MANAGEMENT OF APPENDICULAR LUMP: SINGLE INSTITUTE EXPERIENCE IN A TERTIARY CARE CENTRE

2021 ◽  
pp. 52-53
Author(s):  
Pranjal Moharjal ◽  
Amit Singh
Keyword(s):  
Hospital Stay ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Routine Practice ◽  
Interval Appendectomy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Standard Management ◽  
Group 2 ◽  
Early Surgical Intervention

Background/Aim: In every surgeon's routine practice, one of the most common acute surgical condition is acute appendicitis. Appendicular lump is formation occurs if treatment is delayed, in around 2- 6% of patients. The standard management of appendicular lump is conservative, followed by interval appendectomy. If conventional treatment is followed around 10-20% of the cases are not resolved and lead to gangrene or perforation followed by appendicular abscess or generalised peritonitis requiring early surgical intervention. Our study is a comparison of early exploration versus conservative management of appendicular lump. Material and Methods:Aprospective study conducted on 200 patients who presented to emergency or surgical opd at a tertiary care centre in central Rajasthan, India. All patients presenting with an appendicular lump over a period of 2 years were included in the study. The participants were divided randomly into two groups; Group 1 consisted of people who underwent early surgical intervention and group 2, consisting of people in whom conservative approach with OCHSNER SHERREN REGIME followed by interval appendectomy was done. Results: Out of 200 patients, the majority were males belonging to the age group of 15–20 years. Clinical presentation was similar among both the groups, although complications were signicantly more among Gr(P-0.04). The mean hospital stay among group 2 was 6+/-1.8 days which was substantially less than that of group 2, 8+/-2.06 days.Conclusion: Thus, we concluded from the study ndings that early surgical exploration in cases of appendicitis helps in early diagnosis and treatment, decrease the hospital stay as well as complications thereby reducing the cost of treatment.

scholarly journals Lower Genital Tract Trauma in a Tertiary Care Centre in Mid-Western Nepal

2017 ◽  
Vol 56 (205) ◽  
pp. 137-140
Author(s):  
Anil Kumar Adhikari ◽  
Mahuya Dutta ◽  
Chittra Ranjan Das
Keyword(s):  
Genital Tract ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Lower Genital Tract ◽  
Clinical Presentations ◽  
Fall From Height

Introduction: The study of lower genital tract trauma has become important in gynaecological practice. There is paucity of reports on this clinical entity from our settings. The main aim of this study is to document injuries in female lower genital tract in Mid-Western Nepal. Methods: Sixty female patients admitted to the hospital with genital tract injuries caused by coitus or accidents were included in the study. Details of the causes of trauma clinical presentations and management were recorded. Results: These injuries were grouped according to etiological factors. This study included 33 (55%) coital injuries and 27 (45%) non- coital injuries. Out of coital injury, 12 cases were criminal assault (rape) in age group of 4 to 18 years. Four unmarried girls had consensual sex. Non-coital injuries were due to fall from height, cattle horn injuries, straddle type of trauma, vulvar haematoma and anorectal injuries. Conclusions: Appropriate surgical intervention can avert morbidity and mortality. Keywords: accident; lower genital tract; Nepal; trauma.

scholarly journals Accidental Hijab Pin Ingestion: 10 Years Experience from a Tertiary Care Centre

2018 ◽  
Vol 1 (1) ◽  
pp. 54-59
Author(s):  
Naim Abu Freha ◽  
Muhammad Abu Tailakh ◽  
Doron Schwartz ◽  
Ohad Etzion ◽  
Alex Rosenthal ◽  
...  
Keyword(s):  
Emergency Room ◽  
Hospital Stay ◽  
Clinical Observation ◽  
Tertiary Care ◽  
Muslim Women ◽  
Tertiary Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Duration Of Hospitalization ◽  
Time Of Admission

