scholarly journals Evaluation of Prophylactic Antibiotic in Caesarean Section

2016 ◽  
Vol 12 (2) ◽  
pp. 40-41
Author(s):  
Nazmussaba Ansari ◽  
CR Das ◽  
Miraj Alam Ansari

Introduction: Caesarean section is one of the most rewarding surgeries when performed in time and indication. The number of C/S has been growing rapidly in the developing as well as developed world.Aims & Objectives: Evaluation of prophylactic antibiotic in caesarean section.Methodology: This study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur from June 2014 to September 2014. Group A consisted of 100 patient who were randomly allocated & injection ceftriaxone 1gm. I/V stat was given at the time of induction of anesthesia (30 mins. before incision). Group B also consisted of 100 patients who were given 5 days antibiotics.Results: In post operative evaluation the infection rate were compared in both groups, group A wound infection 2% and group B 3% , Endometritis - group A 1% and group B 2%, UTI- group A 3% and group B 4%, Fever - group A 6% and group B 4%.Conclusion: Single dose prophylactic antibiotic is comparable to multi dose antibiotic in this study. Since the single dose antibiotic is as efficacious as multi dose regime, it is advocated that single dose prophylactic antibiotic can be given in caesarean section as it is cost effective and as efficient as multi dose regimen.JNGMC Vol. 12 No. 2 December 2014, Page: 40-41

Author(s):  
Subhashchandra R Mudanur ◽  
Shreedevi S Kori ◽  
Aruna Biradar ◽  
Rajasri G Yaliwal ◽  
Dayanand S Biradar ◽  
...  

Introduction: Surgical site infections are a serious cause of maternal morbidity and mortality. Various preventive measures are being used to reduce the incidence of surgical site infections. One of them is the use of prophylactic antibiotics. In this study, authors have evaluated three antibiotic regimen with respect to preventing infectious morbidity in caesarean section. Aim: To study the efficacy and cost-effectiveness of a single dose (ceftriaxone) versus multiple doses of antibiotic therapy (ceftriaxone and ornidazole) administered preoperatively in women undergoing caesarean delivery. Materials and Methods: A prospective interventional study was conducted on 300 pregnant women undergoing emergency or elective caesarean delivery. Study was conducted at BLDE (DU) Shri BM Patil Medical College and Research Centre, Vijayapur, Karnataka, India. Patients were randomly assigned to three groups by block random sampling with 100 women in each group. Group A received Inj. ceftriaxone 1 gm single dose 60 minutes prior to commencement of surgery. Group B received Inj. ceftriaxone 1 gm along with Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and Group C received Inj. ceftriaxone 1 gm and Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and a repeat dose 12th hourly for 24 hours followed by Tab. cefixime 200 mg and Tab. ornidazole 500 mg twice daily for four days postoperatively. The effectiveness of therapy was measured in terms of adverse effects of antibiotics such as nausea and vomiting and postoperative complications like pyrexia, foul smelling lochia, surgical site infections, uterine tenderness, peritonitis and endometritis. Results: There was no statistical difference in outcome measures in side-effects of antibiotics (p-value=0.13), fever (p-value=0.68), lochia discharge (p-value=0.88), wound infection (p-value=0.39) and peritonitis (p-value=0.30) among the three groups. The single dose medication in group A had a cost of Rs.60 INR (0.82 cents USD), which was significantly less compared to the multiple dose regimens in group B that cost Rs.203 INR ($2.76 USD). The mean hospital stay in non infectious and infectious patients were 5 and 10 days in present study (p<0.0001). Conclusion: Caesarean delivery poses 5-20 times greater risk of postoperative infection when compared to vaginal birth. There has been a shifting trend of increasing caesarean deliveries and postoperative infections can contribute to overwhelming health and economic burden. Present study shows outcome measures which were statistically insignificant among the three study groups with different prophylactic regimen for caesarean delivery, so it’s safe to state that both single dose and multiple dose regimen provided equal protective coverage in reducing maternal infectious morbidity. Also, single dose regimen proved to be cost-effective. So, to conclude single dose prophylactic antibiotic given preoperatively in caesarean section is both cost-effective and as is efficient.


