A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

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Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0041-1727578 ◽

2021 ◽

Author(s):

Vanajakshamma Velam ◽

Vyshnavi Kancherla ◽

Latheef Kasala ◽

Anusha Kancherla ◽

Mounica Reddy Pillaram

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Well Being ◽

Care Hospital ◽

Cross Sectional ◽

Significant Difference ◽

Female Employees ◽

The Mean ◽

Lifestyle Patterns ◽

Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

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The clinical profile, management, and outcome of febrile neutropenia in acute myeloid leukemia from resource constraint settings

Therapeutic Advances in Infectious Disease ◽

10.1177/20499361211036592 ◽

2021 ◽

Vol 8 ◽

pp. 204993612110365

Author(s):

Kundan Mishra ◽

Suman Kumar ◽

Sandeep Ninawe ◽

Rajat Bahl ◽

Ashok Meshram ◽

...

Keyword(s):

Overall Survival ◽

Acute Myeloid Leukemia ◽

Febrile Neutropenia ◽

Burkholderia Cepacia ◽

Myeloid Leukemia ◽

Tertiary Care ◽

Care Hospital ◽

Significant Difference ◽

The Mean ◽

Acute Myeloid

Introduction: Acute myeloid leukemia (AML) is the commonest leukemia in adults. Mortality in thew first 30-days ranges from 6% to 43%, while infections account for 30–66% of early deaths. We aim to present our experience of infections in newly-diagnosed AML. Method: This prospective, observational study, was undertaken at a tertiary care hospital in Northern India. Patients with confirmed AML (bone marrow morphology and flow cytometry) and who had developed febrile neutropenia (FN), were included. Result: A total of fifty-five patients were included in the study. The median age of the patients was 47.1 years (12–71) and 28 (50.9%) were males. Fever (33, 60%) was the commonest presentation at the time of diagnosis. One or more comorbid conditions were present in 20 patients (36.36%). Infection at presentation was detected in 17 patients (30.9%). The mean duration to develop febrile neutropenia since the start of therapy was 11.24 days. With each ten-thousand increase in white blood cell (WBC) count, the mean number of days of FN development decreased by 0.35 days ( p = 0.029). Clinical and/or radiological localization was possible in 23 patients (41.81%). Thirty-four blood samples (34/242, 14.04%) from 26 patients (26/55, 47.3%) isolated one or more organisms. Gram negative bacilli (GNB) were isolated in 24 (70.58%) samples. Burkholderia cepacia (8/34, 23.52%) was the commonest organism. The number of days required to develop febrile neutropenia was inversely associated with overall survival (OS). However, when compared, there was no statistically significant difference in OS between patients developing fever on day-10 and day-25 ( p = 0.063). Thirteen patients (23.63%) died during the study period. Discussion: Low percentage of blood culture positivity and high incidence of MDR organisms are a matter of concern. Days to develop febrile neutropenia were inversely associated with overall survival (OS), emphasizing the importance of preventive measures against infections. Conclusion: Infections continues to be a major cause of morbidity and mortality among AML patients.

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A randomized controlled trial comparing oxytocin administration before and after placental delivery in the prevention of postpartum haemorrhage in a tertiary care hospital in Bankura district of West Bengal, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201791 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1976

Author(s):

Rahul Kirtania ◽

Jayita Pal ◽

Sisir Biswas ◽

Aditi Aich

Keyword(s):

Randomized Controlled Trial ◽

Blood Loss ◽

Controlled Trial ◽

Active Management ◽

Control Group ◽

Care Hospital ◽

Normal Delivery ◽

Randomized Controlled ◽

Significant Difference ◽

The Mean

Background: PPH is the prime cause of maternal mortality worldwide. The incidence of PPH can be drastically combatted by application of uterotonic in active management of third stage labour. Timing of its administration is a matter of concern. This study aimed to assess whether timing of administration of oxytocin would have any impact on incidence or mean blood loss of PPH.Methods: It was a single blinded randomized controlled trial conducted in the department of Obstetrics and Gynecology, Bankura Sammilani Medical College for 6 months where 100 antenatal mothers admitted for normal delivery in labour room were allocated randomly in study and control group considering inclusion and exclusion criteria. Incidence of PPH and mean blood loss had been identified clinically by following them for 24 hours.Results: Only 9% of study population had experienced PPH. There was no statistically significant difference in incidence of PPH with difference in timing of administration of oxytocin (p >0.05). But there was statistically significant decrease in mean blood loss if oxytocin was administered before the placental delivery. The mean blood loss with oxytocin administered before placental delivery was 296.8 ml (102.45) and after placental delivery was 452.0 (128.87) ml respectively.Conclusions: Policy makers should keep in mind not only the incidence of PPH, but the mean blood loss amount too in a setting where anaemia in pregnancy is quite prevalent.

