scholarly journals A STUDY OF PORT SITE COMPLICATIONS AFTER LAPAROSCOPIC CHOLECYSTECTOMIES AT TERTIARY CARE HOSPITAL IN WESTERN RAJASTHAN

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Surendra Saini ◽  
Manish Kumar Saini
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Tertiary Care ◽  
Quality Of Healthcare ◽  
Port Site ◽  
Care Hospital ◽  
Medical College ◽  
Port Site Hernia ◽  
Elective Laparoscopic Cholecystectomy

Background: Port site complications though rare, shall be evaluated and studied so as to improve the quality of healthcare. Materials and Methods: This prospective study was conducted in the Department of General Surgery, Sardar Patel Medical College & P.B.M. Hospital, Bikaner, Rajasthan. 200 patients of all age group and both sexes with symptomatic cholelithiasis undergoing laparoscopic cholecystectomy. Result: Out of 200 patients studied only 1 patient presented with port site hernia in the follow up and 13 patients presented with port site infection. No other complication was detected   after laparoscopic cholecystectomies. Conclusion:  It is concluded that port site complications are rare in elective laparoscopic cholecystectomy and can be further reduced by proper selection of patients, and strictly following basic principles of laparoscopic cholecystectomy. Keywords: Laparoscopic surgeries, Port site infections, Complications

scholarly journals A retrospective study on management of bell\'s palsy in a tertiary care hospital

2021 ◽  
Vol 11 (2) ◽  
pp. 173-176
Author(s):  
P.K Purushothaman ◽  
Dhanyan Harshidan ◽  
Priyangha Elangovan
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Bell’S Palsy ◽  
Care Hospital ◽  
Bell's Palsy ◽  
College Hospital ◽  
Medical College ◽  
Therapeutic Measures

Bell's palsy is the most common facial nerve disorder. The clinical symptoms of Bell's palsy include facial muscle paralysis, difficulty in eating, drinking and talking. Bell's palsy management is still controversial. Many patients recover spontaneously; some require medicines like corticosteroids, antiviral drugs and other managements.To study the effectiveness of Bell's palsy management that has been followed in our institution.This analysis had carried out from June 2016 to June 2019at SRM Medical College Hospital and Research Institute, Chennai. Total of 30 patients with Bell's palsy who had admitted in the Department of Otorhinolaryngology had enrolled in this study. All the patients underwent thorough clinical examination and laboratory investigation, and the results were statistically analyzed and discussed.Out of 30 patients, 16(53%) patients were males, and 14(47%) patients were females. 53.3% of patients had onset of symptoms after 48 hours. There was a statistical significant improvement in House-Brackman scale on 6 months follow-up.The therapeutic measures for Bell's palsy if initiated within 72 hours of onset aids in bringing better outcome and improves the quality of life in patients.

scholarly journals Disease Pattern at Medicine Outpatient Department of A Tertiary Care Hospital

2019 ◽  
Vol 18 (1) ◽  
pp. 27-30
Author(s):  
Raushan Akter ◽  
M Jalal Uddin ◽  
Rajat Sankar Roy Biswas
Keyword(s):  
Tertiary Care ◽  
Quality Of Healthcare ◽  
Outpatient Department ◽  
Common Disease ◽  
Care Hospital ◽  
Medical College ◽  
Number Of Patients ◽  
Disease Pattern ◽  
Laboratory Investigations

Background : Bangladesh, like many transitional nations, is straddling with the demographic and epidemiological transition. There is a critical need to improve public health in this region. But number of studies & representative data on the prevalence of diseases is inadequate. The objective of this study is to detect type & frequency of diseases among patients attending in medicine outpatient department (OPD) to improve the quality of healthcare. Materials and methods: This observational study was conducted at the outpatient department (OPD) of Chattogram Maa-O-Shishu Hospital Medical College from February to April 2018. Purposive sampling was used. Total 500 patients were included. Details were recorded in a data form and diagnosis was made on the basis of history, physical examination and necessary laboratory investigations. Data were collected and analyzed using the SPSS Version 20. Results : Total 500 patients were evaluated. Majority were female (61.2%). Highest number of patients i.e. 299 (59.4%) belonged to the age group of 16–35 years. Majority 405 (81%) of the patients in our study were from surrounding locality (Urban). The most common diseases was DM affecting 55(11%). HTN was 2nd common disease 51(10.2%). During this study we found gastrointestinal system was the most common affected organ system. Conclusion: Disease pattern study is very important to focus top problems, so that we can prepare ourselves to fight against them. Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 27-30

