scholarly journals Single Stages Repair of Hypospadias Using The Snodgrass Technique: A Modern Choice

2018 ◽  
Vol 14 (2) ◽  
pp. 50-52
Author(s):  
Binod Karn ◽  
N. M. Shrestha
Keyword(s):  
Observational Study ◽  
Plastic Surgery ◽  
Teaching Hospital ◽  
The Other ◽  
Fistula Formation ◽  
Meatal Stenosis ◽  
Proximal Hypospadias ◽  
Medical College ◽  
Cosmetic Appearance

 Background: Proximal hypospadias with chordee is the most challenging variant of hypospadias to reconstruct. During the last 10 years, the approach to severe hypospadias has been controversial.Materials & Methods: This is a hospital based observational study conducted in the plastic surgery unit of department of surgery at Nepalgunj Medical College and Teaching Hospital Kohalpur from 2012 March to 2016 September. All patients underwent single staged procedures using Snodgrass technique.Results: Thirty three patients were operated. Twenty four patients had no complications. Single fistula was present in 6(18.18%) patients. Two (6.06%) patients had 2 fistulae; one at the original site of the hypospadias and the other was sub-coronal. One (3.03%) patient had moderate meatal stenosis, which was successfully treated by repeated dilatations.Conclusion: Single Staged procedure using the principles of Snodgrass's technique; is a versatile operation that can be used for the proximal hypospadias. It decreases the rate of fistula formation; disruption; stenosis and gives a satisfactory cosmetic appearance. JNGMC,  Vol. 14 No. 2 December 2016, Page: 50-52

scholarly journals BLEEDING IN EARLY PREGNANCY;

2017 ◽  
Vol 24 (04) ◽  
pp. 516-521
Author(s):  
Riaz Ahmad ◽  
Farah Naz Aziz
Keyword(s):  
Observational Study ◽  
Early Pregnancy ◽  
The Other ◽  
Molar Pregnancy ◽  
Vaginal Examination ◽  
Recurrent Miscarriages ◽  
Medical College ◽  
Fetal Movements ◽  
History Of ◽  
Incomplete Miscarriage

Objectives: (1) To determine various ways of presentation of bleeding in earlypregnancy. (2) To classify the different causes of bleeding in early pregnancy. Study Design:A descriptive observational study. Place and Duration of Study: This study was done in AzizBhatti Hospital Gujarat attached with Nawaz Sharif Medical College (U.O.G) for a period ofone year during 2014-15. Methodology: The patients who presented with the complaint ofbleeding in early pregnancy before twentieth weeks of gestation were included in the study.The patients who presented after this gestational age and the patients with DUB or any otherincidental cause were excluded. Results: Majority of the patients presented between the agesof 21 to 30 years, and the miscarriage was in the embryonic period. The other ways were painand passage of vesicles (4%). Shoulder tip pain and fainting attacks were the other associatedsymptoms, twenty two percent presented with disappearance of pregnancy symptoms, only4% patients presented with loss of fetal movements. The important predisposing factors werehistory of I.U.C.D, spontaneous miscarriage; E&C and 6% with history of recurrent miscarriages,diabetes, UTI. The most common were incomplete miscarriages. Second commonest werethreatened. Two important diagnostic aids were U.S.G. (TVS) and vaginal examination to classifythe causes of bleeding. Conclusion: Bleeding is the commonest complaint with which thepregnant population presents. The commonest cause is incomplete miscarriage followed bythreatened miscarriage; ultrasonography is of utmost importance for diagnosis. The expectantmanagement of complete miscarriage in selected cases when not bleeding heavily should beconsidered. The patients with inevitable abortion should be evacuated under aseptic conditions.The most serious causes e.g. ectopic pregnancy, molar pregnancy, missed miscarriage andincidental local causes should always be kept in mind.

scholarly journals LIMITED URETHERAL MOBILIZATION PROCEDURE (LUMP) FOR DISTAL PENILE HYPOSPADIAS REPAIR, A SINGLE CENTRE RETROSPECTIVE ANALYSIS

2021 ◽  
Vol 9 (5) ◽  
pp. 1335-1343
Author(s):  
Muhammad Riaz-ul-Haq ◽  
◽  
Arslan Raza Wasati ◽  
Mazhar Rafi ◽  
Sohail Jamil ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Surgical Techniques ◽  
Operation Time ◽  
Postoperative Management ◽  
Fistula Formation ◽  
Paediatric Surgery ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Meatal Stenosis ◽  
Cosmetic Appearance

