A COMPARATIVE STUDY ON COMPLICATIONS OF EMERGENCY AND ELECTIVE TRACHEOSTOMY IN ENT DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 58-60
Author(s):  
Md. Ozair Md. Ozair ◽  
Md. Ale Imran Ansari ◽  
Rizwan Ahmad ◽  
Debarshi Jana

Background: Both elective and emergency tracheostomy as life saving procedure is frequently performed. Tracheostomy can be associated with numerous (intraoperative and postoperative) complications. Methods: In this study 120 patients were studied age ranged from 9 years to 79 years in the Department of ENT, Darbhanga Medical College & Hospital, Laheriasarai, Bihar from January 2020 to December 2020. Results: Among 120 tracheostomized patients, 75 (62.5%) were patients of emergency tracheostomy group and 45 (37.5%) were patients of elective tracheostomy group. Laryngeal carcinoma and other head-neck malignancy were the common (67.34%) indications for emergency tracheostomy. Maxillofacial and laryngeal surgery (50.1%) was the common indications for elective tracheostomy. Haemmorage was the most common complication. The second most common complication were subcutaneous surgical emphysema and wound infection. Then the tube displacement, perichondritis and stomal stenosis/ granulation tissue formation were the complications. In all stages (intraoperative, immediate postoperative, early postoperative and late postoperative), the frequency of complications was more in emergency tracheostomy and it was statistically signicant (p<0.05). Conclusion: Complications are more in emergency than elective tracheostomy. Reduction of complications should be aim of all types of tracheostomy.

2016 ◽  
Vol 21 (2) ◽  
pp. 69-75
Author(s):  
Md Harun Or Rashid ◽  
Ahmmad Taous

Background: Both elective and emergency tracheostomy as life saving procedure is frequently performed. Tracheostomy can be associated with numerous (per operative and post operative) complications.Methods: this was a cross sectional study 120 patients were studied age ranged from 9 years to 79 years in four different tertiary hospitals in Dhaka from July 2011 to June 2013.Results: Among 120 tracheostomized patients, 75 (62.5%) were patients of emergency tracheostomy group and 45 (37.5%) were patients of elective tracheostomy group. Laryngeal carcinoma and other head-neck malignancy were the common (67.34%) indications for emergency tracheostomy. Maxillofacial and laryngeal surgery (50.1%) was the common indications for elective tracheostomy. Haemmorage was the most common complication. The second most common complication were subcutaneous surgical emphysema and wound infection , Then tube displacement, pericondritis and stomal stenosis/ granulation tissue formation were the complications . In all stages (peroperative, immediate postoperative, early postoperative and late postoperative), the frequency of complications was more in emergency tracheostomy and it was statistically significant (p<0.05).Conclusion: Complications are more in emergency than elective tracheostomy. To reduce complications should be aim of all types of tracheostomyBangladesh J Otorhinolaryngol; October 2015; 21(2): 69-75


1970 ◽  
Vol 14 (2) ◽  
pp. 57-62
Author(s):  
A Allam Choudhury ◽  
Tuhin Sultana ◽  
Md Abul Hasnat Joarder ◽  
Kamrul Hassan Tarafder

This is a cross sectional study done in I.C.U & Dept. of otolaryngology - Head & Neck Surgery, B.S.M.M.U, Dhaka and Dhaka Medical College Hospital during the period of 1st March, 2003 to 30th August, 2003. 60 cases of tracheostomies, were included in this study, among them 30 cases of elective tracheostomies and 30 cases of emergency tracheostomies. In this study mean age of elective tracheostomy was 40.46 years & mean age of emergency tracheostomy was 50.50 years. Here Male was predominant both in elective (M:F= 6.5:1) and emergency tracheostomy (9:1). The common indications of elective tracheostomy were ICSOL (26.67%) & Head injury (26.67%) where as commonest indication of emergency tracheostomy was laryngeal carcinoma (53.33%). The frequency of complication for elective tracheostomy was 9.99% and emergency tracheostomy 33.35%. Here complications were 3.33 times more common in cases of emergency tracheostomy then elective tracheostomy. Key-words: Tracheostomy, elective and emergency.  DOI: 10.3329/bjo.v14i2.3282 Bangladesh J of Otorhinolaryngology 2008; 14(2) : 57-62


