scholarly journals HISTOMORPHOLOGICAL FINDINGS AND CLINICO-RADIOLOGICAL CORRELATION OF INTESTINAL ATRESIA AT A TERTIARY CARE CENTRE

2021 ◽  
Vol 9 (12) ◽  
pp. 716-724
Author(s):  
Kumari Sunita Bharati ◽  
◽  
Sanjeet Kumar Singh ◽  
Kalpana Chandra ◽  
Zaheer Hasan ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Tertiary Care ◽  
Intestinal Atresia ◽  
Radiological Feature ◽  
Calcium Deposition ◽  
Control Group ◽  
Tertiary Care Centre ◽  
Hollow Viscus ◽  
Luminal Narrowing ◽  
Histomorphological Changes

Background: An atresia is a congenital defect of a hollow viscus that results in complete obstruction of the lumen. Intestinal atresia is one of the most frequent causes of bowel obstruction in the newborn and can occur at any point in the gastrointestinal tract. This study was undertaken to study the histomorphological findings of intestinal atresia and to correlate it with different subtypes and clinico-radiological feature. Material and methods: This was a prospective observational study conducted in 24 months on the resected gastrointestinal tract of 40 neonatal intestinal obstruction cases admitted in Pediatric surgery ward received in the Department of Pathology, Indira Gandhi Institute of Medical Sciences, Patna. Control Group- A total of 5 cases of vitello-intestinal duct patency were taken as control and compared with the study group. Results: With respect to total 40 cases, there were six, i.e. 15.0% female babies and 34, i.e. 85.0% male babies studied. Out of that, 15 i.e. 37.50% were full term and 25, i.e. 62.5% were premature. Mucosa showed oedema, ulceration and flattening in 9 cases. Apart from flattening and oedema, mucosa was denuded at some places and also showed congestion and extravasated blood in 6 cases each. Abnormal villus configuration, calcium deposition in 4 cases each and hypertrophied mucosa were found in 3 cases. Luminal narrowing, loss of mucosa, duplication of mucosa and gangrenewere found in one case each. Sub mucosal changes showed congestion in 33 cases, oedema in 15, Fibrosis in 4, thickened submucosa in 2 cases and dilated irregular branching blood vessels, extravasted blood, calcification in 1 case each. Muscularispropria having changes i.e. thinning in 16 cases, congestion, hypertrophy in 4 cases each, focal loss in 3 cases, calcification in 2 cases and thinning in 2 cases. Similarly, histopathological changes in serosa shows serositis in 16 cases, congestion in 11 cases and thinning in 3 cases. Oedema and congestion were present in 2 cases, hypertrophy and calcification in 1 case each. Conclusion:In this study spectrum of histomorphological changes in the atretic segment has been described. Histomorphological changes at atretic segment can be valuable to surgeons in deciding the type of surgery and minimizing the postoperative intestinal dysmotility, which remains the most common complication of intestinal atresia.

A study of histopathological spectrum of gastrointestinal tract lesions in a rural tertiary care centre

2019 ◽  
Vol 12 (3) ◽  
pp. 153-160
Author(s):  
Neha Mukesh Goel ◽  
◽  
Abhay Y Desai ◽  
Waghmare Rohan Mohan ◽  
Vijay D Dombale ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre

Carnitine deficiency in chronic obstructive lung disease: A study in a tertiary care centre

2021 ◽  
Vol 6 (3) ◽  
pp. 183-187
Author(s):  
M Ravindranath ◽  
C H Raju
Keyword(s):  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Tertiary Care ◽  
Chronic Obstructive Lung Disease ◽  
Carnitine Deficiency ◽  
Control Group ◽  
Chronic Obstructive ◽  
X Rays ◽  
Tertiary Care Centre ◽  
Regular Diet

Chronic Obstructive Lung Disease (COPD) is a condition where there is poor airflow to the lungs and over a period of time this condition worsen, resulting in severe morbidity. L-carnitine (LC) is a soluble qaurtenary amine and is essential for the tissues and lung tone to function normally. This study was therefore find out the association of L-carnitine in patients with chronic Obstructive Pulmonary Disease. 75 patients who came to the Department of Pulmonology of either sex between 40 to 75 years with confirmed COPD were included into patients group and 75 healthy patients were included into the control group. Blood was collected for Fasting blood sugar, AST, ALP, ALT, Urea, Creatinine, Albumin, pre-albumin, iron , magnesium, sodium, phosphorous, calcium, Acylcarnitines, total and free carnitine levels. X-rays were taken and pulmonary function test was done for all the patients. The mean age of the patients in our study was 62.53 and 61.86 years among the patients and controls respectively. Among the controls the Ph and Fe levels were 3.1 ± 0.9mmol/L and 21.69 ± 3.19 mcg/dL respectively and among the patients the same levels were 2.6 ± 1.9mmol/L and 43.82 ± 8.22mcg/dL respectively. The albumin and the prealbumin in the patients were significantly lower in the patients with 21.81 ± 2.88 and 23.53 ±2.58 mg/dL and in controls they were 32.61 ±3.87 and 26.87 ± 1.93 mg/dL respectively. There was a considerable carnitine deficiencies in COPD patients when compared to the controls and since carnitine can be found in regular diet, people can be educated to have a proper intake of foods containing carnitine in their regular diet.

