scholarly journals Management of Acute Appendicitis during COVID-19 Pandemic in a Tertiary Care Centre: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (235) ◽  
Author(s):  
Anupama Thapa Basnet ◽  
Suraj Singh ◽  
Bijay Thapa ◽  
Anuj Kayastha
Keyword(s):  
Acute Appendicitis ◽  
Conservative Management ◽  
Binary Data ◽  
Tertiary Care ◽  
Medical Science ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Acute appendicitis is the most common reason for abdominal surgery in children. Though appendectomy considered the gold standard there are a lot of complications related to it. Conservative management of acute appendicitis is not new to medical science. In pandemic like COVID-19 when all the health systems were about to shut-down because of lack of manpower and resources, we started a trial of non-operative management. The main aim of this study is to find out the management of acute appendicitis during COVID-19. Methods: This was a descriptive cross-sectional study conducted in a tertiary care centre. Data collection was done from the record section which included the patients diagnosed with acute appendicitis from February 2020 to July 2020 after obtaining ethical clearance from Institutional Review Committee. Cases of appendicular lump, appendicular abscess, appendicular perforations have been excluded. Data was collected and entry was done in Statistical Package for the Social Science software version 20, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The conservative management of acute appendicitis was done in 44 cases (55.7%) while 35 cases (44.3%) had to undergo appendectomy. Conclusions: COVID-19 can complicate the perioperative course as a result of direct lung injury and multiple organ dysfunctions and can also bring serious threats to the safety of medical staffs involved in managing the acute appendicitis case operatively, so conservative management can be considered as an alternative way of management of acute appendicitis in the pandemic outbreak.

scholarly journals Advance Age Pregnancy in a Tertiary Care Centre: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (236) ◽  
Author(s):  
Vibha Mahato ◽  
Pravin Shrestha ◽  
Smita Shrestha
Keyword(s):  
Binary Data ◽  
Perinatal Death ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Hypertensive Disorder ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Women who conceive at advance age are at risk of pregnancy complications and adverse foetal outcome. This study aims to find out the prevalence of pregnancy at advance age in a teaching hospital. Methods: A descriptive cross-sectional study was conducted between October 2019 to August 2020 at department of obstetrics and gynaecology of a tertiary care centre of Nepal, after obtaining ethical clearance from Institutional Review Committee (dated 03/09/2019 with ref no. 266) and informed consent from patient. Convenience sampling was done. All the patient who were ≥35 years and >28 weeks of gestation without any chronic illness were selected. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Women aged 35 years and above constituted 104 (5.73%) of the total deliveries of study period. Most were multigravida 72 (69.23%) and 23 (22.12%) had preterm delivery. Rate of caesarean section were higher in advance maternal age 69 (66.35%). Maternal complications such as Hypertensive disorder of pregnancy 9 (8.65%), and mal-presentation 15 (14.42%) were higher among them. Perinatal outcome in form of low birth weight 9 (8.65%) and perinatal death 5 (4.80%) were increased in those women. Conclusions: From this study, it can be concluded that prevalence of advanced age at pregnancy was lower than study done in developed country but it was similar to study in India and is increasing in Nepal.

scholarly journals CARDIAC MANIFESTATIONS IN DENGUE FEVER: A CROSS SECTIONAL STUDY FROM A TERTIARY CARE CENTRE OF NORTH INDIA

2019 ◽  
Vol 6 (17) ◽  
pp. 1300-1305
Author(s):  
Mansi Singh ◽  
Ajay Kumar ◽  
Sanjay Mehrotra ◽  
Virendra Atam ◽  
Ravi Mishra ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
North India ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cardiac Manifestations

scholarly journals Prevalence of perforated appendicitis and its determinants in pediatric appendicitis patients admitted in tertiary care centre, South India: a cross sectional study

2018 ◽  
Vol 5 (12) ◽  
pp. 3926
Author(s):  
Chandrashekar S. ◽  
Lokesh M. G. ◽  
Avinash S. R.
Keyword(s):  
Acute Appendicitis ◽  
Tertiary Care ◽  
Perforated Appendicitis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Pediatric Age Group ◽  
Perforated Appendix

