Comparison of Antibiotic treatment and Appendectomy for non-complicated Acute Appendicitis during Covid-19 pandemic

2021 ◽  
Vol 15 (10) ◽  
pp. 2699-2700
Author(s):  
M. Waseem Anwar ◽  
M. Faheem Anwer ◽  
Wasif Majeed Chaudhry ◽  
Farhana Anwar ◽  
M. Usman Aslam ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Tertiary Care ◽  
Care Hospital ◽  
Oral Antibiotics ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Complicated Acute Appendicitis

Aim: To evaluate the efficacy of antibiotic treatment as the primary option for non-complicated acute appendicitis in pandemic situation. Study Design: Prospective interventional study. Setting & Duration of Study: CMH Lahore, a 700 bedded tertiary care hospital, for 4 months from 15th April 2020 to 15th august 2020. Methodology: A total of 110 cases meeting inclusion criteria, aged 13-65 years of both genders with suspicion of non-complicated appendicitis were included in the study, using probability sampling. They were divided in two groups on randomization basis. Group A for antibiotic therapy and Group B for appendectomy. Group A patients admitted in the ward 48 hours for IV antibiotics, were re-evaluated after 24 hours. If condition improves, the patient was discharged on oral antibiotics for next 10 days & if condition does not improve, antibiotics were prolonged for 48 hours. If deteriorating or patient. .chooses to change group, they underwent appendectomy. If condition improved, they were discharged on oral antibiotics for next 10 days. Group B patient were discharged after 2 post-operative doses of I/V antibiotics. Post-operative I/V antibiotics for 48 hours & 3 days oral antibiotics were given when appendix was gangrenous or perforated. Results: In a population of 110 patients, we studied the comparison of the groups having antibiotics and appendectomy as treatment for acute appendicitis. There is no significant difference in outcomes on basis of mean pain score and mean duration of hospital stay. Both ways of treatment can be adapted accordingly. Conclusion: Non-complicated acute appendicitis can be managed non-operatively in crisis situations like COVID-19 pandemic causing overburdening of hospitals. Keywords: Acute appendicitis, antibiotic therapy, appendectomy, pandemic.

scholarly journals Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

2019 ◽  
Vol 8 (10) ◽  
pp. 2197
Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig
Keyword(s):  
Tertiary Care ◽  
Nausea And Vomiting ◽  
Research Centre ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
First Line Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

scholarly journals Comparing efficacy of Rifaximin plus Lactulose vs. Lactulose alone in treating Hepatic Encephalopathy

2020 ◽  
Vol 24 (4) ◽  
pp. 339-343
Author(s):  
Tanveer Hussain ◽  
Misbah Sattar ◽  
Sara Mustafa ◽  
Uzma Batool ◽  
Shafqat Iqbal ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Local Population ◽  
Tertiary Care ◽  
Simple Random Sampling ◽  
Complete Recovery ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Hepatic Encephalopathy is a syndrome observed in patients with liver cirrhosis. Various treatment modalities are in use for treatment of Porto Systemic Encephalopathy (PSE). Our study aimed to compare the efficacy of Rifaximin plus Lactulose vs.Lactulose alone in treating Hepatic Encephalopathy in local population. Materials & Methods: The study was conducted at a tertiary care hospital recruiting decompensated chronic liver disease(DCLD) patients with PSE. Using simple random sampling, patients were divided in two groups (A & B). Patients in group A received Lactulose plus Rifaximin while group B received Lactulose alone. Efficacy of treatment was assessed as return of the conscious level to pre-encephalopathy state as per clinical examination within 1 week after  start of the treatment. Results: A total of 124 patients were included in the study with each group (A & B) containing 62 patients. Frequency and percentage of efficacy among group A (Rifaximin plus Lactulose) verses group B (Lactulose alone) in treating Hepatic encephalopathy was 45 (72.6%) and 32 (51.6%) respectively. Conclusion: The study concluded that there is a significant difference in proportions of patients showing complete recovery from Hepatic encephalopathy treated with Lactulose plus Rifaximin as compared to Lactulose alone.

scholarly journals Management of Neglected Achilles Tendon Division: Assessment of Two Novel and Innovative Techniques

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Pradeep Jain ◽  
Parthapratim Dutta ◽  
Prabal Goswami ◽  
Amol Patel ◽  
Shammi Purwar ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tertiary Care ◽  
Tendon Graft ◽  
Care Hospital ◽  
Plantaris Tendon ◽  
Significant Difference ◽  
Group A ◽  
And Gender ◽  
Group B ◽  
Innovative Techniques