Background: Distal penile hypospadias is one of the commonest varieties of hypospadias. Different techniques have been mentioned in literature. The success rate is usually assessed by rate of fistula formation and over all cosmetic appearance and functional outcome. Limited Uretheral Mobilization Procedure (LUMP) for distal penile hypospadias is considered a good technique with almost zero fistula rate in some series. As no new urethral tube is constructed there is no risk of fistula. Objective: To evaluate the results of the Limited Urethral Mobilization Procedure (LUMP) for distal hypospadias repair. Methods.It is retrospective analysis of 32 patients aged up to 12 years who were treated with Limited urethral mobilization procedure for distal penile hypospadias in the Department of Paediatric Surgery Jinnah Hospital Lahore from December 2018 to November 2019. All patients were operated under general anesthesia. The urethra proximal to the meatus was mobilized adequately in such a way that it should reach the tip of glans easily without any ventral bending of penis.Then the urethra was placed in the glandular wings and reconstruction of glans was carried out. Dartos flap was also placed to cover the urethra as a safety measure to avoid urethrocutaneous fistula formation. Follow up was done for a period of 3 months with respect to fistula formation, meatal stenosis, retraction , chordee and over all cosmetic appearance. Results: Age range of children was 9 months to 12 years. Operation time ranged from 60-80 minutes. Seven of 32 cases were previously operated for distal penile hypospadias but after disruption of repair meatus was lying at coronal or subcoronal level. They also underwent LUMP. Five cases had minor chordee, it was corrected at the time of uretheral mobilization by simple excision of fiberous tisse in 4 patients while modified Nesbit dorsal placation was done in one. Cosmetically normal looking circumcised penis with slit like meatus was achieved in all.Two cases got superficial wound infection, two had meatal stenosis, one meatal retraction, one ventral chordee and one urethrocutaneous fistula. Conclusion: LUMP for distal penile hypospadias is a simple and effective procedure with minimum complications.There is no chance for development of urethrocutaneous fistula, a major postoperative complication of other surgical techniques for uretheroplasty. Postoperative management is simple and hospital stay is short.

scholarly journals Comparison of 550 cases of surgical and natural menopause in respect to Genito-urinary Syndrome of Menopause (GSM)

2019 ◽  
Vol 1 (Number 2) ◽  
pp. 19-21
Author(s):  
Nusrat Mahjabeen ◽  
Sk. Zinnat Ara Nasreen
Keyword(s):  
Observational Study ◽  
Sampling Method ◽  
Prospective Observational Study ◽  
The Other ◽  
Natural Menopause ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Data Collection Sheet ◽  
Hot Flush ◽  
Surgical Menopause

Natural menopause and surgical menopause are used interchangeably when conditions of patients are discussed. But they are different entirely. One is a natural stage of life that all women experience, the other is the result of surgery. This prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Z.H. Sikder Women’s Medical College & Hospital, Dhaka from January 2016 to December 2018 over a period of three years to compare the GSM effects in natural and surgical menopause cases. During the study period a total of 275 patients with surgical menopause and 275 patients with natural menopause were enrolled employing purposive sampling method using a predesigned data collection sheet. Age of the most of the patients in surgical menopause group was within 41 to 50 years and most of the patients were >50 years old in natural menopause group. Most of the patients were illiterate in both groups and maximum patients were poor in both groups. Hot flush (48.0% vs 28.0%), dryness of vagina (12.0% vs 0.0%) and dyspareunia (72.0% vs 28.0%) were found significantly higher in surgical menopause than natural menopause. Dysuria (92.0% vs 40.0%) and increased frequency of urination (68.0% vs 36.0%) were significantly higher in surgical menopause than natural menopause group. Urgency, hesitancy and incontinence of urination were significantly lower (p=<0.001) in surgical menopause than natural menopause group. In most of the surgical menopause cases, ovaries were also sacrificed. And this may be the reason of more deleterious effects in surgical menopause than natural menopause. So, it is highly recommended to preserve ovaries in hysterectomies due to benign indications.