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Anterior Trimming vs Outer Displacement of Inferior Turbinate: A Comparative Study at a Tertiary Care Hospital

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2021.11.3.654 ◽

1969 ◽

Vol 11 (3) ◽

pp. 169-174

Author(s):

Habib-Ur-Rehman ◽

Fazal-I-Wahid ◽

BakhtZada ◽

Muhammad Javaid ◽

Naseemul Haq

Keyword(s):

Comparative Study ◽

Nasal Obstruction ◽

Objective Assessment ◽

Tertiary Care ◽

Adhesion Formation ◽

Inferior Turbinate ◽

Care Hospital ◽

Female Ratio ◽

Significant Difference ◽

Group A

Background: Obstruction of nose due to enlargement of inferior turbinate is a very common problem faced by ENT surgeon.In thisstudy a usefultechnique for treatment of inferior turbinate hypertrophy is described.Objective:To determine the surgical outcome and complications ofthe two surgicalprocedures.Material and Methods: This non-randomized comparative study was performed in the Department of ENT, HNS, MTI/LRH,Peshawar, Pakistan, from June 01, 2017 to May 31, 2018. After ethical approval, sample size of 112 was calculated and patientsincluded of both genders fulfilling inclusion criteria. After taking consent patients were equally divided into two groups with nonrandom number table method. Both subjective and objective assessment was carried out and observations were recorded on apredesignedproforma.Data were analyzed using SPSS 20.Results: Total patients were 112,in age range from 16 to 50 years. There were 56(50%) patients in each group.Maleswere 71 andfemale 41withmale to female ratio of 1.7:1 and mean age was 32.92+S.D 10.29 years.Relief from nasal obstruction obtained was94.64% and 92.86% in Group A and B respectively. Headachewas relived 83.34 % and 88.38% in Group A and B respectively. Thecomplications experienced were post operative bleeding, adhesion formation and crusting 2.6%, 3.5% and 1.78% respectively.Statistics showed no significant difference between the two operations (p >0.05).Conclusion: Both trimming and outer displacement of hypertrophied inferior turbinate are effective procedures for relief of nasalobstruction but there was no significant difference betweenthe two techniques interm of outcome and complications.Keywords:Inferiorturbinate, Hypertrophy, Trimming, Outer displacement. Nasal obstruction

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Conventional Dissection and Bipolar Electrocauterization Methods of Tonsillectomy: A Comparative Study

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v19i1.40429 ◽

2022 ◽

Vol 19 (1) ◽

pp. 77-80

Author(s):

Anshu Sharma ◽

Shama Bhandari ◽

Dhundi Raj Paudel

Keyword(s):

Blood Loss ◽

Comparative Study ◽

Pain Intensity ◽

Postoperative Blood Loss ◽

Intraoperative Blood Loss ◽

Advantages And Disadvantages ◽

Post Operative Pain ◽

Significant Difference ◽

The Mean ◽

Dissection Method

Introduction: Tonsillectomy is frequently performed surgical procedure. There are several different methods with varied advantages and disadvantages. In spite of the different techniques available there is no consensus and definite evidence for best method. The most commonly performed are conventional dissection and bipolar electrocauterization methods. Aims: The aim of the study was to compare time required for the completion of surgery, intraoperative and postoperative blood loss along with post operative pain between conventional dissection and bipolar electrocauterization methods. Methods: This comparative study was conducted from August 2019 to March 2021 in total of 30 patients planned for tonsillectomy in department of Otorhinolaryngology, Nepalgunj Medical College Teaching Hospital.In every patient right side tonsillectomy was done with conventional dissection method and left side tonsillectomy was done with bipolar electrocauterization method. Results: The mean age was 27.2±13.08 years. The mean duration of surgery was 16.53 ± 2.43 min and 11.10 ± 1.93 min in conventional dissection method and bipolar electrocauterization method respectively. The difference was statistically significant. Intraoperative blood loss was significantly lower in bipolar electrocauterization method with mean intraoperative blood loss of 19 ±4.62 ml in bipolar electrocauterization group and 81.83 ±36.54 ml in conventional dissection method. The pain intensity was statistically similar in both methods at all-time intervals post operatively. Conclusion: In tonsillectomy, bipolar electrocauterization method has advantage over conventional dissection method in regards to reduced surgical time and intra operative blood loss, without any significant difference in post-operative pain intensity and post-operative hemorrhage.