Objective. Repair of injured Achilles tendon in neglected cases is one of the difficult and challenging procedures for surgeon. Here, we share our experience with the use of two innovative techniques for repair of chronic rupture of Achilles tendon. Design. Prospective Study. Setting. Tertiary care hospital. Patients. Twelve patients with chronic Tendo Achilles rupture were followed up over a period of three to five years. Intervention. Patients were divided in two groups, A and B. In Group A, the repair was done with Gastroc-soleus turndown flap and weaving with Plantaris tendon graft and in Group B, with modified Kessler’s technique strengthened with the free plantaris tendon graft. Outcome Assessment. Clinically and by Modified Rupp Scoring system. Results. At an average follow-up of 4 years (Group A, 3.7 and Group B, 4.4 years), the majority of the patients had excellent to good results as assessed with Modified Rupp Scoring with few minor complications in both the groups. There was no significant difference in the baseline variables such as age and gender and also in the Rupp’s score between the two groups. Conclusion. The two techniques are novel and simple and have been found to be useful for repair of chronically ruptured Achilles tendon.

scholarly journals A Comparative Study of Endoscopic Versus Navigation Guided Microscopic Transsphenoidal Pituitary Surgery at Tertiary Care Centre in India

2018 ◽  
Vol 32 (3) ◽  
pp. 443-457
Author(s):  
Anurag Sahu ◽  
Sharad Pandey ◽  
Kulwant Singh ◽  
Vivek Sharma
Keyword(s):  
Operative Time ◽  
Tertiary Care ◽  
Pituitary Surgery ◽  
Controlled Study ◽  
Complication Rates ◽  
Care Hospital ◽  
Significant Difference ◽  
Transsphenoidal Pituitary Surgery ◽  
Group A ◽  
Group B

Abstract Introduction: The transsphenoidal route for pituitary surgery is considered the standard treatment for pituitary adenomas. The disadvantage of the smaller exposure of this route is partially compensated for by the introduction of the microscope with its coaxial illumination, stereoscopic view, adequate magnification, and microsurgical instruments. However, there are only few reports about the outcome of endonasal endoscopic transphenoidal technique. Aims & Objectives: Current study has been conducted to compare the efficacy, advantages and dis advantages of endoscopic versus navigation guided microscopic transsphenoidal Pituitary surgery. Material and methods: A controlled study was done in the department of neurosurgery, at tertiary care hospital in India, from the period of August 2012 to December 2017 prospectively. In Group A- 30 patients in whom endoscopic transnasal trans Sphenoidal pituitary surgery and in Group B - 30 patients, intraoperative neuronavigation was used. Observations and Results: Both the groups were similar in demographic variables. The most common age group of pituitary tumor patients was 30-40 years. Fourteen (46.6 %) patients in group A and fifteen (50 %) of the patients in group B had tumor volume less than 5 ml. In group A, thirteen (43%) patients had intrasellar tumors with no suprasellar extension, while in group B, fifteen (50%) patients had intrasellar tumors with no extension. Operative time was noted from incision to closure and average time taken in both the groups was compared. Twenty five (83%) cases of group A took between 2-3 hours and only four cases (13%) took more than 3 hours. While in group B, twenty (66%) cases took between 4-5 hours. This shows a significant difference by fisher extact test (p<0.001) in the operative time required in both the groups. Eighteen (60%) patients in group B had a residual volume between 1-1.5 ml while only two patients in group A had so. This difference is also significant Fischer Exact test (p<0.001). Four (13.3%) patients in group A had diabites insipidus while only half of this, i.e. two (6.6%) had so in group B. however this difference in postoperative complication rate is not statistically significant between two groups. Conclusion: The results of our study correlate with many previous studies to compare endoscopic and microscopic transsphenoidal surgery. These two approaches are equally efficacious in oncological outcomes and the complication rates are comparable.

scholarly journals A comparative study of the efficacy and tolerability of parenteral ceftriaxone and cefotaxime in pediatric population for acute bacillary dysentery in a tertiary care hospital

2018 ◽  
Vol 7 (6) ◽  
pp. 1109
Author(s):  
Sagar K. ◽  
Shanmukananda P. ◽  
Veena D. R. ◽  
Shwetha H.
Keyword(s):  
Comparative Study ◽  
Bacillary Dysentery ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Paediatric Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Acute Bacillary Dysentery

