scholarly journals MORBI-MORTALITY RELATED TO ILEOSTOMY AND COLOSTOMY CLOSURE AT TERTIARY CARE HOSPITAL BIKANER

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Bhupendra Sharma ◽  
Narendra . ◽  
Nitu Singh
Keyword(s):  
Renal Dysfunction ◽  
General Surgery ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Colostomy Closure ◽  
Medical Complications ◽  
Complication Rates ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
Closure Of Ileostomy

Background:  To study the morbi-mortality related to ileostomy or colostomy closure at tertiary care hospital Bikaner Material and Method: prospective hospital based study. 30 patients reporting to the General Surgery dept. within study duration and eligible as per inclusion criteria will be included in the study. Results: Out of 30 Cases ,(30.00%) patients had hypertension ,6(20.00%) had diabetes,  5 (16.67%) had renal dysfunction and 2(6.67%) cases had COPD. 11 (36.67%) patients developed complications post closure of ileostomy or colostomy. Medical complications accounted for a large proportion of complications (n=5), while major (n=4) and minor complications (n=2) were present. Conclusion: ileostomy is effective and feasible as a diversion procedure and has reduced morbidity and complication rates.  Keywords:  Ileostomy, Colostomy. Complications.

scholarly journals Ultrasound-guided percutaneous renal biopsy at a university hospital: retrospective analysis of success and complication rates

2021 ◽  
Vol 54 (5) ◽  
pp. 311-317
Author(s):  
Orlando Vieira Gomes ◽  
Bianca Alencar Dias de Almeida ◽  
Leonardo Fernandes e Santana ◽  
Mateus de Sousa Rodrigues ◽  
Guilherme Bruno Pires Marques Locio ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Retrospective Analysis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
University Hospital ◽  
Complication Rates ◽  
Care Hospital ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Second Procedure

Abstract Objective: To evaluate the success and complication rates of ultrasound-guided renal biopsy at a tertiary care hospital. Materials and Methods: This was a retrospective analysis of 97 ultrasound-guided renal biopsies, all performed by the same radiologist, between 1 March, 2017 and 31 October, 2019. Results: Of the 97 biopsies evaluated, 87 had a definitive pathological diagnosis. In five cases (5.4%), the biopsy results were inconclusive and a second procedure was required. In seven procedures (7.6%), there were complications, all of which were properly resolved. Conclusion: Ultrasound-guided renal biopsy has proven to be a safe, effective method for the diagnosis of nephropathies, with high success rates.

scholarly journals Outcome of Cranioplasty Done within and Beyond 2 Months after Decompressive Craniectomy for Traumatic Brain Injury

2021 ◽  
Vol 10 (10) ◽  
pp. 711-714
Author(s):  
Khongbantabam Vyas ◽  
Khaidem Mani Singh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Categorical Variables ◽  
P Value ◽  
Consecutive Series ◽  
Complication Rates ◽  
Care Hospital

BACKGROUND Cranioplasty although a simple elective neurosurgical procedure is burdened by considerable morbidity. The timing of doing cranioplasty and a good outcome remains a topic of much debate. We wanted to compare the outcome of doing cranioplasty within (early) and beyond (late) 2 months after decompressive craniectomy for traumatic brain injury. METHODS The study was carried out in a tertiary care hospital. A 5-year retrospective study of patient records was analysed. Consecutive series of traumatic brain injury patients who underwent cranioplasty after decompressive craniectomy from a tertiary care hospital operated by a single neurosurgeon, were studied. Data was analysed using SPSS version 21, IBM. Associations of categorical variables were compared using chisquare test and of continuous variables by using unpaired 2-tailed Student t-test. RESULTS Altogether 90 patients were identified who had undergone cranioplasty after decompressive craniectomy for traumatic brain injury and were grouped into early (within 2 months; 44 patients) and late (beyond 2 months; 46 patients). Cranioplasty operative time was significantly shorter in the early (59.39 mins) than the late (77.28 mins) with a P value of 0.001. Infection rates were significantly higher in the early (4.55 %) than late (0 %), with P value 0.144. Other complication rates were postoperative haematoma (0 % early, 2.17 % late, P = 0.325), hydrocephalus (0 % early, 6.52 % late, P = 0.085), sunken brain (0 % early, 4.35 % late, P = 0.162), and bone graft resorption (0 % early, 2.17 % late, P = 0.325). These differences were not statistically significant though. CONCLUSIONS Early cranioplasty performed within 2 months of decompressive craniectomy has better outcome in the form of reduced hospital stay, decreased cost, and fewer complications. KEY WORDS Traumatic Brain Injury, Decompressive Craniectomy, Outcome, Cranioplasty