scholarly journals Cutaneous manifestations in obese patients and non-obese controls in a tertiary care centre: a case-control study

2019 ◽  
Vol 5 (4) ◽  
pp. 695
Author(s):  
Raghuveer Chekuri ◽  
Thameena Mohamed
Keyword(s):  
Acanthosis Nigricans ◽  
Tertiary Care ◽  
Control Group ◽  
Obese Patients ◽  
Striae Distensae ◽  
Tertiary Care Centre ◽  
Cutaneous Manifestations ◽  
High Prevalence ◽  
Skin Conditions ◽  
And Function

<p class="abstract"><strong>Background:</strong> Obesity has emerged as one of the most serious public health concerns in the 21<sup>st</sup> century. It is responsible for varied changes in structure and function of different components of skin. Skin care of obese patients deserves particular attention, not only because of high prevalence of cutaneous alteration but mainly because many of these disorders are preventable and could be treated, improving patient’s quality of life.</p><p class="abstract"><strong>Methods:</strong> Two hundred patients with BMI ≥30 kg/m<sup>2</sup> and two hundred age and sex matched controls (BMI: 18.5-24.9 kg/m<sup>2</sup>) were included in this study.<strong></strong></p><p class="abstract"><strong>Results:</strong> Compared to the control group, obese patients were having higher prevalence of various skin conditions of which most common were acanthosis nigricans, acrochordons, striae distensae, frictional hyperpigmentation and infections.</p><p class="abstract"><strong>Conclusions:</strong> There is increased incidence and severity of cutaneous manifestations like acanthosis nigricans, acrochordons, striae distensae, frictional hyperpigmentation and infections in obese patients than control subjects. These can be used as markers for the early detection of various components of metabolic syndrome.</p>

scholarly journals Surgical management and perioperative complications of peritonitis secondary to hollow viscus perforation in a tertiary care centre

2021 ◽  
Vol 8 (11) ◽  
pp. 3359
Author(s):  
Lokesh M. G. ◽  
S. Chandrashekar ◽  
Arundathi Raikar ◽  
Abhishek S. S.
Keyword(s):  
Perioperative Complications ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Threatening Condition ◽  
Hollow Viscus Perforation

Background: High mortality and morbidity is associated with peritonitis secondary to hollow viscus perforation, proving it a most common life threatening condition which needs emergency surgical care. Hence a proper evaluation was needed regarding appropriate management to have a better outcome, which was a challenge to operating surgeon.Methods: A serial study of 96 cases of peritonitis secondary to hollow viscus perforation was conducted at tertiary care centre, department of general surgery, Mysore medical college and research institute, Mysore, Karnataka from the period of August 2020 to July 2021. Data related to aetiology, surgical intervention and its peri-operative complications were noted. Appropriate statistical analyses were done to draw the inference.Results: Out of 96 cases studied, 74 were male, 22 were female with mean age of 45.53 years. Most common cause of peritonitis was GU perforation, followed by idiopathic, infective, malignancy, appendicular perforation and Trauma.Conclusions: Hollow viscus perforation being most common surgical emergencies, surgical outcomes and its related complications depends on age, general condition, site, co-morbidities and aetiologies.

scholarly journals Epidural analgesia during labour: its influences on pain relief, progress of labour, mode of delivery, maternal and foetal

2020 ◽  
Vol 9 (2) ◽  
pp. 555
Author(s):  
M. Suneetha ◽  
A. Saritha
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Obstetric Care ◽  
Fetal Outcome ◽  
Control Group ◽  
Sitting Position ◽  
Tertiary Care Centre ◽  
Group 2

Background: Today, the availability of regional anaesthesia for labour is considered a reflection of standard obstetric care. This study is to be conducted in a tertiary care centre with all facilities available for proposed end of proving that epidural analgesia is a safe and effective method for both parturient and the foetus in abolishing pain during labour.Methods: A total of 60 parturients were studied. they were randomly divided into two groups Group 1 includes 30 parturients. In this group parturient received epidural analgesia. The loading dose consisted of 10 ml of Bupivacaine 0.1% and Fentanyl 0.0002% (20 mcg). The top up doses were 10 ml of 0.1% Bupivacaine and Fentanyl 0.0002%, administered whenever the parturient complained of pain. When parturients enters into second stage a further 12-15 ml was injected with parturient in sitting position or semi-sitting position. Group 2 - (control group) Includes 30 parturients. In this group parturient was monitored without any analgesia.Results: This prospective study was done to assess the effect of epidural analgesia on the progress of labour and its outcome, to evaluate its efficacy as an analgesic technique and to study the maternal and fetal outcome. The total number of 60 parturients were selected and randomly categorized into two groups. CASE-Those who received epidural analgesia, CONTROL-Those who did not receive any analgesia.Conclusions: Epidural analgesia provides a versatile method of administering effective and satisfactory pain relief to parturient women. The technique should not be considered as a single entity, because the type and the dose of epidural medication can be altered as needed.

