scholarly journals SPECTRUM OF PERFORATION PERITONITIS IN WESTERN NEPAL

2018 ◽  
Vol 6 (1) ◽  
pp. 11-13
Author(s):  
Rajesh Poudel ◽  
Santosh Shah ◽  
Kailash Chandra ◽  
Saroj Pradhan ◽  
Pravin Joshi
Keyword(s):  
Indian Subcontinent ◽  
Care Center ◽  
Tertiary Care ◽  
Exploratory Laparotomy ◽  
Medical Sciences ◽  
Peptic Disease ◽  
Perforation Peritonitis ◽  
One Year ◽  
Operative Findings ◽  
Perforated Peritonitis

Introduction: Despite advances in surgical technique, antimicrobial therapy and perioperative care morbidity and mortality in perforated peritonitis is still high.   Aim of this study was to highlight the clinical presentation, intra operative findings and postoperative complications and mortality among patient who has undergone emergency surgery for perforated peritonitis in tertiary care center in western Nepal.Materials and Methods: This was a retrospective descriptive study carried out in Universal College of Medical Sciences, Bhairawha, Nepal. All patients who underwent emergency exploratory laparotomy for perforated peritonitis in one year period (from April 2014 to March 2015) were included in the study.Results: Total 90 cases met inclusion criteria and were analyzed. Most common presenting symptom was pain abdomen. Pneumoperitoneum was seen in 86 (95.6%) patients. Most common site of perforation was prepyloric perforation followed by duodenum. Most common cause of perforation was Acid peptic disease. Most common surgical procedure performed was Omentopexy. There were total of 11 (12.2%)mortality.Conclusion: The spectrum of perforation peritonitis in our study differs from western countries whereas it is similar to that of other research from Indian subcontinent. Majority of perforations are noticed in the duodenum and stomach due to acid-peptic disease and small bowel typhoid followed by trauma. Overall mortality was seen in 12.2%.Journal of Universal College of Medical ScienceVol. 6, No. 1, 2018, Page: 11-13

scholarly journals A STUDY ON SPECTRUM OF CONGENITALANOMALIES DELIVERED IN A TERTIARY CARE CENTER

2020 ◽  
pp. 65-66
Author(s):  
Shilpa Kantamneni ◽  
Y. Eswara Sai Prasad ◽  
Anusha Deepthi Ch
Keyword(s):  
Congenital Anomalies ◽  
Preventive Measures ◽  
Care Center ◽  
Tertiary Care ◽  
Medical Sciences ◽  
Neonatal Deaths ◽  
Factors Associated ◽  
Minor Anomalies ◽  
One Year ◽  
Common Defect

INTRODUCTION: Congenital anomaliesaccount for 9% of neonatal deaths in India. Prevalence of birth anomalies in India is 6-7%. AIMS AND OBJECTIVES: The objective was to determine proportion and clinical spectrum of congenital anomalies and maternal and perinatal risk factors associated with congenital anomalies in live newborns in our area. MATERIALS AND METHODS: Neonates born in ALLURI SITARAMA RAJU ACADEMY OF MEDICAL SCIENCES hospital during study period with documented congenital anomalies are included. All still-borns and gestational age <22wks & birth weight <400gm were excluded. Retrospective hospital-based study, conducted between January 2019 to December 2019 in ASRAM Hospital. RESULTS: The total number of births is 1132 during this one year of which, 106 newborns had congenital anomalies. In this study we found that major anomalies (80.2%) , Minor anomalies (19.8%).In this study we found that most of the anomalies were major and mostly involved cardiovascular system. In minor anomalies the most common defect was sacral dimple. CONCLUSION: Congenital anomalies can be reduced with in-utero surgeries, and necessary preventive measures which are becoming feasible.

scholarly journals Awareness and acceptance of contraceptives among the mothers of infants attending an immunization session at a field practices area of a tertiary care hospital

2018 ◽  
Vol 6 (1) ◽  
pp. 374
Author(s):  
S. B. Gupta ◽  
Meenakshi Singh ◽  
Atul Kr. Singh ◽  
Huma Khan ◽  
Alpana Saxena
Keyword(s):  
Health Workers ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Sciences ◽  
Postpartum Contraception ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Contraceptive Measure ◽  
One Year ◽  
Type Of Delivery