Background and Aim: Hijab pins ingestion is increasing. Some women hold the pin between their teeth while arranging the Hijab and the inadvertent ingestion of the pin can be the result of any careless movements. The aims of our study were to investigate the clinical outcomes of patients who underwent endoscopic pin removal via gastroscopy as opposed to patients who were treated conservatively with clinical observation, and to compare clinical and endoscopic data pertaining to patients who underwent early versus late gastroscopy.Methods: Muslim women hospitalized in a tertiary hospital from 2005-2015 due to ingestion of Hijab pin ingestion were included. Patients who underwent gastroscopy during 12 hours from the time of admission to Emergency Room (ER) were included in the “early” gastroscopy group, while endoscopy performed at a later time defined the “late” gastroscopy group.Results: During the study period 37 women were included. Twenty four patients (65%, mean age 20 ± 8.9) underwent gastroscopy; and thirteen (35%, mean age 19.9 ± 1.6) were hospitalized for observation. Six patients (25%) had normal gastroscopy; by 8 patients (33%) the pin was located in the antrum, 6 (25%) body, 2 (8.3%) and 1 (4.1%) in the duodenum. Fifteen patients underwent early gastroscopy and nine underwent late gastroscopy. The Duration of hospitalization was significantly shorter among patients who underwent early gastroscopy 1-day (1, 1) median, (IQR) compared with 2 days (1, 3) p < 0.02. Severe complications were found in one patient (2.7%) with stomach perforation which required surgery.Conclusion: Most pins will pass spontaneously, however severe complication may arise inadvertent Hijab pin ingestion. Early gastroscopy shortens the hospital stay.

scholarly journals Comparative evaluation of composite and simplified who partograms in a tertiary care centre in North India

2017 ◽  
Vol 6 (11) ◽  
pp. 5003
Author(s):  
Prachi Sarin Sethi ◽  
Sujata Sharma ◽  
Indu Chawla
Keyword(s):  
Perinatal Outcome ◽  
Randomized Study ◽  
Tertiary Care ◽  
North India ◽  
Routine Practice ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Vaginal Deliveries ◽  
Latent Phase

Background: Early detection of abnormal progress and prevention of prolonged labour can significantly improve the outcome of labour. Partograph is an inexpensive tool which can provide a continuous pictorial overview of labour and is essential to monitor and manage labour. The objectives were to study the course of normal and abnormal labour and to evaluate the maternal and perinatal outcome using simple and composite WHO partogram.Methods: This was a randomized study conducted at Department of Obstetrics and Gynaecology, Government Medical College, Amritsar, a tertiary care centre in North India. 200 women with term, singleton, vertex gestation, in spontaneous labor were included in the study. In 100 cases composite partograph was plotted and in rest 100 cases simple partograph was plotted. The following outcomes were compared: labor crossing the alert and action line, augmentation of labor, rate of cesarean section, perinatal and maternal outcome.Results: The partogram crossed the alert line (p 0.008) and action lines (p 0.017), causing increased need for augmentation (p 0.034) in the composite partogram which was statistically significant. The numbers of vaginal deliveries were high (p<0.001) and decrease number of cesarean sections (p 0.007) and instrumental deliveries (p 0.009) in the simplified group. NICU admissions were also higher in the composite group (p<0.05), though most of the NICU admissions were due to hyperbilirubinemia and low birth weight and was not directly related to monitoring of labour.Conclusions: It was observed in the present study that labour can be managed without the latent phase being plotted on the partograph. The interventions were higher when the latent phase was included, with increased number of labours crossing the alert and action lines, increased no. of augmentations and larger number of caesarean sections. Our study favours the use of the WHO modified partograph, which should become routine practice in monitoring labour for better maternal and perinatal outcome.

A COMPARATIVE STUDY OF DEEP NECK SPACE INFECTIONS (DNSI) IN DIABETIC VERSUS NON-DIABETIC PATIENTS: OUR EXPERIENCE IN A TERTIARY CARE CENTRE

2021 ◽  
pp. 32-34
Author(s):  
Arijit Chatterjee ◽  
Rajarshi Chakraborty
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Treatment Protocol ◽  
Vascular Complications ◽  
Older Age ◽  
Diabetic Patients ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Airway Infections ◽  
Deep Neck Space Infections

