Non fermenters are emerging from pyogenic lesions: a case series from burdwan medical college

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally.

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Transorbital approach to infratemporal fossa: novel technique

The Journal of Laryngology & Otology ◽

10.1017/s002221511100003x ◽

2011 ◽

Vol 125 (6) ◽

pp. 638-642 ◽

Cited By ~ 5

Author(s):

A Mishra

Keyword(s):

Infratemporal Fossa ◽

Case Series ◽

Cerebrospinal Fluid Leakage ◽

Malignant Tumours ◽

Operative Morbidity ◽

Diagnostic Uncertainty ◽

Medical College ◽

Case Series Report ◽

Cranial Nerve Injury ◽

Considerable Morbidity

AbstractObjective:To present a conservative surgical approach, via the transorbital route, for selected cases of infratemporal fossa involvement or inferolateral orbital tumours extending to the infratemporal fossa.Design:Case series report.Setting:Department of ENT, CSM Medical University (King George Medical College), Lucknow, India.Participants:One patient.Main outcome measures:Operative feasibility, intra-operative access, post-operative morbidity and cosmesis.Results:This novel and relatively conservative technique provides excellent exposure in selected cases of infratemporal fossa involvement and has minimal post-operative morbidity. Cosmesis is excellent, as osteotomy is not required and scarring is minimal. There is no risk of trismus, Vth or VIIth cranial nerve injury, or cerebrospinal fluid leakage, and haemostasis is easily achieved.Conclusion:Classical, open approaches to the infratemporal fossa involve considerable morbidity, while conservative approaches have their limitations. Diagnostic uncertainty over a small infratemporal fossa mass (perhaps an extension from an inferolateral orbital tumour) is an uncommon clinical challenge. The transorbital approach described is suited to benign and early malignant tumours, and has excellent results when combined with orbital exenteration (if needed). This paper discusses this approach's technical details and feasibility in different clinical situations, and compares it with other infratemporal fossa approaches.

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PATIENTS WITH CONVERSION DISORDER

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.04.3031 ◽

2010 ◽

Vol 17 (04) ◽

pp. 715-720

Author(s):

NIAZ MAQSOOD ◽

BUSHRA AKRAM ◽

WAJID ALI

Keyword(s):

Life Events ◽

Stressful Life Events ◽

Case Series ◽

Strong Relationship ◽

Conversion Disorder ◽

Stressful Life ◽

Psychosocial Stressors ◽

Medical College ◽

Case Series Study ◽

Series Study

Objectives: To assess the frequency of the various psychosocial stressors and stressful life events in patients presenting with conversion disorder. Study Design: Case series study. Place & Duration of Study: The study was conducted in the Department of Psychiatry & Behavioural Sciences, Bahawal Victoria Hospital & Quaid-e-Azam Medical College, Bahawalpur from January, 2009 to March, 2009. Subjects & Methods: The sample consisted of 100 in-patients (89 Female, 11 Male) with Conversion Disorder. They were interviewed andresults were analysed from the entries in a Performa. Results: Stressors were clearly identified in 100 patients. In all patients, we found more than one stressor. Among patients, there were (24%) In-laws problems, (23%) Love problems, (21%) Relationship problems with family, (20%) exam/study stress, (15%) marriage against will, (13%) demanding and pampered child, (11%) Issue less, (10%) sexual abuse, (8%) demand of marriage, (6%) overage in wait of marriage, (4%) death of partner, (3%) husband abroad and (3%) patient’s engagement break. Conclusions: We concluded that stressors and life events were present in all conversion disorder’s patients and these stressful life events are important causal factors for Conversion Disorder. Conversion Disorder has strong relationship with psychosocial stressors.

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Accidental tramadol ingestion in children admitted in tertiary care centre

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20195200 ◽

2019 ◽

Vol 8 (12) ◽

pp. 2661

Author(s):

Vadlakonda Sruthi ◽

Annaladasu Narendra

Keyword(s):

Pediatric Population ◽

Care Center ◽

Tertiary Care ◽

Ventilatory Support ◽

Case Series ◽

Pediatric Intensive Care ◽

Hemodynamic Instability ◽

Tertiary Care Centre ◽

Medical College ◽

History Of

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.

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Pediatric Septic Shock: Early Recognition and Aggressive Fluid Therapy Improves Outcome

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2019/v31i630352 ◽

2019 ◽

pp. 1-6

Author(s):

Shahzad Najeeb ◽

Shabana Sarwar ◽

Rafayat Ullah ◽

Asfandyar . ◽

Khurram Saleem ◽

...