2018 ◽  
Vol 16 (2) ◽  
pp. 16-18
Author(s):  
Anup Sharma ◽  
Arun Shah

Background: Elective laparoscopic cholecystectomy (LC) has a low risk for Surgical Site Infection (SSI). In spite many surgeons still use prophylactic antibiotics. The aim of this study was to find out the need of prophylactic antibiotics in elective LC. Method: This study was carried out from 2017 June to 2018 August in the Department of Surgery Nepalgunj Medical College and Teaching Hospital Kohalpur (NGMC). Patients were placed into two groups. Group A received a single dose of prophylactic antibiotic and group B patients did not receive any prophylactic antibiotic. In both groups the SSI were recorded and compared. Results: Overall SSI was 5(3.33%) among 150. In group A 2 (2.66%) patients had SSI and in group B 3 (4%) had SSI. Using or not using prophylactic antibiotics did not correlate with SSI (p= .154). Conclusions: Prophylactic antibiotic is not recommended in elective LC. Prophylactic antibiotic does not reduce the rate of SSI.


Author(s):  
Pragya Verma ◽  
Dolly Chawla ◽  
Rashmi Khatri ◽  
Preeti Verma

Background: Despite of wide spread use of prophylactic antibiotics and various antiseptic measures, post-operative infection remains one of the significant and serious complication of caesarean delivery contributing to high maternal morbidity and mortality. Objective was to study the incidence of post-operative infectious morbidities in patients with/without povidone iodine vaginal cleansing done prior to caesarean section.Methods: A prospective randomized control study was done in the department of obstetrics and gynecology of Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi.Results: Mean age of participants in group A is 26.22±2.47 years and in group B is 26.48±2.3 years. Majority women (84.0%) underwent emergency lower segment caesarean section (LSCS). (6.4%) women developed post-operative endometritis, out of which maximum (4.6%) belong to no vaginal cleansing group (B) compared to 1.8% in povidone iodine vaginal cleansing group(A), which is statistically significant (p=0.01). Over all (13%) women had post-operative fever, with significant difference among the two groups i.e. (8.6%) were in group B versus (4.4%) in group A (p=0.005).Conclusions: Povidone iodine vaginal cleansing prior to caesarean section is significantly effective in reducing post-operative infectious morbidities.


2015 ◽  
Vol 12 (1) ◽  
pp. 22-24
Author(s):  
N Ansari ◽  
CR Das

Introduction: The third stage of labour is the period which follows the completed delivery of the foetus and consists of delivery of the placenta and its attached membranes.Aims and objectives: Comparison of oxytocin & misoprostol in active management of third stage of labour.Material and Methods: This is a comparative cross-sectional study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur from March 2013 to March 2014. Group A - Oxytocin 10 IU IV bolus in 100 patients and Group B - Misoprostol 600 micro gram rectally. The collected were subjected to statistical analysis using SPSS 15.Results: After active management with bolus oxytocin, the blood loss was grossly reduced being 40-100ml in 84% cases and only 7% had blood loss more than 100ml. blood loss between 200-300ml were only 6% and only 3% had PPH, after misoprostol 80% of cases had blood loss within 40 – 100 ml., 6% cases had blood loss within 100 – 200 ml. and larger amount of blood loss i.e. between 200 – 300 ml. was observed in 7% cases, in 3% cases blood loss was between 300 – 400 ml. and 4% of women in this group had PPH.Conclusion: There was no statistically significant difference in the efficacy of oxytocin and misoprostol in reducing amount of blood loss and duration of labour rd in 3 stage of labour.Journal of Nepalgunj Medical College Vol.12(1) 2014: 22-24


2021 ◽  
Vol 8 (3) ◽  
pp. 89-93
Author(s):  
Dr. Poorvi Agarwal ◽  
Dr. Harshal Nimbannavar ◽  
Dr. Prajakta Khose ◽  
Dr. Supraja Subramanian ◽  
Dr. Himadri Bal

