgical procedure was hernioplasty. Combination therapy with two antimicrobial agents was more preferred regimen 126 (58.9%). Among the antimicrobial agent's cefotaxime 114 (24.8%) was the most commonly prescribed drug and it was followed by metronidazole 121 (21.9%). ceftriaxone 60 (13.1%) was the third most commonly prescribed antimicrobial agent. The mean duration of prescription of antimicrobial agents in the present study was 4.78 d and the mean cost of drug treatment was 787.54 rupees. The cost-effective regimen was that of aminoglycosides and imidazole.Conclusion: The choice of antimicrobial agent was based on the local prevalence pattern of microorganisms. The intravenous administration of antibiotic prophylaxis immediately before or after the induction of anaesthesia is the most reliable method for ensuring effective serum concentration at the time of surgery. The antimicrobial agent chosen must cover all the most likely contaminating organisms.

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Hospital Based Birth Defect Surveillance in a Tertiary Care Centre

IRA-International Journal of Applied Sciences (ISSN 2455-4499) ◽

10.21013/jas.v6.n3.p2 ◽

2017 ◽

Vol 6 (3) ◽

pp. 81

Author(s):

MK Mohan Kumar ◽

M.S. Vinodkumar ◽

, Indu

Keyword(s):

Congenital Anomalies ◽

Tertiary Care ◽

Care Centre ◽

Timely Manner ◽

Tertiary Care Centre ◽

Live Births ◽

Medical College ◽

Still Births ◽

One Year ◽

And Child Health

<div>According to WHO in 2010, an estimated 270000 deaths globally were attributable to congenital anomalies during first 28 days of life. In an effort to decrease the number of congenital anomalies worldwide, 63rd the WHO adopted a birth defects resolution. The aim was to prevent congenital anomalies and raise awareness about their effects. Hospital based surveillance was implemented in India in collaboration with WHO. Institute of Maternal and Child Health (IMCH), Govt. Medical College Kozhikode was selected from the state of Kerala. Aim of this study includes, monitor and detect clusters (outbreaks) of congenital anomalies among a defined population and refer affected infants to appropriate services in a timely manner. Out of 15519 live births and 409 still births during the period of one year from November 2015 to 2016, there were 123 newborns with selected external congenital anomalies. </div>

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Rationale in management of entero-cutaneous fistula following routine and emergency surgery: a prospective study in a tertiary care hospital of Odisha

International Surgery Journal ◽

10.18203/2349-2902.isj20185034 ◽

2018 ◽

Vol 5 (12) ◽

pp. 4000

Author(s):

Jagmohan Mishra ◽

Afroza Firodous ◽

Biplab Mishra

Keyword(s):

Gastrointestinal Tract ◽

Emergency Surgery ◽

Surgical Complication ◽

Enterocutaneous Fistula ◽

Tertiary Care ◽

Care Hospital ◽

Medical College ◽

Surgical Nutrition ◽

Enteric Perforation ◽

A Prospective Study

Background: The enterocutaneous fistula is an abnormal communication between gastrointestinal tract and skin. It is a grave surgical complication following surgery on gastrointestinal tract. Despite in surgical nutrition and critical care, mortality from enterocutaneous fistula remains high. Improvements in outcome are focused on prevention and when fistula occurs, prompt recognition and intervention is essential.Methods: This is institutional based prospective observational study which was conducted in S.C.B Medical college, Cuttack, Odisha for a period from September 2015 to September 2017 on 30 patients with enterocutaneous fistulae occurring as post-operative complication among patients admitted and operated at our institution for various gastrointestinal conditions and also referred from other centres after complication had set in. Detailed history, physical examination, routine workup, management and its outcome were studied.Results: The maximum number of fistulae (86.7%) developed after emergency surgery than routine. Incidence of enterocutaneous fistulae was observed in cases operated for intestinal obstruction (40%) followed by operation for enteric perforation (28%). The highest incidence of enterocutaneous fistula occurred on 8th post-operative day (36.7%). 24 cases were treated conservatively while 6 patients underwent operative treatment.Conclusions: Hence, the enterocutaneous fistula is frequently seen with emergency surgery of gastrointestinal tract, particularly on ileum, usually occurring around 8th post-operative day and most of them end in spontaneous closure with conservative treatment.

