scholarly journals A prospective study of post-operative surgical site infections after abdominal surgeries

2021 ◽  
Vol 8 (10) ◽  
pp. 3088
Author(s):  
Sanjay Jain ◽  
Rahul Shivhare ◽  
Shoranki Pardhan ◽  
Deepti Chaurasiya

Background: Surgical site infections have plagued surgeons since time immemorial. There is significant morbidity and mortality associated with surgical site infections. In this study we tried to identify the incidence, various patient and procedure related factors, which could have led to SSIs, the various organism associated with the SSIs and their pattern of sensitivity and resistance to various antibiotics.Methods: This study was conducted in the department of general surgery, Gandhi medical college and Hamidia hospital Bhopal. In this prospective study, we included all patients more than 12 years of age undergoing abdominal surgeries between 2018-2020. Patient data was recorded in a case recording form and all patients were examined post-operatively for soakage along with culture and antibiotic testing.Results: A total of 299 patients were included. Overall incidence of SSI was 23.07%, elective surgeries showed 19.5% incidence and elective showed 26.08% incidence. Higher incidence of SSI was found in, male patients (25.9%), contaminated and dirty surgeries, higher ASA scores, smokers, alcoholics diabetics, anaemics, and malnourished patients. E. coli and klebsiella were the most common organisms isolated in both elective and emergency setting. Organisms isolated were highly sensitive to colistin, meropenem, imipenem, gentamicin and amikacin. Amoxycillin, ceftriaxone, doxycycline were fairly resistant in the current study.Conclusions: Modifiable risk factors like smoking, alcoholism, anaemia, malnourishment, contaminated wound class and emergency surgeries should be addressed systematically along with judicious use of antibiotics and tailoring then according to culture profile whenever possible is needed to reduce SSI rate.

2016 ◽  
Vol 4 (1) ◽  
pp. 131
Author(s):  
Samir Shukla ◽  
M. C. Songra ◽  
Naveen Kumar Patbamniya ◽  
M. Damor ◽  
Vijay Tyagi

Background:This prospective study was carried out to compare outcome and postoperative complication in patients with gastro-intestinal malignancy who received preoperative total parentral nutrition with those whom doesn’t.Methods: The study was a prospective single-centre, two-arm, conducted in department of general surgery, Gandhi Medical College and Associated Hamidia Hospital, Bhopal, Madhya Pradesh, India of one year duration, a total of 60 patients with G. I. malignancy, with or without sign of malnutrition, were included in the study. Patients were randomized and 30 patients were placed in each arm (interventional and control group) patients in the control group were asked to continue their normal feeding while interventional arm were given TPN in addition to their normal diet, for 7 to 10 days before surgery.Results:Infectious complications were more in control group, while one case each of pneumonia and sepsis was observed in patients receiving supplementation. Complications related to nutritional status of the patient like wound infection and anastomotic leak were observed only in patients without supplementation. There was no death observed in interventional group but two deaths occurred in control group.Conclusions:Preoperative nutritional support is beneficial and should be routinely used in abdominal and gastrointestinal cancer patient with or without clinical signs of malnutrition.


2017 ◽  
Vol 5 (1) ◽  
pp. 34
Author(s):  
Brijendra Singh Raghuwanshi ◽  
Sandeep Jain ◽  
Mahendra Damor ◽  
Naveen Kumar Patbamniya

Background: This prospective study was carried out to analyse the prevalence of subclinical hypothyroidism in patients of gall stones.Methods: A prospective study was carried out in the Gandhi Medical College and associated Hamidia Hospital Bhopal from 2015 to 2016. Data was collected from patients who were admitted in surgical wards, with a provisional diagnosis of cholelithiasis. Patient was diagnosed cholelithiasis on abdominal ultrasonography and was tested for having subclinical hypothyroidism by testing fasting blood samples for serum TSH.Results: A total of 50 patients of cholelithiasis were included in present study. Females were 42 out of 50 (84%) and males were 8 out of 50 (16%). Most common age group was 41-50 (36%) correct (insignificant at p<0.05). 12 (24%) out 50 patients were hypothyroid. Out of total 42 females 11(26.19 %) were hypothyroid (insignificant at p<0.05). All stones in hypothyroidism patients were >1cm and overall 58% stones were >1cm (statically significant P<0.05). 03 out of 12 hypothyroidisms (25%) patient had single stones while 9 (75%) patient have multiple stone (statically significant P value <0.05). In hypothyroid cases most stones were of cholesterol type (58%) (Statically significant at P value≤0.05).Conclusions: Early diagnosis of hypothyroid state at subclinical level by monitoring TSH level so that they can be treated at early stages and burden of Cholelithiasis thus can be prevented.


2020 ◽  
Vol 7 (8) ◽  
pp. 2578
Author(s):  
Ramashankar Gupta ◽  
Surendra Kumar Shrivastava ◽  
Prateek Malpani ◽  
M. C. Songra

Background: Wound dehiscence is separation of some or all layers of incision. It may be partial or complete. It is called as complete when all layers of the abdominal wall have been separated with or without evisceration of viscous. The study aims to find out and record the prognostic factors for wound dehiscence in vertical midline laparotomy.Methods: This was a prospective study in 1400 laparotomies that developed wound dehiscence operated in Gandhi Medical College, Bhopal from august 2017 to august 2019. All the patients with burst abdomen operated during emergency or elective setting by midline vertical laparotomy were included.Results: Wound dehiscence was most common in 51-60 years age group (26%). Majority patients were males (62%). Emergency laparotomy showed maximum incidence (71%). Bursts were seen mostly during 6th to 10th postoperative day. 78% patients presented as partial wound dehiscence and remaining as complete wound dehiscence. 46% presented as early wound dehiscence (7 days).Conclusions: Post laparotomy wound dehiscence has multifactor etiology. Respiratory infections, anemia, and hypoproteinaemia are the contributing factors. Improper haemostasis during surgery and poor surgical technique are the predisposing factors.


