scholarly journals A case report on pemphigus foliaceus

2021 ◽  
pp. 53-56
Author(s):  
Divyasree Muppineni ◽  
Vishnu Sree Uppu ◽  
Dr.Firoz Shaik
Keyword(s):  
Tertiary Care ◽  
The Body ◽  
Wound Management ◽  
Pemphigus Foliaceus ◽  
Care Hospital ◽  
Cotton Swab ◽  
Objective Evidence ◽  
Serous Discharge ◽  
Chief Complaints ◽  
Vesicular Disease

Pemphigus Foliaceus (PF) is second most common autoimmune vesicular disease in the pemphigus family characterized by superficial blisters of the skin and rarely mucous membranes which rupture to produce scaly, crusted lesions. A 54 year old female patient admitted in female derma ward in tertiary care hospital, with the chief complaints of painful ruptured blisters all over the body with crusty, scaly patches associated with serous discharge and itching since 15 days. A positive Nikolsky’s sign is when the skin shears off easily when the surface is wiped sideways with a cotton swab or a finger. Based on both subjective and objective evidence, this case is assessed as Pemphigus Foliaceus. The plan incudes Corticosteroids, Immunosuppressants, Antibiotics, Vitamin A & D supplements, IV fluids, calcium and aminoacids supplements, antivirals and antifungals (if needed), proper wound management and finally plasmapheresis.   

A CLINICOEPIDEMIOLOGICAL STUDY ON PAEDERUS DERMATITIS IN A TERTIARY CARE CENTRE, CHENNAI

2021 ◽  
pp. 25-27
Author(s):  
P. Mohan ◽  
P. Revathi Guru ◽  
V. Sudha ◽  
L. Balamurugan ◽  
Pavithra Gunasekaran ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sudden Onset ◽  
The Body ◽  
Care Hospital ◽  
Age Group ◽  
Common Condition ◽  
Tertiary Care Centre ◽  
Linear Lesions ◽  
Paederus Dermatitis

Paederus dermatitis is a form of irritant contact dermatitis due to contact with certain insects of the genus Paederus presenting with mostly erythematous linear lesions of sudden onset on exposed parts of the body. To study the clinico epi Aim: demiological features in patients with Paederus dermatitis. A retrospective analysis of clinicoepidemiological Materials & Methods: features of patients affected with Paederus dermatitis who had attended the Dermatology OPD, in a tertiary care hospital between January 2018 to December 2019 was done. All the required data had been collected from the OPD records and details were tabulated and analysed. A total of 56 patients had been affected with Result: Paederus dermatitis during the study period, of which 32 were males and 24 were females. 41out of 56 (73.21%) of patients presented between the months of August and December. Most common age group affected were between 11 to 30 yrs, with front and back of neck being the most common affected sites. In 42 out of the 56 patients the lesions resolved with post inammatory hyperpigmentation. Conclusion: Paederus dermatitis is a common condition that is often misdiagnosed and hence awareness is required for the clinicians and the general public to prevent it.

scholarly journals A comparative study of impact on cognitive function between diabetic and non-diabetic patients in a tertiary care hospital

2018 ◽  
Vol 7 (8) ◽  
pp. 1547
Author(s):  
Dharnaben A. Patel ◽  
Dhruv J. Patel ◽  
N. D. Kantharia
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Tertiary Care ◽  
The Body ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Proper Understanding ◽  
History Of ◽  
Control Of Diabetes ◽  
The Brain

Background: Diabetes Mellitus is a chronic metabolic disorder characterized by hyperglycemia, polyuria, hyperlipidemia etc, resulting from defects in insulin secretion, insulin action or both. It affects various organs of the body including the brain. Cognitive function is the thinking process of the brain. In any chronic disease evaluation of cognitive function is justified as it may affect various common day to day activities.Methods: It is a prospective, observational and non-interventional study. Thirty diabetic patients who were recently started on insulin i.e. within 7 days were enrolled in the study based on inclusion and exclusion criteria. Thirty non diabetic healthy individuals served as a control. Cognitive function was accessed by Adenbrooke’s Cognitive Examination (ACE III) at the time of enrollment.Results: The results were analysed using paired t-test. Attention, Memory and Visiospatial ability was significantly reduced in diabetic patients compared to control. Verbal fluency and language was also reduced but the change was not significant. Total ACE III score was significantly reduced in diabetic patients compared to control.Conclusions: Cognitive function is significantly reduced in Diabetic patients recently started on insulin. Hyperglycemia could be the possible reason of cognitive decline. Proper understanding of the natural history of Diabetes and the pathogenesis of cognitive decline as well as control of Diabetes can help to prevent development of cognitive dysfunction.