scholarly journals A STUDY OF PORT SITE INFECTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Mahesh Joshi ◽  
Prama Dubey
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Quality Of Healthcare ◽  
Port Site ◽  
Site Infection ◽  
Proper Selection ◽  
Basic Principles ◽  
Elective Laparoscopic Cholecystectomy ◽  
Selection Of Patients ◽  
Selection Of

Background: Port site infections though rare, shall be evaluated and studied so as to improve the quality of healthcare. Materials and Methods: This prospective study was conducted on100 patients of all age group and both sexes with symptomatic cholelithiasis undergoing laparoscopic cholecystectomy were analysed for port site infection. Result:   Out of 100 patients studied only 3 patients presented with port site infection. Conclusion: It is concluded that port site infection are rare in elective laparoscopic cholecystectomy and can be further reduced by proper selection of patients, and strictly following basic principles of laparoscopic cholecystectomy Keywords: Port site infection, laparoscopic, Cholecystectomy

scholarly journals POSTOPERATIVE PORT-SITE PAIN AFTER GALL BLADDER RETRIEVAL FROM EPIGASTRIC VS UMBILICAL PORT IN LAPAROSCOPIC CHOLECYSTECTOMY: A RANDOMIZED CONTROLLED TRIAL

2021 ◽  
Vol 9 (09) ◽  
pp. 333-337
Author(s):  
Neel Ketu ◽  
Santosh Kumar ◽  
Prem Prakash
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Tertiary Care ◽  
Port Site ◽  
Adult Patients ◽  
P Value ◽  
Care Hospital ◽  
Duration Of Surgery ◽  
Elective Laparoscopic Cholecystectomy ◽  
Site Pain

Objective: To determine whether gall bladder (GB) retrieval from umbilical port is associated with more pain at port site as compared to GB retrieval from epigastric port in adult patients undergoing four port elective laparoscopic cholecystectomy at a tertiary care hospital. Methods: Adult patients, who were undergoing elective laparoscopic cholecystectomy during a six-month period in 2010 at our institute, were randomized to either group A (n = 60, GB retrieval through epigastric port) or group B (n = 60, GB retrieval through umbilical port). VAS for pain was assessed by a registered nurse at 1, 6, 12, 24 and 36 h after surgery. Results: The VAS for pain at umbilical port was less than epigastric port at 1, 6, 12, 24 and 36 h after surgery (5.9 ±1.1 vs. 4.1± 1.5, 4.6± 0.94 vs. 3.5± 1.05, 3.9± 0.85 vs. 2.4± 0.79, 3.05± 0.87 vs. 2.15± 0.87, respectively) and the difference was statistically significant (p-value < 0.001). Multiple linear regression was done for port site pain at 24 h and the VAS at umblical port was less than epigastric port with VAS difference of 0.9 after adjusting for age, sex, duration of surgery and additional analgesia use (r 2 =0.253, p-value < 0.001). Conclusion: Gall bladder retrieval from umbilical port is associated with lower port site pain than GB retrieval from epigastric port in patients undergoing elective laparoscopic cholecystectomy. We recommend umbilical port for gall bladder retrieval.

scholarly journals Impact of Anticoagulation Clinic Intervention on Patient Centred Outcomes in a Tertiary Care Hospital

