Evaluation of prolonged febrile illness in elderly

Background: Febrile illness in elderly patients in hospitals is a challenge to the physician for diagnosis and treatment due to high morbidity as well as mortality and it increases if the febrile illness is prolonged. So proper evaluation and effective management is necessary for a better outcome. Keeping in mind the scarcity of studies in elderly febrile illness in India this study was taken up.Method: A prospective study was designed in medical ICU of S.C.B Medical college and Hospital, Cuttack Odisha, India. 50 patients were included in this study from July 2007 to December 2008. Institutional Ethics Committee cleared the study.Results: In 50 elderly (Age>60 yrs) patients of prolonged febrile illness, 36 (72%) were male and 14 (28%) were female. All had fever for >21 days. Pallor was the commonest sign (62%). 30 patients had infectious etiology, 15 had malignancies. Tuberculosis was the commonest infection (28%) comprising of 46.66% of infectious etiology with Pulmonary Tuberculosis (PTB) in 20% and Extrapulmonary Tuberculosis (ETB) in 26.66%. Malignancies accounted for 30% of cases with Non-Hodgkin’s lymphoma (NHL) in 33.33% being the commonest amongst the malignancies. On follow up of 50 patients 21 (42%) got cured.Conclusion: Febrile illness in elderly needs carefully evaluation as infections account for most of the cases and Tuberculosis in our part of India as a major cause in these patients is treatable. Malignancies remain the second most common cause where timely intervention goes a long way in reducing morbidity and mortality.

Download Full-text

Use of Seton in Management of High Variety of Anal Fistula

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v8i2.33662 ◽

2017 ◽

Vol 8 (2) ◽

pp. 100-104

Author(s):

Mohammad Noor A Alam ◽

Sharmin Abbasi

Keyword(s):

Anal Fistula ◽

Low Cost ◽

Dentate Line ◽

Internal Opening ◽

Efficacy And Safety ◽

Medical College ◽

Small Channel ◽

A Prospective Study ◽

Low Rate

Background: Anal fistula is an abnormal communicative small channel that has an internal opening and an external opening and connected by the primary track. Our study evaluate the effectiveness of seton in high variety anal fistula.Objectives: Evaluation the efficacy and safety of seton as surgical management of high anal fistula. Methods: This is a prospective study done on 57 patients in BIRDEM hospital and some other clinic of Dhaka city in 3 years period with high variety of anal fistula which is above the dentate line and were treated with seton .Outcome measured during follow up period were- successfully healed, recurrence, incontinence, percentage of complications and patients satisfaction.Result: Among 57 patients mean age was 38.2+_6.8 years. Overall outcome of the patients showed-fistula completely healed in 51 patients, incontinence occurred in 2 patients and recurrence occurred in 4 patients.Conclusion: Seton is relatively safe, effective and low cost for the management of high anal fistula with low rate of incontinence. It can therefore, be recommended as the standard of treatment for high variety fistula in ano.Anwer Khan Modern Medical College Journal Vol. 8, No. 2: Jul 2017, P 100-104

Download Full-text

A Prospective Study to Observe the Results and Complications of Lateral Internal Sphincterotomy in Anal Fissure

MVP Journal of Medical Sciences ◽

10.18311/mvpjms/2015/v2/i2/779 ◽

2015 ◽

Vol 2 (2) ◽

pp. 81

Author(s):

Sandesh Pawar ◽

Sudhir D. Bhamre ◽

Vijay Malpathak ◽

Yamini Sorate

Keyword(s):

Anal Fissure ◽

Care Center ◽

Time Frame ◽

Lateral Internal Sphincterotomy ◽

Health Care Center ◽

Internal Sphincterotomy ◽

Medical College ◽

A Prospective Study ◽

Surgery Department

Aim: To observe the results and complications of lateral internal sphincterotomy in anal fissure. Materials&Methods: The study was carried out as a prospective observational study of 40 patients at surgery department of a medical college&tertiary health care center, over a period of two years that included cases of anal fissure in the age group of 16 years and above for conservative&surgical management. Results: The recovery of the patient after this marvellous operation was fast and the pain relief was dramatic. On follow-up at 2 weeks post-operatively pain and other symptoms were present only in 11 patients (27.5%). On follow-up at 8 weeks post-operatively all 40 patients (100%) were symptom-free in this study. The complications that were observed within time frame of this study were Soiling in 4 patients (10%) and incontinence to flatus in 1 patient (2.5%). There was no recurrence of anal fissure observed in this study group within the time frame of this study. Conclusion: It is very evident from the above study that 'Lateral Internal Sphincterotomy' is by far the best operation for an indolent anal fissure.