Profile of Road Traffic Accident Injuries in a Tertiary Care Teaching Hospital – An Institution Based Cross Sectional Observational Study in Velammal Medical College Hospital and Research Institute, Tamil Nadu

2021 ◽  
Vol 8 (14) ◽  
pp. 904-908
Author(s):  
Kumaran R ◽  
Yogaraj S
Keyword(s):  
Observational Study ◽  
Teaching Hospital ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Tertiary Care ◽  
Road Traffic Accidents ◽  
Abdominal Injuries ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

BACKGROUND Road traffic accidents (RTA) account for most of the injury patients encountered in the department of emergency resulting in significant death and morbidity. The current research was conducted to analyse the demographic, clinical and radiological profile of patients presenting with RTA to a tertiary care teaching hospital (Velammal Medical College Hospital and Research Institute). METHODS This cross-sectional observational study was done among 68 subjects presenting with RTA to the department of emergency medicine. Detailed history taking, clinical & radiological investigations including plain radiographs, ultrasound and computed tomography (CT) were done. Site of injury was considered as primary outcome of the study. The data was analysed statistically by deriving mean and standard deviation. International Business Machines Statistical Package for the Social Sciences (IBM SPSS) version 22 was used for statistical analysis. RESULTS Among the study population, the mean age was 36.18 ± 13.73 years. 83.82 % were males. Individuals aged less than 40 years of age were greatly involved in RTA. Majority (77.9 %) had abdominal injuries followed by 36.7 % with craniofacial trauma, 25 % had thoracic trauma, 17.6 % had spinal trauma, and 10.2 % had extremity and pelvic bone injuries. In abdominal trauma, spleen (26.4 %) was the commonly affected organ. Liver (25 %) and renal injuries (16.17 %) were next commonly observed. A significant difference (P-value < 0.05) was found in abdominal injuries due to different types of vehicles. CONCLUSIONS RTIs are common in the younger population. The predominance of the male population was seen. The most common organ to be injured was spleen. Proper understanding of the pattern of trauma may help in improving the outcome. Early diagnosis, aggressive resuscitation and timely surgical intervention were essential in improving the outcome in trauma patients. KEYWORDS Road Traffic Accidents, Road Traffic Injuries, Head Injury, Blunt Abdominal Trauma, CT Scan

Study on Knowledge and Prevalence of Computer Vision Syndrome among Computer Operators in Nobel Medical College Teaching Hospital, Biratnagar, Nepal

2020 ◽  
Vol 9 (2) ◽  
pp. 45-49
Author(s):  
Pramod Sharma Gautam ◽  
Uday Chandra Prakash ◽  
Subreena Dangol
Keyword(s):  
Computer Vision ◽  
Teaching Hospital ◽  
Human Life ◽  
College Teaching ◽  
Extended Period ◽  
Visual Display ◽  
Work Place ◽  
Medical College ◽  
Computer Vision Syndrome ◽  
Department Of Ophthalmology

Background: The eye and vision related problems that results from continuous use of computers and other visual display terminals for extended period of time leads to computer vision syndrome. Due to rapid digitalization in human life, the risk of developing it has also increased in many folds. So, with an aim of determining the prevalence and level of awareness of computer vision syndrome among computer users along with their attitude and practices to prevent it, this study was conducted in the office employees who use computer for a considerable period of time. Materials and Methods: A hospital based observational descriptive study was conducted in the out-patient department of Ophthalmology in Nobel Medical College and Teaching Hospital, Biratnagar, where 105 employees working in different work stations of same institution were enrolled. A questionnaire and the clinical findings were used to collect data. Results: About 80% of the employees were using computer for about (8-11) hours per day. Prevalence of computer vision syndrome noted was (92.4%) with low level of knowledge (85.7%) about it. About 45% of them wore glasses for their refractive errors but attitude and practices in work place to prevent the bad effects of using visual display terminals were found to be lacking (53.3%). Burning sensation in the eye, headache, ocular irritation and itching and neck, shoulder or back pain were the common symptoms. Around (60-70)% of the eyes tested positive for dry eye. Conclusion: Lack of awareness of computer vision syndrome and lack of personal protective measures were associated with its high level of prevalence.  

