A prospective study of arthroscopic evaluation of patients with chronic shoulder pain

Background: Shoulder pain is a common musculoskeletal complaint that may be due either to intrinsic disorders of the shoulder or referred pain. In this study, we aimed to find out the sensitivity and specificity of the clinical and radiological methods in diagnosing the chronic shoulder problems and to compare clinical and radiological diagnosis with arthroscopic diagnosis.Methods: After obtaining approval of the institutional ethics committee, we enrolled patients who presented with chronic shoulder pain in the outpatient clinic of Department of Orthopedics, DY Patil Medical College and Hospital, Navi Mumbai from August 2003 till August 2005. We obtained historical data of each patient in detail and made clinical, radiological and arthroscopic diagnosis. The findings from each diagnostic modality were compared and analysed.Results: During the study period, 34 patients were enrolled in the study. Injury was traumatic in 32% of the patients and 50% of all patients were heavy workers by occupation. Half of all the patients had pain in shoulder for more than 6 months. Clinical diagnosis of biceps tendinitis was made in 44% of patients, but radiological and arthroscopic diagnosis of biceps tendinitis was made in 18% and 12% respectively. Impingement was diagnosed in 29% patients clinically, in 15% patients radiologically and in 21% patients arthroscopically. Rotator cuff injury was diagnosed in 26% patients clinically, in 41% patients radiologically and in 67% patients arthroscopically. Conclusions: Findings from this single centre study suggest that arthroscopy can diagnose and treat conditions causing chronic shoulder pain, which is cost effective as well.

Download Full-text

A COMPARATIVE STUDY OF EFFICACY, POTENCY AND RECOVERY OF INTRATHECAL 0.5% ROPIVACAINE WITH FENTANYLAND 0.5% LEVOBUPIVACAINE WITH FENTANYL IN LOWER ABDOMINAL SURGERIES IN PATIENTS OF 18-60YEARS OF AGE

10.36106/ijsr/6220134 ◽

2021 ◽

pp. 74-76

Author(s):

Payel Mitra ◽

Archana Roy ◽

Aamir Huda

Keyword(s):

Comparative Study ◽

Motor Block ◽

Length Of Hospital Stay ◽

Cost Effective ◽

Outpatient Setting ◽

P Value ◽

Equal Concentration ◽

Medical College ◽

Institutional Ethics ◽

Care Surgery

INTRODUCTION:The recent trend in health care centres everywhere is to provide cost effective care to the patients. There is an increasing trend towards ambulatory day care surgery and rapid discharge of the patients. The operation of inguinal hernia or incisional hernia and even simple ligation surgeries are done without much complexities nowadays and can be completed in 60-90min without much intra or postoperative complications. Hence these have become an ideal procedure for outpatient setting and thereby reducing length of hospital stay. AIMS AND OBJECTIVE:A comparative study of efcacy, potency and recovery of intrathecal 0.5% ropivacaine with fentanyl and 0.5% levobupivacaine with fentanyl in lower abdominal surgeries in patients of 18-60years of age. MATERIALS AND METHOD: This is a prospective, comparative, observational study was conducted on 60 patients undergoing various lower abdominal surgeries under subarachnoid block (SAB) at Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal. This study was conducted over a period of 24-month. Approval of the Institutional Ethics Committee was taken. Awritten informed consent in the local language was taken from every patient. RESULT AND ANALYSIS: In RF 5 patients (17%) had onset at 3min, 17patients (57%) at 6min, 7 patients (23%) at 9min, 1 patient (3%) at 12min. In LBF 8 patients had onset at 0 min, 22 patients had onset at 3min. p value is less than 0.0001 which is statistically signicant. In RF, 23 patients (77%) had duration of motor block for 150min and 7 patients (23%) had for 180min. In LBF, 26 patients (87%) had duration of motor block for 210 min and 4 patients (13%) had for 180min. The p value is less than 0.0001, which is statistically signicant. SUMMARYAND CONCLUSION: This study was to compare potency, efcacy and recovery between the two groups of drugs. A potency of a drug is a measure of drug activity expressed in terms of the amount required to produce an effect of given intensity. Here both the drugs in comparison was given in equal concentration and found that levobupivacaine produced higher effect, reached Bromage 3 in lesser time than ropivacaine. So levobupivacaine was more potent drug. Efcacy is the ability to get a job done satisfactorily