Download Full-text

Comparative study between endoscopic cartilage myringoplasty and endoscopic temporalis fascia myringoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185116 ◽

2018 ◽

Vol 5 (1) ◽

pp. 24 ◽

Cited By ~ 1

Author(s):

P. Chozhan ◽

M. Sankara Subramanian ◽

D. Kannathal ◽

R. Malarvizhi

Keyword(s):

Comparative Study ◽

Prospective Study ◽

Temporalis Fascia ◽

Ear Surgery ◽

Medical College ◽

The World ◽

Prospective Comparative Study ◽

Patient Series ◽

A Prospective Study

Background: Myringoplasty is a common ear surgery performed all over the world. This study is focused on prospective comparative study using two different graft materials.Methods: 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. Results: 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.Conclusions: 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.

Download Full-text

A clinical study of evaluation of tympanoplasty with mastoidectomy in mucosal chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195709 ◽

2019 ◽

Vol 6 (1) ◽

pp. 163

Author(s):

Ritesh Mahajan ◽

Nidhi Abraham ◽

Nagaraj T. M.

Keyword(s):

Otitis Media ◽

Disease Process ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Medical College ◽

Cortical Mastoidectomy ◽

A Prospective Study

Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in developing countries with a varying incidence of 3% to 57%. It the disease process is further divided into mucosal type and squamosal type depending on clinical presentation. The mainstay of therapy in CSOM remains surgery which aims at eradication of disease and restoring the hearing mechanism. The main objective of our study was to evaluate the changes and impact of tympanoplasty with mastoidectomy as a surgical treatment modality in mucosal type of CSOM.Methods: A prospective study was conducted in Rajarajeshwari Medical College and Hospital between November 2015 and June 2017, involving 50 patients with mucosal type of chronic otitis media. These patients, after complete clinical examination and hearing analysis, underwent tympanoplasty with cortical mastoidectomy. Follow-up of the patients was done at one month and three months after the surgery where the parameters recorded preoperatively were assessed. Results: The graft uptake three months after the surgery was 94%. Patients reported a subjective improvement in symptoms of ear discharge, decreased hearing, earache and tinnitus to 94%, 70%, 86% and 78% respectively. There was hearing improvement in ears that had discharge preoperatively and those ears that did not.Conclusions: Chronic suppurative otitis media is a very common problem and it can lead to recurrent ear discharge and hearing problems. Timely intervention is necessary as early diagnosis results in good surgical outcomes and can make an impact on patient’s quality of life.

Download Full-text

Clinical profile and surgical management of primary vaginal hydrocele: our experience in a rural India

International Surgery Journal ◽

10.18203/2349-2902.isj20171615 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1653

Author(s):

Mohd Hamid Shafique Ahmed ◽

Bankar S. S. ◽

Gosavi V. S. ◽

Dalavi S. B. ◽

Gurav P. D.

Keyword(s):

Wound Infection ◽

Surgical Management ◽

Surgical Procedures ◽

Clinical Profile ◽

Medical College ◽

History Of ◽

Male Patients ◽

A Prospective Study ◽

Age Range

Background: Hydrocele is one of the commonest diseases occurring worldwide. Since olden days surgical procedures have been described for the treatment of hydrocele. Aim of the study was to analyse the clinical profile, diagnosis and surgical management of primary vaginal hydrocele in adults (>12 years)Methods: A prospective study of 60 male patients of age range of more than 12 years with a history of scrotal swellings were studied for their clinical profiles, diagnosis and management. The study was carried out in Government Medical College, Miraj, Maharashtra, India from November 2010 to November 2012. In the present study Jaboulay's Procedure was performed on 48 patients and Lord's Procedure was performed on 12 patients.Results: The data was collected and results were analysed. Post-operatively about 1.6% of patients developed hematoma, 5% developed wound infection, 21.66% of the patients developed skin oedema and only 1 patient i.e 1.6 % had recurrence over a period of 2 years of follow up. Out of the total 60 patients,12 patients who underwent Lord's plication 8.33%,0%,0% developed skin oedema, hematoma and wound infection respectively as compared to 25%,2.08%,6.25% in the remaining 48 patients who underwent Jaboulay's procedure, respectively.Conclusions: These two surgical procedures were very safe, easy to perform and economical and associated with minimal recurrence. Lord's procedure has lesser incidence of post-operative complications as compared to Jaboulay's procedure.

