A SURGICAL AUDIT OF GENERAL SURGERY CASES IN A TERTIARY CARE HOSPITAL AND THE IMPACT OF COVID-19 ON THE SAME

2021 ◽  
pp. 39-41
Author(s):  
Ravi Landge ◽  
Sumit Satish Malgaonkar ◽  
Girish Bakhshi ◽  
Ajay Bhandarwar ◽  
Jaymin Gupta

BACKGROUND: After the COVID-19 pandemic was declared on March 11, 2020 by the World Health Organization (WHO), routine clinical and surgical practices were affected, including General Surgery services. We aimed to compare how our General Surgery department was affected during this time period of Covid, we have included various parameters, we have also statistically shown how the elective and emergency services were before the Covid outbreak and during the COVID-19 pandemic in our institution. MATERIAL AND METHODS: We retro spectively compared General Surgery practices, including elective, emergency and septic surgeries in a surgical unit of Sir JJ Group of Hospitals over a span of 3 years (April 2018 - March 2021), including the era before and during Covid. RESULTS: The frequency of all the surgeries performed during the pandemic was lower as compared to previous two years before the pandemic in our study, also there was a signicant drop in the number of laparoscopic surgeries. CONCLUSION: The General Surgery practices in our institution have been drastically affected by the COVID-19 pandemic. This setback needs a denite strategy to be formulated to decrease the morbidity and mortality from the neglected elective surgical cases, the real risk-benet ratio must be met before operating such cases.

2021 ◽  
pp. 223-225
Author(s):  
Dhara Singh ◽  
Sujata bhargava

Background: Recent guidelines of the World Health Organization (WHO) indicated administering tranexamic acid (TXA) in order to treat postpartum bleeding (PPH). Therefore, nding low-cost and lowrisk alternative methods to control obstetric bleeding is of great importance. The present study aimed to evaluate the prophylactic effect of TXA on bleeding during and after the LSCS. In addition, it was attempted to explore the impact of TXA as a safe and inexpensive method for decreasing bleeding during and after CS so that to decrease the hazard of blood transfusion or hysterectomy in these patients. Material and Methods: This prospective study conducted on 100 women in Department of Obstetrics &gynecolgy for one year period. They were divided in two groups: Cases: (n=50; women receiving prophylactic Tranexamic Acid) and Control: (n=50; women receiving saline). Estimated the amount of blood loss during surgery. The amount of blood loss during surgery were calculated Estimation of weight of dry towels and mops before autoclaving is noted. Results: Most common age group among Cases and Control was 26-30 years .%. Mean age among cases group (26.69±7.51 years) was signicantly lesser compared to control study cohort (29.75±7.72). Post operativehemoglobin level was signicantly higher among Case (11.26±12.03) as compared to Control (8.56±1.01). Comparing post operative complications revealedno signicant changes. Use of topical hemostatics was higher among the control (77%) as compared to Cases (57%). Conclusion: Prophylactic treatment with TXA in relation to elective LSCS reduces the overall total blood loss, and the risk of reoperations owing to postoperative hemorrhage as revealed by higher hemoglobin level among cases.


2021 ◽  
pp. 097321792110607
Author(s):  
Chinmay Chetan ◽  
Nishant Banait ◽  
Vikramaditya Athelli ◽  
Bhvya Gupta ◽  
Prince Pareek ◽  
...  

Introduction: World Health Organization (WHO) in 2014 recommended delayed cord clamping (DCC) in all babies who cry immediately after birth. Despite many benefits, there are concerns of increased rate of phototherapy in babies receiving DCC. This study was done to determine the increment in the rate of phototherapy required in infants managed with DCC vs infants managed with early cord clamping (ECC). Methods: A retrospective observational study was conducted in a tertiary care hospital in Pune, India. All the infants born between January 2018 and July 2018, for whom ECC was done, were compared with infants who were born between January 2019 and July 2019, after DCC policy was adopted. All the infants with birth weight ≥2 kg and gestation ≥35 weeks, who were with their mother, were included. Baseline characteristics were compared for both the groups. American Academy of Pediatrics guidelines for treatment of neonatal jaundice were used to determine the need for phototherapy. Number of infants in both the groups who required phototherapy were compared. Results: The ECC group had 565 infants while DCC group had 731 infants. There was no difference in the baseline characteristics of the 2 groups. Jaundice requiring phototherapy was noted in 31% of infants in the ECC group, compared to 45% in infants in the DCC group (relative risk: 1.47 [1.27-1.71] [ P < .001]). Conclusion: In this study, DCC increased the need for phototherapy by 47% in late preterm and term infants. Randomized control trials with larger sample size are required to confirm this finding.