Adverse Drug Reactions to Radiographic Contrast Media in a Teaching Hospital in North India: An Observational Study

2019 ◽  
Vol 14 (2) ◽  
pp. 122-126
Author(s):  
Deepti Chopra ◽  
Abhinav Jain ◽  
Richa Garg ◽  
Shreya Dhingra
Keyword(s):  
Observational Study ◽  
Contrast Media ◽  
Adverse Drug Reactions ◽  
Teaching Hospital ◽  
Adverse Reactions ◽  
North India ◽  
Drug Reactions ◽  
Iodinated Contrast ◽  
Radiographic Contrast ◽  
Radiographic Contrast Media

Background: Radiocontrast media are used extensively nowadays to visualize internal organs. Currently, non-ionic iodinated contrast media are used which are generally considered to be safe but some adverse reactions have been reported. Thus, the present study was carried out to analyze the nature and incidence of adverse drug reactions (ADRs) to radiographic contrast media in a teaching hospital. Methods:An observational study carried out for a period of six months in a teaching hospital. Contrast media induced adverse reactions were analyzed in terms of affected organs, rate, causality assessment, severity and preventability. The treatment and outcomes of adverse events were also recorded. Naranjo Probability Scale was used to evaluate the relationship between the contrast agent used and the suspected ADR. The severity of the suspected ADRs was determined using Hartwig Scale and preventability was assessed using modified Schumock and Thornton criterion. Results:A total of 15 suspected ADRs occurred in 11 patients with an incidence of 1.4%. It included 5 (45.4%) males and 6 (54.5%) females (p < 05). The highest percentage (72.7 %) of ADRs was seen in adult patients, the mean age being 40.8 years. Vomiting (33.3%) was the most common ADR noted followed by severe nausea and rashes. 64.7 % of ADRs were categorized as probable and 35.3 % were possible. Adverse reactions required treatment in 46.6% patients. There was no fatality reported. Conclusion:The reactions observed were mild to moderate in severity and occurred within 30 minutes of the administration of the contrast.

scholarly journals Follitropin Delta as a State-of-the-Art Incorporated Companion for Assisted Reproductive Procedures: A Two Year Observational Study

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 379
Author(s):  
Bogdan Doroftei ◽  
Ovidiu-Dumitru Ilie ◽  
Ana-Maria Dabuleanu ◽  
Roxana Diaconu ◽  
Radu Maftei ◽  
...  
Keyword(s):  
Observational Study ◽  
Ovarian Hyperstimulation Syndrome ◽  
Twin Pregnancy ◽  
Assisted Reproductive Technologies ◽  
State Of The Art ◽  
Follicle Stimulating Hormone ◽  
Exact Result ◽  
Reproductive Technologies ◽  
The Other ◽  
Ovarian Hyperstimulation

Background and objectives: The latest reports suggest that follitropin delta is a highly efficient recombinant human follicle-stimulating hormone (r-hFSH) that became a part of the current assisted reproductive technologies (ARTs). Therefore, the present study aims to assess a series of parameters (follicles, oocytes, and embryos) and further by the outcomes in women following the administration of follitropin delta. Materials and methods: This observational study included 205 women. They were aged between 21 and 43 years (mean 33.45) and an anti-Müllerian hormone (AMH) level ranging from 0.11 to 16.00 ng/dL (mean 2.89). Results: In accordance with the established methodology and following the centralization of data, a total of fifty-eight pregnancies (28.29%) were achieved; forty-five (36.88%) were achieved in women under 35 years and thirteen (15.66%) in women above 35 years. These figures are positively correlated with women’s age considering that the number of follicles >18 mm, oocytes fertilized and embryo(s) varies among groups. Regarding the interest parameters, we noted n = 1719 follicles > 18 mm, n = 1279 retrieved oocytes, and n = 677 embryos at day 3. On the other hand, the following figures have been registered in women above 35 years: 814–follicles > 18 mm, 612 oocytes retrieved and 301 embryos at day 3. During this study, we registered only three cases of abortions (n = 1–0.81% in women under 35 years and n = 2–2.40% in women above 35 years). Nine pregnancies (7.37%) were stopped from evolution in females under 35 years, and twelve pregnancies (n = 8–6.55% in women under 35 years, while n = 4 in women above 35 years) were unsuccessful. A twin pregnancy has been confirmed (1.20%) in women above 35 years, six ongoing pregnancies (4.91%) in those under 35 years, and two in both groups (one per group–n = 1–0.81%, and 1.20%–n = 1) in which we did not know the exact result were registered at the end of the established studied interval. However, there were also situations in which the treatment cause an over-reactivity or had no effect; n = 2 were non-responders, and n = 1 exhibited moderate ovarian hyperstimulation syndrome (OHSS). Conclusions: Based on our results, we strongly encourage the use of this recombinant gonadotropin on a much larger scale.

