scholarly journals Morphological spectrum of gallstone and bacteriology of bile in patient of cholelithiasis visiting tertiary care centre in North India

2020 ◽  
Vol 8 (1) ◽  
pp. 91
Author(s):  
Himank Gandhi ◽  
Gopal Swaroop Bhargava ◽  
Darpan Bansal ◽  
Karaninder Singh
Keyword(s):  
Open Cholecystectomy ◽  
Gallstone Disease ◽  
Tertiary Care ◽  
Gall Stone ◽  
Biliary Tract Disease ◽  
North India ◽  
Health Concern ◽  
Infection Rates ◽  
Tertiary Care Centre ◽  
E Coli

Background: Calculus biliary tract disease continues to be a major health concern. It is normal to see predisposing factors such as cirrhosis, ileal resection in the West; while infection predominates in South East Asia as a cause. We prospectively examined gall stones in this study to investigate the causes and role of bacteria in the disease of gall stone disease.Methods: This is a cross sectional study conducted in department of surgery, Sri Guru Ram Das University of Health Sciences, Sri Amritsar, India, from November 2018-August 2020. Total 50 cases were selected and operated by lap/open cholecystectomy were included in this study. During cholecystectomy bile was aspirated and was sent to laboratory for culture. Gallstone retrieved from the specimen was classified based on morphological appearance. Results: Gallstone disease found to be common in female 92% and in the age group of 4-50 years. Bile of gallstones patients is often infected. In this study though morphologically cholesterol stones were commonest but mixed stones were associated with highest infection rates. Most common bile infecting bacterium in all kinds of stones was found to be E. coli 60.8% followed by klebsiella 17.3% and proteus 17.3%. All the organisms cultured were sensitive to cephalosporins, quinolones, aminoglycosides and penicillin group of antibiotics.Conclusions: Bile culture was positive in 46% of the cases. Morphologically cholesterol stones were commonest 52% but mixed stones were associated with highest infection rates (80%). Most common bile infecting bacterium in all kinds of stones was found to be E. coli.  

scholarly journals Epidemiology of Gall Stone Diseases among Patients attending Surgical Department of a Tertiary Care Hospital in Nepal

2020 ◽  
Vol 8 (1) ◽  
pp. 50-55
Author(s):  
Sanjay Chaudhary
Keyword(s):  
Large Scale ◽  
Gallstone Disease ◽  
Tertiary Care ◽  
Gall Stone ◽  
College Teaching ◽  
P Value ◽  
Cholesterol Stone ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Surgical Department

Background and Objectives: Gallstone disease (GSD) is a chronic disease that consumes a lot of economic and medical resources. It not only affects patients’ life quality, but also is associated with the potential risks of the development of consequences of gallstone diseases. Therefore, the study is aimed to investigate the epidemiology and risk factors of gall stone diseases among patients attending tertiary care centre in Nepal. Material and Methods: A cross sectional study was conducted among patients attending surgical department of Janaki Medical College Teaching Hospital (JMCTH) over a period of one year from January 2019 to December 2019. Chi-square test was applied to show the association between the two groups. P-value < 0.05 was considered statistically significant. Results: In a total of 148 patients, 69.59% had mixed gallstone, 17.57% had cholesterol stone and 12.84% had pigment gallstone. Types of gallstone was found significant for age group (p=0.006), gender (p=0.027) and presence of diabetes (p=0.003) but insignificant with presence of hypertension (p=0.992). Conclusion: Age of the patients, gender and presence of diabetes were found significant for the all types of gall stone. Further large scale research need to be conducted.

