scholarly journals Antibiotic Prophylaxis in Laparoscopic Cholecystectomy: A Retrospective Study

2020 ◽  
Vol 3 (2) ◽  
pp. 268-271
Author(s):  
Santosh Shrestha ◽  
Binod Bade Shrestha ◽  
Pradip Ghimire
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Private Hospital ◽  
Standard Treatment ◽  
Gallstone Disease ◽  
Surgical Site Infections ◽  
Inclusion Criteria ◽  
Female Ratio ◽  
Perioperative Prophylaxis ◽  
Perioperative Antibiotics ◽  
Male To Female

Introduction: Laparoscopic cholecystectomy is considered as the gold standard treatment for gallstone disease. There has remained a controversy on use of peri operative prophylactic antibiotics during laparoscopic cholecystectomy in reducing perioperative prophylaxis surgical site infections. Various studies has been done to evaluate whether single dose/ three doses or multiple doses are needed to decrease the incidence of surgical site infections. The objective of this study was to identify the incidence of postoperative surgical site infections with three doses of perioperative antibiotics after laparoscopic cholecystectomy. Materials and Methods: This is a retrospective observational study conducted at a private hospital from November 2017 to March 2020. All the patients received three doses of ceftriaxone 1 gram within the first 24 hours of surgery. The incidence of surgical site infection was noted. Results: A total of 449 patients who fulfilled the inclusion criteria were studied. The age ranged from 16 to 88 years. Male to female ratio was 1:4. Seven cases (1.55%) developed postoperative surgical site infections. Conclusion: Three doses of perioperative antibiotics are recommended in laparoscopic cholecystectomy to prevent postoperative surgical site infections.

Time to abandon the old dictum of delayed laparoscopic cholecystectomy after acute cholecystitis has settled in Caribbean practice

2021 ◽  
pp. 004947552110100
Author(s):  
Shamir O Cawich ◽  
Avidesh H Mahabir ◽  
Sahle Griffith ◽  
Patrick FaSiOen ◽  
Vijay Naraynsingh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gold Standard ◽  
Standard Treatment ◽  
Gallstone Disease ◽  
Acute Attack ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Surgery ◽  
Delayed Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy

Although laparoscopic cholecystectomy is the gold standard treatment for acute cholecystitis, many Caribbean surgeons are reluctant to operate during the acute attack. We collected data for all consecutive patients who underwent laparoscopic cholecystectomy for acute cholecystitis from January 1 to 31 December 2018. Delayed cholecystectomy was done >6 weeks after acute cholecystitis settled. We compared data between early and delayed groups. Delayed laparoscopic cholecystectomy was performed in 54 patients, and 42 had early laparoscopic cholecystectomy. Delayed surgery resulted in significantly more complications requiring readmission (39% vs 0), longer operations (2.27 vs 0.94 h) and lengthier post-operative hospitalisation (1.84 vs 1.1 days). Caribbean hospitals should abandon the practice of delayed surgery after cholecystitis has settled. Early laparoscopic cholecystectomy would be financially advantageous for our institutions, and it would save patients recurrent attacks of gallstone disease.

scholarly journals Association of high BNP level with heart failure in patients presenting with STEMI.

2021 ◽  
Vol 28 (04) ◽  
pp. 491-496
Author(s):  
Muhammad Waqas ◽  
Hafiz Muhammad Faiq Ilyas ◽  
Irfan Majeed ◽  
Muhammad Nouman Ahmad ◽  
Muhammad Nazim ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Informed Consent ◽  
Study Design ◽  
Inclusion Criteria ◽  
Demographic Information ◽  
Female Ratio ◽  
The Mean ◽  
Male To Female ◽  
Study Setting