2016 ◽  
Vol 4 (1) ◽  
pp. 12-15
Author(s):  
Laxmi RC ◽  
Chitra Ranjan Das

Background: Vaginal hysterectomy is one of the most common gynecological procedures performed in Nepal. The most common indication is pelvic organ prolapse (POP). The common complications associated with vaginal hysterectomy are hemorrhage, infections and injury to adjacent organs.Objectives: The aim of this study was to study the type of complications following vaginal hysterectomy in pelvic organ prolapse.Methods: A Prospective observational study was carried out at Lord Buddha Educational Academy Nepalgunj Medical College, Kohalpur, Banke, Nepal from November 2008 to May 2009. A total of 311 patients belonging to age group (20-80) years, presenting to the out-patient department with second to fourth degree utero-vaginal prolapse without any severe medical and surgical problems were included in this study. All the patients who had undergone vaginal hysterectomy during the study period and met the inclusion criteria were included in this study. The data collected was analyzed with standard statistical method (SPSS statistics 16.0).Results: Total of 311 women were included in this study between the age group (20-80 years) with pelvic organ prolapsed (second to fourth degree). All of them underwent vaginal hysterectomy. Among them 39 (12.5%) had complications. The most common complication was secondary haemorrhage accounting for eleven (28.2%) of all complications. Eight (20.5%) patients had retention of urine, four (10.3%) had headache, three (7.7%) patients had primary haemorrhage, three (7.7%) had pelvic cellulitis, three (7.7%) had UTI, three (7.7%) vault abscess, one (2.6%) had bladder injury, one (2.6%) had pelvic peritonitis, one (2.6%) had vault prolapse. We had one death due to septicemia following seven days of post operation.Conclusion: In our study, complication of vaginal hysterectomy was 39 (12.5%) out of 311 patient. The most common complication being secondary haemorrhage 11 (28.2%).Journal of Kathmandu Medical College, Vol. 4(1) 2015, 12-15


1970 ◽  
Vol 16 (2) ◽  
pp. 120-125
Author(s):  
Mohammad Ashequr Rahman Bhuiyan ◽  
Md Shazibur Rashid ◽  
Md Kamruzzaman ◽  
Mohammed Shafiqul Islam ◽  
Khabir Uddin Ahmed

Objectives: To find out the frequency ,indications and effects of tracheostomy in head-neck malignancy.Methods: Total 100 cases of head-neck malignancy that needed tracheostomy were studied in the department of Otolaryngology and Head-Neck surgery of Dhaka Medical College Hospital and Begum Khaleda Zia Medical College and Shahid Sohrawardi Hospital, Dhaka.Results: The mean age of the subjects was 53.60 years. Out of 100 cases male were 86 and female were 14 with male to female ratio 6.14:1. The highest number of the subjects were related to cultivation and majority of the subjects came from poor socio-economic status. Malignancy in head-neck region is multifactorial disease. Regarding habits 71% were smoker, 21% were habituated with chewing betel nut and leaf. Only 2% were alcoholic. In 93% tracheostomy was done on an emergency basis and rest 7% was elective. Carcinoma of larynx was the most frequent indication (65%), which was followed by carcinoma pyriform fossa (28%), carcinoma base of the tongue (3%), carcinoma tonsil 2% and carcinoma thyroid gland 2%. The rate of complications was 41%. Surgical emphysema was the commonest complications (19%), which were followed by haemorrhage (7%), wound infection (4%), tube displacement (3%), tube blockage (3%), crusting (2%), stomal stenosis and subglottic stenosis (1%). No fatality was found in this study.Conclusion: The rate of complication of tracheostomy is high in patients of head-neck malignancy with respiratory distress. Key words: Tracheostomy; Head Neck Cancer. DOI: 10.3329/bjo.v16i2.6847Bangladesh J Otorhinolaryngol 2010; 16(2): 120-125