Background:The term deep neck space infections (DNSIs) encompasses infections of several different areas of the neck formed by the potential spaces formed by different fascial layers of the neck. The etiology of DNSI include pharyngo-tonsillar infections (most commonly in children), odontogenic infections, sialolithiasis and sialadenitis, congenital anomalies like cysts and sinuses of the neck. Predisposing factors may include Extremes of age, Immunodeciency, Diabetes mellitus and Intravenous drug abuse. The microbiology of deep neck infections usually reveals mixed aerobic and anaerobic organisms, often with a predominance of oral ora. Both gram-positive and gram-negative organisms may be cultured. DNSI usually mandate early intervention on an urgent basis because of the risk of potentially fatal complications such as airway obstruction, mediastinitis and vascular complications. Airway assessment and intervention plays a pivotal role in the management of DNSI. Aims and Objectives: The present study aims to compare the clinical presentation, complications, treatment outcomes and microbiology of DNSIs in diabetic vs non-diabetic patient populations.The objective is to have a proper understanding of the disease so that a much organized treatment protocol can be established. 70 patients were enrolled for this comparative st Materials and Method: udy in Indoor wards of a Tertiary care centre. The study was conducted from January 2019 to December 2019 for 1year. Patients diagnosed with DNSI (by imaging studies) and admitted in ward of ENT and Head Neck Surgery were selected. Parapharyngeal Space was mos Results: t common involved space in both Diabetics (52.38%) and Non Diabetics (41.46%), followed by Submandibular Space. Most common organism in both groups was Klebsiella pnemoniae. Odontogenic infection and Upper airway infections were 2 leading causes of DNSI in both Diabetics and Non Diabetics in this study. The Diabetic groups affected had much older age with longer hospital stay and had more frequent complications than Non Diabetic group. Diabetics also needed more frequent tracheostomy (28.57%) than Non Diabetics (2.44%). Diabetic patients as a subgroup Conclusion: of DNSIs pose many unique problems including older age at presentation, involvement of multiple neck spaces, prolonged hospital stay and operative interventions. As these patients have higher rate of complications and poorer prognosis, early institution of therapy, strict glycemic control and operative interventions are more often required.

scholarly journals Assessment of Post-Covid Symptoms in Covid-19 Recovered Patients: A Prospective Cohort Study in a Tertiary Care Centre of South India

2021 ◽  
Author(s):  
Chithira V Nair ◽  
Merlin Moni ◽  
Fabia Edathadathil ◽  
A Appukuttan ◽  
Preetha Prasanna ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hospital Stay ◽  
South India ◽  
Tertiary Care ◽  
Care Centre ◽  
Persistent Symptom ◽  
Tertiary Care Centre ◽  
Steroid Administration ◽  
Female Sex

Abstract Background: The post-Covid symptoms among patients hospitalised with covid has to be determined for elucidating the spectrum of illness which persists even after the apparent recovery. The understanding of the post-Covid symptoms will help us to better manage aftermath of the pandemic.Aim: To determine the incidence of post-Covid symptoms in a cohort of inpatients who recovered from COVID-19 from a tertiary care centre in South India.Method: 120 survivors from patients admitted with COVID 19 were prospectively followed up for 6 weeks after their discharge from the hospital. The cohort included 50 patients requiring Intensive care unit (ICU) care and 70 ward patients. The follow-up was conducted on the second and sixth week after discharge with a structured questionnaire. The questionnaire was filled by the patient/bystanders during their visit to the hospital for follow-up at 2 weeks and through telephone follow up at 6 weeks.Results: Mean age of the cohort was 55 years and 55% were males. 58.3% had mild covid and 41.7% had moderate to severe covid infection. 60.8% (n=73) of patients had at least one persistent symptom at sixth week of discharge. 50 (41.7%) patients required intensive care during their inpatient stay. Presence of persistent symptoms at 6 weeks was not associated with severity of illness, age or requirement for intensive care. Fatigue was the most common reported persistent symptom with a prevalence of 55.8% followed by weight loss (22.5%) and dyspnoea (20%). Female sex (OR 2.4, 95% CI: 1.03–5.58, p = 0.041) and steroid administration during hospital stay (OR: 4.43; 95% CI: 1.9–10.28, p = 0.001), were found to be significant risk factors for the presence of post-Covid symptoms at 6 weeks as revealed by logistic regression analysis.Conclusion: 60.8% of inpatients treated for covid had post-Covid symptoms at 6 weeks post- discharge from hospital. Female sex and steroid administration during hospital stay were identified as predictors of persistence of post-Covid symptoms at 6weeks.

scholarly journals Outcome of Eclamptic Mothers Attending Tertiary Care Centre from Home and those Referred from Primary Heath Care Site

2016 ◽  
Vol 4 (1) ◽  
pp. 24
Author(s):  
Upendra Pandit ◽  
Chittaranjan Das ◽  
Farhat Banu ◽  
Shakil Ahamad
Keyword(s):  
Primary Care ◽  
Magnesium Sulphate ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Hilly Region ◽  
Group 2 ◽  
Group 1