2021 ◽  
pp. 23-25
Author(s):  
Nandram Saryam ◽  
Raja Yadav ◽  
Manish Rajpoot

Background: Congenital talipes equinovarus is the most common congenital foot disorder. neglected of clubfoot deformity occurs after the treatment by Ponseti method .we evaluate the relapse pattern of clubfoot basis of bhasker et al then treat the patient by Ponseti technique. Methods: This is a Prospective study .We are conducting a clubfoot clinic since 2013 in Department of Orthopaedics Gandhi medical college Bhopal . We register all clubfoot patient at our clubfoot clinic on his/her rst visit. All the clubfeet assessed with Pirani scoring system on the initial presentation to our institution and treat by Ponseti method. During this study there were a total of 558 children with 713 idiopathic clubfeet registered at our clinic. A total of 80 neglected clubfeet in 56 children presenting with neglected clubfeet were included in our study. Results: We found that The neglected feet in our study is (80 feet out of 713 feet. The male patient is 38 (67.86%) and female patient is 18 (32.14%). Male were predominantly involved as compared to female.The post treatment Pirani score after relapse treatment is 0.40 Conclusion: Ponseti technique is a simple, effective, inexpensive method for treatment of clubfeet there is, no requirement of special setup with limited resources and less rate of recurrence/complication than the surgical treatment It has been concluded that Ponseti method is a effective technique to treat congenital idiopathic clubfeet with success rate is 94.65% in our study


Author(s):  
Nikhil Gupta ◽  
RS Maniram ◽  
Garima Vijayvergiya

Background: Malaria is a major health problem all over the globe. WHO recorded that 228 million people suffered and 405000 died due to malaria in 2018. Severity of malaria is known to be the cause of serious morbidity and mortality in poor population. Understanding of its current symptoms and associated complication can help in early diagnosis. Aims and objectives: To study the malarial complications among the adult patients. Materials and Methods: Hundred malaria patients were studied at Gandhi Medical College and associated with Hamidia Hospital from Jan 2019 to Dec 2019. For all the subjects’ medical history, demographic details and medical complications were recorded. Results: Major symptoms at the time of admission were fever, nausea and headache. Major complications in SM patients were severe anemia, prostration, hyperpyrexia (9%) respiratory distress in (6%), thrombocytopenia (70%), low leukocyte count (21%), and cerebral malaria was recorded in 4%. No mortality was recorded during this study. Conclusion: Severe anemia, prostration, hyperpyrexia, ARDS, thrombocytopenia and low leukocyte count are the major complications of SM. Keywords: nausea, anemia, prostration, hyperpyrexia, thrombocytopenia


Author(s):  
SUMAN LATA ◽  
VIJAY KHAJURIA ◽  
VINEETA SAWHNEY ◽  
KAMLESH KUMARI

Objective: The objective of present study was to examine the non-adherence among tuberculosis patients to antitubercular drugs and the factors associated with non-adherence. Methods: Prospective observational study was conducted in department of pharmacology Government Medical College, Kathua in collaboration with the district tuberculosis centre, Kathua for a period of four months. TB Patients on treatment for last 8 w were included in the study. The pre validated questionnaire was provided to patients and their responses were analysed. Morisky’s Medication Adherence Scale (MMAS-4) was used to assess adherence/non-adherence to antitubercular drugs. Results: Total 72 patients were included in trial and out of which 60(83.33%) were males and12 (16.66%) were females and the maximum were between 40-50y (38%) of age, mostly illiterate (50%) and from lower socioeconomic status (38%). Out of 60 male patients, 48(80%) showed adherence to anti-tuberculosis drugs, while remaining 12(20%) were non-adherent. Whereas 10females (83%) were adherent and 2 (16.66%) were non-adherent. Forgetfulness (42%), followed by illiteracy (21.4%) and longer distance from health institute (14%) were main reasons for non-adherence. Conclusion: Present study has shown non-adherence is maximum among males, illiterate, low socioeconomic group, longer distance from the health institution.


Author(s):  
P. Chozhan ◽  
M. Sankara Subramanian ◽  
D. Kannathal ◽  
R. Malarvizhi

<p class="abstract"><strong>Background:</strong> Myringoplasty is a common ear surgery performed all over the world. This study is focused on prospective comparative study using two different graft materials.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study done in the Department of ENT Stanley Medical College, Chennai during the period from March 2013 to September 2013. Sample size was 60 patients. Follow up was done till 6 months.  </p><p class="abstract"><strong>Results:</strong> Graft acceptance was achieved in 28 patients (93%) who underwent palisade cartilage myringoplasty, whereas it was achieved in 24 patients (80%) in the temporalis fascia myringoplasty group.</p><p class="abstract"><strong>Conclusions:</strong> The outcomes in our patient series indicate that cartilage myringoplasty achieves good results. Cartilage, a very effective material for the reconstruction of the TM and grafts can provide an excellent anatomical result, perfect stability and good functional outcome.</p>


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