Background: Diarrheal disorders in childhood account for a large proportion (18%) of childhood mortality. Among diarrheal diseases, dysentery is a major cause of childhood morbidity and mortality, especially in developing countries.Methods: This is an open labelled, prospective, randomised, comparative study carried out at Dr. B. R. Ambedkar Medical College Hospital, Bangalore from November 2014 to November 2015 after Institutional Ethics Committee approval. A total of 80 Paediatric patients who met the inclusion criteria were included in the study after taking written informed consent from parents and assigned into two groups, Group A- Inj. Ceftriaxone (50-100mg/kg/day) and Group B- Inj. Cefotaxime (100 mg/kg/day) in divided doses for a period of 3-5 days based on requirement.Results: In this study, Cefotaxime was non inferior to Ceftriaxone as the Mean Duration of Hospitalisation was 3.30±0.72 days in Group A and 3.30± 0.72 days in Group B with p value of 1.000, showing no statistically significant difference. Both were well tolerated without any reports of ADR (Adverse Drug Reaction).Conclusions: In this study shows that Inj. Cefotaxime is equally efficacious and well tolerated as Inj. Ceftriaxone in the treatment of Acute Bacillary Dysentery in paediatric patients.

scholarly journals Comparison of efficacy and safety of topical luliconazole with topical fluconazole against tinea corporis in a tertiary care hospital

2021 ◽  
Vol 10 (7) ◽  
pp. 840
Author(s):  
E. Seshathri ◽  
R. Deepthi Krishna
Keyword(s):  
Tertiary Care ◽  
Tinea Corporis ◽  
Tolerability Profile ◽  
Care Hospital ◽  
Efficacy And Safety ◽  
Once Daily ◽  
Significant Difference ◽  
Group A ◽  
Low Incidence ◽  
Group B

Background: Dermatophytosis is a common cutaneous infection worldwide with prevalence varying from 20% to 25%. Luliconazole is a newer topical antifungal applied once daily with greater reservoir property in stratum corneum. Objective of the study was to compare the clinical efficacy and safety of luliconazole 1% cream with Fluconazole 1% cream in patients with mild to severe grades of tinea corporis.Methods: A total of 100 patients with mycologically confirmed tinea corporis were randomised into group A and B respectively. Group A, 50 patients received luliconazole 1% for 2 weeks and group B, 50 patients received fluconazole 1% cream for 4 weeks. Patients were clinically and mycologically evaluated on 0, 2nd and 4th week of treatment and followed up on 8th week for any relapse.Results: Significant improvement in efficacy was seen in Luliconazole while compared with fluconazole group against tinea corporis infection. Mycological cure and clinical improvement showed significant difference in group A. The safety and tolerability profile of both groups were good and statistically comparable.Conclusions: Luliconazole 1% cream is found to be safe, effective and tolerable with low incidence of relapse than fluconazole 1% cream.

scholarly journals Blast injury to the ear: management and long term follow up at a tertiary care hospital in a terrorism affected area of North India

2018 ◽  
Vol 4 (6) ◽  
pp. 1417
Author(s):  
Subodh Kumar ◽  
Awadhesh Kumar Mishra ◽  
Ajay Mallick ◽  
Ashwani Sethi
Keyword(s):  
Hearing Loss ◽  
Otoacoustic Emissions ◽  
Pure Tone ◽  
Tertiary Care ◽  
Care Hospital ◽  
Distortion Product ◽  
Significant Difference ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> A large proportion of blast victims suffers ear injuries; however, these injuries are often overlooked.</p><p class="abstract"><strong>Methods:</strong> We assessed 411 blast victims to detect ear injury employing detailed history, otological examination, pure tone audiometry, auditory steady state response and distortion product otoacoustic emissions. TM perforations were managed by thorough cleaning of ear by suctioning, edges approximation and gelfoam splinting in group A and only suctioning in group B. Prednisolone in tapering doses was prescribed for managing hearing loss in all except those in whom it was contraindicated.  </p><p class="abstract"><strong>Results:</strong> Out of 411 blast victims, 228 (55.47%) had aural trauma. All cases were males (being serving soldiers) between ages of 21 and 57 years. (Mean 37.77 years, SD 10.38). 285 ears had a perforated TM. Of these, 145 were assigned to group A while 140 were in group B. There was no significant difference in spontaneous healing of perforation between the two groups but at 5 years’ follow up group A had significantly higher number of unscarred, healthy TMs than group B (Z score=2.2111, p=0.0271). Mean pure tone average was 51.16 dB (SD 8.79 dB) at presentation and 38.91 dB (SD 7.86 dB) at 5 years. Recovery of SNHL component was significantly better in steroid treated patients.</p><p class="abstract"><strong>Conclusions:</strong> Edges approximation and gelfoam splinting helped in reducing scarring of TM on healing, on long follow up. Steroid treated group showed better recovery of hearing loss.</p>

scholarly journals An assessment of knowledge, attitude and practices (KAP) towards warfarin medication among patients with prosthetic valve in a tertiary care hospital of south India