scholarly journals Endoscopic Management of Foreign Body Impaction in the Upper Gastrointestinal Tract in a Tertiary Care Centre of Nepal

2020 ◽  
Vol 18 (2) ◽  
pp. 36-40
Author(s):  
A. Shrestha ◽  
R.B. Gurung ◽  
P. Sharma ◽  
R. Shrestha ◽  
P. Shrestha
Keyword(s):  
Gastrointestinal Tract ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Tertiary Care ◽  
Upper Gastrointestinal Tract ◽  
Endoscopic Management ◽  
Tertiary Care Centre ◽  
Male Predominance ◽  
Foreign Body Impaction ◽  
Upper Gastrointestinal

Background Ingested foreign body impaction on upper gastrointestinal tract is common incidence among children, older age group, mentally challenged individuals, and people the influence of alcohol. In most cases, the foreign bodies pass spontaneously and uneventfully but when this does not occur; endoscopic management to ensure removal under direct visualization is required. Relief upon removal of foreign body and prevention of complications is essential. Objective To assess the endoscopic management and outcome of foreign body impacted in the upper gastrointestinal tract. Method This is a hospital based observational retrospective cross sectional study involving 165 patients at Endoscopy Department of Dhulikhel Hospital in Nepal between November 2015 and October 2019. The data regarding the demographic profile, clinical characteristics and endoscopic findings were retrieved and analyzed to determine endoscopic interventions performed, complications and outcomes. Result One hundred and sixty five patients presenting with history of ingestion of foreign body were included in the study. The mean age of the patients was 46.8 ± 19.1 years with male predominance (60%). The most common site of foreign body impaction was oesophagus (70%). The most common foreign body encountered was bone (62.2%) among which chicken bones (91.1%) were most frequent. For the retrieval of sharp-pointed foreign bodies, rat forceps and graspers (45.7%) were most commonly used. Total 14 cases required rigid oesophagoscopy as the foreign body could not be retrieved by flexible endoscopy. Conclusion Foreign body ingestion and its impaction in the upper gastrointestinal tract has been found to be common in endoscopic practise. Early detection and timely removal of foreign bodies is of utmost importance to avoid discomfort to the patient as well as to ensure successful removal without complications.

scholarly journals Association of subclinical hypothyroidism and HbA1c levels in non-diabetic subjects attending rural tertiary care centre in central India

2017 ◽  
Vol 5 (8) ◽  
pp. 3345 ◽  
Author(s):  
Vidya Sagar Ram ◽  
Granth Kumar ◽  
Manoj Kumar ◽  
Vivek Kumar Verma ◽  
Dheeraj Kela ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Elevated Serum ◽  
Control Group ◽  
Case Group ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Hypothyroid Patients ◽  
Serum Tsh ◽  
Hba1c Levels

Background: Subclinical hypothyroidism is defined as an elevated serum TSH level and normal concentrations of free T3 (FT3), free T4 (FT4), T3 and T4. A positive association between thyroid and diabetes mellitus is well recognized but to study the effect of thyroid disorders on glucose metabolism in non-diabetic patients is an area for extensive research. Present study was planned to assess correlation between subclinical hypothyroidism and glycosylated haemoglobin levels in non-diabetic patients.Methods: A case-control study was conducted on total 209 subjects. 109 patients were allotted in case group and 100 in control group. Controls were relatives and friends of patients who were matched for age and sex. Comparison between the case and the control groups were made using Student’s t-test (unpaired) and Box and Whisker Plot and regression graph were presented for correlation between serum TSH and HbA1c.Results: It was found that there was a positive correlation between the levels of serum TSH (µU/L) and HbA1c (%) in all the participants of the study by Pearson’s correlation coefficient (r=0.35, p < 0.0001).Conclusions: HbA1c levels are increased in subclinical hypothyroid patients. The effects of the elevated levels of Serum TSH on the HbA1c must be considered when interpreting the HbA1c for the diagnosis of diabetes or pre-diabetes in the subclinical hypothyroid patients.

scholarly journals A comparative study of two different techniques of subcutaneous tissue closure in abdominal surgery