Objective: The objective of this study is to to determine the association of high BNP level with heart failure in patients presenting with STEMI. Study Design: Cohort Study. Setting: Department of Cardiology, Punjab Institute of Cardiology, Lahore. Period: 01 January 2017 to 30 June 2017. Material & Methods: After meeting the inclusion criteria 150 patients were enrolled. Informed consent and demographic information was taken. Then patients divided in two groups, high and normal BNP groups. Then patients were admitted in cardiology wards and were followed-up there for 5 days. Patients evaluated for symptoms of heart failure and underwent echocardiography for confirmation of presence or absence of heart failure. All the collected data was entered and analyzed on SPSS version 21. Results: In this study the mean age high BNP group was 48.87± 10.18 years while the mean age in normal BNP group was 48.99±12.15 years. Male to female ratio of the patients was 2:1. The heart failure occurred in 19(12.67%) patients. There is 1.58 times higher risk of heart failure in high BNP than normal BNP i.e. RR=1.58[1.14-2.19]. Conclusion: This present study concluded that high BNP level is strongly associated with heart failure in patients presenting with STEMI.

scholarly journals Primary Choledocholithiasis 15 Years Postcholecystectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Michael Simon ◽  
Irfan Nazir Hassan ◽  
Dhanasekaran Ramasamy ◽  
David Wilson
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Standard Treatment ◽  
Case Reports ◽  
Gallstone Disease ◽  
The Elderly ◽  
Western Society ◽  
Bile Duct Stones ◽  
Symptomatic Gallstones

Gallstone disease is extremely prevalent in the western society with laparoscopic cholecystectomy (LC) being the standard treatment for patients with symptomatic gallstones. The prevalence of common bile duct (CBD) stones with concomitant gallstones increases with age from 8–15% in patients <60 years of age and up to 60% in the elderly. There have been only a few case reports of postcholecystectomy bile duct stones occurring more than 10 years following surgery in the literature. Most of these reports describe the presence of stones within the gallbladder/cystic duct remnant or secondary to migrating surgical clips.

EVALUATION OF HAEMODYNAMIC AND CAPNOGRAPHIC CHANGES IN OPEN AND LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 58-60
Author(s):  
Bimal Krushna Panda ◽  
Mahendra Ekka ◽  
Sagarika Rout ◽  
Shreemayee Mohapatra ◽  
Anish Rajan ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gold Standard ◽  
Standard Treatment ◽  
Open Cholecystectomy ◽  
Inclusion Criteria ◽  
P Values ◽  
Duration Of Surgery ◽  
Intraoperative Period ◽  
Bladder Pathology ◽  
Elective Cholecystectomy

Introduction: Laparoscopic cholecystectomy is one of the most commonly performed operations worldwide and gold standard treatment for benign gall bladder pathology. Increasing practice of lap cholecystectomy demands concurrent advancement in anaesthetic technique and monitoring standard. Objectives: Comparison of haemodynamic and ETCO2 changes intraoperatively during laparoscopic and open cholecystectomy and evaluation of any additional effects of insufated CO2. Study Design: Hospital based observational study done over 24 months Subjects and methods: 60 patients of both sex scheduled to undergo elective cholecystectomy under general Anaesthesia, selected on the basis of the inclusion criteria , were included in this study. Patients are assigned into two groups namely Group O[ planned for open cholecystectomy] and Group L[laparoscopic cholecystectomy], each group having 30 patients. Heart rate, systolic BP, diastolic BP, mean arterial pressure, EtCO2, SpO2 and ECG monitored continuously and record maintained before surgery, during induction, intubation, extubation and every 10 min interval up to the completion of surgery in both group.CO2 insufation and exsufation time also noted in laparoscopic cholecystectomy cases. Result: Age, sex, weight, height, ASA grade and duration of surgery of all the patients of both the groups were comparable. The HR, MAP and ETCO2 of group L started increasing during the intraoperative period and P values these were statistically signicant from t=20 minutes after intubation to t=60 min. In our study CO2 insufation done within 8 to 15 minutes after intubation. .It is clear from our study that pneumoperitoneum created during laparoscopic cholecystectomy might have caused this increase in HR,MAP and ETCO2. There was a decrease in SpO in Group L during the intraoperative period i.e from t=20 minutes after intubation to t=80 min after intubation and the P values during this 2 period were statistically signicant. Conclusion: From our study we come to the conclusion that in laparoscopic cholecystectomy there is signicant increase in HR, MAP, ETCO2 and decrease in SPO2 following insufation of the abdomen with CO2 and institution of the reverse Trendlenberg position.

