scholarly journals The Pattern of Day Case (Ambulatory) Percutaneous (PCNL): A Descriptive Retrospective Study from a Tertiary Care Hospital

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Rehan Fareed ◽  
Huma Shamim
Keyword(s):  
Retrospective Study ◽  
Tertiary Care ◽  
Ureteral Stones ◽  
Transfusion Rate ◽  
Care Hospital ◽  
High Grade ◽  
High Grade Fever ◽  
Access Methods ◽  
The Mean ◽  
Staghorn Stones

Background: Percutaneous nephrolithotomy (PCNL) has experienced remarkable development and alteration since it was first described in 1976 by Fernstorm et al. It has also experienced miniaturization of equipment, improvement in operative systems, and refining renal access methods leading to the achievement of maximum clearance of stone while causing minimal morbidity. For example, in endourological practice, when the patient is subjected to PCNL, he traditionally needs programmed inpatient admission, as part of their recovery, it is applicable as an outpatient method in properly selected cases. Objectives: We aimed at evaluating the safety and applicability of the outpatient PCNL procedure. Methods: This retrospective study was done on 210 cases of tubeless PCNL performed by a single urologist at our institute from January 2016 to January 2019. Patients’ mean age (134 males and 76 females) was 57 ± 11.8 years, and 7 patients aged 8 - 12 years. There were 71 pelvic or calyceal solitary stones, 62 non-complete staghorn stones, 17 ureteral stones, 32 renal + ureteric stones (simultaneous renal and ureteral stones) , and 28 complete staghorn stones. The average stone size was 3.5 ± 2.8 (range: 0.7 to 11.8 cm). Results: The mean operation duration was 85.0 ± 29.4 min, and the mean hospital stay was 21.7 ± 3.4 h. Out of 210 patients, 6 patients had longer stay due to high-grade fever and 3 patients due to severe pain, and also 7 patients refused discharge due to personal and social reasons. Our ambulatory PCNL rate was 97 % ( 194 out of 210). Within 72 h, 5 patients were readmitted due to high-grade fever, 3 patients due to haematuria, and 4 patients due to pain and dysuria, and all patients were discharged 2 - 4 days after conservative treatment. Thus, the readmission rate was 6.18% (12 cases were readmitted out of 194 cases). Patients showed a blood transfusion rate of 1.4 %. Also, 19 cases (9.02%) were found with post-operative fever, and no urosepsis was reported. No pulmonary complications and mortality were noted. No re-exploration was done, and no major leak was noted. The angio-embolization rate was 0.59%. We did not use HEMO-SEAL technology, cautery, or suture in the tracks. Conclusions: In conclusion, the outpatient PCNL procedure is an applicable and feasible procedure under selected criteria; however, more investigations using a larger sample size are needed.

scholarly journals Experience of Laparoscopic Cholecystectomies in a Tertiary Care Hospital: a Retrospective Study

2020 ◽  
Vol 27 (4) ◽  
pp. E202043
Author(s):  
Aamir Hussain Hela ◽  
Haseeb Mohammad Khandwaw ◽  
Rahul Kumar ◽  
Mir Adnan Samad
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Retrospective Study ◽  
Bile Duct ◽  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Care Hospital ◽  
Site Infection ◽  
The Mean

Introduction: Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder.  It is estimated that approximately 90% of cholecystectomies in the  United States are performed using a laparoscopic approach.  The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital.  Methods: This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J & K, India and necessary data was collected and reviewed. Results: In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 minutes with range of 45 – 90 minutes. Conversion rate was 2.6%. 2 patients were re-explored. Bile duct injury was found in 6 patients (0.5%).  Conclusions: Gallstone disease is a global health problem. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first choice of treatment for gallstones. Gall stone diseases is most frequently encountered in female population. The risk factors for conversion to open cholecystectomy include male gender, previous abdominal surgery, acute cholecystitis, dense adhesions and fibrosis in Calot’ s triangle, anatomical variations, advanced age, comorbidity, obesity, suspicion of common bile duct stones, jaundice, and decreased surgeon experience. The incidence of surgical site infection has significantly decreased in laparoscopic cholecystectomy compared to open cholecystectomy. In our study we could not find any case of surgical site infection.

scholarly journals Exploring caesarean delivery in the second stage of labour at a tertiary care hospital: a retrospective study

2021 ◽  
Vol 10 (10) ◽  
pp. 3929
Author(s):  
Pravinkumar A. Jadav ◽  
Palak M. Dabhi ◽  
Dhruti A. Rathod
Keyword(s):  
Retrospective Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Transfusion Rate ◽  
Care Hospital ◽  
Intraoperative Complication ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour

