scholarly journals A Single Institute Five-Year Surgical Experience with Chronic Subdural Hematoma: Analysis of 270 Consecutive Patients at a Tertiary Care Centre

2018 ◽  
Vol 32 (3) ◽  
pp. 473-482
Author(s):  
Gaurav Jaiswal ◽  
Vivek Kankane ◽  
Ashok Kumar ◽  
Pavan Kumar ◽  
Tarun Kumar Gupta
Keyword(s):  
Subdural Hematoma ◽  
Care Center ◽  
Tertiary Care ◽  
Treatment Strategies ◽  
Chronic Subdural Hematoma ◽  
Twist Drill ◽  
Surgical Experience ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Surgery Mortality

Abstract Chronic subdural hematoma (CSDH) is one of the very common surgically treatable neurosurgical entities. Still there is lack of uniformity in the management of CSDH amongst surgeons in terms of various treatment strategies and protocols. Burrhole drainage is the treatment modality of choice for an uncomplicated CSDH. Some recent trials support the use of drain to lessen the rate of recurrence. Twist drill craniostomy and craniotomy do also play a role in the management of CSDH. The current study is a retrospective analysis of 270 surgically treated patients with chronic subdural hematoma at a tertiary care center over a span of five years. The present study highlighted on rate of recurrence, re-surgery, mortality and morbidity.

scholarly journals Patterns and Severity of Injuries in Patients Following Physical Assault– A Medicolegal Aspects

2020 ◽  
Vol 2 (2) ◽  
pp. 16-20
Author(s):  
Archana Chaudhary ◽  
Srijana Kunwar ◽  
Samjhana Ghimire ◽  
Harihar Wasti
Keyword(s):  
Tertiary Care ◽  
Treatment Strategies ◽  
Point Of View ◽  
Physical Assault ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Mortality And Morbidity ◽  
Exact Test ◽  
Young Males ◽  
Far Eastern

Background and purpose: Physical assault (PA) is a common cause of mortality and morbidity throughout the world and the prevalence is still very high in underdeveloped and developing countries. With the objective to see the spectrum of injury following PA from the medico legal point of view, this study was design in a tertiary care centre at far eastern part of Nepal. Material and method: This is a prospective analytical study with non- probability consecutive sampling of physical assault cases presented in the emergency department over the duration of 4 months. All the patients who meet the inclusion criteria were collected in preformed proforma. Gender, types of weapons used for PA, location of external and internal injuries, various treatment strategies, and severity of injuries were presented in frequencies and percentage. Association of different age categories, gender and types of weapons used with severity of injuries were analysed using Chi square/ Fisher’s exact test wherever applicable. Result: There were total 99 patients presented with physical assault during the study period with mean age of presentation 31.69 (SD 13.38) Years with male (70%) predominance. Among various types of weapons used for PA; punches/ kicks were used in 50% of assaults followed by blunt heavy objects (35%) and sharp heavy weapons (14%). Location of the external injuries were more common in head and neck area . Obvious internal injuries were seen in 14% of the assaulted patients. Among all the case of PA, 42% patients needed some sort of surgical intervention during hospital stay. There were 9% cases of grievous injury and 6% had life threatening injuries. Conclusion: Physical assault is a common mode of injuries in eastern Nepal, where young males are more prone to such injuries. Violence are commonly carried out using fists, kicks and blunt objects. Severity of injuries is similar with all the types of weapons used.

scholarly journals Profile of Children Presenting with Epilepsy at a Tertiary Care Centre: A Hospital Based Cross Sectional Study

2020 ◽  
Vol 8 (3) ◽  
pp. 12-16
Author(s):  
Amol Ramrao Suryavanshi ◽  
Sachin Bapurao Bodhgire ◽  
Shivaji Sangappa Phulari ◽  
Rahul Digambarrao Anerao
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Seizure Type ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Acute Seizures

Background: Epilepsy is associated with significant mortality and morbidity. It is one of the common causes of childhood hospitalization. Regarding acute seizures episodes, there is limited data form the developing countries. This study aims to study the profile of children presenting with epilepsy at a Tertiary Care Centre. Subjects & Methods: This was a hospital based, prospective cross-sectional study conducted at the ‘epilepsy clinic’ of Paediatric department of a Tertiary Care Center. Total 260 children with epilepsy and having the age of 1 months to 12 years attending to the epilepsy clinic during the study period, were studied for clinical features, types, imaging studies, EEG, etc. Results: Most of the children (59.61%) affected with epilepsy were males. Majority of the cases (108) were in the age group 1 month to 1 year age. It was observed that, 185 cases (71.15%) were born through pre term delivery. It was found that 214 cases (82.31%) had abnormal EEG, 40 cases had abnormal CT scan and 46 cases had abnormal MRI. A significant number of children (60.38%) had generalized tonic clonic seizures. Conclusion: Epilepsy in children is a common indication for hospital admission. Evaluation of the type of seizure type with specific EEG findings and other related investigations helps in early and appropriate initiation of treatment. It is utmost important that the children with seizures should be on regular long term follow up and treatment, for better prognosis and disease outcome.

Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India

2020 ◽  
Vol 20 (4) ◽  
pp. 433-439
Author(s):  
Monika Rajani ◽  
Molay Banerjee
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Diagnostic System ◽  
Diagnostic Techniques ◽  
Automated System ◽  
North India ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Extra Pulmonary ◽  
Uv Lamp

Introduction: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. Methods: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). Results: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. Conclusion: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

scholarly journals Detection and Enumeration of the Commonest Stool Parasites Seen in a Tertiary Care Center in South India

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Vani Chandrashekar
Keyword(s):  
Entamoeba Histolytica ◽  
South India ◽  
Care Center ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Center ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Stool Samples

The aim of this study was to identify common stool parasites in patients attending a tertiary care centre in South India. We evaluated 2355 stool samples and parasites were detected in 7.9% of samples. 41.1% of our patients were in the 45–58-year age group. Protozoal infections were the commonest seen in 7.8% of samples. Entamoeba histolytica was the commonest protozoa (4.6%) followed by Entamoeba coli (1.2%) and Giardia (0.8%). Entamoeba histolytica and Entamoeba coli were together seen in 0.63%, and they were the commonest organisms seen in samples with multiple-organism infection. Both were equally detected in diarrheal samples.

scholarly journals Chronic subdural hematoma: a systematic review and meta-analysis of surgical procedures

2014 ◽  
Vol 121 (3) ◽  
pp. 665-673 ◽  
Author(s):  
Weiming Liu ◽  
Nicolaas A. Bakker ◽  
Rob J. M. Groen
Keyword(s):  
Outcome Measures ◽  
Surgical Procedures ◽  
Subdural Hematoma ◽  
Meta Analysis ◽  
Chronic Subdural Hematoma ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Twist Drill ◽  
Recurrence Rates ◽  
Postoperative Drainage

Object In this paper the authors systematically evaluate the results of different surgical procedures for chronic subdural hematoma (CSDH). Methods The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other databases were scrutinized according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement, after which only randomized controlled trials (RCTs) and quasi-RCTs were included. At least 2 different neurosurgical procedures in the management of chronic subdural hematoma (CSDH) had to be evaluated. Included studies were assessed for the risk of bias. Recurrence rates, complications, and outcome including mortality were taken as outcome measures. Statistical heterogeneity in each meta-analysis was assessed using the T2 (tau-squared), I2, and chi-square tests. The DerSimonian-Laird method was used to calculate the summary estimates using the fixed-effect model in meta-analysis. Results Of the 297 studies identified, 19 RCTs were included. Of them, 7 studies evaluated the use of postoperative drainage, of which the meta-analysis showed a pooled OR of 0.36 (95% CI 0.21–0.60; p < 0.001) in favor of drainage. Four studies compared twist drill and bur hole procedures. No significant differences between the 2 methods were present, but heterogeneity was considered to be significant. Three studies directly compared the use of irrigation before drainage. A fixed-effects meta-analysis showed a pooled OR of 0.49 (95% CI 0.21–1.14; p = 0.10) in favor of irrigation. Two studies evaluated postoperative posture. The available data did not reveal a significant advantage in favor of the postoperative supine posture. Regarding positioning of the catheter used for drainage, it was shown that a frontal catheter led to a better outcome. One study compared duration of drainage, showing that 48 hours of drainage was as effective as 96 hours of drainage. Conclusions Postoperative drainage has the advantage of reducing recurrence without increasing complications. The use of a bur hole or twist drill does not seem to make any significant difference in recurrence rates or other outcome measures. It seems that irrigation may lead to a better outcome. These results may lead to more standardized procedures.

scholarly journals Thyroid status and Treatment Response of Hypothyroid Infertile Women in Tertiary Care Center of Bangladesh

2017 ◽  
Vol 31 (2) ◽  
pp. 86-89
Author(s):  
Farzana Deeba ◽  
Parveen Fatima ◽  
Jesmine Banu ◽  
Shakeela Ishrat ◽  
Nurjahan Begum ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Early Stage ◽  
Care Center ◽  
Tertiary Care ◽  
Target Population ◽  
Fertility Treatment ◽  
Tertiary Care Centre ◽  
Infertile Women ◽  
The Mean ◽  
Tsh Levels

Objective(s): Aim of this study was to find out the prevalence of hypothyroidism in infertile women as well as to assess their response to treatment.Materials and methods: This descriptive study was conducted in Infertility unit of Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Bangladesh, a tertiary care centre from January 2014 to December 2014. Four hundred women who visited infertility clinic of the department for fertility treatment were the target population for this study. Routine investigations such as CBC, Blood sugar 2 hours postparandial or GTT, TSH and Prolactin was done. Subclinical hypothyroidism was diagnosed when there was increased TSH and normal FT4. Hypothyroid patients were given Levothyroxin depending upon TSH levels and continued until end of the study. Patients were followed up for six months even if pregnancy was attained.Results: Out of 400 women 55% were primary and 45% were secondary subfertility. Mean duration of infertility was 4.5 ± 1.2 years. Ninety two (23%) patients were hypothyroid. Among them 66 (16.5%) were subclinical hypothyroid and 26 (6.5%) were frank hypothyroid. The mean TSH levels were 7.34 ± 2.13 ìIU/ml, and the mean PRL levels were 52.46 ± 11.17 ng/ml. Out of 92 infertile women diagnosed as hypothyroidism 75 (81.52%) women conceived after treatment with drugs for hypothyroidism (dose depending upon severity of hypothyroidism, i.e. TSH levels). More than 90% women had regular ovulation for consecutive three cycles after initiation of treatment.Conclusion: The normal TSH levels are the pre-requisite for fertilization. The decision to initiate thyroid replacement therapy in both clinical and subclinical hypothyroidism at early stage is justified in infertile women.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 86-89

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