Download Full-text

Evaluation of prolonged febrile illness in elderly

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20194203 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1513

Author(s):

Nirmal Chandra Sahu ◽

Prafulla Kumar Dash ◽

Arindam Maitra ◽

Samarendra Nath Das ◽

Saroj Kumar Tripathy

Keyword(s):

Extrapulmonary Tuberculosis ◽

Febrile Illness ◽

High Morbidity ◽

Effective Management ◽

Elderly Age ◽

Medical College ◽

Institutional Ethics ◽

A Prospective Study ◽

Infectious Etiology

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

A PROSPECTIVE STUDY OF THE PATTERN OF USE OF ANTIMICROBIAL AGENTS IN SURGICAL PROPHYLAXIS IN A TERTIARY CARE CENTRE

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2017v9i1.15803 ◽

2016 ◽

Vol 9 (1) ◽

pp. 283

Author(s):

C. S. Brethis ◽

S. Thamizharasan ◽

S. A. Sridevi ◽

B. Kalaiselvi ◽

M. Balaji Singh ◽

...

Keyword(s):

Antimicrobial Agent ◽

Antimicrobial Agents ◽

Tertiary Care ◽

Cost Effective ◽

Surgical Prophylaxis ◽

Tertiary Care Centre ◽

Medical College ◽

The Mean ◽

A Prospective Study ◽

Induction Of Anaesthesia

Objective: To evaluate the most common class of antimicrobial agents used in surgical prophylaxis. To evaluate the timing, dosage, route and duration of use of antimicrobial agents in surgical prophylaxis.Methods: The study subjects were 214 patients who underwent general surgical procedures at Vinayaka Missions Kirupananda Variyar Medical College from July 2013 to June 2014. The use of antimicrobial agents was noted from the first dose of antibiotic given before the induction of anaesthesia. After surgery was completed the duration of antibiotic in the post-operative ward was noted. Results: Majority of the patients were males of age group 50-60 y and the most common surgical procedure was hernioplasty. Combination therapy with two antimicrobial agents was more preferred regimen 126 (58.9%). Among the antimicrobial agent's cefotaxime 114 (24.8%) was the most commonly prescribed drug and it was followed by metronidazole 121 (21.9%). ceftriaxone 60 (13.1%) was the third most commonly prescribed antimicrobial agent. The mean duration of prescription of antimicrobial agents in the present study was 4.78 d and the mean cost of drug treatment was 787.54 rupees. The cost-effective regimen was that of aminoglycosides and imidazole.Conclusion: The choice of antimicrobial agent was based on the local prevalence pattern of microorganisms. The intravenous administration of antibiotic prophylaxis immediately before or after the induction of anaesthesia is the most reliable method for ensuring effective serum concentration at the time of surgery. The antimicrobial agent chosen must cover all the most likely contaminating organisms.

Download Full-text

A prospective study on emergency laparoscopic or open cholecystectomy in acute cholecystitis in a tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20192986 ◽

2019 ◽

Vol 6 (7) ◽

pp. 2525

Author(s):

Hari Babu M. A. ◽

Hareesh G. S. R. ◽

Praneeth Reddipogu ◽

Venkata Ramanaiah Nannam

Keyword(s):

Acute Cholecystitis ◽

Open Cholecystectomy ◽

Tertiary Care ◽

Gallbladder Wall ◽

Good Prognosis ◽

Care Hospital ◽

Medical College ◽

Single Centre Study ◽

Operative Findings ◽

A Prospective Study

Background: Gallstones are among one of the most common diseases affecting the digestive system requiring hospitalisation with a prevalence of 11% to 36%. Until 2 decades ago, patients presenting with acute cholecystitis were treated conservatively and a delayed interval cholecystectomy was performed after 6 weeks, now a days laparoscopic cholecystectomy was gaining popularity in acute cholecystitis. It cannot be said with certainty preoperatively whether the cholecystectomy is going to be easy or difficult. The aim of the study was to evaluate safety and outcomes of emergency laparoscopic or open cholecystectomy in acute cholecystitis.Methods: This is a prospective, observational, single centre study conducted in the Department of General Surgery, S.V. Medical College/ SVRRGG hospital, Tirupati, for a period of one year from the time of approval of IEC. All patients undergoing emergency laparoscopic or open cholecystectomy for acute cholecystitis and its related complications are studied for various clinical, radiological and other variables.Results: Total 100 patients who presented with acute cholecystitis and undergone cholecystectomy are studied. Age, sex, BMI, comorbities, clinical and usg criteria and intra-operative findings and post-operative complications are analysed.Conclusions: Difficult dissection in cholecystectomy can be predicted using pre-operative parameters like increasing age, male gender, multiple attacks in the past, gallbladder wall thickness >3 mm, and presence of pericholecystic fluid. Surgery performed within 72 hrs had good prognosis and few intra op complications due to good place of dissection due to inflammation.