A betegek kor és nem szerinti eloszlása a laparoscopos cholecystectomia szövődményei és a műtét utáni felépülés szempontjából

2011 ◽  
Vol 64 (4) ◽  
pp. 193-201
Author(s):  
Muhammed RS Siddiqui ◽  
JA Barry ◽  
K Lodha ◽  
M Parker ◽  
F Hasan
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Return To Work ◽  
Operative Time ◽  
Response Rate ◽  
Daily Activities ◽  
Female Ratio ◽  
Conversion Rates ◽  
Male To Female ◽  
Age And Sex

Abstract Objectives: Database review to analyse age and sex differences in complication and conversion rates and influence on return to normal daily activities and work after laparoscopic cholecystectomy (LC). Methods: 658 patients had a laparoscopic cholecystectomy for proven gallstones between 9/4/2001 and 15/2/2006 under the care of one surgeon (F. H.) at Benenden hospital, Kent, UK. Results: We had a 65.5% response rate with 431 replies at a mean follow up of 22.4 months (2.3–52.8). There was a male to female ratio of 5:23 with a mean age of 54.2 years (22–83). Using linear regression we found no significant correlation with operative time and variables of age and sex (df = 2, 251, R2 = 0.03, F = 0.574, p < 0.564). No significant correlation with number of complications and age or sex (df = 2, 334, R2 = 0.004, F = 1.615, p < 0.200). Age (Exp(B) = 1.040, p < 0.51) and sex (Exp(B) = 0.863, p < 0.855) had no effect on conversion. No difference was found in relation to age and sex with return to normal daily activities (df = 2, 307, F = 0.904, p < 0.406). Age was a non-significant predictor of return to work (Beta = 0.040, p < 0.572) however men return to work significantly sooner (Beta = 0.191, p < 0.007). Conclusions: Operative time, number of complications, conversion to open and return to normal daily activities may not be affected by age or sex of patients. Hospital stay may be longer in older patients. Men appear to return to work sooner. Further analysis with validated questionnaires are required.

scholarly journals Prevalence of Gall Stones in Liver Cirrhosis

2015 ◽  
Vol 53 (200) ◽  
pp. 275-279
Author(s):  
Sudhamshu K.C. ◽  
Dilip Sharma ◽  
Sandip Khadka ◽  
Niyanta Karki ◽  
Bikash Jaishi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Cirrhosis ◽  
Portal Vein ◽  
Gallstone Disease ◽  
Gallstone Formation ◽  
Female Ratio ◽  
Gall Stones ◽  
Vein Diameter ◽  
Severity Of The Disease ◽  
Male To Female

Introduction: Increased incidence and prevalence of gallstones in liver cirrhosis has already been reported by many studies. This study aimed to investigate the prevalence of gallstone disease in Nepali patients with liver cirrhosis and to identify risk factors for gallstone formation. Methods: Consecutive patients of liver cirrhosis presenting to liver clinic from January, 2010 to December, 2012 were evaluated for GS by ultrasonography at their first visit. Liver cirrhosis was diagnosed on the basis of clinical features, laboratory parameters, ultrasonography, and/or histopathology. Results: Two hundred and twenty four LC patients were studied. Male to female ratio was 2.3:1. Alcohol was the major etiological factor for LC followed by hepatitis B, alone or in conjunction with alcohol. Seventy-four patients (33%) were found to have GS. Incidence of GS was more in advance stage of cirrhosis. There was no significant correlation between formation of GS and etiology of LC, except for the HCV related liver cirrhosis, in which it was present in 39% of the patients. More the advance disease,more was the incidence as 57% of Child-C patients had GS. Portal vein diameter was also associated with GS formation. When portal vein diameter was more than 13 mm, there was more GS formation. Conclusions: One third of the patients of LC showed GS at the presentation. Patients with HCV related cirrhosis are more prone to develop GS than other. Severity of the disease and portal vein diameter was found to be associated with GS formation. Keywords: gallstones; liver cirrhosis; ultrasonography.