2018 ◽  
Vol 7 (10) ◽  
pp. 1877
Author(s):  
Gopisankar M. G. ◽  
Surendiran A. ◽  
Hemachandren M.
Keyword(s):  
Valve Replacement ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cardiac Valve ◽  
Care Hospital ◽  
Significant Difference ◽  
Group A ◽  
Cardiac Valve Replacement ◽  
Group B

Background: Warfarin is a drug with narrow therapeutic index. It requires varied adequate doses for achieving target INR so as to prevent episodes of thromboembolism. It is important to properly educate the patient while prescribing this drug to reduce the side effects and maintain perfect anticoagulation status. This study was done to assess the baseline Knowledge, Attitude and Practices (KAP) towards warfarin medication among patients with cardiac valve replacement in a tertiary care hospital of south India to get a baseline data which can recommend implementation of health education programs targeting these patients.Methods: An observational cross-sectional study was approved by Institute Ethics Committee JIPMER, Puducherry. It included patients on treatment with warfarin maintenance therapy for a period of not less than three months following cardiac valve replacement in the months of October 2016 to October 2017. The questionnaire included 39 questions of qualitative and quantitative basis, which was scored for a total of 50 and analysed using SPSS software.Results: About 240 patients were interviewed who attended cardiothoracic vascular surgery outpatient department and taking warfarin for at least 3 months following surgery of valve replacement. Patients were divided into two groups. Group A included patients who achieved target INR and group B are those out of target INR. 15.7 percent (35) had low score, 76.2 (160) had medium score and 15 (7.1) percent had high scores in group A. In group B 22(81.5%) had medium score and 5 (18.5%) had high score. The median score was more among patients with higher education (p=0.01). There was no significant difference between scores between different age groups or profession.Conclusions: Lack of adequate knowledge exists in patients who are followed in CTVS OPD when assessed about the basic nature of their disease and drug use. It has been shown that group B had more score which may be due to more education they may have received owing to non-attainment of target INR. This study acts as a baseline and thus advocates the need of proper patient education for patients taking warfarin which may improve the treatment outcome.

scholarly journals Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
P Value ◽  
Care Hospital ◽  
Intravenous Lidocaine ◽  
Operative Outcomes ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

scholarly journals A prospective study of lornoxicam as pre-emptive analgesic in abdominal surgeries in tertiary care hospital in Salem, India

2017 ◽  
Vol 6 (7) ◽  
pp. 1778
Author(s):  
Mohammed Ziauddin Sarkhil ◽  
Hemant Kumar Dutt ◽  
Rajaram S.
Keyword(s):  
Rating Scale ◽  
Tertiary Care ◽  
Open Appendectomy ◽  
Care Hospital ◽  
Pain Rating ◽  
Pain Scores ◽  
Analgesic Regimen ◽  
Group A ◽  
Group B ◽  
Pain Rating Scale

Background: Preemptive analgesia, involves the introduction of an analgesic regimen before the onset of noxious stimuli, with the goal of preventing sensitization of the nervous system to subsequent stimuli that could amplify pain.Methods: To determine the efficacy and safety of Lornoxicam when administered preemptively by using Wong-Baker FACES Pain Rating scale. The patients undergoing abdominal surgery were randomly categorized into group A and B of 25 each. Group A- Received Lornoxicam 8mg (1ml) one hour before surgery. Group B- Not received any analgesic before surgery. Primary measurement of the efficacy was done by using Wong-Baker Faces Pain Rating Scale at 2, 4, 8, 12 and 24 hour. All parameters were analyzed by using student t test.Results: Surgeries which were included in the study are hernia repair, open appendectomy, laparoscopic (appendectomy, cholecystectomy). Reduction in pain scores at 12th hourly and 24th hourly pain scores (<0.05) was significant. Tramadol usage decreased significantly with laparoscopic surgeries.Conclusions: In this study we could demonstrate that lornoxicam when used preemptively reduces the pain score slightly and reduces the requirement of post-operative analgesics significantly.

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