Download Full-text

Threat of scrub typhus in post-earthquake Nepal

Journal of Chitwan Medical College ◽

10.3126/jcmc.v6i4.16707 ◽

2017 ◽

Vol 6 (4) ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

S Thapa ◽

L B Sapkota ◽

P Hamal

Keyword(s):

Fever Of Unknown Origin ◽

Scrub Typhus ◽

Febrile Illness ◽

Unknown Origin ◽

Serum Samples ◽

Mortality And Morbidity ◽

Medical College ◽

Recent Outbreak ◽

High Index Of Suspicion ◽

A Prospective Study

Scrub typhus is a potentially fatal zoonotic infection, reported from many parts of Asia including Nepal. There is increasing reports of outbreak of Scrub typhus, after the earthquake hit Nepal on April 25, 2015. The recent outbreak of Scrub typhus posed problems in diagnosis and treatment of the disease. It may be related to poor awareness of the disease or lack of suspicion for Scrub typhus which often presents with clinical features indistinguishable from typhoid fever. Since, various parts of Nepal appeared to be suitable hubs for Scrub typhus, the clinical suspicion of Scrub typhus in the differential diagnosis of fever of unknown origin (FUO) is of utmost importance to prevent mortality and morbidity. This is a prospective study conducted in Chitwan Medical College (CMC), Chitwan, Nepal. This study was carried out over a period of 4 months extending from June 2016 to September 2016. A total of 410 serum samples were collected from all patients visiting CMC, clinically suspected of having Scrub typhus infection. The samples were processed for the detection of IgM antibodies for Scrub typhus by ELISA. Results: A total of 410 samples from patients suspected with Scrub typhus infection were processed which included 200 males and 210 females. Out of total 410 samples tested, 181 (44.1%) were seropositive for Scrub typhus. Seropositivity was highest 25.9% among the age group 11-20 years of age. Females were infected more than males. This study implies the re-emergence of Scrub typhus in different regions of Nepal. Although the disease is endemic in our country, it is grossly underdiagnosed owing to non-specific clinical presentation and lack of diagnostic facilities. It is thus suggested that high index of suspicion should be maintained for cases presenting with febrile illness. Infection with Scrub typhus was found high and this calls for an urgent need to introduce vaccine against Scrub typhus.

Download Full-text

Interlocking intramedullary nailing in comminuted femoral shaft fractures

Journal of Nobel Medical College ◽

10.3126/jonmc.v1i2.7300 ◽

2012 ◽

Vol 1 (2) ◽

pp. 57-63

Author(s):

Abul Kalan Mohammad ◽

Ram Kewal Shah ◽

Awais Syed ◽

Pradeep Gupta

Keyword(s):

Intramedullary Nailing ◽

Femoral Fractures ◽

Invasive Procedure ◽

Femoral Shaft ◽

Short Operative Time ◽

Medical College ◽

Almost All ◽

A Prospective Study

A prospective study of 20 comminuted femoral fractures, open and close, treated with interlocked intramedullary nailing. The mechanical strength of the nail and less invasive procedure has made the procedure preferable. Short Operative time and less blood loss was seen during surgical procedure. Out of 20 cases , 10 cases were taken from Nepal Medical College, Kathmandu and 10 cases from Nobel Medical College, Biratnagar, during years 2009 to 2011, which had been completed at least six months follow up. Almost all cases were relatively free from long term complication. The results were promising .All fractures healed within 6 months.DOI: http://dx.doi.org/10.3126/jonmc.v1i2.7300 Journal of Nobel Medical College (2012), Vol.1 No.2 p.50-56

Download Full-text

A clinico-observational study of intestinal stoma and their complications

International Surgery Journal ◽

10.18203/2349-2902.isj20190816 ◽

2019 ◽

Vol 6 (3) ◽

pp. 691

Author(s):

Shyam Bhutra ◽

Amit Singh ◽

Ramkishore Darwal ◽

Piyush Jain ◽

Vineet Kala

Keyword(s):