SOCIO-DEMOGRAPHIC PROFILE OF PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Suneet Katoch ◽  
Mukesh Kumar Jamwal ◽  
Sanjay Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Age Group ◽  
Female Ratio ◽  
Demographic Profile ◽  
Elective Laparoscopic Cholecystectomy ◽  
Male To Female

Background: In this study we evaluate the socio-demographic profile of patients undergoing elective laparoscopic cholecystectomy Methods: The present study was conducted at Department of Surgery, Dr RPGMC Kangra at Tanda. The 50 patients admitted for elective laparoscopic cholecystectomy, aging less than 75  years of both the genders were included Results: In the present study, mean age of the patients was 44.12±11.56 years B.In our study, majority of the patients (30%) were in age-group of 41-50 years followed by patients in age-group of 31-40 years (26%). 14% of the study subjects were aged more than 60 years while only 4% patients aged less than 20 years. 40% of the patients were male while 60% of the patients were female. Male to female ratio in the present study was 0.75:1. Conclusion: We concluded that a maximum patient in our study was 41-50 yrs age group female. Keywords: Age, sex, Cholelithiasis,  Cholecystectomy.

scholarly journals VISITING HOLY SHRINES

2010 ◽  
Vol 17 (03) ◽  
pp. 493-497
Author(s):  
ZULFIQAR ALI SHAIKH ◽  
FAHMIDA KHATOON ◽  
SYED SHAJEE HUSAIN ◽  
Abdullah Mohammad Ibrahim ◽  
Mansour Abdullah
Keyword(s):  
Sex Workers ◽  
Inclusion Criteria ◽  
Sacred Places ◽  
Exclusion Criteria ◽  
Cross Sectional ◽  
Female Ratio ◽  
Beneficial Effects ◽  
The People ◽  
The Common ◽  
Male To Female

Background: There are frequent visits of the devotees to the holy shrines mainly for the purpose of mental healing. The people with various beliefs and religions attribute divine powers to the graves of their saints. This study surveyed the purpose of the visits to shrines, their beneficial effects, and also the sanctity violated by drug addicts and others. Objectives: 1) To assess the common reasons of visiting holy shrines. 2) To determine the use / misuse of these visits. Methodology: Study Design: Cross-sectional. Setting: One most commonly visited shrine in Karachi. Duration of Study: 01-06-2008 to 30-07-2008. Sample size: 120 visitors. Inclusion Criteria: Visitors of 20 years age or older, who consented to participate. Exclusion Criteria: Visitors of less than 20 years age and who did not agree to participate. Results: Total number of study subjects was 120, with male to female ratio of 58:42. Their age varied from 20 to 80 years. They belonged to various socioeconomic and ethnic groups with varying educational level. Majority of the visitors come frequently. The purpose of visits included reward (swab), poverty, domestic problems, infertility, ill health, in addition to see lovers to have an access to commercial sex workers and narcotics Some devotees had a mishap during the visit. Conclusion: Most of the visitors come for mental healing and relaxation with the hope of gettingsolutions for their problems, and a few use these sacred places for their wrong doings. 

scholarly journals Study of secondary hemo-phagocytic lympho-histiocytosis in children at a tertiary centre

