scholarly journals Our experience with enteric ileal perforation: a retrospective study at a tertiary care centre in northern India

2019 ◽  
Vol 6 (12) ◽  
pp. 4318 ◽  
Author(s):  
Puneet Agrawal ◽  
M. Zaid Imbisat
Keyword(s):  
Retrospective Study ◽  
Typhoid Fever ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Delayed Presentation ◽  
Tertiary Care Centre ◽  
Ileal Perforation ◽  
Perforation Peritonitis

Background: Typhoid fever is one of major causes of intestinal perforation in India and is one of the common surgical emergencies for which intervention is required. The study aims to evaluate the clinical presentation, operative findings, outcome of surgical procedures, postoperative complications and associated mortality among the patients managed for typhoid ileal perforation in a tertiary care hospital.Methods: This was a retrospective study evaluating the patients who were operated for typhoid ileal perforation peritonitis in FH Medical College, Agra, UP, India between April 2017 and September 2019. Diagnosis of typhoid ileal perforation was made with the combination of clinical presentation, laboratory investigations, radiological results and per-operative findings.Results: In the present study, 57 patients were managed for typhoid ileal perforation. Majority of the patients were young. In our study 40 patients (70.18%) were male and 17 patients (29.82%) were female. All patients presented with pain in abdomen and abdominal distension. However there was no history of fever in 19.3% of patients. Free gas under the right diaphragm was present in 60% of patients. Exploratory laparotomy was done in all the patients and multiple perforations were found in 59.65% of patients. Ileostomy was made in 75% of patients. Most common post-operative complication was wound infection (85.96%) and mortality was 12.28%.Conclusions: Perforation peritonitis is an alarming complication of typhoid fever which needs urgent and aggressive management. Mortality rate is high (12.28%) and may be attributed to delayed presentation.

scholarly journals A retrospective study of ectopic pregnancy at a tertiary care centre

2017 ◽  
Vol 6 (12) ◽  
pp. 5241 ◽  
Author(s):  
Archana Mehta ◽  
Shehla Jamal ◽  
Neerja Goel ◽  
Mayuri Ahuja
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Tubal Pregnancy ◽  
Tertiary Care Centre ◽  
Future Fertility ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is a global problem and is the most common life-threatening emergency in early pregnancy leading to significant morbidity and fetal loss. It occurs in variable presentations. The rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. The aim of this study was to determine the incidence, clinical presentation, risk factors, treatment, and morbidity and mortality associated with ectopic pregnancy.Methods: The present retrospective study was conducted over a period of three years in the department of obstetrics and gynecology at SMS and R, Greater Noida, UP from Feb 2014 to Jan 2017.A total of 80 patients with ectopic pregnancy were analyzed regarding clinical presentation, risk factors, operative findings and treatment modality.Results: Total number of 80 cases of ectopic pregnancies were admitted during this period against 2645 deliveries representing frequency of 3%. Majority of cases (43.75%) were in the age group of 25-29 years and 41.25% were gravida 4 and above. Risk factors were identifiable in 66.25% of cases. Previous abortion was the most common risk factor (31.25%). The classical triad of amenorrhea, pain abdomen and vaginal bleeding was present in 71.25% of cases. More than half of case (55%) had ruptured tubal pregnancy on admission. Unruptured tubal pregnancy was seen in 10% case. Interestingly we found one rare case of bilateral ectopic pregnancy. Salpingectomy by open method was the mainstay of treatment (86.25%).Conclusions: Ectopic pregnancy is still a major challenge in gynecological practice. In our country most of the cases present late after tubal rupture requiring radical surgical treatment. Early diagnosis and timely intervention in the form of medical treatment or conservative surgery not only reduces maternal morbidity but also preserves future fertility.

Delayed Presentation of Primarily Missed Fractures Reporting to a Tertiary Care Centre: A Retrospective Study

2013 ◽  
Vol 1 (2) ◽  
pp. 23
Author(s):  
Muzamil Ahmad Baba ◽  
Bashir Ahmed Mir ◽  
M A Halwai ◽  
Adil Bashir Shikari ◽  
Shakir Rasheed ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Tertiary Care ◽  
Delayed Presentation ◽  
Care Centre ◽  
Tertiary Care Centre

scholarly journals A Case of Congenital Tuberculosis in a Tertiary Care Hospital

2012 ◽  
Vol 1 (2) ◽  
pp. 85-87
Author(s):  
Ishrat Jahan ◽  
Mehedi Parvez ◽  
Laisha Yeasmin
Keyword(s):  
Clinical Presentation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Male Infant ◽  
Abdominal Distension ◽  
Drug Regimen ◽  
Care Hospital ◽  
Gastric Aspirate ◽  
Congenital Tuberculosis ◽  
Low Weight