2020 ◽  
Author(s):  
S Sunil Kumar ◽  
Oliver Joel Gona ◽  
Nagaraj Desai ◽  
B Shyam Prasad Shetty ◽  
KS Poornima ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Outcomes ◽  
Therapeutic Range ◽  
Tertiary Care ◽  
Anticoagulation Clinic ◽  
Care Hospital ◽  
Thromboembolic Events ◽  
Co Morbidity

Introduction: Vitamin K Antagonists (VKAs) have been in use for more than 50 years. They have remained as mainstay therapy in the prevention of thromboembolic events in atrial fibrillation, mechanical heart valves and venous thromboembolism. Despite many years of clinical experience with VKAs, the quality of anticoagulation achieved in routine clinical practice is suboptimal. Aim: To study the effects of structured Anticoagulation Clinic (ACC) interventions on patient centred outcomes in subjects taking VKAs. Materials and Methods: A retrospective study was conducted among patients taking VKAs enrolled in ACC. A total of 169 patients receiving VKAs for at least six months with 4 INR (International Normalised Ratio) values and completed 12 months of follow-up were analysed. Anticoagulation related quality measures like Time in the Therapeutic Range (TTR), Percentage of International Normalised Ratios in the therapeutic Range (PINRR) and clinical outcomes like stroke, systemic embolic events and bleeding was analysed at the time of enrolment and compared with those during ACC care. Results: Among 352 patients enrolled in ACC, 169 patients were eligible for analysis. The mean age of the study population was 55.62±13.77 years. Atrial fibrillation (59%) was the most common indication for VKA therapy. Hypertension (66.3%) was the most common co-morbidity. Mean TTRs were significantly higher in the ACC care when compared with the pre-ACC care at 12 months follow-up (77.58±8.85% vs 51.01±16.7%, p<0.0001). There was a significant improvement in TTRs as early as three months of ACC intervention (73.18±13.56%). At the time of enrolment, 21.9% of patients had individual TTRs (i-TTR) >70% which increased to 70.4% at 12 months of follow-up. INR testing was done more frequently in ACC care. Adverse clinical events were higher in pre-ACC care than ACC care (4.7% vs 2.4%, p>0.05). Major bleeding and thromboembolic events were higher in pre-ACC care than ACC care (1.8% vs. 0.6% and 2.4% vs. 0.6% respectively). Conclusion: ACC services helps in achieving better quality of anticoagulation control as measured by time in therapeutic range translating into better clinical outcomes.

scholarly journals Comparative study of post-partum intra uterine contraceptive device insertion and interval intra uterine contraceptive device insertion in a tertiary care hospital

2017 ◽  
Vol 6 (7) ◽  
pp. 2760
Author(s):  
Manimegalai R. ◽  
Suganthi R.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Family Health ◽  
Common Reason ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Medical College

Background: NFHS (National Family Health Survey) 2005-2006 in India revealed that the contraceptive prevalence rate is 53.5%. 10% of all pregnancies are mistimed and 11% of all pregnancies are unwanted in India. Objective of present study was to compare the benefits and complications of postpartum IUCD insertion (PPIUCD) over interval IUCD insertion in a tertiary care hospital.Methods: It is a retrospective study conducted in the Department of Obstetrics and Gynecology, Govt. Mohan Kumaramangalam Medical College, Salem from 2009-2014. The cases of interval IUCD for the year 2009-2014 and PPIUCD cases for the year 2012-2014 both vaginal insertion and intracaesarean insertion were taken for study. Complications, benefits and reasons for removal were compared between the two groups.Results: The total number of cases of IUCD insertion significantly increased after the introduction of PPIUCD programme in 2012. The acceptance of IUCD insertion was steadily increasing after the introduction of PPIUCD even though the follow up of PPIUCD cases was less (32%). The rate of removal in patients who came for follow up was less in PPIUCD group (18%) compared to interval IUCD cases (57%) when the reason was menorrhagia. The most common reason for removal was menorrhagia in interval IUCD patients. Abdominal pain was the most common reason for removal in PPIUCD patients. The rate of expulsion was higher in PPIUCD (6%) compared to interval IUCD patients (<1%). No cases of perforation and no cases of pregnancy in situ were reported in PPIUCD cases during the study period. Even though the rate of infection and missing strings were higher in PPIUCD patients when compared to interval IUCD patients who came for follow up the number of women with infection in PPIUCD patients is less and easily managed with appropriate antibiotics.Conclusions: In India PPIUCD insertion soon after delivery is a safe, effective, reversible and reliable method of long term contraception. Both vaginal and intracaesarean insertions are safe, efficacious and convenient even though there are few complications which are easily manageable. There are no incidences of perforations, pregnancy in situ, ectopic pregnancy and low rates of infection. Hence PPIUCD is a promising approach to decrease the fertility rate in the field of family planning.