Introduction: Magnesium sulphate (MgSO4) is an effective and safe drug which stabilizes the patient within few hours of eclampsia and terminates subsequent seizures if it is given on time. The aim of this study was to compare maternal and fetal outcome between a group of eclamptic mothers who came to the tertiary care hospital directly without receiving MgSO4 (Group 1) and those referred from primary care centers after receiving loading dose of MgSO4 (Group 2).   Methods: This is a retrospective cohort study of eclamptic mothers who were admitted and managed from the period of 1st January 2012 to 31st March 2016 at Nepalgunj Medical College Teaching Hospital, Nepal. Sociodemographic characters and maternal and fetal outcome was compared between the two groups.   Results: Among 92 cases, 57 (62%) were from Group 1 and 35 (38%) were from Group 2. Most of the mothers attended from Banke district (n=52, 56.5%) followed by Bardia district (n=17, 18.5%). Brahmin and Chhetri were 20 (35%) and 10 (29%); Muslim 16 (28%) and 4(11%); Janajati from Terai 16 (28%) and 8 (23%); Janajati from hilly region 4 (7%) and 5 (14%); and Chaudhari 1 (2%) and 8 (23%) in Group 1 and Group 2 respectively.  More (n=26, 74%) mothers had baby with good Apgar score in Group 2 than in Group 1 (n=33, 58%). There were 14 (15.2%) still births; 9 (16%) in Group 1 and 5 (14%) in Group 2. Complication rate was observed more in Group 1 (n=16, 28%) than in Group 2 (n=7, 20%) and the most common complication in both groups was wound infection. The mean days of hospital stay was 5.96 (SD=3.32) and 5.91 (SD=3.38) in Group 1 and Group 2 respectively.   Conclusion: The group receiving magnesium sulphate in primary care centre have good fetal outcome and less maternal complications compared to those who were admitted directly in tertiary care centre and receive the treatment there.

scholarly journals Morbidly adherent placenta –A burden on tertiary care centre.

2020 ◽  
Vol 27 (09) ◽  
pp. 1795-1798
Author(s):  
Zahra Safdar ◽  
Sumera Zaib ◽  
Sumera Fatima
Keyword(s):  
Caesarean Section ◽  
Hospital Stay ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Prolonged Stay ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta

Objectives: To determine the burden of Morbidly Adherent Placenta on tertiary care centre in terms of prolonged hospital stay, multiple blood transfusions, Intensive care unit stay, involvement of surgical urological colleges. Study Design: Descriptive Case Series. Setting: Department of Obstetrics and Gynaecology, Unit I Lahore, General Hospital Lahore LGH. Period: 06 months (1st August 2017-28th February 2018). Material & Methods: Total Obstetrical patients admitted in this period were 2754 total births 2567, lower segment caesarean 1184 patients, with Morbidly Adherent Placenta were 28. Date was analysed regarding maternal age, parity, previous surgeries and diagnosis prior to admission. The complications analysed were hospital stay >10 days, multiple transfusions>04 days, ICU admission>72hours, requirement of surgical and urological colleges. Patients fulfilling inclusion and exclusion criteria were studied. Results: Morbidly Adherent Placenta results in patient’s prolonged stay in hospital and ICU which results in high consumption of hospital resources. Conclusion: Morbidly Adherent Placenta is directly related with caesarean section rate. Every effort should be made to reduce the %age of primary caesarean section so that incidence of Morbidly Adherent Placenta can be minimised.

scholarly journals Laparoscopic versus open pyeloplasty: an experience at a tertiary care centre

2018 ◽  
Vol 5 (9) ◽  
pp. 3150
Author(s):  
Sunil Krishna M. ◽  
Moideen Nafseer T. A. ◽  
Benakatti Rajendra
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Renal Damage ◽  
Ureteropelvic Junction Obstruction ◽  
Randomized Study ◽  
Tertiary Care ◽  
Care Centre ◽  
Laparoscopic Pyeloplasty ◽  
Tertiary Care Centre ◽  
Open Pyeloplasty

Background: Ureteropelvic junction obstruction can lead to symptoms such as hydronephrosis and progressive renal damage. Authors explain present primary experiences about laparoscopic pyeloplasty and open pyeloplasty in the treatment of UPJO.Methods: A bidirectional non-randomized study from March 2012 to April 2015 was conducted at a tertiary care centre in southern India. A Total 37 cases, 18 patients in laparoscopic pyeloplasty group and 19 patients in open pyeloplasty group were included.Results: A total of 37 patients were included in the study. 18 patients underwent laparoscopic Anderson-Hyne's pyeloplasty, 19 patients underwent open Anderson-Hyne's pyeloplasty patients. Outcomes were measured in terms of pain, surgery duration, postoperative pain, complications which were significant.Conclusions: Laparoscopic pyeloplasty was found to be better in terms of postoperative pain, hospital stay and complications.

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