2021 ◽  
Vol 28 (2) ◽  
pp. 159-163
Author(s):  
Chowdhury Md Mushfiqur Rahman ◽  
Rajat Shuvra Das ◽  
Khundkar Alamin Rumi ◽  
Kazi Monisur Rahman

Background: Emergency tracheostomy is the commonest surgical intervention performed as lifesaving procedure by ENT surgeons on patients in emergency room of ENT and ICU. Several operative and postoperative complications have been reported after tracheostomy including fatal hemorrhage. Massive subcutaneous neck emphysema occurred because ventilation started at the time when the hemorrhage was not completely managed and the tracheal tube was not fully secured. Objective: This study was conducted to compare haemorrhage and surgical emphysema as complication of emergency tracheostomy among patients admitted in Department of ENT and Head-Neck Surgery in Dhaka Medical College & Hospital. Methods and Materials: This was a Cross Sectional Study conducted in the ENT and Head- Neck Surgery Department, Dhaka Medical College Hospital from July 2015 to June 2016. A total of 90 patients were included who fulfilled the selection criteria. Non probability convenient sampling was used to collect data. Statistical analysis was done by SPSS version 21. Results: Mean± SD of the study subjects was 49.84±17.4 years with most patients belonged to 40-79 years age group. 28.9% patients had habit of smoking and betel nut chewing. (48.9%) patients suffered from Ca larynx. Out of 90 tracheostomy patients, 40(44.4%) patients had had different complications including haemorrhage (13.3%), surgical emphysema (10%), haemorrhage with surgical emphysema (6.7%), tube blockage (3.3%), wound infection (3.3%) and injury to local tissue (2.2%). Haemorrhage occurs from anterior jugular vein, middle thyroid veins and thyroid gland and included peroperative haemorrhage (7.8%), immediate post- operative haemorrhage, <24 hours, (4.43%) and late post-operative haemorrhage (1.2%). Conclusion: In this study, haemorrhage followed by surgical emphysema and haemorrhage with surgical emphysema were found as major complications following emergency tracheostomy, J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 159-163


2016 ◽  
Vol 2 (1) ◽  
pp. 62-78
Author(s):  
. Hemraj ◽  
Raj Kumar ◽  
Sourabh Kosey ◽  
Amit Sharma ◽  
Nalini Negi

To determine the most common physical side effects experienced by local chemotherapy patients. Their perceptions of these side effects and informational needs from clinical pharmacists were also evaluated. This was a single center, observational cross-sectional study conducted at department of General Surgery, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. A face to face interview was conducted. Information collected included chemotherapy related side effects after last chemotherapy experience, the most worrisome side effects, overlooked by healthcare professionals and the preferred method, amount and source of receiving related information. In this study, hundred patients were enrolled out of them 48 were male and 52 were female. When differential calculations was done, common side effects or adverse effects of chemotherapy in the patients of breast, lung cancer, Ovarian Cancer, Colon cancer, Prostate cancer, Lymphoma Cancer, Cervix cancer where there is much irregular medicine intake 57.4% may be due to common problem of joint pain reported by all the patients under study, with the consecutive problem of nausea and vomiting. The high prevalence of chemotherapy related side effects among local patients is a major concern and findings of their perceptions and informational needs may serve as a valuable guide for clinical pharmacists and physicians to help in side effect management. This study shows the common problems reported by the patients when they are suffering from cancer condition, according to their incidence perceptions as experienced by the patient, this will allow the physician and clinical pharmacist to effectively counsel and manage the common symptoms as reported prior to its occurrence in the patient, so that withdrawal can be checked.