Author(s):  
Sumalatha R. ◽  
Nagabushan H. ◽  
Hanumanth Prasad M.

Background: Drug utilization research is defined by the World Health Organization (WHO) as marketing, distribution, prescription, and use of drugs in society, with special emphasis on the resulting medical, social, and economic consequences. Drug utilization study identifies the problems that arise from prescription and highlights the current approaches to the rational use of drugs. The main aim of the study is to assess the pattern of drug usage and the rationality of drug use in Otorhinolaryngology out-patient department (OPD).Methods: A prospective observational study was conducted in the OPD of Otorhinolaryngology at tertiary care hospital, Mandya, Karnataka, over a period of one year. Prescriptions of all OPD patients were collected, relevant information entered in a specially designed proforma and analysed using descriptive statistics.Results: A total of 21058 drugs were prescribed out of 8028 prescriptions. Majority of the patients were male (51%). Antimicrobials were the most commonly prescribed drugs (28%), followed by antihistamines (25%), antipyretics (20.5%).Most of the drugs 18576 (88.2%) were prescribed by oral route, followed by topical route. Majority of the drugs were prescribed by the generic names (86.5%). Most common type of infection was ear infection (3176), followed by throat infection (2848) and nose infection (2004).Conclusions: The present study showed that among antimicrobial agents, β lactams were commonly prescribed drugs in the department of Otorhinolaryngology. The maximum number of cases was diagnosed with ear infections and majority of the drugs were prescribed orally.


Author(s):  
Pradip Kumar Bhue ◽  
Himansu Prasad Acharya ◽  
Subrat Kumar Pradhan ◽  
Pratima Biswal ◽  
Amit Pritam Swain ◽  
...  

Background: World Health Organization has defined low birth weight (LBW) as birth weight less than 2,500 grams. Giving birth to a LBW infant is influenced by several factors. Objective of the study was to measure the proportion of low birth weight babies delivered in V.S.S medical college and hospital, Burla and its association with socio-demographic factors.Methods: Hospital based cross -sectional study comprising of 1030 postnatal women who delivered single live baby in V.S.S Medical College and Hospital, Burla. Selection of study participants was done by systematic random sampling in the study period October 2012 to September 2014. Chi-square test was used to measure association between LBW and socio-demographic factors.Results: The proportion of LBW was found to be 27.76%. The proportion of LBW babies was high and significant in extremes of age i.e. teenage (44.19%) and 30 years and above age group (39.56%) and Muslim mothers (36.36%), illiterate mothers (53.52 %), manual labourer (67.14%), socioeconomic class IV and V (32.98%), consanguinity history (60.58%), smoky fuel (30.02%), consumption of tobacco (49.11%).Conclusions: The proportion of LBW (27.76%) was found to be higher than national average (21.5%).


2021 ◽  
pp. 69-71
Author(s):  
Ruby Naz ◽  
Akil Hussain ◽  
Sameena Khan

Hospital acquired infections (HAIs) are a major concern in the intensive care units (ICU)and postoperative wards. HAIs prolonged the stay of patient in hospital and increase the cost of treatment and morbidity. In ICU, stroke unit, neurosurgery ward burn unit patients are prone to have a variety of nosocomial infections. The World Health Organization (WHO) has described HAIs as one of the infectious diseases which have a huge economic impact on health industry. (1). many health workers like Staff Nurses, resident doctors and housekeeping are in direct or indirect contact with the Patients and surrounding in wards around the clock. These HCW play major role in preventing and controlling HAIs. In overpopulated country like India majority of public hospitals are overcrowded.