SONOGRAPHIC MEASUREMENTS OF SCROTAL WALL THICKNESS

2021 ◽  
pp. 31-32
Author(s):  
Sahil Gandhi ◽  
Asit Natekar
Keyword(s):  
Wall Thickness ◽  
Tertiary Care ◽  
The Body ◽  
Wall Thickening ◽  
Temperature Sensitive ◽  
Main Function ◽  
Care Hospital ◽  
Sperm Production ◽  
Time Duration ◽  
Anterior Posterior

Main function of scrotum is to hold testes at optimal temperature for spermatogenesis. Sperm production in the testes is a temperature sensitive process. It requires an environment that is 2 to 6°C cooler than the body core. The temperature of the testes is regulated by the scrotal wall. Tunica dartos muscle changes the surface area of the scrotal skin by contracting or relaxing depending on the ambient temperature. This study postulates that if the thickness or the tone of this muscle is more thereby contributing to scrotal wall thickening, it will hamper the thermoregulation and spermatogenesis leading to poor sperm production. This could be an besides varicocoele another cause of male infertility which has been an established cause. This study will help to suspect the patients of infertility caused by thick scrotal wall. This study is aimed to study scrotal wall thickness and with the help of Ultrasonography. to establish norms The study was conducted at department of Radio-diagnosis at the tertiary care hospital, Sangli. The study started after approval of institutional ethical committee. This is a cross sectional observational study for the duration of 4 months. Total number of 50 cases was achieved in this time duration which satised the inclusion criteria. Statistical method used was Student's T test. Scrotal ultrasonography was performed using linear and curvilinear probe with sta (5-12 MHz) (2-5 MHz) on Philips Afniti50, after ndoff pad allowing some time for the dartos muscle to relax and scrotal wall thickness is measured on either side on three surfaces (anterior, posterior and lateral) and means were obtained. This study found that there was no difference between anterior, posterior, lateral wall thicknesses on ipsilateral side or contralateral side. There is no need to take three different wall thicknesses and convenience and suitability of any scrotal wall thickness would be equally effective.

scholarly journals Outcome of Internal Fixation of Metacarpal Fractures of Hand at a Tertiary Care Hospital, Kathmandu

2019 ◽  
Vol 21 (1) ◽  
pp. 35-39
Author(s):  
Praphulla Shrestha ◽  
SR Paudel ◽  
P Chalise
Keyword(s):  
Pain Relief ◽  
Internal Fixation ◽  
Tertiary Care ◽  
Kirschner Wire ◽  
The Body ◽  
Care Hospital ◽  
Metacarpal Fractures ◽  
Active Flexion ◽  
Hand Fractures

Hand fractures are different from other fractures elsewhere in the body. Functional impairment of hand leads to a prominent issue to the patient. We have a common practice of treatment of hand fractures by using kirschner wire(s). The internal fixation using plates and screws for metacarpal fractures of the hand is technically demanding but it is beneficial to the patients as it permits early mobilization and better pain relief. We studied the outcome of this type of internal fixation of the metacarpal fractures at Nepal Medical College. We included 26 patients above 18years with isolated extraarticular, closed and open Swanson I metacarpal fractures of the hand. Fractures with rotation of the digit and unacceptable angulation, shortening and unstable fractures were included. Pain was evaluated by visual analogue scale and function using American Society for Surgery of hand Total Active Flexion (ASSHTAF) score. The mean pain score (VAS) was 0.27 at 12 weeks. The ASSHTAF score showed excellent results in 92.3% patients at 12 weeks. At the final follow up 92.3% patients had excellent results, 3.8% had good and 3.8% had poor results. Fracture union was seen in all patients at final follow up. The study shows that internal fixation of unstable metacarpal fractures gives significant pain relief to the patient and an excellent functional outcome.