Background: Rampant antibiotic use brought about its own set of problems like the rise in incidence of antibiotic resistant strains, allergies and other complications of antibiotic use. Unfortunately in many of our set ups we are still stuck in prolonged post-operative antibiotic regimes. This study aims to fill that lacunae and thereby aid our gradual shift away from over reliance on prolonged antibiotic usage in prevention of SSI. Hence we decided to investigate the efficacy of the use of a single prophylactic intravenous dose of antibiotic vis a vis multiple doses in reducing post-operative infective morbidity in caesarean sections. Methods: The study included 200 patients at term, satisfying the inclusion and exclusion criteria, reporting to the labour room and undergoing caesarean section. The patients were then divided into two groups of 100 each by simple randomization. Patients in Group A were given a single dose of Inj. Cefotaxime 1gm IV + Inj. Metronidazole 500 mg IV infusion 30 minutes before the skin incision. Group B cases were given the first dose of Inj. cefotaxime 1g IV + Inj. metronidazole 500 mg IV 30 minutes before the skin incision followed by injectables for 2 days: Inj. cefotaxime 1g IV BD and Inj. metronidazole 500mg IV TDS. Subsequently for the next 3 days Tablet Cefixime 200mg BD and Tablet Metronidazole 400mg TDS were administered orally. Results:  The present study did not show any significant difference in the post operative infection incidence between the single dose and multiple dose schedule. Conclusion: our study makes an important observation regarding use of antibiotic prophylaxis and its duration for prevention of post operative infections in mothers without compromising any safety aspects of either the mother or the child.  As noted in our study, there was no difference in the outcome as regards post operative infectious morbidity in patients of both the groups. Hence, based on the findings of our study we conclude that single dose prophylactic antibiotic should be the norm for caesarean sections.


2016 ◽  
Vol 24 (1) ◽  
pp. 57-61
Author(s):  
Jinnatun Nur ◽  
Rashida Khanom ◽  
Sumaya Akter

Repeat Caesarean section always carries more risk than first time caesarian delivery. In our country, antenatal care is always neglected. When this negligence occurs during subsequent pregnancy who had already goes on Caesarean section for the first pregnancy. In our study, we try to compare between the planned and unplanned repeat Caesarean section. The study was carried out at Mymensingh Medical College Hospital, Mymensingh and Amina Nursing Home at Charpara Mymensingh. This was a retrospective case control study, There were 100 patients in Group: A, (Planned repeat Caesarean section), Group B was also consisted with 100 patients (Unplanned repeat Caesarean section). Odd ratio was measured. Odd ratio between group; A and Group: B was 2.8. The two groups were compared by their age and independent t test was carried out. Group: A. Mean ± SD 25.76 ± 4.461Group: B. Mean ± SD = 26.12 ± 5.513. By pair independent t test: P value: .076ns. So we can conclude that regular antenatal Check up is mandatory for those whose 1st delivery was conducted by Caesarean section irrespective of age and economical status.J Dhaka Medical College, Vol. 24, No.1, April, 2015, Page 57-61


2008 ◽  
Vol 15 (01) ◽  
pp. 81-86
Author(s):  
MUHAMMAD NAWAZ ◽  
MUHAMMAD SULTAN ◽  
QAISAR HANIF ◽  
Muhammad Sadiq

Purpose: To compare the results of standard dacryocystorhinostomy with the results ofdacryocystorhinostomy done with silicon tube stentting of the lacrimal canaliculi. Study design: This is a hospitalbased, prospective, comparative and interventional study. Setting: Department of Ophthalmology, Allied HospitalPunjab Medical College Faisalabad. Period: January 2006 to December 2006. Methods: Twenty seven patients ofchronic dacryocystitis fulfilling the inclusion criteria were selected and divided in two groups. Group A consisted of 15patients who underwent standard dacryocystorhinostomy and Group B consisted of 12 patients who underwentdacryocystorhinostomy along with intubation of the lacrimal canaliculi with silastic tubes. All the patients were followedup for at least six months post-operatively. Success of the procedure, defined as the symptomatic relief of epiphoraand infection was assessed at the end of follow-up period. Results: Of the total 27 patients of chronic dacryocystitis23 (85%) were female and 4(15%) were male. The mean age of the patients was 45 years. The success of theprocedure was recorded in 14 (93.33%) patients in group-A and in 10 (83.33%) patients in group B. Quite a few andsimple complications were recorded during the study period. Conclusions: 1. Standard externaldacryocystorhinostomy is a simple and cost effective procedure forthe management of chronic dacryocystitis. 2. Silicontube stentting of the lacrimal canaliculi does not have any extra advantage in the management of chronic dacryocystitiswithout canalicular obstruction.