High Morbidity ◽

Ileal Perforation ◽

Medical College ◽

Stoma Formation ◽

Surgical Expertise ◽

Formation Type ◽

Elective Setting ◽

Intestinal Stoma ◽

The Common

Background: The present study is designed to study the indications of intestinal stoma formation, type of stoma formation, complications of intestinal stoma made in patients under emergency or elective setting and postoperative care of the intestinal stomas.Methods: The study was carried out in Department of surgery at J. L. N. Medical College, Ajmer from January 2016 to September 2017. In this study only >12 years age patient were included. The data were collected prospectively and analysed.Results: It was observed that most patients were operated in emergency (90%) as compare to elective (10%) setting for the formation of intestinal stomas. The stoma was formed more in male (58%) as compared to female (42%). There were two peak age group 31-45 year and 45-60 years in which more stoma formation occur. The common indications for stoma were found to be ileal perforation with gangrenous ileum. The common stoma formed was ileostomy (64%) in compared to colostomy (34%). The loop stomas were formed in compared to end stoma and temporary stoma (84%) more formed compared to permanent stoma (16%). The most common complications were found to be skin excoriation (64%) as compared to other complications.Conclusions: Despite increasing surgical expertise, complications of intestinal stomas still occur frequently in all setups and result in high morbidity. Meticulous skin care with regular follow-up, early detection of complications with their timely management along with education and counselling can decrease morbidity.

Download Full-text

Diagnosis and management of the fracture of the Penis - a seven year experience at Jinnah Hospital, Lahore

Annals of King Edward Medical University ◽

10.21649/akemu.v10i1.1160 ◽

2016 ◽

Vol 10 (1) ◽

Author(s):

Syed Saleem Abbas Jafri ◽

Khizer Hayat Gondal ◽

Muhammad Nawaz Chughtai

Keyword(s):

Prospective Study ◽

Sexual Function ◽

Operative Management ◽

Surgical Exploration ◽

Diagnosis And Management ◽

Medical College ◽

Operative Repair ◽

A Prospective Study ◽

Corporeal Body

Objective: To establish that management of penile fractures by operative repair of corporeal tear is safe and effective because operative repair speeds recovery and lessens the chance of erectile deformity or dysfunction, Design: A prospective study, Place and duration of study: This study was conducted in the department of Urology of Allama Iqbal Medical College/Jinnah Hospital, Lahore from December, and 1995 to October 2002. Material and Methods: Twelve patients with fracture of penis have been treated in this department during the last seven years. Their mean age was 38 years (range 21-53) and 58% of the injuries resulted from coitus, All these patients underwent immediate surgical exploration, which included degloving of the penis, evacuation of the hematoma and closure of the corporeal tear, Results: During the follow up period, all patients reported firm and straight erections, Postoperatively, there was no infection, hematomas or complaints of a lack of penile sensation. The patients did not report any disturbances in sexual function. Conclusion: We conclude that operative management of fractured corporeal body is safe and effective.

Download Full-text

Are the first year medicos empathetic?

National Journal of Clinical Anatomy ◽

10.1055/s-0040-1701715 ◽

2018 ◽

Vol 07 (01) ◽

pp. 017-023

Author(s):

Anly Antony ◽

Anu Francis ◽

Aaron David Kotturan ◽

V. Bhagyam

Keyword(s):

P Value ◽

First Year ◽

Male Population ◽

Female Population ◽

Medical College ◽

Student Version ◽

The Mean ◽

A Prospective Study ◽

Academic Year

Abstract Background: Empathy is an essentiality among the medical fraternity. Literature indicates better competency, patient compliance and clinical outcomes in relation to higher levels of empathy. Gender differences in empathy level are universal and various factors influence it. So it's quintessential to understand empathy and its correlates among medicos in India. Aims: To evaluate changes in empathy levels of the M.B.B.S students of a renowned medical college in India, during their course in the first year. Materials and methods: A prospective study was carried out among hundred 1st year medical students [M=34, F= 66] enrolled at a medical college in Kerala during the academic year 2014 - 2015. Participants completed the Jefferson Scale of Empathy [Student Version]. Results: The mean empathy at the entry & exit points of the study stood at 112 ± 11.39 & 112.07 ± 13.98 respectively. Comparing the male & female population, the females had higher empathy levels. When comparing the empathy levels at the entry & exit points of the male population, significant decline [p value= 0.001] was seen. The female population showed a significant increase [p value= 0.001] in their empathy levels over the same period. Conclusion: There were significant changes in empathy levels of the male & female population, though discernable changes in the whole population were not evident. This study necessitates further follow up of the present students, to analyze the changes occurring over the entire period of medical school.

Download Full-text