Congenital tuberculosis is an unusual and severe clinical presentation of Mycobacterium tuberculosis (MTB) infection. It is usually difficult to diagnose and treat. We report a tenweek-old male infant who had presented with fever, difficulty in breathing, abdominal distension, convulsion, low weight gain since one month of his age. The diagnosis was made by demonstration of MTB bacilli in the gastric aspirate of baby and chest radiography. Treatment with the four drug regimen including streptomycin was initiated, but the baby died   on the third day of ATT. This case gives an account of difficulties in diagnosis and therapeutic   management of congenital tuberculosis and alerts for development of protocols that foresee   these difficulties. DOI: http://dx.doi.org/10.3329/jemc.v1i2.11469   J Enam Med Col 2011; 1(2): 85-87  

scholarly journals Prevalence of non-infectious dermatoses in patients attending a tertiary care center in Rajasthan

2019 ◽  
Vol 5 (1) ◽  
pp. 192
Author(s):  
Bhagirath Singh ◽  
Indira Subhadarshini Paul
Keyword(s):  
Clinical Evidence ◽  
Clinical Presentation ◽  
Skin Diseases ◽  
Genetic Disorders ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Pigmentary Disorders ◽  
Protozoal Infection

<p class="abstract"><strong>Background:</strong> Pediatric dermatoses require a separate view from adult dermatoses as there are important differences in clinical presentation, treatment and prognosis. There is very little epidemiological study available on non-infectious childhood dermatoses in India. The aims of the study were to find the prevalence, clinical profile and various etiological factors associated with childhood non-infectious dermatoses and to determine the prevalence of most common non-infectious childhood dermatoses.</p><p class="abstract"><strong>Methods:</strong> This cross-sectional observational study conducted at tertiary care centre in Rajasthan, India. Children with age 13 years and below with clinical evidence of cutaneous disorders were studied. Parents who have not given consent for the study, acutely ill children, Children having infectious dermatoses (bacterial, fungal, viral, arthropods, parasitic and protozoal infection) were excluded from the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 232 cases were studied which showed a female preponderance of 55.60%. Most of the skin diseases were seen in the 5 to 13 years (school children) age group. The most common dermatoses was eczematous (36.63%), among eczema atopic diathesis was the commonest (17;20%) followed by hypersensitivity dermatoses (21.12%), genetic disorders (13.36%), disorders of genetic disorders (7.4%), sweat gland disorders (8.18%), pigmentary disorders (4.31%), papulo squamous disorders (4.74%), Nevi (6.46%).</p><p class="abstract"><strong>Conclusions:</strong> Eczematous dermatoses were the most commonly noted in the study, followed by hypersensitivity dermatoses. Atopic diathesis was the commonest endogenous eczemas. Acne, insect bite reaction and miliaria were the other common dermatoses. There was no significant association of various dermatoses with systemic diseases in the study.</p>

scholarly journals Efficacy and Safety of Rituximab in Immunobullous Diseases: A Retrospective Study from a Tertiary Care Centre of Nepal

2020 ◽  
Author(s):  
Sudip Parajuli ◽  
Jyoti Vidhan ◽  
Dinesh Binod Pokhrel ◽  
Upama Paudel
Keyword(s):  
Retrospective Study ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Data Entry ◽  
Pemphigus Vulgaris ◽  
University Teaching ◽  
Efficacy And Safety ◽  
Tertiary Care Centre ◽  
Cutaneous Lesions

Introduction: Rituximab is effective and safe treatment of immunobullous disorders. There are variations in doses of drugs used in different studies and uncertainties on when to use it along with use of adjuvant therapies. Efficacy and safety of this drug has not been described in Nepalese population till date. Dermatologists have hesitation in starting this drug in immunobullous diseases because of lack of data on efficacy and safety. Aim: To assess the efficacy and side effects of Rituximab therapy in treating immunobullous disorders in Nepalese patients. Materials and Methods: This was a retrospective study of patients with immunobullous diseases treated with Rituximab in Dermatological ward of Tribhuvan University Teaching Hospital, Kathmandu, Nepal from May 2018 to August 2019. Data were analysed for duration of disease and treatment received before Rituximab therapy, duration of steroid used before Rituximab, adverse effects due to prolonged steroid use, time to remission from 1st Rituximab pulse, duration of remission, relapse, duration of steroid and adjuvant drug used post 1st pulse and adverse effects associated with Rituximab. SPSS version 20 was used for data entry and descriptive statistics was used for analysis of the data. Results: Nine patients (Pemphigus Vulgaris-8 (PV-8), Bullous Pemphigoid-1 (BP-1) were treated with Rituximab. Seven were treated for refractory disease not controlled by conventional therapy and two received Rituximab as first-line therapy. The patients were under follow-up for 15-60 weeks (mean 31.89±15.62 weeks). Out of these nine patients, eight were free of lesions in one to eight weeks (mean 5.125±2 weeks) of first pulse. One patient with Oral Pemphigus had persistence of old lesions, however there were no new cutaneous lesions after first pulse. Adverse effects were seen in four patients that included infusion reaction in one and infection in three. There was relapse in one patient at last follow-up. Conclusion: Rituximab is efficacious and is safe in treating immunobullous disorders in Nepalese Population.

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