Author(s):  
Rohit K Phadnis ◽  
Faiz Hussain ◽  
Praneeth Tenneti

Introduction: Traditionally antibiotics have been advised pre and post operatively in surgery for gall bladder. The knowledge about usage of a single dose prophylactic preoperative antibiotic in comparison to conventional usage of perioperative antibiotics in laparoscopic Cholecystectomy is limited. Hence, this study focuses on comparing the efficacy of a single dose prophylactic antibiotic versus the usage of pre and postoperative antibiotics in laparoscopic Cholecystectomy. Method: This is a prospective study conducted in the General Surgery department of Apollo Institute of Medical Sciences and Research. Over 192 consecutive patients subjected for laparoscopic Cholecystectomy were included in study. They were divided in two groups (A&B) after applying exclusion. 74 patients in group A were given single dose of preoperative prophylactic antibiotic. No further post-operative antibiotics were given. 78 patients in group B were given both pre and postoperative antibiotics. Infective complications and cost constraints were compared between both the groups. Statistical analysis was done using chi-square test wherever necessary. Results: there is no significant difference in the rate of incidence of wound infection in both the groups. Age and gender had no significant association for SSI. The overall cost of Group B was found to be significantly higher than Group A. Conclusion: Usage of single dose prophylactic preoperative antibiotics with no further post operative antibiotics would be sufficient to prevent surgical site infection in uncomplicated laparoscopic Cholecystectomy. Keywords: Prevention, Antibiotic Resistance, Laparoscopic Cholecystectomy.


2019 ◽  
Vol 8 (1) ◽  
pp. 27-32
Author(s):  
Vijay Kumar Sah ◽  
Arun Giri ◽  
Sanjay Sah ◽  
Niraj Niraula

Background: Bronchiolitis is an acute, highly communicable lower respiratory tract infection. A variety of agents ranging from nebulised racemic epinephrine, salbutamol and routinely available levoepinephrine have been tried. The Present study was aimed at comparing the effectiveness of adrenaline and salbutamol in acute bronchiolitis in children aged 2 months to 2 years. Materials and Methods: The Present study was conducted at Nobel medical College Teaching Hospital over the period of one year from Feb 2018 to Jan 2019. Two different cohorts were identified in which clinically diagnosed cases and were grouped into Group A and Group B to receive the different drugs as per the study protocol. Respiratory Distress Assessment Instrument (RDAI) Scores was used for clinical assessment. Results: The age of the patients ranged from 2 months to 24 months with a median of 8 months. The males constituting about 57.42% of the study population of 155 patients. On comparing the prenebulisation variables with 10 and 30 minutes post nebulisation values, it was found that Both adrenaline and salbutamol caused overall significant improvement in RR (p-value <0.00001 in both groups) except in the age group of 19-24 months. Adrenaline was seen to be superior to salbutamol in decreasing the RR (p<0.0001) except for children in the age group of 19-24months. Adrenaline also caused greater rise in heart rate in comparison to salbutamol in all age groups. Conclusion: This study concludes that Adrenaline was seen to be superior to salbutamol in decreasing the RR and RDAI, although it showed variance with age.


2020 ◽  
Vol 23 (1) ◽  
pp. 14-18
Author(s):  
Manish Pokhrel

Introduction: Comparison of penile measurements between boys with and without hypospadias is important to determine whether there is any truth in the notion that the hypospadic penis is shorter than its age-matched normal counterpart. This study was designed to check whether there was any difference in penile sizes between Nepalese boys with and without hypospadias. Methods: A cross-sectional study was conducted among 72 Nepalese boys (36 with hypospadias and 36 without hypospadias) attending the paediatric surgical unit of Kathmandu Medical College Teaching Hospital between July 2019 and June 2020. The penile length was measured in both the flaccid state and the stretched state yielding the flaccid penile length (FPL) and the stretched penile length (SPL) for each subject utilizing standardized measuring conditions. The SPL/FPL ratio was calculated for each patient. Results: The mean FPL in the hypospadias group (A) was 3.42±0.80cms while that in the normal group (B) was 3.62±0.61cms. The mean SPL in group A was 4.58±0.94cms compared to 5.52±0.68cms in group B. The SPL/FPL ratio was 1.34±0.14 in group A compared to 1.54±0.17 in group B. The difference in FPL was not significant between groups but the difference in SPL and the SPL/FPL ratio was statistically significant between groups. Conclusion: The flaccid penile length (FPL) does not vary between the two groups. However, the stretched penile length (SPL) and the Stretched penile to Flaccid penile length ratio (SPL/FPL ratio) are significantly different between the two groups of boys.


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