APPENDICITIS IN PREGNANCY : OUR CLINICAL EXPERIENCE AT A TERTIARY CARE CENTRE

2021 ◽  
pp. 22-23
Author(s):  
Anil Kumar ◽  
Rekha Rani ◽  
Hamid Wani
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Common Symptom ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Lower Quadrant ◽  
Number Of Patients

Objective: Acute appendicitis is a common surgical condition presented to emergency. In this study we evaluated the clinical presentation, management and outcome of acute appendicitis complicating pregnancy at a tertiary care centre. Material And Methods: A total of 20 cases of pregnant women who were diagnosed as a case of acute appendicitis were studied from January 2018 to December 2020. Results: Total number of patients diagnosed with acute appendicitis were 20. There were 10 (50%) patients in rst trimester , 6 (30%) in second and 4 (20%) in the third trimester. Abdominal pain was the most common symptom seen in all patients. 12 (60%) patients were multigravida whereas 8 (40%) patients were primigravida. Duration of abdominal pain was 6 hours to 5 days with median of 30 hours. Right lower quadrant was the most common site of pain. Rebound tenderness was seen in 14 (70%) patients. Total leucocyte was raised in 14 (70%)cases. Ultrasound was done in all patients showing viable fetus and features of acute appendicitis in 12 (60%) cases. Surgery was done in 16 (80%) cases. Midline laparatomy was done in 3 patients whereas 4 (20%) patients were managed conservatively with antibiotics. Postoperative tocolytics were given in 6 patients. Postoperative complications such as wound infections seen in 5 cases and pelvic abscess in 1 case. Fetal loss was seen in 2 (10%)cases. Conclusion: Diagnosis of acute appendicitis during pregnancy can be difcult due to anatomical and biochemical changes during pregnancy. Correct diagnosis can be achieved by taking proper history, clinical examination and relevant investigations. Surgery remains the treatment of choice.

scholarly journals Clinical profile of scrub typhus patients in a tertiary care centre in Himachal Pradesh, India

2019 ◽  
Vol 7 (9) ◽  
pp. 3266
Author(s):  
Ritin Sharma ◽  
Roshan Lal ◽  
Sanjay Mahajan ◽  
Satish Chaudhary
Keyword(s):  
Primary Care Physicians ◽  
Scrub Typhus ◽  
Monsoon Season ◽  
Tertiary Care ◽  
Himachal Pradesh ◽  
Common Symptom ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
High Grade Fever ◽  
Number Of Patients

Background: Scrub typhus a zoonotic disease caused by gram negative bacteria O. tsutsugamushi, is endemic in Himachal Pradesh. This illness occurs mainly in monsoon and post monsoon season. study design of  this study was conducted in a tertiary care centre in Himachal Pradesh between July 2015 and June 2016. All the indoor patients with age above 18 years with a diagnosis of scrub typhus were included in this study.Results: Out of total 180 patients, 130 were female patients. Most patients were in the age group 21-30 (23.3%). All the patients presented with history of fever, but 54 patients presented with high grade fever. Other Most common symptom was chills and rigours (81%), followed by vomiting and headache each 32%, cough 31%. On examination 21% patients had eschar,14% patients had lymphadenopathy. Most number of patients presented in the month of September (51.6%), followed by August (33.3%).Conclusion: Scrub typhus being an important differential of acute undifferentiated fever in this region, should not be missed by primary care physicians, as once multi organ dysfunction sets in, mortality rate starts rising. So, there is a high need of sensitization of doctors and people about this illness so that early diagnosis and early treatment can be ensured.

CLINICAL PROFILE OF OUTPATIENTS ATTENDING DERMATOLOGY DEPARTMENT DURING COVID-19 LOCKDOWN RELAXATION PERIOD IN A TERTIARY CARE CENTRE IN SOUTH INDIA – A CROSS-SECTIONAL ANALYTICAL STUDY

2021 ◽  
pp. 13-16
Author(s):  
Afthab Jameela Wahab ◽  
Pavithra Gunasekaran ◽  
P. Mohan ◽  
V. Sudha ◽  
L. Balamurugan ◽  
...  
Keyword(s):  
South India ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Relaxation Period ◽  
Number Of Patients ◽  
Outpatient Practice ◽  
The Impact

Background - The cutaneous manifestations of the novel coronavirus have been well documented. However, there are few studies that relate to the clinical prole of regular dermatology outpatients seeking treatment during the lockdown relaxation period braving the pandemic. With the Aim - view to determine the changes seen in dermatology outpatient practice, this study analysed the clinical prole of new patients attending the Dermatology Outpatient Department (OPD) during the COVID-19 lockdown relaxation period in a tertiary care centre in a metropolitan suburb in South India. New dermatology outpatients during the months of May, June, July and August Method - 2020 were included in the study. Outpatient data for this period was analysed and compared with corresponding data for the same period in the previous two years. There was a Result – decrease in the OP census, number of patients in the extremes of life as well as those with asymptomatic dermatoses. There was an increase in the number of patients with infections, particularly dermatophytosis. There was also a noteworthy absence of dermatological emergencies. Conclusion - In essence, our study shows the impact of COVID-19 pandemic on the routine dermatology outpatient services with signicant changes in the clinical prole of outpatient practice following lockdown relaxation.