scholarly journals An analysis of postoperative adverse events following laparoscopic cholecystectomy in a tertiary care hospital

2019 ◽  
Vol 6 (7) ◽  
pp. 2533
Author(s):  
Ramanuj Mukherjee ◽  
Vaibhav Agarwal ◽  
Arup Mohanta ◽  
Gouri Mukhopadhyay ◽  
Sudipta Samanta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Adverse Events ◽  
Tertiary Care ◽  
Unintentional Injury ◽  
Common Adverse Event ◽  
Care Hospital ◽  
Age Group ◽  
Cross Sectional ◽  
Medical College ◽  
Life Threatening

Background: Being one of the most commonly performed surgery in the modern era, post-operative complications following laparoscopic cholecystectomy deserve special mention. Though not very life threatening, they are quite common. Considering these aspects, this study aims to identify them and possibly a potential remedy for decreasing the incidence in the future.Methods: This is a retrospective, institution-based, observational and cross-sectional analysis conducted in R.G. KAR Medical College and Hospital over 5 years on 1000 patients undergoing surgery. Here we intend to observe the adverse events following laparoscopic cholecystectomy in the post-operative period.Results: Most of the complications were seen in the age group greater than 40 years(63%) followed by the age group 30-40 years (26%).Adverse events were much more common in females (85%) followed by males (15%). The symptoms appeared mostly during 3-7 days post operatively (57%) followed by 20% within the first 6 hours. Non-specific abdominal pain (28%) was the most common adverse event followed by port-site infection in 16.5% cases.Conclusions: Proper pre-anaesthetic check-up with proper instrument handling with proper caution and before closing confirmation of proper placement of clip and no other unintentional injury anywhere can decrease the post-operative complication.

scholarly journals Port site hernia: Minor but severe complication of laparoscopic cholecystectomy.

2020 ◽  
Vol 27 (08) ◽  
pp. 1717-1721
Author(s):  
Ehsanullah Malik ◽  
Sania Bhatti ◽  
Muharram Ali Abbasi ◽  
Yasmeen Bhatti ◽  
Abdul Sattar Abro ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
College Teaching ◽  
Port Site ◽  
Care Hospital ◽  
Site Infection ◽  
Case Series Study ◽  
Port Site Hernia ◽  
Duration Of Surgery ◽  
The Mean