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A PROSPECTIVE COMPARATIVE STUDY OF OPEN VERSUS CLOSED METHOD OF CREATING PNEUMOPERITONEUM IN LAPAROSCOPIC SURGERY

10.36106/paripex/7904461 ◽

2020 ◽

pp. 1-3

Author(s):

Akshar Patel ◽

Shashank Desai

Keyword(s):

Laparoscopic Surgery ◽

Comparative Study ◽

Tertiary Care ◽

Needle Insertion ◽

Care Hospital ◽

Open Method ◽

Group A ◽

Prospective Comparative Study ◽

Group B ◽

Open Versus

Objective: The aim of the study was to compare open and closed method in terms of time require for creation of pneumoperitoneum and to ascertain safety in laparoscopic surgery. Methodology: This was a prospective comparative study carried out at a tertiary care hospital from January 2019 to December 2019.We selected 100 patients who were planned for laparoscopic surgery and divided them into two equal groups using the envelop method of randomization. Group A comprised of patients in whom we created pneumoperitoneum by classical veress needle insertion and in Group B by open method. Results: In our study, the mean time require for closed method was 6.92 minutes while by open method it was 4.36 minutes. Complication rate was 18% in closed and 16% in open method. Conclusion: open method is quick but comparable to closed method in terms of complications.

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Laparoendoscopic Two-Site Myomectomy (LETS-M) Using Conventional Laparoscopic Instruments and The Glove-Port Technique

10.21203/rs.3.rs-129591/v1 ◽

2021 ◽

Author(s):

Pei-Chi Wu ◽

Bor-Ching Sheu ◽

Kuan-Ju Huang ◽

Su-Cheng Huang ◽

Wen-Chun Chang

Keyword(s):

Blood Loss ◽

Operation Time ◽

Intraoperative Blood Loss ◽

Tertiary Referral Center ◽

Experienced Surgeon ◽

Minimally Invasive Surgical ◽

Postoperative Hematoma ◽

Significant Difference ◽

The Mean ◽

Glove Port

Abstract We aim to evaluate the surgical outcome of laparoendoscopic two-site myomectomy (LETS-M). The medical records of 204 women receiving LETS-M in a tertiary referral center, including 183 surgeries performed by the experienced surgeon and 21 surgeries performed by 3 well-supervised trainees were retrospectively reviewed. The age of the participants was 39.3±6.4 years. The mean diameter of the largest myoma was 8.5±2.2 cm. The mean weight of the myomas was 281.1±183.1 g. The operation time was 97.6±40.2 min, and the intraoperative blood loss was 99.3±115.2 mL. There were 3 (1%) cases of excessive blood loss (more than 500 mL) and 2 (1%) of postoperative hematoma. The only significant difference between the experienced surgeon and trainees was the operation time (92.3±32.2 min vs. 141.2±54 min, p<.001), while the myoma number, myoma diameter, myoma weight, and intraoperative blood loss were not significantly different. The operation time did not differ among different myoma locations. In multivariate analysis, virginity, myoma number, more than 2 large myomas, and myoma size were independent variables for longer operation times. No patient experienced any major complications. The result revealed that LETS-M is a minimally invasive surgical method that is safe, effective, and easy to learn for managing uterine myoma.

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TOTAL KNEE ARTHROPLASTY;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.09.823 ◽

2017 ◽

Vol 24 (09) ◽

pp. 1403-1408

Author(s):

Faisal Abdul Jabbar ◽

Rehana Ali Shah ◽

Muhammad Hashim

Keyword(s):

Total Knee Arthroplasty ◽

Patient Satisfaction ◽

Knee Arthroplasty ◽

Tertiary Care ◽

Osteoarthritis Of The Knee ◽

Care Hospital ◽

Level Of Satisfaction ◽

Significant Difference ◽

Total Knee ◽

The Mean

Objectives: We aim to evaluate the level of satisfaction after total knee arthroplastyprocedure in the patient population at a tertiary care hospital in Karachi, Pakistan, and to assessthe relationship between patient satisfaction and the outcome based on traditional scores.Methods: Study Design: Case series for determination of patient satisfaction. Period: Oneyear duration from April 2015 to May 2016. Setting: Tertiary care centre in Karachi, Pakistan.The inclusion criteria was all the patients with late stage osteoarthritis of the knee joint andunderwent total knee arthroplasty at our institute. Data was analyzed using SPSS version 22.Results: A total of n= 102 patients were included in the study while n= 109 knee surgerieswere done in total (n= 95 patients had unilateral surgery, while n= 7 patients had bilateralsurgeries on both the knee joints) n= 58 patients were females while n= 44 patients weremales, the median age was 60 years, patients had a mean body mass index (BMI) of 27kg/m2. Of the total surgeries performed n= 100 were in the satisfaction group while n= 9 were inthe dissatisfaction group. The majority of the patients reported that they would recommend theprocedure. The co morbid conditions did not affect the patient’s level of satisfaction having ap value of 0.678. In the dissatisfied group, there was no significant difference when it comes togender, the mean age of patients in the dissatisfaction group was higher than the mean age ofpatients in the satisfaction. We found that WOMAC scores for functioning and the final WOMACscores were correlated with patient satisfaction and that was statistically significant, similarlySF-36 form patients were satisfied about the improvement in the physical health while they didnot improve the mental health aspect of their disease. Conclusion: According to our studytotal knee arthroplasty is an effective treatment for osteoarthritis of the knee, patient satisfactionis correlated with post-operative WOMAC function and overall scores, and SF-36 physicalcomponent. It is important to keep patients expectations in check through proper counseling.