scholarly journals EPIDEMIOLOGICAL STUDY OF TRAUMA IN A TERTIARY CARE CENTRE IN NORTHWEST INDIA

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Mohit Badgurjar ◽  
Vaibhav Lakhanpal ◽  
Pankaj Saxena ◽  
Suman Parihar ◽  
Poojan Thakor ◽  
...  
Keyword(s):  
Road Traffic ◽  
Tertiary Care ◽  
Total Mortality ◽  
Public Health Problem ◽  
Common Mechanism ◽  
Mechanism Of Injury ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Keywords Trauma ◽  
Number Of Patients

Objective: Traumatic injuries are a matter of concern worldwide. However, the rapidly changing socio economical dynamics in a developing country like India deeply influence the epidemiology behind trauma. The aim of this study was to document and analyze the epidemiological parameters and characteristics behind trauma victims admitted to our tertiary care centre. Methods: The observational study was carried out over a period of one year (January 2019 to December 2019) enrolling a total of 300 trauma patients. The age, sex, locality, delay in hospitalization, mechanism of injury, sites of injury and outcomes were documented. Results: Injuries occurred predominantly in the 20-40 age group with males being the chief victims. There was a considerable amount of delay in hospitalization ranging from one hour to more than 24 hours while only 7 patients arrived to the emergency within one hour of trauma. Vehicular trauma (54%) was the most common mechanism of injury. Injuries to the extremities (38.6%) and head (28.6%) were the most common sites. A considerable number of patients (45.3%) required care in the intensive care unit. A total of 172 patients required surgical interventions of various kinds and there was a total mortality rate of 6%. Amongst the polytrauma cases, 54 patients (81.8%) required ICU admission, 42 patients (63.6%) required surgical intervention and 6 patients (9.1%) died after admission. Conclusion: The results of this study highlight some of the problems with our existing infrastructure bringing to light the need for stricter enforcement of traffic safety laws and improvement of infrastructure particularly the roadways in rural areas as well as the referral systems. Vehicular trauma should be seen as a public health problem and appropriate interventions should be implemented. Keywords: Trauma, Road Traffic Accidents, Epidemiology, Head injuries

scholarly journals ROLE OF TLC NLR & SERUM CREATININE IN DIAGNOSING ACUTE APPENDICITIS: A PROSPECTIVE STUDY IN A TERTIARY CARE CENTRE

2021 ◽  
pp. 1-3
Author(s):  
Madhu B S ◽  
Shraddha Shenoy
Keyword(s):  
Acute Appendicitis ◽  
Serum Creatinine ◽  
Prospective Study ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cutoff Value ◽  
A Prospective Study ◽  
Complicated Acute Appendicitis

Aim- To assess the role of TLC and NLR and serum creatinine in diagnosing acute appendicitis. Background-Acute appendicitis being the most common surgical emergency globally can lead to varied consequences if not detected and treated accurately. Early and precise biochemical detectors affect the severity of acute appendicitis. Materials and methodology- A prospective study was conducted in K R Hospital, Mysore from 2019-2020. All cases of acute appendicitis during this period were assessed for severity. TLC, NLR and serum creatinine were assessed and correlated with severity of acute appendicitis. Results- A total of 96 patients were included in the study, 72 patients had SAA and 24 had CAA. This was classified in accordance to the cut off values. TC cut off point was 15,050 cells/cumm ,Sn 91.7 %, Sp 74.6%. The NLR cutoff value was 4.56, Sn of 83.3%, Sp of 66.2%. The cutoff value for neutrophil count was 77.6%, Sn 91.7% , Sp 71.18%. The cutoff value for lymphocyte count was 18.2%, Sn was 91.7%, Sp 65.8%. The cutoff value of creatinine was 0.73, Sn of 83.3%, Sp 80.03%. Conclusion- TC, TLC, NLR and Serum creatinine combinedly help distinguishing between the simple acute appendicitis and complicated acute appendicitis and is a very economical measure for the prediction

scholarly journals Acute Appendicitis in Pregnant Women: Our Clinical Experience

2016 ◽  
Vol 39 (6) ◽  
pp. 159 ◽  
Author(s):  
Ahmet Türkan ◽  
Metin Yalaza ◽  
Mehmet Tolga Kafadar ◽  
Gürka Değirmencioğlu
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Acute Appendicitis ◽  
Pregnant Women ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Fetal Loss ◽  
University Research ◽  
Lower Quadrant ◽  
Right Lower Quadrant