2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.


Author(s):  
Tripta S. Bhagat ◽  
Luv Kumar ◽  
Prakhar Garg ◽  
Apoorv Goel ◽  
Amit Aggarwal ◽  
...  

Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large proportion of hospital beds. This study was conducted for analysis of patients with cellulitis according to their demographics and clinical presentation and to examine their comorbidities, complications, and its management. This observational cross-sectional study was conducted in the Department of Surgery at Santosh Medical College and Hospitals involving a total of 60 cases having cellulitis and other soft tissue infections of lower limb. Analysis of their demographic profile, management, and complications was done. Cellulitis is seen commonly in males, 46 (76.6%). The mean age of patients affected by cellulitis in the study was 36.4 ± 1.23 years. The most common site affected is leg involving more people in field jobs. The most common risk factor was trauma in 46.6%, and other factors were diabetes mellitus and smoking, while abscess formation was the most common complication observed in 36.6% of cases. A total of 56.6% cases were managed conservatively, while 43.3% cases required surgical intervention. Mean hospital stay in this study was 5.02 ± 0.23 days. It was concluded that cellulitis is subcutaneous, spreading bacterial infection is more common in males, and its incidence is highest in working age group population. Lower limb is commonly involved. Trauma, smoking, and diabetes are significant risk factors for development of cellulitis. Abscess is the most common complication. About 50% patients with cellulitis can be managed conservatively and the rest require surgical intervention.


ORL ◽  
2021 ◽  
pp. 1-9
Author(s):  
Carlos M. Chiesa-Estomba ◽  
Maria Soriano-Reixach ◽  
Izaskun Thomas-Arrizabalaga ◽  
Jon A. Sistiaga-Suarez ◽  
Jose A. González-García ◽  
...  

<b><i>Introduction:</i></b> Functional neck dissection (FND) represents a surgical procedure usually associated with less morbidity. <b><i>Methods:</i></b> An observational, retrospective, analysis of patients diagnosed with any type of head and neck malignancy was designed to summarize and report the incidence of postoperative complications in patients undergoing FND including just those levels described for selective neck dissections in a tertiary university hospital between June 2016 and June 2019. <b><i>Results:</i></b> 131 patients met the inclusion criteria. The total number of sides studied was 200. 40.5% of the patients suffer a complication in the postoperative period, being the spinal accessory nerve (SAN) injury the most common complication (10%). We did not find any statistical ­correlation between the previous organ-preservation treatments and surgical complications (<i>p</i> = 0.207). An advanced T stage (<i>p</i> = 0.009) and the need of bilateral FND (<i>p</i> = 0.034) were significantly correlated with a higher risk of surgical complications. <b><i>Conclusion:</i></b> FND represents a useful technique. In this study, 40.5% of the patients suffer a complication in the postoperative period, being the SAN injury the most common complication. However, these data contribute to increasing our knowledge about surgical complications related to FND.


2021 ◽  
Vol 25 (03) ◽  
pp. e459-e462
Author(s):  
Darwin Kaushal ◽  
Shilpa Goyal ◽  
Nithin Prakasan Nair ◽  
Kapil Soni ◽  
Bikram Choudhury ◽  
...  

AbstractThe number of critically-ill coronavirus disease 2019 (Covid-19) patients requiring mechanical ventilation is on the rise. Most guidelines suggest keeping the patient intubated and delay elective tracheostomy. Although the current literature does not support early tracheostomy, the number of patients undergoing it is increasing. During the pandemic, it is important that surgeons and anesthesiologists know the different aspects of tracheostomy in terms of indication, procedure, tube care and complications. A literature search was performed to identify different guidelines and available evidence on tracheostomy in Covid-19 patients. The purpose of the present article is to generate an essential scientific evidence for life-saving tracheostomy procedures.


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