scholarly journals Workload of nurses: observational study of indirect care activities/interventions

2018 ◽  
Vol 71 (2) ◽  
pp. 297-305 ◽  
Author(s):  
Mariana Santos de Campos ◽  
Bruna Andrade de Oliveira ◽  
Marcia Galan Perroca
Keyword(s):  
Observational Study ◽  
Teaching Hospital ◽  
Exploratory Study ◽  
Sao Paulo ◽  
São Paulo ◽  
Measurement Instruments ◽  
Work Process ◽  
Workload Measurement ◽  
Indirect Care

ABSTRACT Objective: Observe the workflow of nurses in hospitalization units identifying indirect care activities/interventions; measure the frequency and average time spent in performing them; and to verify the associations between average time of the activities interventions grouped into categories and per hospitalization unit. Method: Observational exploratory study using the timed technique. It was conducted in medical, surgical and specialized clinic units of a teaching hospital in the northwest of São Paulo Brazil, with 16 attending nurses as participants. Results: 90 hours of observation were performed, of which 58% (52 hours and 10 minutes) were related to indirect care activities of the patients. The most frequent activities/interventions were: "Communication" - 1,852 (44.1%), mean 34.6 (SD = 54); "Walking" - 1,023 (24.3%), mean 22 (SD = 49.2); and "Documentation" - 663 (15.8%), mean 82.7 (SD = 144.4). Conclusion: These findings favor a redesign of the work process and foster the need to update and refine the current workload measurement instruments.

First description of NDM-1-, KPC-2-, VIM-2- and IMP-4-producing Klebsiella pneumoniae strains in a single Chinese teaching hospital

2014 ◽  
Vol 143 (2) ◽  
pp. 376-384 ◽  
Author(s):  
Y. LIU ◽  
L.-G. WAN ◽  
Q. DENG ◽  
X.-W. CAO ◽  
Y. YU ◽  
...  
Keyword(s):  
16S Rrna ◽  
Klebsiella Pneumoniae ◽  
Teaching Hospital ◽  
Multidrug Resistant ◽  
The Other ◽  
Quinolone Resistance ◽  
Resistance Determinants ◽  
Carbapenem Resistant ◽  
Extended Spectrum ◽  
Chinese Teaching

SUMMARYA total of 180 non-duplicate carbapenem-resistant Klebsiella pneumoniae isolates were recovered from patients hospitalized between December 2010 and January 2012 at a Chinese hospital. Eight KPC-2, four NDM-1, one VIM-2, and five KPC-2 plus IMP-4 producers were identified and all were multidrug resistant due to the presence of other resistance determinants, including extended-spectrum β-lactamases (CTX-M-15, SHV-12), 16S rRNA methylases (armA, rmtB) and plasmid-mediated quinolone-resistance determinants (qnrA, B, S, aac(6′)-Ib-cr). Nine K. pneumoniae clones (Kpn-A1/ST395, Kpn-A3/ST11, Kpn-A2/ST134, Kpn-B/ST263, Kpn-C/ST37, Kpn-D/ST39, Kpn-E/ST1151, Kpn-F/ST890, Kpn-G/ST1153) were identified. blaKPC-2 was located on transferable ~65 kb IncL/M (ST395, ST11, ST134, ST39) and ~100 kb IncA/C (ST37, ST1153, ST890) plasmids, respectively. On the other hand, blaNDM-1 was associated with a ~70 kb IncA/C plasmid (ST263). However, non-typable plasmids of ~40 kb containing blaVIM-2 were detected in the ST1151 clone. This work reports the first co-occurrence of four diverse types of carbapenemase of K. pneumoniae clones from a single hospital in China. IncA/C, IncL/M, and other successful plasmids may be important for the dissemination of carbapenemases, producing a complex epidemiological picture.

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