Download Full-text

Role of Ultrasonography in the Evaluation of Painful Shoulder

Nepal Medical Journal ◽

10.37080/nmj.9 ◽

2018 ◽

Vol 1 (01) ◽

pp. 19-24

Author(s):

Sindhu Sharma ◽

Santosh Pant ◽

Bibek Rajbhandari

Keyword(s):

Shoulder Pain ◽

Clinical Diagnosis ◽

Clinical Examination ◽

Frozen Shoulder ◽

College Teaching ◽

Cost Effective ◽

Radiology Department ◽

Medical College ◽

Diagnostic Arthroscopy ◽

Considerable Morbidity

Introduction: Shoulder pain is a common problem encountered in clinical practice. It is often disabling to the patient and results in considerable morbidity and unsatisfactory outcomes if therapy is not instituted effectively or delayed. Ultrasonography is a rapid, real time and cost effective alternative to MRI and diagnostic arthroscopy. Here, we compare sonographic diagnosis with clinical diagnosis in the diagnosis of the various causes of shoulder pain. Methods: This descriptive study was done in the radiology department of Nepalgunj Medical College Teaching Hospital, Kohalpur during a time period of 18 months. About 30 cases of shoulder pain that had been evaluated clinically by a single examiner in the orthopedics OPD were diagnosed with the help of sonography. Correlation between clinical diagnosis and USG diagnosis was done. Results: Clinically, most of these cases were provisionally diagnosed as Frozen shoulder 9 (30%) followed by Cuff tendinopathy 8 (26.66%) and Impingement syndrome 6 (20%). However, USG of the shoulder revealed rotator cuff tendinopathy and cuff tear (n=6 each) to be the main etiology behind shoulder pain. Supraspinatus calcific tendinopathy was found in 4 individuals. Hence, it was seen that the diagnosis of the causes of shoulder pain with clinical tests alone is unsatisfactory. Out of 30 cases, clinical examination could correctly diagnose only 20% of the time (n=6). 73% of the time (n=20), USG showed a different diagnosis compared to clinical examination whereas in 4 (7%) cases a more specific diagnosis was reached.Conclusions: We conclude that USG is more specific and frequently leads to increased diagnostic accuracy when compared to clinical examination.

Download Full-text

Biofilm Producing Enterococcus Isolates from Vaginal Microbiota

Antibiotics ◽

10.3390/antibiotics10091082 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1082

Author(s):

Mallika Sengupta ◽

Soma Sarkar ◽

Manideepa SenGupta ◽

Sougata Ghosh ◽

Riya Sarkar ◽

...

Keyword(s):

Diffusion Method ◽

Enterococcus Species ◽

Automated Identification ◽

Biochemical Tests ◽

Medical College ◽

Institutional Ethics ◽

Enterococcus Spp ◽

Important Virulence Factor ◽

Vitek 2 ◽

A Prospective Study

Background: Enterococcus is an important cause of infection in the hospital as well as in the community. Methods: A prospective study was done in Medical College, Kolkata for a period of 2 years (from January 2018 to December 2019). After obtaining clearance from the Institutional Ethics Committee, Enterococcus isolates from cases of vaginitis were included in the study. Identification of Enterococcus species was done by Gram stain and conventional biochemical tests along with automated identification by VITEK 2 Compact. These isolates were tested for antimicrobial susceptibility to different antibiotics by Kirby Bauer disc diffusion method and minimum inhibitory concentration (MIC) by VITEK 2 Compact. Interpretation of susceptibility was done according to the Clinical and Laboratory Standards Institute (CLSI) 2017 guidelines. Biofilm detection for Enterococcus species was done. Results: During the period of 2 years, 39 isolates of Enterococcus spp. were obtained from vaginitis cases. Among these, 27 were Enterococcus faecalis and 12 Enterococcus faecium. All isolates were highly susceptible to vancomycin, teicoplanin, and linezolid. Biofilm was detected in eight isolates of which five were strong biofilm producer and three moderate biofilm producers. Conclusion: Biofilm production is an important virulence factor in Enterococcus isolates from vaginitis.