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Study of benign neck swellings of anterior neck triangle at a tertiary care centre

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192709 ◽

2019 ◽

Vol 5 (4) ◽

pp. 941 ◽

Cited By ~ 1

Author(s):

Pradipkumar Digambar Khokle ◽

Vinod Tukaram Kandakure ◽

Ujjwala Madhukar Kolekar

Keyword(s):

Tertiary Care ◽

Surgical Excision ◽

Lateral Neck ◽

Neck Swelling ◽

Thyroglossal Cyst ◽

Tertiary Care Centre ◽

Medical College ◽

Wide Range ◽

Thyroid Swelling ◽

A Prospective Study

Background: Tumors of the neck are interesting to surgeons especially because of the complex neck anatomy and difficult differential diagnosis. The aim is to study different types of neck swellings i.e. thyroid swelling, salivary gland swelling, other neck swellings such as thyroglossal cyst, branchial cyst, lymphangioma and also the miscellaneous and rare lumps in the neck. The study also discusses their age and sex-wise distribution, clinical features, presentation, diagnostic modalities and treatment.Methods: This is a prospective study, conducted at our institute Government Medical College, Latur from June 2017 to May 2018 for a duration of one year. Results: A total of 57 patients were studied during this period. Out of the 57 patients, 47 of them were midline swellings (82.45%) and 10 among them were lateral neck swellings (17.55%). People over a wide range of age group between 5-60 years were affected. Midline neck swelling were more common than lateral neck swellings.Conclusions: Among the midline benign neck swellings, thyroid swelling was found to be the commonest followed by thyroglossal cyst. Thyroid swellings occur more commonly in the females than males. Ultrasound guided FNAC is the most common, effective and safe investigation that aids in the diagnosis. Treatment of choice for benign, non-inflammatory and non-malignant neck swelling is mostly surgical excision rather than medical management.

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Prevalence of oral mucosal lesions in a tertiary care centre: one-year prospective study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203577 ◽

2020 ◽

Vol 6 (9) ◽

pp. 1704

Author(s):

Smruti Milan Tripathy ◽

Poonji Gupta ◽

Akshay Jain ◽

Probal Chatterji

Keyword(s):

Oral Cavity ◽

Early Stage ◽

Tertiary Care ◽

Outpatient Department ◽

Research Centre ◽

Tertiary Care Centre ◽

Medical College ◽

Number Of Patients ◽

Malignant Lesions ◽

One Year

Background: Lesions of the oral cavity are very common among the general population and account for a significant number of patients in the outpatient department of otorhinolaryngology. The lesions of oral cavity can cause varied symptoms like pain, dysphagia, and difficulty in speaking. The lesions can range from simple benign conditions to life threatening malignancies.Methods: This study was conducted in the department of otorhinolaryngology, Teerthanker Mahaveer Medical College and Research Centre from January 2019 till December 2019. All the 256 patients who presented to the outpatient department with lesions in the oral cavity during the given time period were included in the study after getting informed and written consent. Results: Aphthous ulcers were the most common lesion (18.7%) found in this study. Buccal mucosa (50%) and anterior 2/3rd of tongue (34.3%) were the most common sites involved. Total of 204/256 (79.6%) patient had some form of addiction which included both smoked and smokeless form of tobacco as the most common type of addiction. Among the tobacco smokers, 24/80 (30%) had pre malignant and malignant lesions while among tobacco chewers 37/76 (48.6%) had pre malignant and malignant lesions.Conclusions: Lesions of the oral cavity are common among Indian population due to high prevalence of tobacco addiction. A thorough history taking and examination can detect premalignant and malignant lesions at an early stage, so that timely treatment can reduce the mortality rates in such patients.

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