2017 ◽  
Vol 6 (12) ◽  
pp. 5512
Author(s):  
Jyotsna S. Dwivedi ◽  
Alka S. Gupta ◽  
Sachin H. Pardeshi
Keyword(s):  
Subcutaneous Tissue ◽  
Tertiary Care ◽  
Total Duration ◽  
Wound Complications ◽  
Control Group ◽  
Tertiary Care Centre ◽  
Surgical Access ◽  
Suction Drain ◽  
The Difference

Background: Surgical access to abdomen is required for many operative procedures. The subcutaneous tissue of the anterior abdominal wall can either be sutured or left unsutured with drain in situ. The purpose of this study was to compare the two methods of closure of the subcutaneous tissue and determine the benefit of one over the other.Methods: The study was conducted in a tertiary care centre with sample size of 30 each in study and control group. Patients fulfilling the inclusion criteria were selected and depending on the randomisation the closure of subcutaneous tissue was done either by polyglactin 910, 2-0 or left unsutured with indigenously designed syringe suction drain kept in situ. The patients were followed up till the day of suture removal and further in case of any complications.Results: Total duration taken for the procedure was significantly increased in the study group. There was a significant level of discomfort among the participants due to drain. The rate of surgical site infection, hospital readmission morbidity was significantly higher in the study group.Conclusions: The type of drain studied was indigenously designed where the closed system was not maintained during charging the drain, hence further studies need to be conducted which will compare this with the other closed suction drains to determine the difference in the risk of wound complications.

scholarly journals Gastrointestinal Duplication Presenting as Neonatal Intestinal Obstruction: An Experience of 15 Years at Tertiary Care Centre

2016 ◽  
Vol 6 (1) ◽  
pp. 5 ◽  
Author(s):  
Kamal Nain Rattan ◽  
Shruti Bansal ◽  
Aastha Dhamija
Keyword(s):  
Gastrointestinal Tract ◽  
Intestinal Obstruction ◽  
Abdominal Mass ◽  
Tertiary Care ◽  
Operative Management ◽  
Duplication Cyst ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Common Location ◽  
Gastrointestinal Duplication

Background: Gastrointestinal tract (GIT) duplications are one of the rare congenital anomalies and can occur in any portion of the gastrointestinal tract but are more commonly encountered in small intestine. The duplication cysts cause symptoms like abdominal mass and intestinal obstruction requiring surgery or may remain asymptomatic. We are reporting our 15 years’ experience duplication cysts presenting in neonates.Methods: It is a retrospective study undertaken in the department of pediatric surgery between 2001 and 2015 for GIT duplications in neonates. Patients were analyzed for their antenatal diagnosis, age, sex, clinical diagnosis, investigatory approach, operative management and surgical outcomes.Results: Total number of neonates, diagnosed with gastrointestinal duplication in the last 15 years, was 17. Male to female ratio was 3.3:1. The most common location was found to be the ileum occurring in 71% of cases. Apart from ileum, 2 cases of duodenal and 1 case each of gastric, colonic and cecal duplication cyst were encountered. Majority cases presented with sub-acute intestinal obstruction and were managed successfully by resection and end to end anastomosis. Associated gut atresia was found in 4 cases while 1 case was found to be associated with perforation of gut.Conclusion: Gastrointestinal tract duplications often present with typical symptoms of gastrointestinal tract obstruction. Early diagnosis and management is required to prevent postoperative morbidity and mortality.

scholarly journals Comparative study of fetomaternal outcome in adolescent and young adult primigravidas

2017 ◽  
Vol 5 (3) ◽  
pp. 912
Author(s):  
Kanti Meherda ◽  
Shikha Mathur
Keyword(s):  
Young Adult ◽  
Adolescent Pregnancy ◽  
Economic Status ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Adolescent And Young Adult ◽  
Control Group ◽  
P Value ◽  
Tertiary Care Centre ◽  
Chi Square

Background: Adolescent pregnancy is a worldwide public health problem. WHO has defined adolescence as the period from 10-19 years of age. Purpose of the study was to compare the fetomaternal outcome in adolescent and young adult primigravidas.Methods: The study was conducted at a tertiary care centre over a period of six months. 150 adolescent (in our study between 15-19 years of age) and 150 young adults (20-25 years) primigravidas who delivered at our institution were randomly selected for the study. All the data including age, booking status, educational and economic status and address were noted. All essential antepartum, intrapartum and postpartum data were collected for both the groups and compared using Chi square test.Results: In our study the incidence of antepartum, intrapartum and postpartum complications was 86%,36% and 10% respectively in the study group. But in the control group only 40% of the subjects had antepartum complications ,17.33% had intrapartum complications and the incidence of postpartum complications was only 4%. The difference is highly significant with a p value <0.001.Conclusions: Adolescent pregnancy is associated with adverse fetomaternal outcome and any effort to prevent it is worthwhile.

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