Background: India was the first country in the world to have launched a National Programme for Family Planning.Methods: A cross-sectional descriptive study was carried out in the in Vaccination unit of rural field practice area of Shri Ram Murti Smarak institute of Medical Sciences (SRMSIMS) Bareilly (U.P). Objective of the study was to assess knowledge and practice of postpartum contraception and factors affecting the usage of contraceptives in Rural area. All females who delivered within last one year were included in the study. A pre-structured questionnaire was used. A total of 98 females were included. The appropriate statistical analysis was done to present the results.Results: 28.57% females had adopted one or the other postpartum contraceptive measure. Condom was the most common method used. Usage of postpartum contraception was significantly associated with women’s and husband’s education, type of delivery and availing of antenatal and postnatal visits.Conclusions: Overall usage of postpartum contraception was low there is need to focus at every step to contact of these women with health facility or health workers.

scholarly journals Clinico-epidemiological features of Japanese encephalitis patients hospitalized in a tertiary care center

2018 ◽  
Vol 5 (10) ◽  
pp. 4548
Author(s):  
Abu Hasan Sarkar ◽  
Bishnu Ram Das
Keyword(s):  
Japanese Encephalitis ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
High Morbidity ◽  
Medical College ◽  
Clinical Signs And Symptoms ◽  
One Year

Background: Japanese encephalitis (JE) is of particular interest as it has a high morbidity and mortality. Neurological sequale is the most dreaded damage caused by JE. It is a preventable disease with specific interventions. The objective of the study was to study the demography, clinical profile and outcome of patients with Japanese Encephalitis admitted to the wards of Internal Medicine and Pediatrics at Jorhat Medical College Hospital.Methods: Hospital based observational study for one year in Jorhat Medical College, Jorhat, Assam.Results: The mean age for JE was 32.25±27 years for male, 27.47±22 years for female and 29.94±24 years overall. Assessment of clinical signs and symptoms showed that fever and change in mental status were present in 100% of JE cases followed by neck rigidity in 79.3% and headache in 68.9%. 44.8% of JE cases had history of seizure, 37.9% had vomiting, 34.5% had irritability, 13.8% were unconscious. The peak of JE incidence occurred in the month of July (77.6%). Complete recovery was seen in 39.2%, followed by death in 32.6% and recovery with neurological sequalae in 28.2% at the time of discharge.Conclusions: Vigorous awareness activities should be carried out to sensitize people on prevention of JE. 

scholarly journals One-year postoperative mortality rate among the elderly with hip fractures at a single tertiary care center

2020 ◽  
Vol 40 (4) ◽  
pp. 298-304
Author(s):  
Khalid A. Alsheikh ◽  
Firas M. Alsebayel ◽  
Faisal Abdulmohsen Alsudairy ◽  
Abdullah Alzahrani ◽  
Ali Alshehri ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Mortality Rate ◽  
Hip Fractures ◽  
Surgical Intervention ◽  
Care Center ◽  
Tertiary Care ◽  
The Elderly ◽  
Tertiary Care Center ◽  
Factors Associated ◽  
One Year

ABSTRACT BACKGROUND: Hip fractures are one of the leading causes of disability and dependency among the elderly. The rate of hip fractures has been progressively increasing due to the continuing increase in average life expectancy. Surgical intervention is the mainstay of treatment, but with an increasing prevalence of comorbid conditions and decreased functional capacity in elderly patients, more patients are prone to postoperative complications. OBJECTIVES: Assess the value of surgical intervention for hip fractures among the elderly by quantifying the 1-year mortality rate and assessing factors associated with mortality. DESIGN: Medical record review. SETTING: Tertiary care center. PATIENTS AND METHODS: All patients 60 years of age or older who sustained a hip fracture between the period of 2008 to 2018 in a single tertiary healthcare center. Data was obtained from case files, using both electronic and paper files. MAIN OUTCOME MEASURES: The 1-year mortality rate for hip fracture, postoperative complications and factors associated with mortality. SAMPLE SIZE: 802 patients. RESULTS: The majority of patients underwent surgical intervention (93%). Intra- and postoperative complications were 3% and 16%, respectively. Four percent of the sample died within 30 days, and 11% died within one year. In a multivariate analysis, an increased risk of 1-year mortality was associated with neck of femur fractures and postoperative complications ( P =.034, <.001, respectively) CONCLUSION: The 1-year mortality risk in our study reinforces the importance of aggressive surgical intervention for hip fractures. LIMITATION: Single-centered study. CONFLICT OF INTEREST: None.