2021 ◽  
Vol 8 (11) ◽  
pp. 1855
Author(s):  
Usha B. Kantharajanna ◽  
Pragalatha Kumar A. ◽  
Sanjay K. S. ◽  
Pooja Gujjal Chebbi ◽  
Anil Kumar Tenneli
Keyword(s):  
Liver Enzymes ◽  
Scrub Typhus ◽  
Inclusion Criteria ◽  
Bacterial Sepsis ◽  
Female Ratio ◽  
Tertiary Centre ◽  
Elevated Liver Enzymes ◽  
Number Of Patients ◽  
High Index Of Suspicion ◽  
Male To Female

Background: Hemophagocytic lympho-histiocytosis (HLH) is fatal condition characterised by aggressive immune activation, dysregulation and up regulation of inflammatory cytokines leading to uncontrolled activation of T-cells, defective granule mediated cytotoxicity. HLH is classified into primary and secondary HLH.Methods: This is retrospective study of case-records of children who fulfilled criteria of HLH-2004 guidelines from November 2016 to November 2020.Results: Total number of patients with HLH was 33, excluding 4 cases of primary HLH, 29 cases met the inclusion criteria. 19 (65.5%) were children less than 5 years of age at the time of diagnosis. Six (20.7%) children were between 6 to 10 years and the rest 4 (13.8%) ten years. Average age at presentation was 4.93 years. Male to female ratio was 0.8 to 1. Fever was the chief complaint present in 29 (100%) of cases. Laboratory parameters showed anaemia, thrombocytopenia, hyper-ferritinemia and hypertriglyceridemia in all 29 (100%) cases. CRP elevated in 28 (96.6%) cases. Infections found in 29 (100%) of cases, bacteria in 19 (65.5%), viral in 10 (34.5%). Mortality seen in 11 (37.9%) cases. Average time of diagnosis from admission was 5.6 days. 4 children out of 11 had dengue as cause for secondary HLH and 4 had bacterial sepsis one each CMV, scrub typhus and SLE. Following factors affected the outcome by multivariate analysis, coagulopathy, elevated liver enzymes, bone marrow biopsy and immunosuppressive therapy.Conclusions: HLH should be considered in differential diagnosis of children with sepsis.  High index of suspicion for HLH with early initiation of treatment should be considered for better outcome.

scholarly journals PERIODONTAL TISSUE;

2017 ◽  
Vol 24 (06) ◽  
pp. 930-934
Author(s):  
Irum Naz ◽  
Aamir Mehmood Butt ◽  
Uzma Bashir ◽  
Hina Memon
Keyword(s):  
Periodontal Tissue ◽  
Third Molars ◽  
Inclusion Criteria ◽  
Periodontal Health ◽  
Female Ratio ◽  
Orthodontic Therapy ◽  
Periodontal Index ◽  
Community Periodontal Index ◽  
Oral Hygiene Instructions ◽  
Male To Female

Objectives: Object of present study is to determine the effect of fix orthodonticstreatment on supporting tissues. Study Design: Observational study. Place and Duration ofStudy: This study was conducted at department of orthodontics, Liaquat University HospitalJamshoro, from January 2015 to December 2015. Methodology: 60 hundred were selectedfrom orthodontic clinic opd. Inclusion criteria were to select patients with complete dentitionsapart from third molars. Pts with compromise periodontal tissue condition are excluded. All thepatients underwent oral prophylaxes and were given oral hygiene instructions at the start oforthodontic treatment. The patients were examined before the start of orthodontic treatment,after 10 months to 12 months of treatment and the periodontal health was assessed by usingCPITN (community periodontal index for treatment need) around the index teeth using WHOprobe. Results: 22(36.7%) cases out of 60 subjects were males and rest were females 38(63.3%)cases, male to female ratio 1:1.7. Means age was 20.11+1.1 years. In this study CPITN Score-0were observed in 19(31.66%) cases, Score-I in 21(35%) cases, Score-II in 14(23.33%) cases,Score-III in 5(8.33%) cases and Score-IV in 1(1.66%) case. Conclusion: Regular assessmentduring and after completion of orthodontic therapy plays big time role.

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