Background: Appendicitis remains a common indication for urgent surgical intervention in pediatric age group. Acute appendicitis has the highest incidence during the second decade of life. When the diagnosis is performed, perforation could be already present in 30%-75% of children, with young children being at higher risk. The challenge for the practitioner is to perform a timely diagnosis of acute appendicitis in first years of life before complications occur.Methods: A facility based cross sectional study was conducted with sample size of 108. The patients diagnosed and operated for acute appendicitis using Alvarado score were correlated with intra operative findings.Results: Total 108 patients with median age of 11 (IQR 9–13) years, were included in the study in which 66% were male. Overall 18% (95% CI 11%-25%) had perforated appendix and 5% (95% CI 2%-11%) had appendicitis with abscess. Male gender, patients presenting with fever, guarding, rigidity and patients presenting 48 hours after developing symptoms, had higher chance of perforation. Mean count of WBC (17000 v/s 11000) and neutrophils (75% v/s 68%) were found to be higher in patients with perforated appendicitis.Conclusions: One-fifth of the pediatric appendicitis patients presenting in tertiary care patients had perforated appendicitis.

scholarly journals Injury amongst Medicolegal Cases in Department of Forensic Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (244) ◽  
pp. 1277-1282
Author(s):  
Arbin Shakya ◽  
Jenash Acharya ◽  
Sunil Joshi
Keyword(s):  
Confidence Interval ◽  
Road Traffic ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Physical Assault ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Life Threatening

Introduction: Victim of injuries presenting to a hospital is a medico-legal issue. So, with medical management, proper documentation of injuries should be done as a legal duty by all physicians attending such cases. The study aims to find the prevalence of injury amongst medicolegal cases inthe Department of Forensic Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done amongst 328 medicolegal cases presenting at a tertiary center, from January 2019 to February 2021. Ethical approval was obtained from the Institutional Review Committee (Reference number: 2603202101). Convenience sampling was used to select study samples. After detailed history regarding the incidence, injuries were examined and documented in a performa. The data were entered in Statistical Package for Social Sciences version 18. Point estimate at 95% Confidence Interval was calculated along with frequency and percentagefor binary data. Results: Among 328 cases presenting to hospital for medicolegal issues, 237 (72.25%) (67.40-77.09 at 95% Confidence Interval) had injuries, out of which 170 (71.73%) cases were due to physical assault, 64 (27%) cases due to accident; 2 (1.26%) were undetermined. Majority of victims of injury were adult males, with mean age of 32.41±13.96 years. In most accidental injuries internal organs were also injuries and life-threatening. Conclusions: The prevalence of injuries amongst medicolegal cases was found to be higher in our study in comparison to other studies done in similar settings. Most of the injuries were due to physical assault; however, the majority of road traffic injuries were life-threatening. These road traffic injuries could have been prevented by following a safe system approach to road safety.

scholarly journals Prevalence of Covert Hepatic Encephalopathy in A Tertiary Care Centre

2020 ◽  
Vol 58 (221) ◽  
Author(s):  
Rahul Pathak ◽  
Pukar Ghimire ◽  
Sabin Thapaliya ◽  
Sashi Sharma ◽  
Prem Khadga
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Covert Hepatic Encephalopathy ◽  
Number Connection Test

Introduction: Among patients with Hepatic Encephalopathy, prevalence of Minimal HE variesbetween 30-50%. Identifying patients with MHE has been shown to improve with medications anddelay development of Overt HE, however only limited clinicians screen for MHE in patients due totime consuming neuropsychological and neurophysiological tests. The Number Connection Test isan easy way to evaluate patients to diagnose MHE. The aim of this study is to find out the prevalenceof covert hepatic encephalopathy. Methods: The descriptive cross-sectional study was done to find out the prevalence of covert hepaticencephalopathy among patients with chronic liver disease. To diagnose Covert HE which includedMHE as well, NCT was used in Devanagari script. Results: The prevalence of covert hepatic encephalopathy is found to be 56 (58.3%) at 90% confidenceinterval (58.23-58.37%). A total of 96 patients (71.9% male) were diagnosed as HE, with mean age of49.6+11.8 years. The cause of CLD in 85 (88.5%) of these patients was alcohol, of which 76 (79.2%)consumed locally brewed alcohol. Of these 96 patients with HE, only 40 (41.7%) had overt HE.Among all these, maximum patients had MHE (37.5%). Conclusions: Our study showed that although the prevalence of minimal HE is quite high amongcirrhotics, they are usually missed in clinical practice due to absence of symptoms. Active screeningwith easy-to-administer tests, like Number Connection tests, can help identify patients with minimalHE and hence treat them early.

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