scholarly journals Reducing the Risk of Severe Complications among Patients withClostridium difficileInfection

2011 ◽  
Vol 25 (7) ◽  
pp. 368-372 ◽  
Author(s):  
Kamran Manek ◽  
Victoria Williams ◽  
Sandra Callery ◽  
Nick Daneman
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Rapid Onset ◽  
Complication Rates ◽  
Care Hospital ◽  
Clinical Factors ◽  
Blood Cell Count ◽  
First Line ◽  
Repeat Infection

BACKGROUND: The incidence and severity ofClostridium difficileinfections are increasing, and there is a need to optimize the prevention of complicated disease.OBJECTIVE: To identify modifiable processes of care associated with an altered risk ofC difficilecomplications.METHODS: A retrospective cohort study (with prospective case ascertainment) of allC difficileinfections during 2007/2008 at a tertiary care hospital was conducted.RESULTS: Severe complications were frequent (occurring in 97 of 365 [27%]C difficileepisodes), with rapid onset (median three days postdiagnosis). On multivariable analysis, nonmodifiable predictors of complications included repeat infection (OR 2.67), confusion (OR 2.01), hypotension (OR 0.97 per increased mmHg) and elevated white blood cell count (OR 1.04 per 109cells/L). Protection from complications was associated with initial use of vancomycin (OR 0.24); harm was associated with ongoing use of exacerbating antibiotics (OR 3.02).CONCLUSION:C difficileinfections often occur early in the disease course and are associated with high complication rates. Clinical factors that predicted a higher risk of complications included confusion, hypotension and leukocytosis. The most effective ways to improve outcomes for patients withC difficilecolitis are consideration of vancomycin as first-line treatment for moderate to severe cases, and the avoidance of unnecessary antibiotics.

scholarly journals RENAL DYSFUNCTION IN PATIENTS WITH ACUTE CORONARY SYNDROME (ACS) AT A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 24 (09) ◽  
pp. 1275-1279
Author(s):  
Ayesha Ijaz ◽  
Asna Ijaz ◽  
Abubakr Ali Saad ◽  
Salman Zafar ◽  
Sohail Safdar ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Renal Dysfunction ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Coronary Syndrome

scholarly journals Psychiatric morbidity in epilepsy

2017 ◽  
Vol 5 (10) ◽  
pp. 4267 ◽  
Author(s):  
Prem Singh ◽  
Achyut K. Pandey
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
The Mean ◽  
Antiepileptic Medications ◽  
Generalized Epilepsy ◽  
One Year ◽  
Patients With Epilepsy

Background: Psychiatric morbidity occurs more frequently in patients with epilepsy than in the general population. Routine evaluation and treatment of psychiatric morbidity can be helpful in improving epilepsy care but such data are relatively meagre from developing countries.Methods: The study was conducted in the Epilepsy Clinic of Department of Neurology at a tertiary care hospital over a period of one year.101 patients were included after fulfilling the inclusion criteria. All the patients seeking treatment in the OPD were screened, assessed and then all procedures were fully explained to them. History regarding name, age sex, socio-demographic profile and detailed history regarding seizure disorder was taken from both the patient and the reliable informant. Bengali version of SRQ-24 was used to screen for psychiatric morbidity.Results: One hundred and one patients with epilepsy consisting of 70 men (69.3%) and 31 women (30.7%) were included. Their ages ranged from 15 to 52, the mean age being 26.17 (SD = 7.84). Out of the 101 patients, 65 patients (64.4%) were suffering from partial epilepsies and 36 patients (35.6%) were suffering from generalized epilepsies. 50.49% of the subjects screened positive for psychiatric morbidity. Psychiatric morbidity was higher in unmarried, unemployed males from rural background who were suffering from generalized epilepsy and taking multiple antiepileptic medications. Psychiatric morbidity was statistically significant in people with poor education and those born at home (p<0.05) as compared to well educated, institutionally born persons.Conclusions: 50.49% of the subjects screened positive for psychiatric morbidity.