Association of Body Mass Index and Waist to Hip Ratio With Gallstone Disease in Patients Visiting Rural Tertiary Care Center in North India

2020 ◽  
pp. 155335062095058
Author(s):  
Pushpendra Malik ◽  
Deepak Singla ◽  
Mahinder K Garg ◽  
Mukesh Sangwan
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Care Center ◽  
Gallstone Disease ◽  
Tertiary Care ◽  
Gall Stone ◽  
North India ◽  
Daily Routine ◽  
Waist To Hip Ratio ◽  
South Indian

Introduction. In India the prevalence of gall stone disease varies in different parts of India. Malhotra in 1996 conducted an epidemiological study in Indian Railway employees and showed that North Indians has 7 times higher prevalence of gall stones compared to South Indian employees. It is said that Gall bladder is a disease of “Fatty, Fertile, Females in their Forties”. In our daily routine we observe that it is found not only in fatty females but common in average built patients also. Material and Methods. Study includes patients visiting to BPS GMC Khanpur Kalan with diagnosis of gall stone diseases and operated at our center with sample size of 135. Body mass index (BMI) and Waist to Hip ratio are calculated using their standard formulas. All data was compiled in IBM SPSS statistics (20.0). Result. Normal BMI is considered up to 25 and more than 50% patients lie in normal BMI range. Only 13% of cases lie in obese group that is BMI greater than 30. Waist to hip ratio, maximum patients that is BMI greater than 30. Waist to hip ratio, maximum patients that is (83%) lie in group more than 0.85. Minimum Waist to Hip ratio is .77 and maximum Waist to Hip ratio is 1.45. Out of 135 patients 90 patients are having high Waist to Hip ratio. Conclusion. Waist to Hip Ratio (abdominal adiposity) is better indicator of Gall stone diseases than BMI.

scholarly journals CLINICAL EVALUATION OF LAPAROSCOPIC CHOLECYSTECTOMY WITH REFERENCE TO CONVERSION RATE AND COMPLICATIONS- OUR EXPERIENCE IN A TERTIARY CARE CENTRE OF EASTERN INDIA

2020 ◽  
pp. 7-10
Author(s):  
Swapnil Sen ◽  
Sandeep Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conversion Rate ◽  
Gallstone Disease ◽  
Tertiary Care ◽  
Gall Stone ◽  
Injury Rate ◽  
Large Series ◽  
Care Centre ◽  
Eastern India ◽  
Tertiary Care Centre

Cholelithiasis is one of the most common surgical conditions requiring intervention worldwide. Since its introduction nearly four decades ago, laparoscopic cholecystectomy has become the gold standard of treatment for gallstone disease AIM: To critically evaluate our experience of laparoscopic cholecystectomy in a tertiary care centre of eastern India. MATERIALS AND METHODS: Hospital based observational study on 180 patients subjected to elective laparoscopic cholecystectomy with features of gall stone disease and meeting the inclusion and exclusion criteria. RESULTS: Our conversion rate of 10% is somewhat higher than that reported in any other series. This probably reflects that few of our surgeons are in their early learning curve. This can be reduced with the experience of the surgeons. A bile duct injury rate of 0.5% compares favourably with an incidence of 0-1% in several large series. Overall complication rate of 5.5% also compares favourably with an incidence of 1.6-8.6% in several large series. CONCLUSION: Laparoscopic cholecystectomy when performed in properly selected patients is very much effective in the treatment of symptomatic cholelithiasis – in terms of earlier return of bowel function, less postoperative pain, improved cosmesis, shorter length of hospital stay, earlier return of full activity and decreased overall cost. It is vital for the surgeons and patients to understand that conversion to open surgery is not failure; in fact, it implies a safe approach and a sound surgical judgment. The conversion rate is low with experienced surgeons indicating direct relationship between experience and conversion. It should be stressed that conversion if required should be done early rather than after an imminent complication.

scholarly journals A clinical study of risk factors of acute pancreatitis in a tertiary care centre in north India

2017 ◽  
Vol 4 (6) ◽  
pp. 1878 ◽  
Author(s):  
Pawan Kumar Jha ◽  
Rajnish Chandran ◽  
Pradeep Jaiswal ◽  
Kumari Seema
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Tertiary Care ◽  
Gall Stone ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Organ Systems ◽  
Mild Acute Pancreatitis ◽  
A Prospective Study