Keyword(s):

Septic Shock ◽

Early Recognition ◽

Fluid Management ◽

Case Series ◽

Generation Cephalosporin ◽

Medical College ◽

Case Series Study ◽

Study Participants ◽

Age Range ◽

Series Study

Objective: To establish the effect of aggressive fluid resuscitation in reversing the pediatric septic shock at 1 hour in children younger than 5 years of age presenting in the emergency unit of the hospital. Methods: This was a descriptive, case series study, done for six months, from December 2015 to May 2016, at Pediatric Department of Ayub Medical College Abbottabad. Patients with age range of 1 month to 5 years, presenting in the emergency department with the diagnosis of septic shock having clinical features of tachycardia, tachypnea or hyperthermia along with hypotension and poor capillary refill time were included. All patients received aggressive fluid management. Clinical examination was repeated at the end of one hour for assessment of reversal of shock. Data was collected by self-made Performa. Results: Mean age of study participants was 22.4 ± 17.6 months. Majority of participants 42(57%) were male. Mean weight was 10.3±4.3 kilograms. Mean heart rate was 173.9±17.8 beats per minutes. 67.6% were treated with a third-generation cephalosporin. At the end of one hour of treatment 51 (68.9%) showed the reversal of shock. Conclusion: Majority of childrens who presented with septic shock showed the reversal of shock at one hour of management with weight-based fluid bolus therapy.

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Efficacy and Side Effects of Intracameral Moxifloxacin as Prophylaxis after Cataract Surgery

Ophthalmology Research An International Journal ◽

10.9734/or/2020/v12i430155 ◽

2020 ◽

pp. 40-46

Author(s):

Bhanu Prakash Chaudhary ◽

Baldev Prasad Tripathi

Keyword(s):

Cataract Surgery ◽

Medical Records ◽

Case Series ◽

Rural Setting ◽

Medical College ◽

Intracameral Antibiotics ◽

Department Of Ophthalmology ◽

Routine Prophylaxis ◽

Study Support ◽

Preservative Free

Purpose: To determine the efficacy of intracameral moxifloxacin at the end of cataract surgery. Methods: Retrospective record based study. Study was based on a consecutive case series of patients who had cataract surgery during 2009 through 2019 in the Department of Ophthalmology at Maharishi Vashishth State Medical College, Basti (India). Intracameral preservative free moxifloxacin injection was given at the conclusion of surgery to most patients. Standardized operating room and sterilization protocols were used. All The medical records were reviewed for the 8 weeks after surgery. Post-operative endophthalmitis rate was computed using the number of cases of postoperative endophthalmitis as the numerator and the number of cataract surgeries as the denominator. Results: Of the 10,108 surgeries performed during study period, 2012 (19.9%) involved intracameral moxifloxacin injection. No adverse drug reactions were reported from administration of intracameral antibiotics during the study period. The post-operative endophthalmitis rate in patient who had not received intracameral antibiotic injection was 0.06%. There was no endophthalmitis case reported in patients who had received intracameral moxifloxacin injection as prophylaxis. Conclusion: The results of this study support the use if intracameral moxifloxacin as a routine prophylaxis for endophthalmitis after cataract surgery. Especially in rural setting as the patients postoperative instruction compliance is poor and many patients are lost to follow-ups sue to different reasons.

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Case series on the on the onset of transient hypo-parathyroidism after thyroidectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20175112 ◽

2017 ◽

Vol 4 (12) ◽

pp. 3849

Author(s):

Kannan Rajendran ◽

S. Saravana Kumar ◽

Robinson Smile

Keyword(s):

Risk Factors ◽

Total Thyroidectomy ◽

Serum Calcium ◽

Statistical Significance ◽

Case Series ◽

Medical College ◽

Number Of Patients ◽

Common Operation ◽

Gandhi Medical College

Background: Surgery for thyroid disorders is the common operation in general surgery and total thyroidectomy is widely performed both for carcinoma as well as benign bilateral diseases of the thyroid and the most common complication is transient hypocalcaemia. A preliminary study was conducted to assess the risk factors for transient hypocalcaemia in our hospital.Methods: This was a prospective observational study conducted from February 2013 to April 2014 at the Mahatma Gandhi Medical College and Research Institute, Pondicherry and have included all patients undergone any type of thyroid surgery with a normal pre-operative serum calcium level. After initial clinical assessment, blood samples were drawn for estimation of thyroid function and serum calcium and albumin. Postoperative hypocalcemia was assessed by eliciting Chovstek’s and Troussea’s sign and biochemically estimating serum calcium and albumin at 6,24, and 24 hours intervals and 1st and 3rd months during follow-up. The risk factors involved are also studied like sex, age, type of thyroidectomy, identification of parathyroid, Identification of recurrent laryngeal nerve and their histology.Results: A total of 50 patients who underwent thyroidectomy were included in the study. The hypocalcemia occurred in 28% of patients studied showed that 66.7% of patients developed hypocalcemia at 48-72 hours. There was no statistical significance for the parameters of age or gender, benign and malignant conditions of thyroid. The analysis of type surgery performed showed a significant number of patients developing transient hypocalcaemia after near or total thyroidectomy (p-0.002).Conclusions: The present study, though consisted of a small group of patients has shown that transient hypocalcaemia after near or total thyroidectomy occurs in early post-operative days. Hence, on an average 2-5 days of hospital stay is mandatory. Near total or total thyroidectomy is a risk factor. Early diagnosis and replacement with calcium intra-venous reduce the morbidity and mortality of hypocalcaemia.