scholarly journals Establishment of CTPA Local Diagnostic Reference Levels with Noise Magnitude as a Quality Indicator in a Tertiary Care Hospital

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 680
Author(s):  
Hanif Haspi Harun ◽  
Muhammad Khalis Abdul Karim ◽  
Mohd Amiruddin Abd Rahman ◽  
Hairil Rashmizal Abdul Razak ◽  
Iza Nurzawani Che Isa ◽  
...  
Keyword(s):  
Body Size ◽  
Quality Indicator ◽  
Tertiary Care ◽  
Pulmonary Arteries ◽  
The Body ◽  
Care Hospital ◽  
Diagnostic Reference Levels ◽  
Ct Scanner ◽  
Reference Levels ◽  
Dose Length Product

This study aimed to establish the local diagnostic reference levels (LDRLs) of computed tomography pulmonary angiography (CTPA) examinations based on body size with regard to noise magnitude as a quality indicator. The records of 127 patients (55 males and 72 females) who had undergone CTPAs using a 128-slice CT scanner were retrieved. The dose information, scanning acquisition parameters, and patient demographics were recorded in standardized forms. The body size of patients was categorized into three groups based on their anteroposterior body length: P1 (14–19 cm), P2 (19–24 cm), and P3 (24–31 cm), and the radiation dose exposure was statistically compared. The image noise was determined quantitatively by measuring the standard deviation of the region of interest (ROI) at five different arteries—the ascending and descending aorta, pulmonary trunk, and the left and right main pulmonary arteries. We observed that the LDRL values were significantly different between body sizes (p < 0.05), and the median values of the CT dose index volume (CTDIvol) for P1, P2, and P3 were 6.13, 8.3, and 21.40 mGy, respectively. It was noted that the noise reference values were 23.78, 24.26, and 23.97 HU for P1, P2, and P3, respectively, which were not significantly different from each other (p > 0.05). The CTDIvol of 9 mGy and dose length product (DLP) of 329 mGy∙cm in this study were lower than those reported by other studies conducted elsewhere. This study successfully established the LDRLs of a local healthcare institution with the inclusion of the noise magnitude, which is comparable with other established references.

scholarly journals Bloodstream infections and trends of antimicrobial sensitivity patterns at Port Blair

2018 ◽  
Vol 10 (03) ◽  
pp. 332-337 ◽  
Author(s):  
Amit Banik ◽  
Sanjeev H. Bhat ◽  
Abhay Kumar ◽  
Agnijeet Palit ◽  
Kandregula Snehaa
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
The Body ◽  
Diffusion Method ◽  
Blood Collection ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Sensitivity Testing ◽  
Disk Diffusion Method ◽  
Antimicrobial Sensitivity

ABSTRACT PURPOSE: Bloodstream infection can range from inapparent bacteremia until fulminant septic shock with high mortality. Microorganisms present in circulating blood whether continuously, intermittently, or transiently are a threat to every organ in the body. Culture of blood is a vital tool to diagnose such infections. Drug susceptibility patterns help in rationalizing therapy. OBJECTIVE: The objective of this study was to perform bacteriological analysis and assess drug sensitivity patterns of isolates from blood stream infections. DESIGN: Retrospective observational study was conducted from May 2015 to February 2017 at a tertiary care hospital, Port Blair, India. Blood samples were collected with aseptic guidelines and cultured for 7 days. Growths were identified using standard biochemical tests and subjected to sensitivity testing according to Modified Kirby–Bauer’s disk diffusion method. Data for the source of blood collection and duration of incubation were noted and compared. RESULTS: A total of 270 (14.24%) pathogens were isolated from 1895 bacteremia suspect patient blood specimens. Contamination was observed at a rate of 1.63%. Gram-positive cocci (60.37%) were predominant organisms recovered followed by Gram-negative Bacilli (36.29%) and Yeasts (3.33%). Staphylococcus aureus, CoNS, and Acinetobacter spp. were the primary pathogens isolated. Aminoglycosides, carbapenems, and glycopeptides were the most effective drugs for treating bacteremia. CONCLUSIONS: Successful treatment of sepsis depends on early diagnosis and proper antimicrobial therapy. Local knowledge of bacteriological profile and antimicrobial sensitivity patterns helps rationalize empiric treatment strategies.

scholarly journals MORPHOLOGY AND MORPHOMETRY OF SCAPULAE IN TERTIARY CARE HOSPITAL IN K.M. MEDICAL COLLEGE AND HOSPITAL, MATHURA (UP).

