scholarly journals Open surgical approach to management of rhino-orbito-cerebral mucormycosis

2021 ◽  
Vol 8 (1) ◽  
pp. 64
Author(s):  
Sunil K. C. ◽  
Praveen Kumar B. Y. ◽  
Ramesh Bhoomannavar ◽  
Rishabh Jain
Keyword(s):  
Surgical Approach ◽  
Effective Means ◽  
Tertiary Care ◽  
Wound Dehiscence ◽  
Open Approach ◽  
Cross Sectional ◽  
Temporal Fossa ◽  
Co Morbidity ◽  
Facial Swelling ◽  
Open Surgical Approach

<p class="abstract"><strong>Background: </strong>Since December 2019, when novel corona virus (COVID 19) was reported, it has spread widely to cause a pandemic. Rhino-orbito-cerebral Mucormycosis (ROCM), an opportunistic fungal infection caused by the order Mucorales and class Zygomycetes has led to an epidemic in our country.</p><p class="abstract"><strong>Methods: </strong>This prospective cross sectional study was conducted at a 1200 bed tertiary care teaching hospital in Mysore. All patients of ROCM who presented to us for treatment were selected for the study after informed consent. Only those patients who were operated via open approach were included.</p><p class="abstract"><strong>Results:</strong> Median age of the patients was 50 years (SD±10). 49 were male patients (67.1%). Diabetes mellitus was the most common underlying co-morbidity seen in 71 patients (97.3%). Facial pain (100%) and facial swelling (90.4%) were the most common presenting complaint. KOH positivity from nasal swab for Mucormycosis was positive in only 37 patients (50.7%). Traditional inaccessible areas to endoscope like the premaxilla, lateral orbit cavity, infra temporal fossa and hard palate were tackled by the open surgical approach route. Advantages of open surgical approach being the access to areas which are traditionally difficult to approach via the endoscope, aggressive debridement is possible which might be challenging endoscopically. Complications like wound dehiscence, oro-antral fistula, osteomyelitis and abscess were noted in our study.</p><p class="abstract"><strong>Conclusions: </strong>Open surgical approach offers a very viable, affordable and a very effective means for aggressive surgical debridement of infection and reduce mortality associated with ROCM.</p><p> </p>

scholarly journals Treatment of juvenile angiofibromas: 18-year experience of a single tertiary centre in Spain

2012 ◽  
Vol 50 (1) ◽  
pp. 95-103
Author(s):  
Fernando Lopez ◽  
Vanessa Suarez ◽  
Maria Costales ◽  
Carlos Suarez ◽  
Jose L. Llorente
Keyword(s):  
Surgical Approach ◽  
Early Stage ◽  
Tumour Size ◽  
Vascular Supply ◽  
Open Approach ◽  
Tertiary Centre ◽  
Preauricular Approach ◽  
Conventional Open Approach ◽  
Open Surgical Approach

Background: The management of juvenile angiofibroma (JA) has changed during the last decades but it still continues to be a challenge. The objective of this study was to review the used treatment and our outcomes. Methods: From 1992 to 2010, 48 cases of JA were treated at our department. Charts were reviewed for standard demographic, tumour size and location, vascular supply and results of embolization, surgical approach, operative results, adjuvant therapies, recurrence and postoperative follow-up. Results: Most tumours were Andrews-Fisch stages III and IV and surgery was used as the main treatment in all cases. We used an open surgical approach in 37 (77%) patients and 11 (23%) were treated endoscopically. The most common open approach used in this series was the subtemporal-preauricular approach. Until 1995, all tumours were operated on by a conventional open approach. Afterwards, early-stage tumours were operated on through an endoscopic approach. Ten patients were treated through surgery followed by radiosurgery. Two (4%) patients had recurrent disease. Conclusions: These tumours should be treated at centres with expertise in skull base surgery to achieve complete surgical resections with low morbidity. Radiosurgery after surgery seems to be a valuable option in the long-term control of some extended JAs.

scholarly journals Knowledge, Attitude and Practices Regarding First Aid against Domestic Injuries in Mothers of Children less than 5 Years of Age Attending Fauji Foundation Hospital Islamabad

2021 ◽  
Vol 11 (3) ◽  
pp. 151-157
Author(s):  
Raima Asif ◽  
Naila Azam ◽  
Fatima Ali Raza ◽  
Mehwish Riaz ◽  
Shaista Zulfiqar ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Tertiary Care ◽  
First Aid ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Strongly Agree ◽  
Home Accidents