Purpose: The purpose of this study was to analyse 13 patients who were treated in our clinic due to acute appendicitis during pregnancy. Methods: Records of the patients who received appendectomy with appendicitis diagnosis in our Turgut Özal University Research and Application Hospital between January 2007 and December 2015 have been analyzed retrospectively. Results: Appendectomies were performed on 13 pregnant patients with an acute appendicitis diagnosis. Average age of the patients was 27.69 years (between 22-37 years). Most frequent complaint of the patients was abdominal pain and most frequent examination finding was tenderness at right lower quadrant. Ultrasonography was used in all cases for diagnosis. Surgery was decided with clinical diagnosis for five cases (38.5%) where appendix had not been identified with ultrasonography. While laparoscopic appendectomy was applied in one case (7.7%) and open appendectomy was applied using a McBurney incision in 12 cases (92.3%). Average hospitalization duration was 1.69 days. All patients were tracked together through the Gynaecology Department for two weeks after they had been discharged from the hospital. Preterm delivery, maternal and fetal loss did not occur. Conclusion: It is considered appropriate to apply ultrasonography routinely to all pregnant patients in whom acute appendicitis is suspected. Concern for maternal or fetal complication that may occur in consequence of an unnecessary surgery should not be at a level that will delay surgical treatment needed by the patient.

scholarly journals COVID 19 pandemic and cancer treatment: experience at a tertiary care centre

2020 ◽  
Vol 7 (7) ◽  
pp. 1055
Author(s):  
Abhishek Pathak ◽  
Anvesh Rathore ◽  
Rajan Kapoor ◽  
Subhash Ranjan ◽  
Alpana Gupta
Keyword(s):  
Cancer Treatment ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Average Delay ◽  
Treatment Experience ◽  
Exact Number ◽  
Number Of Patients ◽  
Working Principle

Background: In these era COVID Pandemic patients are missing their chemotherapy due to multiple reasons. This study was undertaken to quantify the exact number of patients who had missed their appointment for chemotherapy.Methods: All patients who had appointments for chemotherapy from 20th Mar to 20th Apr were included in the study. Details of malignancies, chemotherapy, duration of delay in patients coming for chemotherapy to be recorded.Results: The total number appointments given for chemotherapy for various malignancies were 301 patients for various malignancies for the duration 20th March to 20th April. The total number of appointments given were 301. Out of the total of 301 patients who had appointment for chemotherapy during this period 131 patients could be given chemotherapy and 170 could not be given chemotherapy. The average delay was of 9 days. The data was distributed into four weeks from 20th March to 20th April. Just before the country wide lock down in first week 20th, 70 patients receiving chemotherapy which drastically reduced in later weeks. Both the cases who could come for chemotherapy and those who could not have been kept under follow up, up to 6 months to reassess their response.Conclusions: This article has been written to highlight the number of patients who could not receive chemotherapy due to ongoing Pandemic with an intention to follow them up for 6 months. Since this pandemic is here to stay it is very important that formulate the working principle for administering chemotherapy.

scholarly journals TO SEE THE IMPACT OF LOCKDOWN IN COVID19 PANDEMIC ON TUBERCULAR PATIENTS IN A TERTIARY CARE CENTRE OF HILLY AREA.

2020 ◽  
pp. 33-34
Author(s):  
Subhash Chander ◽  
Ritin Sharma ◽  
Ankit Chaudhary ◽  
Rakesh Chauhan
Keyword(s):  
Health Centre ◽  
Tertiary Care ◽  
Healthcare Services ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Tuberculosis Patients ◽  
Hilly Area ◽  
Number Of Patients ◽  
Group B ◽  
The Impact

Aim: To see the impact of lockdown in Covid19 Pandemic on Tubercular patients in a Tertiary care Centre of hilly area. Material and Methods: The study was conducted among adult patients in a tertiary health centre in a rural area. Study was conducted through lockdown period, comparing it with corresponding period in 2019. Tuberculosis patients or suspects were categorized in two groups. Group A was designated for participants in the year 2020 during lockdown period. Group B was data taken from time period similar to lockdown period in the year 2019. Data from two groups was compared. Observations: There was a 44.1% decline in number of male patients, whose sputum was examined by microscopy for tuberculosis. In case of female patients, decline was 68.6%. This decrease was present in all phases, more in 1st phase, 69.1%. During lockdown period number of patients presenting to medicine department were 45% compared to previous year ( 5129 vs 11280), sputum positive diagnosed during lockdown and similar period in 2019 were (84.4%) 27 vs 32 ( p 0.016). OPD declined by 54.5% during lockdown, however diagnosed tubercular cases by CBNAAT declined by 44.4%. Conclusion: COVID 19 pandemic greatly affected the routine healthcare services. Lockdown period saw a decline in number of patients presenting to outdoor as well as indoor patients. There was a decline in number of tuberculosis suspects as well as number of diagnosed tuberculosis patients. However decline in tuberculosis patients was less as compared to overall patients.

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