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Lavlesh Mittal ◽  
Dr. Sandeep Madaan
Keyword(s):  
Shoulder Arthroplasty ◽  
Shoulder Joint ◽  
Total Shoulder Arthroplasty ◽  
Tertiary Care ◽  
The Body ◽  
Care Hospital ◽  
Glenoid Cavity ◽  
Shoulder Dysfunction ◽  
Inverted Comma ◽  
Morphology And Morphometry

Introduction:  The shoulder joint is the most important joint in the body and limitation of this joint movements affects the quality of life. Severe shoulder injury and glenohumeral arthritis causes shoulder dysfunction with devasting results, and to restore normal functions orthopaedic surgeon can perform total shoulder arthroplasty, or reverse shoulder prosthesis, or hemiarthroplasty.Lateral angle of the scapula becomes truncated and broadened and bears the glenoid cavity which articulates with the humerus in the shoulder joint. Shoulder joint is formed when the glenoid cavity is connected with the head of the humerus. This study was carried out to study the morphology and morphometry of the glenoid cavity as dimensions of the glenoid cavity are important in designing and fitting of glenoid components for total shoulder arthroplasty. Material and Methods: A total of 100 unpaired dry scapula were isolated from the department of Anatomy. Two groups were made according to the side of the scapula and were equally divided into 50 right and 50 left scapula each. Bones were segregated and inspected individually.To classifying shape of the glenoid fossa, presence or absence of a glenoid notch was used and were classified into 3 types, pear shaped or inverted comma shape in presence of a glenoid notch & oval in absence of notch. The pear shaped shows indistinct glenoid notch and the inverted comma shaped shows a distinct notch. Results: On the basis of presence or absence of the glenoid notch. 56%, 28% & 16% glenoid cavities of right side were pear shaped, inverted comma shaped and oval shaped respectively. On the left side 60%, 30% & 10%were pear shaped, inverted comma shaped and oval shaped respectively. In total 58% glenoid cavities were pear shaped, 29% were inverted comma shaped and 13% were oval shaped.Average length and breadth of scapulae included in this study was 134.07±13.87 mm and 98.43 ±9.58 mm respectively.Mean glenoid cavity index of right side was 48.12 to 86.87 %, while in left side it was 44.21 – 84.78%. Conclusion: The most common glenoid cavity was pear shaped followed by inverted comma shaped and the oval glenoid cavity. Mean glenoid cavity index of right side was 48.12 to 86.87 %, while in left side it was 44.21 – 84.78%.

scholarly journals Study of prescription pattern of antimicrobials used in post-operative surgical patients in tertiary care hospital

2021 ◽  
Vol 10 (6) ◽  
pp. 627
Author(s):  
Jitendra H. Hotwani ◽  
Nishikant H. Madkholkar
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Duration ◽  
Hospital Setting ◽  
Surgical Site Infections ◽  
The Body ◽  
Brand Names ◽  
Surgical Patients ◽  
Care Hospital ◽  
Prescription Pattern

Background: Antimicrobials are used for prophylaxis and treatment of infections which occur following surgical procedures, to reduce the morbidity and mortality associated with surgical site infections (SSIs). A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. These are infections of the tissues, organs, or spaces exposed by surgeons during performance of an invasive procedure.Methods: A prospective, non-interventional, observational study in tertiary care hospital for duration of 9 months. Sample size was 330.Results: The prescription pattern shows that nitroimidazoles were the most commonly prescribed group of antimicrobials in 72% of patients followed by penicillins (58%) and cephalosporins (42%). Metronidazole (72%), amoxicillin and clavulanic acid (51.21%) ceftriaxone (20.90%) were most commonly prescribed antimicrobials in these groups. Two antimicrobials were prescribed in 47% patients with nitroimidazole and penicillins being the most commonly prescribed combination of antimicrobial. Three antimicrobials were prescribed in 25% patients and four antimicrobials in 8% patients. This shows trend towards polypharmacy. About 82% of antimicrobials were prescribed by brand names and 64% of total antimicrobials prescribed from outside the hospital pharmacy source. About 12.42% of patients changed antimicrobial therapy after culture and sensitivity report.Conclusions: Total duration, number of anti-microbial used was more in clean-contaminated, contaminated, dirty wound surgeries as compare to clean wound surgeries. Our study provides a framework for continuous prescription audit of antimicrobials in a hospital setting and thus can help in rational use of antimicrobials in post-operative surgical patients.