scholarly journals Psychiatric Illnesses among the Patients Admitted for Self-poisoning in a Tertiary Care Hospital of Nepal

2013 ◽  
Vol 2 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Ajay Risal ◽  
Pushpa Prasad Sharma ◽  
Rajkumar Karki
Keyword(s):  
Tertiary Care Hospital ◽  
Organophosphorus Compounds ◽  
Care Center ◽  
Tertiary Care ◽  
Psychiatric Evaluation ◽  
Care Hospital ◽  
Age Group ◽  
Psychiatric Illnesses ◽  
History Of ◽  
One Year

Background and Aims- Self-poisoning is the commonest mode of suicide in our part of the world. Patients attempting suicide by self-poisoning usually land up in the Emergency. They are admitted for management of medical complications and subsequently referred to Psychiatry for evaluation of possible Psychiatric illnesses. The aim of this study was to explore the patterns of psychiatric illnesses in the patients admitted for self-poisoning in a tertiary care center in Nepal. Methods- The study population included those patients who were admitted and being managed for self-poisoning and brought for psychiatric evaluation during the period of one year (1st June 2011- 30th June 2012) at Dhulikhel Hospital, Nepal. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Details including sociodemographic data, psychiatric diagnosis, and treatment offered and outcome was tabulated and analyzed using SPSS-16. Results- Among the total patients (N=100), 43 were in the age group 21-40 years, median age being 27.5. There was almost equal gender distribution. Majority was of Mongolian ethnicity, homemaker by occupation and married. More than 90% were single-attempters, suicidal attempt using organophosphorus compounds. Almost 50% had depression; family dispute (19%) and marital disharmony (17%) were the most common psychosocial precipitant. Conclusion- Patients with history of self-poisoning are commonly brought to the Emergency Department of any tertiary care hospital. It is widely prevalent on younger age group. It is usually by the use of Organophosphorus compound in our setting and most commonly associated with depression. Hence, psychiatric care is essential for these patients. Journal of Advances in Internal Medicine 2013;02(01):10-13 DOI: http://dx.doi.org/10.3126/jaim.v2i1.7630

scholarly journals Salivary Gland FNA Diagnostics in a Real-Life Setting: One-Year-Experiences of the Implementation of the Milan System in a Tertiary Care Center

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1589 ◽  
Author(s):  
Erkka Tommola ◽  
Satu Tommola ◽  
Sinikka Porre ◽  
Ivana Kholová
Keyword(s):  
Salivary Gland ◽  
Classification System ◽  
Predictive Value ◽  
Care Center ◽  
Tertiary Care ◽  
Diagnostic Category ◽  
Real Life ◽  
Benign Neoplasm ◽  
Tertiary Care Center ◽  
One Year

The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced in 2018 following other organ specific cytopathological reporting systems and it aimed at bringing a practical, evidence-based, user-friendly classification system with characterization and management algorithms. At the Department of Pathology, Fimlab Laboratories, Tampere, Finland all salivary fine needle aspirations (FNAs) have been given cytopathological diagnoses according to the MSRSGC since January 2018. Analyses of a one-year-period (January 2018–December 2018) consisted of 183 salivary FNA samples from 138 patients with correlation to histopathology in 90 cases with surgical follow-up. The MSRSGC performance in patient based analysis was as follows: accuracy was 90.9%, sensitivity was 61.5%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 89.4%, respectively. Risks of malignancy (ROMs) in MSRSGC categories were: 0.0% (0/15) in non-diagnostic category, 100.0% (1/1) in non-neoplastic category biased by only one falsely-negative lymphoma case, 14.3% (1/7) in atypia of undetermined significance category, 0.0% (0/28) in benign neoplasm category, 27.3% (3/11) in neoplasm of uncertain malignant potential category, and 100% for both suspicious for malignancy (4/4) and malignancy (4/4) categories, respectively. The MSRSGC has been proven as a reliable classification system in salivary gland FNA routine diagnostics in a tertiary care center.