Laparoscopic cholecystectomy is a gold standard procedure for the management of patients with cholelithiasis with fewer complications but still port site hernia is one of the severe complications if not treated properly may lead adverse result. This usually results from improper closure or infection of the musculoaponeurotic layers of the abdominal wall. The frequency of port site hernia is variable in literature and its association with infection and other co-morbidities is less explored. Objectives: To determine the frequency of port-site hernia after laparoscopic cholecystectomy at a tertiary care hospital Larkana and its association with infection and co-morbidities. Study Design: Descriptive Case Series study. Setting: Department of Surgery, Chandka Medical College Teaching Hospital, Larkana. Period: December 2018 to December 2019. Material & Methods: One hundred forty-eight patients undergoing elective laparoscopic cholecystectomies, who fulfilled the inclusion criteria and gave informed consent were selected for this study. All the patients were followed for 6 months. Data was recorded for age, gender, BMI, smoking and diabetes mellitus status. Infection and port site hernia were observed during the follow-up period. The SPSS version 21 was used for data analysis. Results: The majority of the patients 79 (53.4%) were above the age of 35 years. The mean age of the patients was 40.14 ±11.40 years. Females were younger than males. Among them 19 (12.8%) were males compared to 129 (87.2%) females. Mean BMI (kg/m2) of male patients were 25.98±3.53 and female patients were 24.80±3.04. The mean duration of surgery was 63.72 (+18.20) minutes, mostly accomplished is within 80mins (54.1%).  Out of 148 patients in 5 (3.4%) patients port site hernia was observed. In all these patients wound to get infected and surgery was for a prolonged period. A significant association has been found between port site hernia, operative time and port site infection. However, no significant association has been found between port site hernia and gender, age, smoking and Diabetes (P>0.05). Conclusion: The frequency of port site hernia is low but could be disastrous if the bowel gets obstructed. Using good technique and reducing operative time are effective measures in reducing the port site infection and the port site hernia.

scholarly journals A study of prevalence of urogenital problem among menopausal women attending the OPD at tertiary care hospital in Bhopal

2021 ◽  
Vol 10 (3) ◽  
pp. 1062
Author(s):  
Malini Bhardwaj ◽  
Tarani Shinde
Keyword(s):  
Care Delivery ◽  
Human Life ◽  
Tertiary Care ◽  
Care Hospital ◽  
Face To Face ◽  
Medical College ◽  
Menopausal Women ◽  
First Time ◽  
Human Life Span

Background: The interest in menopausal problems has increased in recent years, due to the expansion of human life span. Women are spending more than one-third of their lives in menopausal period. Due to this fact, estrogen deprivation can cause vaginal atrophy symptoms and vasomotor symptoms, which critically diminish quality of life (QOL) in postmenopausal women.Methods: This study is a retrospective observational/analytical study conducted in the menopausal specialty clinic in J. K. Hospital, L. N. Medical College, Bhopal over a period of 1 year. All the women who attained menopause either naturally or surgically who presented first time to the clinic for any complaints were evaluated for the UG symptoms with the help of face to face interview.Results: Out of the 300 women with menopausal symptoms, 182 i.e. 60.6% were married and 52% (156) were illiterate. The most prevalent menopausal symptom in present study was vaginal dryness 240 (80%).Conclusions: There is association with lower educational levels. Hence efforts should be made educate women about the symptoms and provide care at all the levels of health care delivery. 

scholarly journals Prevalence of Dunning Kruger effect in first year medical students in a tertiary care hospital

2021 ◽  
Vol 8 (11) ◽  
pp. 5283
Author(s):  
Novonil Deb ◽  
Poulami Roy
Keyword(s):  
Medical Students ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
First Year ◽  
Care Hospital ◽  
Metacognitive Skills ◽  
Cross Sectional ◽  
Medical College ◽  
First Year Medical Students

Background: Dunning Kruger (DK) effect refers to overestimation of one’s ability which is attributed to their inadequacy of metacognitive skills i.e., the low-performing individuals are often nescient of their incompetence which leads them to reach fallacious conclusions and make regrettable choices. Objectives of the study were to assess the degree of DK effect among the first-year medical students and to compare the associated socio-economic variables.Methods:  A descriptive cross-sectional study was conducted among the interested first-year medical students of North Bengal medical college and hospital from March 2021 to April 2021 using a questionnaire. Responses were recorded in Microsoft excel 2017, analysed, and presented in form of tables and charts following principles of descriptive statistics.Results: The overall prevalence of DK effect was found to be 78.38% among the first-year medical students. Higher prevalence was observed among females (80.28%) as compared to males (75%). Students having low study hours (79.13%), no academic achievements (77.5%), and greater hours of sleep (79.74%) manifested more predisposition to DK effect.Conclusions: In our research, we have noticed a higher DK effect among the first-year medical students, which might hamper the quality of treatment and patient care in the future. Proper orientation and counselling methods are required to overcome this phenomenon.

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