scholarly journals Drug utilization study-pattern of use of anti-microbial drugs among post operative patients in department of general surgery at a tertiary care hospital

2017 ◽  
Vol 6 (6) ◽  
pp. 1482
Author(s):  
Dhwani J. Patel ◽  
Sunita B. Chhaiya ◽  
Dimple S. Mehta
Keyword(s):  
General Surgery ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Valuable Insight ◽  
Care Hospital ◽  
Incision And Drainage ◽  
Medical College ◽  
Current Trends ◽  
Urological Procedures ◽  
Microsoft Office

Background: The objective of this study was to assess the current trends of prescribing antibiotics amongst the patients of General surgery postoperative unit of C. U. Shah Medical College and Hospital, Surendranagar, Gujarat.Methods: An observational study was done amongst 200 patients admitted in the General surgery postoperative ward of a C. U. Shah Medical College and Hospital, Surendranagar over a period of 6 months in accordance with the ethical principles of the ethics committee guidelines. Data were analyzed using Microsoft Office Excel 2007 and values were presented descriptively in percentiles.Results: The average number of antimicrobials per encounter was 1.78. The most common surgeries in the postsurgical unit were urological procedures 61 (30.35%) followed by incision and drainage 40 (20%). Most of the patients were in the age group of 35-60 yrs. Higher utilization of cephalosporins (62.91%) and fluoroquinolones (20.27%). The most preferred route of administration of antibiotics in post operative period was oral (55.58%).Conclusions: The present study provides valuable insight about the overall pattern of anti-microbials used in postoperative patients in a tertiary care hospital. It is intended to be a step in broader evaluation of safety and efficacy of drug as well as for improving prescribing habits among the fraternity and minimizing incidence of resistance to antimicrobials in surgical wards of a teaching hospital.

Emergency General Surgery Regionalization: Retrospective Cohort Study of Emergency General Surgery Patients at a Tertiary Care Center

2021 ◽  
pp. 000313482110385
Author(s):  
Sullivan A. Ayuso ◽  
Sharbel A. Elhage ◽  
Kyle W. Cunningham ◽  
A. Britton Christmas ◽  
Ronald F. Sing ◽  
...  
Keyword(s):  
General Surgery ◽  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Geographic Origin ◽  
Care Facility ◽  
Care Hospital ◽  
Emergency General Surgery ◽  
Tertiary Care Facility ◽  
Tertiary Care Hospitals

Background Emergency general surgery (EGS) patients presenting at tertiary care hospitals may bypass local hospitals with adequate resources. However, many tertiary care hospitals frequently operate at capacity. We hypothesized that understanding patient geographic origin could identify opportunities for enhanced system triage and optimization and be an important first step for EGS regionalization and care coordination that could potentially lead to improved utilization of resources. Methods We analyzed patient zip code and categorized EGS patients who were cared for at our tertiary care hospital as potentially divertible if the southern region hospital was geographically closer to their home, regional hospital admission (RHA) patients, or local admission (LA) patients if the tertiary care facility was closer. Baseline characteristics and outcomes were compared for RHA and LA patients. Results Of 14 714 EGS patients presenting to the tertiary care hospital, 30.2% were categorized as RHA patients. Overall, 1526 (10.4%) patients required an operation including 527 (34.5%) patients who were potentially divertible. Appendectomy and cholecystectomy comprised 66% of the operations for potentially divertible patients. Length of stay was not significantly different ( P = .06) for RHA patients, but they did have lower measured short-term and long-term mortality when compared to their LA counterparts ( P < .05). Conclusions EGS diagnoses and patient geocode analysis can identify opportunities to optimize regional operating room and bed utilization. Understanding where EGS patients are cared for and factors that influenced care facility will be critical for next steps in developing EGS regionalization within our system.

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