Background: Caesarean section (CS) performed in the second stage of labour has many implications for maternal and neonatal morbidity as well as for subsequent pregnancies. The objectives of this study were to determine the rates of CS at full dilatation, their indications, associated maternal and neonatal complications.Methods: This retrospective study assessed all the women with a singleton fetus in cephalic presentation at term (≥37 weeks) who underwent CS in the second stage of labor between 1 August 2019 and 31 March 2020 at a tertiary care hospital. Maternal demographics, labour and delivery details as well as neonatal outcomes were collected.Results: During the study period, 2124 (36%) babies were born by CS. Of these, 49 (2.3%) were performed in the second stage of labour at ≥37 weeks of gestation. The most common indication of CS was non-descent of head in 38 (77.55%) of cases. The majority of women 38 (77.55%) delivered by CS in the second stage of labor were primiparous. The 27 (55.10%) women were in the age group of 20-25 years. Most common intraoperative complication was blood-stained urine in 20 (40.81%) women. Overall transfusion rate was 18.36%. Maximum number of babies born 44 (89.79%) were having birth weight between 2.5-3.5 kg. Out of 65 babies born, 17 (34.69%) were admitted to neonatal intensive care unit.Conclusions: Formulation of an institutional protocol and training and supervision of trainees to improve the skill of operative vaginal delivery and second stage cesarean is needed.

scholarly journals Demographic Profile of Liver Injury Managed at a Tertiary Care Hospital in Central Nepal -A Retrospective Study

2018 ◽  
Vol 14 (1) ◽  
pp. 32-38
Author(s):  
Narayan Prasad Belbase ◽  
Aditya Kumar Jalan ◽  
Hari Upadhyay ◽  
Rohit Mishra ◽  
Mukesh Karki ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Liver Injury ◽  
Tertiary Care ◽  
Operative Management ◽  
Hemodynamic Instability ◽  
Solid Organ ◽  
Care Hospital ◽  
Demographic Profile ◽  
Liver Injuries ◽  
The Mean

Background & Objectives:The liver is one of the commonly injured solid organ following abdominal trauma. The aim of this study was to determine the outcome of liver injuries managed operatively or non-operatively and predict factors affecting morbidity and mortality.Materials & Methods:This was a retrospective study of 40 liver injuries managed in the department of Surgical Gastroenterology at College of Medical Sciences over a period of 2 years. The liver injury was classified in accordance with the American Association for the Surgery of Trauma liver injury scoring scale. Patients were divided into two groups those managed operatively or non-operatively and were compared in terms of demographic profile and outcome.Results:Forty patients were analyzed. The mean age of the patients was 29.95years. Male predominance was seen with 72.5% of the cases. Road traffic accidents were the commonest mode of injury seen in 72.5% cases. The mean Revised Trauma Score (RTS) and Injury severity score (ISS)  were 7.11and 22.58. The mean systolic BP, hospital stay and ICU stay were 93.80 mm of mercury, 11.55 days and 3.55 days respectively. Twenty six patients (65%) were initially managed non-operatively and 14 patients were managed operatively. Five patients had to be converted to operative management for hemodynamic instability. Mortality was 7.6% in patient undergoing non-operative management and 21.43% in patients managed operatively. Low systolic BP at presentation, low RTS score, high ISS score, high AST, ALT and prothrombin time were significantly associated with operative management and mortality.Conclusion:Patients with hemodynamic instability, low RTS score, high ISS score, high liver enzymes have high likelihood of operative management.

EVALUATION OF COMPLICATIONS AND SUCCESS RATES OF PCNL,USING MODIFIED CLAVIEN GRADING SYSTEM: A SINGLE-CENTER EXPERIENCE

2021 ◽  
pp. 32-34
Author(s):  
Abhishek Shukla ◽  
F.A. Khan ◽  
Ravinder Pal ◽  
S.S. Chipde ◽  
Neelam. K.Soni
Keyword(s):  
Retrospective Study ◽  
Perioperative Complications ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Grading System ◽  
Transfusion Rate ◽  
Success Rates ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
The Mean

OBJECTIVE: The purpose of this retrospective study is to document the perioperative complications of percutaneous nephrolithotomy (PCNL) using the modied Clavien grading system at a tertiary care centre. MATERIAL & METHODS: A retrospective study of 133 patients who underwent standard PCNL in the department of Urology and Renal Transplant,during the period January 2019 to March 2020 at Sri Aurobindo Institute of Medical Sciences,Indore, India. A structured questionnaire was used to get relevant information,while peri-operative complications were recorded using the modied Clavien grading system. RESULTS: The mean age of patients was 38.2years,male: female ratio was 1.18:1. Stones were categorized as simple in 48.9% and complex in 51.1%. The lower calyx was the commonest site of stone location (45.5%) and puncture site (76.7%). The mean operative time was about 58 minutes and the mean haemoglobin drop was 1.5g/dl. The blood transfusion rate was 3% and the stone free rate after the procedure was 93.2%. The mean length of hospital stay was 3.4 days. CONCLUSION: PCNL is an effective treatment with good clearance rate and acceptable morbidity in experienced hands.