Background: The objective is to assess the knowledge, attitude and practices regarding first aid towards home related injuries among mothers of children less than 5 years of age at tertiary care hospital of Islamabad. Methods: A questionnaire based cross sectional study was conducted in Fauji Foundation Hospital Islamabad. 400 participants were selected using convenience sampling the mother of children under 5 years of age were included and mother of children with any major co morbidity, congenital abnormalities and who didn’t give consent were excluded from the study. A pretested, structured, self-administered questionnaire was used for data collection after obtaining permission from Institutional Ethical Committee. Statistical analysis was carried using SPSS version 20. Frequencies and percentages were computed, descriptive statistical analysis was done. Chi- Square was applied for association between socio demographic variables and knowledge of mothers regarding first aid. Results: About 44% of the mothers and 63% children fall in age group of 31 and 2-5 years respectively. Half of the mothers (48%) are below intermediate level of education. About 34% of the respondents stated bleeding as most urgent and important injury requiring first aid. Regarding attitudes, 50% of the mothers strongly agree towards necessity of first aid and lack of awareness about dealing with domestic injuries. Sixty-five (65%) of the mothers had given first aid to their child. About 33%, 75%, 44% and 39% of the mothers have faced a child with difficulty in breathing; bleeding, burning and insect/sibling bite respectively. Age of mother (p=0.041), education of mother (p=0.001) and total no of children (p=0.001) were significantly associated with knowledge of first aid. Conclusion: Although home accidents are a common problem, mother’s knowledge regarding home accidents was deficient although majority of the respondents have positive attitude.

scholarly journals A retrospective study of febrile seizures among children admitted in a tertiary care hospital

2018 ◽  
Vol 5 (7) ◽  
pp. 3121
Author(s):  
Pralhad Sureshrao Potdar
Keyword(s):  
Family History ◽  
Febrile Seizure ◽  
Tertiary Care ◽  
Positive Family History ◽  
Complex Form ◽  
Febrile Convulsion ◽  
Febrile Seizures ◽  
Care Hospital ◽  
Cross Sectional ◽  
Co Morbidity

Background: Convulsion is the most common neurologic finding in children (10%). Prevention of febrile convulsions is therefore desirable, and is of particular relevance in children with factors carrying a high risk of recurrence. Aim and Objectives were to study the demographic profile and some risk factors of febrile seizures among children.Methods: A record based descriptive cross-sectional study was conducted at paediatric department of Dr. S.C.GMC, Nanded. Considering inclusion & exclusion criteria all children in the 6 month to 6 year age who were diagnosed as having febrile convulsion admitted during January to December 2015 were included in the study.Results: Of the 288 children 173 (60.1%) were boys and 115 (39.9%) were girls. 46.9% children were in the 1-3 year age group. Mean age of occurrence was 2.8 years (±1.5 years). In this study, 80.2% (231) of the patients had simple and 19.8% (57) had the complex form of febrile seizure. In our study, 51.73% (149) of affected children had positive family history of febrile seizure. URTI (9.7%) followed by AGE (7.3%) was the most common co-morbidity. 54.2% children were hospitalized for 1-3 days.Conclusions: Most of the children had a positive family history and the most common causative factor was URTI, LRTI, AGE etc. are associated with febrile convulsion and these diseases can be managed effectively thereby reducing the occurrence of febrile convulsion. 

scholarly journals Guideline adherence and control of diabetes mellitus with or without co-morbidities in various wards of a tertiary hospital in Malaysia

2014 ◽  
Vol 3 (8) ◽  
pp. 309-312 ◽  
Author(s):  
Muhammad Zahid Iqbal ◽  
Muhammad Shahid Iqbal ◽  
Dayana Nicholas ◽  
Jamaluddin Awang ◽  
Amer Hayat Khan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
General Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Negative Association ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Prescription Pattern ◽  
Co Morbidity

To assess the adherence of physicians involved in the management of diabetes mellitus with or without co-morbidities with reference to Clinical Practice Guideline 2009 given by Ministry of Health Malaysia in the tertiary care hospital, Pinang General Hospital Malaysia. Cross-sectional study was done at tertiary care hospital, Penang, Malaysia. The total 51 physicians and 1020 patient’s prescriptions written by same physicians were taken from the record of the Penang General Hospital (20 prescriptions for each enrolled physician). All 1020 patients were suffering from diabetes mellitus with or without co-morbidities. These patients were recruited from the different wards of the Penang General Hospital. Depending on the recommendations of CPG 2009 the prescriptions of patients were divided into adherent and non-adherent prescriptions. The overall good level of physician adherence was seen with respect to the recommendations of CPG 2009 in all prescriptions. A statistically significant negative association (?= 0.094, p-value=0.003) was observed between diabetes mellitus control and co-morbidities. CPG adherent had statistically weak negative association (?= -0.081, p-value=0.010) with patients having co-morbidities. No statistically significant association was observed between CPG adherence and any other co-morbidity. The study explored the several features of prescription pattern of physicians involved in the management of diabetes mellitus with or without co-morbidities and recognized the need for improvement in their prescription pattern for treating the diabetes mellitus.DOI: http://dx.doi.org/10.3329/icpj.v3i8.19405 International Current Pharmaceutical Journal, July 2014, 3(8): 309-312