Background: According to Atlanta Symposium, acute pancreatitis (AP) was defined as an acute inflammatory process of the pancreas that may also involve peri-pancreatic tissues and/or remote organ systems. The objective of this study was to know the risk factors of acute pancreatitis in patients admitted in a tertiary care centre in north IndiaMethods: A prospective study was performed with admitted cases of patients with acute pancreatitis over 2 years period. Total 104 patients were selected for study. All data concerning aetiology were recorded and analysed in all patients forming study groups.Results: Among 104 patients with acute pancreatitis 68 (65%) were females and 36 (35%) were males. Mean age of our study group was 40.9 years and maximum incidence was seen in 36-45 years. Most common cause was biliary pancreatitis (63%) followed by alcohol (27%), idiopathic (6%), trauma (3%), infections (1%). In females, most common aetiology was gall stone (88%), in males most commonly by alcohol (78%). As per Atlanta classification 81 patients (77.8%) had acute mild pancreatitis and 23 patients (22.2%) had acute severe pancreatitis. Majority females (66.7%) were admitted in mild acute pancreatitis. The mean age of patients in mild acute pancreatitis was 39.6 years and in severe group was 45.4 years. Gall stone were the leading cause in both mild and severe acute pancreatitis.Conclusions: Females were more commonly affected than men by acute pancreatitis. The most common aetiology was gall stone followed by alcohol which was leading cause in the males.

scholarly journals Gall bladder stones and the associated histopathology– a tertiary care centre study

2017 ◽  
Vol 5 (4) ◽  
pp. 1368
Author(s):  
Vijayakumaran Pillai ◽  
Renjith Sreekantan ◽  
Meer M. Chisthi
Keyword(s):  
Gallstone Disease ◽  
Tertiary Care ◽  
Gall Stone ◽  
Chronic Cholecystitis ◽  
Premalignant Lesions ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cholesterol Levels ◽  
Gall Stones

Background: Gall stones form one of the main reasons for recurrent upper abdomen pain. Cholecystectomy has turned out to be one of the commonest laparoscopic procedures done all over the world. The objectives of the study were to analyse the histopathological changes in gallstone disease and to study the clinical and biochemical factors that are seen in gall stone disease.Methods: This was a hospital based cross sectional study conducted at a tertiary care centre from January 2013 to December 2014. 108 patients admitted with diagnosis of cholelithiasis and posted for cholecystectomy were studied. Their clinical and biochemical data and post-operative stone analysis results and histopathological reports were collected and analyzed.Results: 63% of the patients were females with a female to male ratio of 1.7:1. Of the group, 64.8% had a BMI between 25 and 29.9. 65.7% patients got operated within one year of the onset of symptoms. Serum cholesterol levels were found elevated in majority of patients. 61% patients had multiple gall stones. 62% had stones composed of cholesterol, bilirubin, calcium carbonate and calcium oxalate. 102 out of the 108 specimens showed histological features of chronic cholecystitis only. One case showed a premalignant change in the form of pyloric metaplasia.Conclusions: Cholelithiasis is seen mostly in females, most of them having elevated cholesterol levels. The commonest histopathological change associated with cholelithiasis is chronic cholecystitis. Premalignant lesions are seen only in a small minority only. Hence early elective cholecystectomy can prevent malignant transformation in asymptomatic gall stones.

Emerging Antimicrobial Resistance Among Methicillin Resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Centre in North India

JMS SKIMS ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 48-49
Author(s):  
Javaid Ahmad Bhat ◽  
Shariq Rashid Masoodi
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Tertiary Care ◽  
Resistance Mechanisms ◽  
North India ◽  
Global Public Health ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Effective Prevention ◽  
Mupirocin Resistance

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.

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