A RETROSPECTIVE STUDY ON ANTIBIOTIC USAGE IN A TERTIARY CARE HOSPITAL

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Anna Joy ◽  
Aparna Anand ◽  
Arathy R Nath ◽  
Meera S Nair ◽  
Dr. K. G. Prasanth
Keyword(s):  
Retrospective Study ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Sensitivity Test ◽  
Actual Process ◽  
Care Hospital ◽  
Rational Use ◽  
Antibiotic Susceptibility Test ◽  
Antibiotic Sensitivity Test ◽  
Rational Use Of Antibiotics

Antibiotics are one of the most commonly prescribed drugs today. Rational use of antibiotics is therefore extremely important as their injudicious use can adversely affect the patient. Drug Utilization Evaluation (DUE) is a system of ongoing systematic criteria based evaluation of drug that will help to ensure that medicines are used appropriately. It is drug/disease specific and can be structured so that it will assess the actual process of prescribing, dispensing, or administration of drug. The retrospective study was conducted At Pk Das Institute of Medical Sciences, Palakkad, Kerala for a duration of 6 months (February 2017 - January 2018). A source of data includes Patient case sheets &medication charts, nursing charts, culture & sensitivity reports. The inclusion criterion includes Patients aged between 18- 80 year, prescribed with oral and parenteral antibiotics. . On analyzing the gender, male gender (n= 111, 55.5%) were higher in numbers as compared to female counterparts (n=89, 44.5%). In our study the majority of the patients prescribed with antibiotics were with the clinical assessment of COPD (n=39, 19.5%), UTI (n=37, 18.5%) and LRTI (n=28, 14%), Bronchial asthma (n=19, 9.5%) respectively. On analyzing the data based on antibiotic sensitivity test, antibiotic test were performed and followed in (n=64,32%)prescriptions and in (n=47,23.5%)prescriptions were test is not followed respectively. In (n=89,44.5%) prescriptions, antibiotic sensitivity test is not performed. On analysis of antibiotics prescribed, the most commonly prescribed antibiotics were cephalosporins, of these ceftriaxone was highly prescribed of all (n=95). The high percentage of antibiotic prescriptions may indicate a high probability of irrational use. This study also point out irrational use of antibiotics are more leading to resistance, misuse and serious problems. So certain strategies should be put forward to strengthen rational use of antibiotics. Keywords: Antibiotics, Antibiotic Susceptibility Test, Irrational use, Resistance

A Retrospective Study of the Clinico-pathological Profile of Primary Extra Nodal Lymphomas in a Tertiary Care Hospital

2019 ◽  
Vol V-5 (I-1) ◽  
pp. 1-5
Author(s):  
Babu Janarthan ◽  
Krishna Nikhil ◽  
Dattatreya P.S. ◽  
Nirni S.S. ◽  
Vasini Vindhya
Keyword(s):  
Retrospective Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

scholarly journals Pattern and prevalence of neuropsychiatric lupus: a retrospective study from a tertiary level hospital in Bangladesh

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Fahima Hossain ◽  
Mohammad Delwer Hossain Hawlader ◽  
Dipak Kumar Mitra ◽  
Mohammad Hayatun Nabi ◽  
Md. Mujibur Rahman
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Retrospective Study ◽  
Cognitive Dysfunction ◽  
Lupus Erythematosus ◽  
Neuropsychiatric Symptoms ◽  
Tertiary Care ◽  
Care Hospital ◽  
Systemic Lupus ◽  
Case Definitions ◽  
American College Of Rheumatology