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EFFECT OF DIABETES MELLITUS ON RIFAMPICIN PEAK SERUM CONCENTRATION

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2016v8i10.13238 ◽

2016 ◽

Vol 8 (10) ◽

pp. 149

Author(s):

Saranya P. ◽

Parthasarathy V. ◽

Hariprasad B. ◽

Shobha Rani H.

Keyword(s):

Diabetes Mellitus ◽

Serum Concentration ◽

Pulmonary Tuberculosis ◽

Tertiary Care ◽

Peak Serum Concentration ◽

Peak Serum ◽

Diabetic Patients ◽

Care Hospital ◽

Significant Difference ◽

The Mean

Objective: To comparatively analyze the peak serum concentration (Cmax) of rifampicin and to determine the incidence of decreased Cmax between diabetic and non-diabetic adult pulmonary tuberculosis patients.Methods: A cross-sectional observational study was carried out in the chest and tuberculosis (TB) department of a tertiary care hospital after the approval of the institutional ethics committee. Five millilitre (ml) of blood was withdrawn by venipuncture from each patient at a time point of 2 h post dose administration at steady state concentration (Css). The separated serum was centrifuged at a rate of 3500 rotations per minute (rpm) for a period of fifteen minutes and the resultant serum was stored at-70 ° C until analysis. Estimation of rifampicin concentration was carried out in Thermo TSQ Ultra (MS/MS) with Shimadzu 20 AD UFLC LC-MS.Results: The mean (Standard Deviation (SD)) age of the study population was 46.8 (14.2) years. The mean serum Cmax of rifampicin was significantly less in diabetic patients with pulmonary tuberculosis (p=0.0305). Statistically, a significant difference in the incidence of a decrease in Cmax was found between diabetic and non-diabetic patients (p=0.0335). Diabetes mellitus was found to be the predominant factor that affects rifampicin Cmax.Conclusion: In this study, an effect of diabetes mellitus (DM) on the peak serum concentration of rifampicin was observed. Patients with hyperglycemia levels had significantly reduced levels of rifampicin serum concentrations, thus showing an inversely proportional relationship between blood glucose and rifampicin serum levels.

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Prospective comparative study of endoscopic ultrasonography-guided fine-needle biopsy and unroofing biopsy.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.38 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 38-38 ◽

Cited By ~ 1

Author(s):

Sung Kwan Shin ◽

Jun Chul Park ◽

Eun Hye Kim ◽

Sang Kil Lee ◽

Yong Chan Lee

Keyword(s):

Comparative Study ◽

Endoscopic Ultrasonography ◽

Needle Biopsy ◽

Diagnostic Yield ◽

Fine Needle Biopsy ◽

Histological Diagnosis ◽

Fine Needle ◽

Significant Difference ◽

Prospective Comparative Study ◽

The Mean

38 Background: Adequate tissue acquisition is important in making treatment decisions for patients with upper gastrointestinal subepithelial tumors (SETs). This study aimed to compare the outcomes of endoscopic ultrasonography-guided fine-needle biopsy (EUS-FNB) with those of the unroofing biopsy technique. Methods: This study was a single-center, prospective comparative study conducted at Severance Hospital, Yonsei University College of Medicine. A total of 39 patients with SETs ≥15 mm were enrolled between January 2016 and August 2017. Results: Of the 39 patients, 28 underwent biopsy with both techniques (4 underwent only unroofing and 7 underwent only EUS-FNB). The mean tumor size was 21.0 mm (median, 19.0 mm; 15.0–45.0 mm). Histological diagnosis was made with EUS-FNB in 64.3% and with unroofing biopsy in 78.6% (p = 0.344), and immunohistochemical diagnosis was made with EUS-FNB in 46.4% and unroofing biopsy in 67.9% (p = 0.180). In the subgroup analysis (28 patients), there was no significant difference in diagnostic yield between the 2 methods. The mean procedural time with EUS-FNB was shorter than that with unroofing biopsy (p < 0.001). The larger SET (≥ 20 mm) (p = 0.035) and satisfaction of procedure (p = 0.019) were positively associated with successful histological diagnosis by EUS-FNB. No complications were reported with both methods. Conclusions: There was no significant difference in the histological diagnostic yield for SETs between the EUS-FNB and unroofing biopsy techniques. Further study is needed to confirm the efficacy of EUS-FNB and unroofing biopsy in a larger study population. Clinical trial information: NCT02646241.

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