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Meckel's Diverticulum Series at UCMS, Bhairahawa, Nepal

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v1i3.8767 ◽

2013 ◽

Vol 1 (3) ◽

pp. 56-57

Author(s):

P Joshi

Keyword(s):

Small Bowel ◽

Meckel’S Diverticulum ◽

Case Series ◽

Pancreatic Tissue ◽

Intestinal Wall ◽

Meckel's Diverticulum ◽

Medical Sciences ◽

Medical College ◽

Ileocaecal Junction ◽

Specific Symptoms

Meckel's Diverticulum is the most common congenital malformation of the Gastrointestinal tract. It represent the patent intestinal end of the vitellointestinal duct. It occurs in 2 % of of population in autospy series and usually lie 60 cm from the Ileocaecal junction. It possesses all the three coats of intestinal wall. It has the same microscopic structure as the adjacent small bowel and it has a separate blood supply from the adjacent small bowel mesentery (the omphalomesenteric artery).1 In 20% of the cases, the mucosa contains heterotopic epithelium, namely gastric, colonic and sometimes pancreatic tissue. Although Meckel's diverticulum occurs with equal frequency in both sexes, symptoms usually resulting from the epithelium contained in the diverticulum predominantly occur in males.2Complications develop in only 4% of patients with this malformation, with most cases presenting in childhood3. Complications of Meckel's diverticulum include hemorrhage, bowel obstruction, inflammation, and perforation. All of these complications can be challenging to diagnose because patients may present with non-specific symptoms, which produce a clinical picture that can mimic other more common gastrointestinal disorders.4 Most of the cases are diagnosed intraoperatively. Here, we present a case series of 5 patients in a year 2012 at Universal College of Medical College & Teaching Hospital, Bhairahawa, Nepal.DOI: http://dx.doi.org/10.3126/jucms.v1i3.8767 Journal of Universal College of Medical Sciences Vol.1(3) 2013: 56-57

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Overview of exanthems: a case series in a tertiary care hospital

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20202652 ◽

2020 ◽

Vol 6 (4) ◽

pp. 484

Author(s):

Ramesh A. ◽

Thamizhinian K.

Keyword(s):

Medical Records ◽

Analytical Study ◽

Viral Infections ◽

Tertiary Care ◽

Case Series ◽

Maculopapular Rash ◽

Care Physician ◽

Care Hospital ◽

Medical College ◽

Madras Medical College

Background: Generalized rashes are the most common conditions seen by primary care physician and the most common reason for new patient visit to dermatologists. There is often difficulty in diagnosing a generalized rash because many conditions produce similar rashes and a single condition can result in rashes with varied appearance. Accurate diagnosis is important because treatment varies depending on the cause. Hence, we decided to undertake a steady on the various presentations of exanthems in Madras medical college Chennai. To find out the incidence of exanthems in the OPD of Department of Dermatology, Venerology and Leprosy (DVL) in Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai to help in early diagnosis and treatment of the diseases. Methods: The study included all the newly diagnosed cases attending to the OPD of DVL, Madras Medical College, Chennai for a period of three months. Diagnosis was done based on clinical grounds and lab investigations were done whenever required.Results: An analytical study of the medical records of patients attending the OPD of DVL, Madras Medical College, Chennai shows that maculopapular rash is the most common presentation of exanthems followed by papules, vesiculobullous, pustular, nodules, verrucous lesions.Conclusions: The present study includes exanthems as a whole on contrary to many such studies performed in other parts of India which included rashes caused by viral infections and drugs. Our study included generalized skin eruptions due to infections, drugs, specific dermatoses, allergy.

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Extradural Sacral Arachnoid Cyst - An Institutional Experience from Rajasthan, India

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/303 ◽

2021 ◽

Vol 8 (21) ◽

pp. 1603-1607

Author(s):

Jitendra Singh Shekhawat ◽

Arvind Sharma ◽

Jagdish Chaudhary ◽

Ashish Ashish

Keyword(s):

Spinal Cord ◽

Arachnoid Cyst ◽

Case Series ◽

Primary Treatment ◽

Medical College ◽

Primary Treatment Modality ◽

Institutional Experience ◽

Spinal Arachnoid Cyst ◽

Prolapsed Intervertebral Disc

BACKGROUND Arachnoid cyst of spinal cord (ACS) is a very uncommon lesion of the spinal cord. The problem with these lesions is that they can stimulate the pain of prolapsed intervertebral disc pathology and patient may be misdiagnosed for the same. In this study we wanted to diagnose and establish a surgical treatment in such patients. METHODS This study is a case series and comprised of 12 patients which was conducted in Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, in which all patients having arachnoid cyst of spinal cord were operated and follow-up for reliving of symptoms or development of new symptoms. RESULTS Our study demonstrates that surgical result is good when spinal arachnoid cyst is better. All patients who underwent surgery were having significant improvement in symptoms and quality of life. CONCLUSIONS Surgical management is primary treatment modality in patients of arachnoid cyst of spinal cord and the results of surgery in such patients are good. KEYWORDS Spinal Arachnoid Cyst, Lumber Pain, Radiculopathy

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