A Cross-Sectional Evaluation of Illness Perception About Asthma Among Asthma Patients at a Referral Tertiary Care Public Chest Hospital in Delhi, India

2012 ◽  
Vol 2 (3) ◽  
pp. 32-43
Author(s):  
Sushil Shendge ◽  
Barnali Deka ◽  
Anita Kotwani
Keyword(s):  
Inhaled Corticosteroids ◽  
Tertiary Care ◽  
Illness Perception ◽  
Clinical History ◽  
Self Management ◽  
Cross Sectional ◽  
The Public ◽  
Co Morbidity ◽  
Asthma Patients ◽  
History Of

Adult patients visiting emergency room (March 2009-December 2009) of the public chest hospital for asthma exacerbation completed interviewer-administered questionnaires on sociodemographics, clinical history, disease beliefs, use of inhaled corticosteroids (ICS), and self-management of asthma after stabilization of their condition. Overall 87% patients believed that they had asthma when they are having symptoms, which is called as no symptoms, no asthma belief. No association was found between no symptoms, no asthma belief with gender, income, family history of asthma, and co-morbidity. Younger patients in the age group 18-29 years had four to five-fold greater odds and patients with education above 10th grade had three to four-fold greater odds of having the no symptoms, no asthma belief or the acute episodic belief. Acute episodic belief was negatively associated with beliefs about always having asthma, asthma being a serious condition, having lung inflammation, or the importance of using ICS, and was positively associated with expecting to be cured. All patients irrespective of their belief of acute or chronic nature of asthma had poor adherence to the treatment and other self-management behaviors.

Comparative Outcomes by Surgical Approach in Patients with Malignant Sinonasal Disease

2021 ◽  
Author(s):  
Nicholas R. Lenze ◽  
Carolyn Quinsey ◽  
Deanna Sasaki-Adams ◽  
Matthew G. Ewend ◽  
Brian D. Thorp ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Surgical Approach ◽  
Complication Rate ◽  
Perioperative Complications ◽  
Intraoperative Complications ◽  
Care Center ◽  
Tertiary Care ◽  
Undifferentiated Carcinoma ◽  
Open Approach ◽  
Sinonasal Disease

Abstract Objective There is a paucity of data on comparative outcomes for open versus endoscopic surgery for patients with malignant sinonasal pathology. Most of the available studies are limited by a sample size <100 patients. Design This is a retrospective cohort study. Setting The findings of this study come from a single-institution tertiary care center from 2008 to 2019. Participants In total, 199 patients who underwent surgery for malignant sinonasal disease participated in this study. Main Outcome Measures The main outcome measures were perioperative complications and reoperation. Results Patients in our sample had a mean age of 59.7 years (SD, 20.4). In total, 62% were male and 72% were white. An endoscopic-only approach was used in 41% of patients and an open or combined approach in 59% of patients. Squamous cell carcinoma was the most common pathology (43.0%), followed by sarcoma (9.5%), skin cancer (6.5%), sinonasal undifferentiated carcinoma (6.5%), and adenocarcinoma (5.5%). The all-cause complication rate was 14.6%. Patients with an open resection had a higher rate of intraoperative complications (5.9 vs. 0%; p = 0.043), postoperative complications (19.5 vs. 3.7%; p = 0.001), and all-cause complications (21.0 vs. 3.7%; p < 0.001). The likelihood of early reoperation (<6 months) or late reoperation (>6 months) did not significantly differ by surgical approach (p = 1.000 and 0.741, respectively). Conclusion The endoscopic approach for resection of malignant sinonasal disease is viable for select patients and may be associated with a favorable complication rate compared with the open approach.

scholarly journals Comparison of early appendectomy versus conservative management for appendicular lump at Tertiary Care Hospital.

2020 ◽  
Vol 27 (09) ◽  
pp. 1818-1822
Author(s):  
Zulfiqar Ali Imtiaz Memon ◽  
Mashooque Ali Khowaja ◽  
Inayat Ali Zardari ◽  
Altaf Hussain Ghumro ◽  
Farkhanda Jabeen Dahri ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Wound Dehiscence ◽  
Cross Sectional Study ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Negative Results ◽  
Clinical Presentations