Download Full-text

Novel Therapy for Pseudocyst of Pinna – An Institutional Study

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2018.v26i2.169 ◽

2018 ◽

Vol 26 (2) ◽

pp. 112-116

Author(s):

Debdulal Chakraborty ◽

Chiranjib Das

Keyword(s):

Cost Effective ◽

Neck Surgery ◽

Cosmetic Outcome ◽

Treatment Modalities ◽

Novel Therapy ◽

Medical College ◽

Good Cosmetic Outcome ◽

Number Of Patients ◽

Good Cosmetic ◽

A Prospective Study

Introduction Pseudocyst of pinna is a cystic swelling with collection of serous fluid between the auricular cartilage and perichondrium. Successful treatment of pseudocyst of pinna is challenging because of its high propensity for recurrence and cosmetic deformity. None of the treatment modalities described in literature gives fully satisfactory result. So a novel treatment modality is required which gives good cosmetic outcome with zero recurrence. Materials and Methods A prospective study was done in the Department of ENT and Head and Neck Surgery of a Government Medical College, West Bengal from April 2014 to March 2017. The effusion was aspirated aseptically with sterilized 10 ml syringe with 18G IV needle. An equal amount of Inj. Dexamethasone and Inj. Gentamicin 80 mg in 1:1 ratio mixed in a new 10 ml syringe was injected into the swelling through the same prick point. Result Most of the patients in this study were males between 31-40 years of age and labourer by profession. Maximum number of patients had swelling involving concha. Only one case of one month old infant had bilateral involvement. All patients were cured without any recurrence or disfigurement. Conclusion The results of present study points to the fact that aspiration and instillation of equal amount of Inj. Dexamethasone and Inj. Gentamicin works very good in treatment of pseudocyst of pinna. This therapy is minimally invasive, less painful, cost-effective and less cumbersome for the surgeon. It gives faster recovery, good cosmetic outcome and recurrence is prevented.

Download Full-text

Dacrocystography: a pre requisite to endoscopic dacrocystorhinostomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201278 ◽

2020 ◽

Vol 6 (4) ◽

pp. 661

Author(s):

Manish Munjal ◽

Amanjot Kaur ◽

G. S. Bajwa ◽

Hitant Vohra ◽

Akashdeep Sohi ◽

...

Keyword(s):

Prospective Study ◽

Contrast Medium ◽

Surgical Intervention ◽

Cost Effective ◽

Water Soluble ◽

Complete Obstruction ◽

Medical College ◽

Lacrimal System ◽

A Prospective Study

Background: Dacryocystography is a simple radiological procedure in which a radiographic water-soluble dye like iohexal or neohydriol is injected into the lacrimal system and free flow of dye is noted from the eyes into the nose and any restriction in the flow of indicates obstruction and site of the same.Methods: This is a prospective study of role of dacryocystography in 31 cases of dacrocystitis who presented to the ENT outpatient clinic of Dayanand Medical College and Hospital over a period of 1.5 years i.e. from June 2016 to December 2017 who were planned for dacrocystorhinostomy. Patient was placed in dorsal decubitus position and local anaesthesia was administered. No. 15 catheter was connected to a syringe containing contrast medium and its ends are introduced into both lacrimal puncta. Head of the patient is fixed and the contrast medium was administered through both the puncta simultaneously and serial radiographs were obtainedResults: The role of dye study, prior to endoscopic dacrocystorhinostomy dacrocystography was studied in 31 subjects. Of the 22 subjects who underwent surgical intervention, 18 (81.8%) had a complete obstruction while 4 (18.2%) had a partial block.Conclusions: Dacryocystography is a useful and cost-effective investigation to delineate the obstruction in the nasolacrimal system. It aids in confirmation of clinical diagnosis as well as making a diagnosis in doubtful cases.

Download Full-text