Abstract Background Neuropsychiatric systemic lupus erythematosus (NPSLE) is well known for its varying presentations and poor outcomes, but little is evident about its distribution and characteristics among the Bangladeshi population. This study aimed to assess the pattern and prevalence of neuropsychiatric symptoms in female systemic lupus erythematosus (SLE) patients of Bangladesh. A retrospective study was conducted at a tertiary care hospital in Dhaka, Bangladesh, between January and December 2018. One hundred female SLE patients were included in the study purposively. Data were collected on sociodemographic and clinical characteristics of diagnosed SLE cases visiting the SLE clinic and indoor medicine department. Neuropsychiatric (NP) syndromes were defined according to the widely accepted American College of Rheumatology (ACR) nomenclature and case definitions. Results A total of 244 NP events were identified in fifty-five patients. Headache was the most frequent symptom (55%), followed by cognitive dysfunction (50%), anxiety (49%), psychosis (43%), seizure (23%), depression (17%), and cerebrovascular disease (ischemic type, 7%). The NP manifestations were more prevalent among urban residents (58.2%), younger patients (41.8%), and patients with graduate-level education (34.5%). Besides, young age at diagnosis (p = 0.038), Raynaud’s phenomenon (p = 0.015), other organ involvement (p < 0.001), and time of NPSLE development (p < 0.001) were found to be significantly associated with the development of these manifestations. Conclusion NP damage is prevalent among Bangladeshi female SLE patients (55%) with headache and cognitive dysfunction being the most common symptoms. Routine screening for neuropsychiatric symptoms among suspected SLE cases and further evaluation with a larger population are warranted.

scholarly journals The clinical profile, management, and outcome of febrile neutropenia in acute myeloid leukemia from resource constraint settings

2021 ◽  
Vol 8 ◽  
pp. 204993612110365
Author(s):  
Kundan Mishra ◽  
Suman Kumar ◽  
Sandeep Ninawe ◽  
Rajat Bahl ◽  
Ashok Meshram ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Febrile Neutropenia ◽  
Burkholderia Cepacia ◽  
Myeloid Leukemia ◽  
Tertiary Care ◽  
Care Hospital ◽  
Significant Difference ◽  
The Mean ◽  
Acute Myeloid

Introduction: Acute myeloid leukemia (AML) is the commonest leukemia in adults. Mortality in thew first 30-days ranges from 6% to 43%, while infections account for 30–66% of early deaths. We aim to present our experience of infections in newly-diagnosed AML. Method: This prospective, observational study, was undertaken at a tertiary care hospital in Northern India. Patients with confirmed AML (bone marrow morphology and flow cytometry) and who had developed febrile neutropenia (FN), were included. Result: A total of fifty-five patients were included in the study. The median age of the patients was 47.1 years (12–71) and 28 (50.9%) were males. Fever (33, 60%) was the commonest presentation at the time of diagnosis. One or more comorbid conditions were present in 20 patients (36.36%). Infection at presentation was detected in 17 patients (30.9%). The mean duration to develop febrile neutropenia since the start of therapy was 11.24 days. With each ten-thousand increase in white blood cell (WBC) count, the mean number of days of FN development decreased by 0.35 days ( p = 0.029). Clinical and/or radiological localization was possible in 23 patients (41.81%). Thirty-four blood samples (34/242, 14.04%) from 26 patients (26/55, 47.3%) isolated one or more organisms. Gram negative bacilli (GNB) were isolated in 24 (70.58%) samples. Burkholderia cepacia (8/34, 23.52%) was the commonest organism. The number of days required to develop febrile neutropenia was inversely associated with overall survival (OS). However, when compared, there was no statistically significant difference in OS between patients developing fever on day-10 and day-25 ( p = 0.063). Thirteen patients (23.63%) died during the study period. Discussion: Low percentage of blood culture positivity and high incidence of MDR organisms are a matter of concern. Days to develop febrile neutropenia were inversely associated with overall survival (OS), emphasizing the importance of preventive measures against infections. Conclusion: Infections continues to be a major cause of morbidity and mortality among AML patients.

scholarly journals Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital

2013 ◽  
Vol 5 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Sunita Hemani ◽  
Premlata Mital
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Care Hospital ◽  
Barrier Method ◽  
Unintended Pregnancies ◽  
Attitude And Practice ◽  
Complete Knowledge ◽  
The Mean ◽  
Medical Healthcare

ABSTRACT Medical healthcare providers are an important link with the general public to impart knowledge regarding contraception. However, their own attitude and practice of contraception is often lacking. Objective This study was conducted to assess the attitude and practice of contraception over the last 5 years of the gynecologists themselves in a tertiary care hospital in Jaipur. Materials and methods The study was conducted on 125 female gynecologists in a tertiary care hospital in Jaipur. All were given a questionnaire which was duly filled by them and data obtained was analyzed. Results All the doctors used some form of contraception. The mean age was 29.32 years. The commonest was the barrier method (38.4%) followed by OC pills (27.2%). Twenty-one percent of the barrier users used them occasionally. Emergency contraception was used by either those using natural methods of contraception or who were occasional users of OC pills or condoms. Fifty percent of the couples relying on natural methods conceived. Conclusion Gynecologists have complete knowledge regarding contraception, yet fail to use it regularly. Proper attitude and practice is essential to prevent unintended pregnancies. How to cite this article Hemani S, Hooja N, Mital P. Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital. J South Asian Feder Obst Gynae 2013;5(3): 129-131.

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