scholarly journals A prospective study on incisional hernia, its incidence, etiology and management in a tertiary care hospital of Odisha

2019 ◽  
Vol 6 (4) ◽  
pp. 1280
Author(s):  
S. K. Pattanaik ◽  
Afroza Firodous ◽  
Ajax John ◽  
Harsha Pattnaik ◽  
Biplab Mishra ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Mesh Repair ◽  
Tertiary Care ◽  
Operating Time ◽  
Surgical Techniques ◽  
Wound Management ◽  
Anatomical Reconstruction ◽  
Suture Repair ◽  
Care Hospital ◽  
Open Mesh Repair

Background: Incisional hernia (IH) is defined as the hernia protruding through incompletely healed abdominal surgical wound. Management of IH can be preventive (avoidance of infection and suture line tension, proper abdominal wound closure) or operative (anatomical reconstruction or repair with synthetic non-absorbable mesh either by open or laparoscopy method).Methods: A descriptive prospective observational study on 51 patients with age >15 yrs was conducted in the Department of General Surgery, SCB Medical College and Hospital, Cuttack from August 2015 to August 2017. Diagnosis was made with clinical history, physical examination, X-ray abdomen and USG abdomen. The patients underwent different surgical procedures depending on size of defect, patient’s consent and expertise available. Post-operative complications were noted and patients were followed up to 1 year for any recurrence.Results: 28 males and 23 females were included. The mean age was 42.3 years. Most common cause of IH was post-operative wound infection (47.1%). Maximum cases were following emergency surgery (88.2%). Midline incision contributes maximum number (52.9%) followed by Pfannenstiel incision (25.4%). Open hernioplasty was the most common procedure (58.8%) followed by anatomical repair (19.6%) and laparoscopic hernioplasty (15.6%). Recurrence with suture repair was 10%, open mesh repair 3.3% and no recurrence was observed following laparoscopic repair.Conclusions: Prevention of IH is to be taken care of, by avoiding infection during index operation with thorough peritoneal toileting, proper surgical techniques and appropriate antibiotics. Although laparoscopic mesh repair needs more operating time and skill, it has lesser blood loss, hospital stay and recurrence rate when compared to other procedures.

scholarly journals Assessment of different stress responses after laparoscopic and open cholecystectomy in patients attending tertiary care hospital, Bhuj, Gujarat, India: a prospective study

2017 ◽  
Vol 4 (5) ◽  
pp. 1575
Author(s):  
Bhavin Kothari ◽  
Gyaneshwar Rao
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Stress Responses ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Serum Cortisol ◽  
The Body ◽  
Surgical Trauma ◽  
Care Hospital ◽  
C Reactive Protein ◽  
Reactive Protein

Background: Surgical trauma by incision and dissection of tissue stimulates the body to respond proportionately to the extent of injury. This study was conducted with an aim to compare metabolic and inflammatory responses after laparoscopic and open cholecystectomy namely serum cortisol and C-reactive protein levels before and after operation at Bhuj, Kutch, India.Methods: Present study was non-randomized, and comparative study carry out in the General Surgery Department at Gujarat Adani prospective institute of Medical Science, Bhuj, Kutch, Gujarat, India for an era of two years. One hundred and two patients were included in this study and were divided into two groups of open and laparoscopic cholecystectomy. Out of these 102 patients, 41 undergo open cholecystectomy and 61 laparoscopic cholecystectomy. Preoperative, intraoperative, postoperative and anesthetic medications were consistent in all the patients.Results: It was found that metabolic responses like serum cortisol were significantly higher after open procedure 6 hours and 48 hours postoperatively. Similarly, inflammatory response indicator C-reactive protein was raised significantly higher 48 hours after open as compared to laparoscopic cholecystectomy.Conclusions: Open cholecystectomy caused further tissue responses as compared to its laparoscopic alternative.

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