scholarly journals Increasing rates of cesarean section, an upcoming public health problem: an audit of cesarean section in a tertiary care center of North India based on Robson classification

2017 ◽  
Vol 6 (11) ◽  
pp. 4998
Author(s):  
Vinita Das ◽  
Namrata Kumar ◽  
Varsha Kumari ◽  
Anjoo Agarwal ◽  
Amita Pandey ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Care Center ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
North India ◽  
Cross Sectional ◽  
Group 5 ◽  
One Year

Background: Increasing rates of cesarean section during last three decades has become a cause of alarm since and a need for ongoing studies. Objective of present study was to investigate cesarean section rates as per modified Robsons Criteria and to determine area of concern which requires maximum focus to decrease overall caesarean rateMethods: This cross sectional study was conducted over a period of one year (From January 2016 to December 2016) in the Department of Obstetrics and Gynecology at King George’s Medical University, Lucknow.Results: Total number of deliveries for one year was 8526. Out of them, 4275 (50.1%) were vaginal and 4251 (49.9%) were abdominal. Overall maximum caesarean section rate was contributed by group 5 of modified Robsons criteria i.e. previous section, singleton, cephalic, ≥37 weeks (17.7%).Conclusions: Robson 10 group classification provides easy way in collecting information about Cesarean section rate which obtains good insight into certain birth groups. It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS rate (group 1 and 2) and on increasing vaginal birth after CS (group 5). The caesarean rate is commonest in group 5 that is previous section (17.7%).

scholarly journals 203. Correlating Cardiac PET Results with Intra-Operative Findings in Infectious Endocarditis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S120-S120
Author(s):  
Sami El-Dalati ◽  
Richard Weinberg ◽  
Venkatesh Murthy ◽  
Anna Owczarczyk ◽  
Jamie Riddell ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Infectious Endocarditis ◽  
Cardiac Pet ◽  
Cardiac Positron Emission Tomography ◽  
Prosthetic Valves ◽  
Duke Criteria ◽  
Positron Emission ◽  
Low Sensitivity ◽  
Operative Findings

Abstract Background Care for patients with infectious endocarditis is complicated by delays in diagnosis and relatively low sensitivity of existing diagnostic algorithms, particularly the Duke Criteria. In recent years, cardiac positron emission tomography (PET) has been identified as a useful tool in detecting occult endocardial infections. Multiple prospective studies have demonstrated that when incorporated with conventional imaging modalities cardiac PET can improve the sensitivity of the Duke Criteria by 27–38 percent. These studies used as their gold standard for diagnosis the consensus opinion of an endocarditis team and were characterized by a relatively low percentage of patients who underwent surgery. We reviewed 4 years of surgically managed IE cases at a tertiary care center where cardiac PET was used to aid diagnosis. Methods Between July 1, 2014 and December 31, 2018 we retrospectively reviewed 68 surgically managed cases of endocarditis. Cases were identified using ICD-9 and ICD-10 codes of patients who underwent surgical valve replacement for endocarditis as well as all patients who had cardiac PET scans to rule out endocarditis. Variables including PET results, operative findings, valve culture, pathology and PCR testing were recorded. Results 14 patients were identified who underwent cardiac PET prior to their surgical intervention. 9 cases were classified as possible endocarditis by Duke Criteria and 10 involved prosthetic valves. 12/14 scans were interpreted as suggestive of or consistent with endocarditis. Twelve positive PETs were associated with either operative findings of infection and/or positive PCR testing on the excised valve (positive predictive value: 100%). The 2 patients with negative scans were found to have noninfectious vegetations intra-operatively, negative valve cultures and negative pathology. Conclusion Cardiac PET correlates closely with intra-operative findings in patients with endocarditis. In patients with suspected endocarditis it may help guide surgical decision making. Cardiac PET should be considered for addition to the Modified Duke’s Criteria similar to the European Society of Cardiology guidelines. Disclosures All authors: No reported disclosures.

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