Author(s):  
Dolly Roy ◽  
Ayan Purkayastha ◽  
Rohit Tigga

ABSTRACTObjectives: Adverse drug reaction (ADR) is an important cause of morbidity, mortality, and prolonged hospitalization. The objective of this study is tomeasure the incidence, types, and nature of ADR in a tertiary care hospital located in Silchar, Assam.Methods: A retrospective noninterventional analysis of all ADRs reported by ADR Monitoring Centre, Department of Pharmacology, Silchar MedicalCollege, from March 2014 to February 2015 was performed. A total of 162 predesigned forms were used for collection of data. All forms were dulychecked for completeness, if not, they were rejected.Results: A total of 162 forms were assessed of which 96 (59%) were females and 66 (41%) were males. The distribution of ADRs in different age groupswere found to be 3 (1.85%) in 0-15 years, 71 (43.82%) in 16-30 years, 65 (40.12%) in 31-45 years, 8 (4.93%) in 46-60 years, and 15 (9.25%) in agegroup >60 years. 150 (92.6%) of the ADRs were serious and 12 (7.4%) were not serious. As per the World Health Organization causality assessmentscale, 120 (74.07%) were probable and 42 (25.92%) were possible. The most common ADR was anaphylactic reaction (AR) in 69 (42.59%) patients.The drugs which commonly caused ADR were iron sucrose infusions, nevirapine, cephalosporins, antiprotozoals, nonsteroidal anti-inflammatorydrugs, and quinolones followed by others.Conclusion: The majority of ADRs were probable. The most common ADR was AR caused by iron sucrose infusion. Different drugs caused differentADRs. ADRs thereby increase morbidity and mortality in patients as well as socioeconomic burden.Keywords: Adverse drug reaction, Anaphylactic reaction, Iron sucrose infusion, Noninterventional, Retrospective analysis.


Author(s):  
Jayshree Dawane ◽  
Kalyani Khade ◽  
Yamini Ingale ◽  
Vijaya Pandit

Objective: The objective of this study is to evaluate pain and to assess if analgesic prescriptions are according to the World Health Organization guidelines. Methods: The study was conducted in the Department of Surgery in a tertiary care hospital. Patients with age >18 years, of either sex, admitted to surgery ward were included in the study. Pain assessment was done using a visual analog scale and McGill questionnaire. Information obtained from case paper sheets was recorded, such as name of analgesics, the generic name of prescribed analgesics, dosage, route of administration, frequency, number of analgesics per prescription, and non-pharmacological techniques. Data generated from the questionnaire were entered into an Excel sheet, and percentages were calculated. Results: A total of eight different analgesics were prescribed in the study group. Paracetamol was the maximally prescribed drug (40%). In 48% of cases, antacids were given along with analgesics. A majority of analgesics were prescribed in generic names (52%). No drug was prescribed to almost 18% cases even though the pain intensity was of mild-to-moderate intensity. Conclusion: Commonly prescribed drugs were paracetamol + tramadol. Prescription pattern of analgesics is partially deviating from standard guidelines. Generic names were written in the majority of prescriptions, which is in accordance with standard prescription writing.


Author(s):  
Sumit Kumar ◽  
Badruddeen Badruddeen ◽  
Singh S P ◽  
Mohammad Irfan Khan

Objective: The objective of this study was to analyze the types of adverse drug reactions (ADRs) associated with platinum analogs (cisplatin, carboplatin and oxaliplatin) used for cancer chemotherapy in a tertiary care hospital and determine their causal relationship with the offending drug.Methods: This prospective, observational, non-interventional study was conducted in a tertiary care hospital at GSVM Medical College Kanpur, India, for 4 months. Patients of all age and either sex were included in the study. ADRs were reported by the physicians of oncology department of the hospital and ADRs were assessed for different parameters -causality, outcome, and seriousness of ADR as per the World Health Organization (WHO), type of ADRs as per expanded Rawlins and Thompson’s classification, predictability using council for international organization of medical sciences guidelines and severity using modified Hartwig’s scale. Descriptive statistics were used for data analysis.Results: A total of 140 ADRs were reported from platinum analogs following treatment of different types of cancer in hospital. The burden of ADRs in each patient was 2.41. Most of the ADRs were observed in the age group of 40–60 years. Vomiting (27 ADRs) was commonly reported reaction. Among platinum analogs, cisplatin leads to 82 ADRs (58.57%) followed by carboplatin with 53 ADRs (37.86%) and least with oxaliplatin 5 ADRs (3.57%). Most of the ADRs on causality assessment were possible (104, 74.29%) and probable (36, 25.71%) in nature. Type -A ADRs account for 4/5th of the total reported ADRs, followed by Type-B and C. Severity of 90.71% ADRs was found to be mild followed by moderate, with no case of severe and serious nature. Nearly, most of the ADRs were of predictable type (97.14%).Conclusion: The potential of platinum analogs to cause ADRs is high; thus, the need of effective ADRs monitoring is highly emphasized.


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