Objectives: The purpose is to compare two options of management of appendicular lump in order to sort out the better one for the benefit and betterment of populace. Study Design: Cross Sectional study. Setting: Peoples Medical College Hospital Nawabshah. Period: 2016 August to August 2018. Material & Methods: Total 50 patients of appendicular lump were included in this research. All patients were divided into 2 groups. Group 1 included those patients undergoing emergency appendectomy. They were admitted, optimized and the required treatment was initiated. Results: Of total 50, 30(60%) were male and 20(40%) were females. Age was between 14 to 51 years. All patients presented with different clinical presentations. Pain in RIF was in 42(84%) patients whereas 47(94%) patients presented with lump in RIF. 20(40%) patients were operated for appendectomy in emergency and 5(10%) patients for right hemi-colectomy. Histopathological diagnosis was inflammation in 24(48%) patients and 1(2%) resulted in cecal tumor. Infected wound was found in 15 (30%) patients, hematoma in 3 (6%), wound dehiscence in 1(2%) and also cecal fistula in 1 (2%). Conclusion: Conservative treatment is better option to treat appendicular lump with least negative results.

scholarly journals Health-Related Quality of Life Among Admitted HIV/AIDS Patients in Selected Ethiopian Tertiary Care Settings: A Cross-Sectional Study

2019 ◽  
Vol 12 (1) ◽  
pp. 532-540 ◽  
Author(s):  
Getandale Zeleke Negera ◽  
Teshale Ayele Mega
Keyword(s):  
Quality Of Life ◽  
Tertiary Care ◽  
P Value ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Related Quality ◽  
Health Related ◽  
Hiv Aids

Background: The introduction of Combined Antiretroviral Therapy (cART) shifted the perception of HIV/AIDS from a fatal to a potentially manageable chronic disease. As a result, patient-perceived health-related quality of life (HRQoL) is becoming an important outcome measure among HIV infected patients. We assessed the quality of life of admitted HIV/AIDS patients and the association of socio-demographic, clinical, and psychosocial characteristics of patients with health-related quality of life. Methods: Health facility-based cross-sectional study was conducted from April 1 to May 31, 2018 in selected tertiary care hospitals of Ethiopia. HRQoL was measured at discharge using the interviewer-administered World Health Organization’s Quality of Life HIV short-form instrument (WHOQoL-HIV BREF). Data were entered into EpiData 3.2 and exported to SPSS version 21.0 for cleaning and analysis. Descriptive analytical results were reported in text and table. Logistic regression was conducted to identify predictors of poor quality of life. Variables with p-value ≤ 0.25 in bivariate regression were considered as a candidate for multivariable regression. Multivariable logistic regression was performed to identify independent predictors. Regression coefficients and their 95% confidence intervals together with p-value < 0.05 were used to identify independent predictor of poor QoL. Results: Majority, 56 (58.9%) of the study participants, had poor general health-related quality of life. Being unemployed (AOR: 4.1, 95% CI; (1.23, 13.64); p=0.02), lack of support from family (AOR: 3.6, 95% CI: (1.05-12.6); p=0.04), and having co-morbidity (AOR: 4.2, 95% CI: (1.08, 16.65); p=0.039) were found to be independent predictors of poor quality of life. Conclusions: The study showed that the majority of the participants had poor health-related quality of life which was affected by unemployment, co-morbidity, and social support from family.

scholarly journals Surgical outcomes of malignant sinonasal tumours: open versus endoscopic surgical approaches

2014 ◽  
Vol 128 (9) ◽  
pp. 784-790 ◽  
Author(s):  
B Saedi ◽  
M Aghili ◽  
M Motiee ◽  
S Valadkhani ◽  
A B Niazi ◽  
...  
Keyword(s):  
Endoscopic Surgery ◽  
Surgical Approach ◽  
Tertiary Care ◽  
Survival Rates ◽  
Surgical Margin ◽  
Disease Free Survival ◽  
Care Hospital ◽  
Open Approach ◽  
Sinonasal Malignancies ◽  
Rare Tumours

AbstractBackground:Sinonasal malignancies are rare tumours, which can be resected using an open or endoscopic approach. The current study evaluated the outcome of both approaches.Methods:A total of 160 patients with malignant nasal tumours were evaluated in an academic tertiary care hospital. The patients were allocated to ‘open’ or ‘endoscopic’ surgery groups, based on the surgical approach employed. The following data were evaluated and compared: patient and tumour characteristics; oncological treatments; and oncological outcomes, including complications, surgical margin, recurrence, overall survival and disease-free survival.Results:The maxillary sinus was the most common tumour location and squamous cell carcinoma was the most common histopathology-based diagnosis. Younger patients had lower grades of tumour. Higher survival rates were significantly related to lower tumour stages in both surgery groups. There were no differences between the two relatively similar groups in terms of surgical margin, the need for adjunctive therapy, and recurrence and survival rates. In addition, multivariate logistical regression analysis indicated no correlations between the type of surgical approach employed and the rates of recurrence and complications.Conclusion:Endoscopic surgery for sinonasal malignancies is comparable to the conventional open approach in carefully selected patients.

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