TO EVALUATE EFFICACY OF LAPAROSCOPIC TRANSPERITONEAL PYELOLITHOTOMY FOR MANAGEMENT OF RENAL PELVIC STONES IN TERM OF POSTOPERATIVE HOSPITAL STAY

Background: To evaluate efficacy of laparoscopic transperitoneal pyelolithotomy for management of renal pelvic stones in term of postoperative hospital stay Methods: This study has been conducted in the Department of General surgery, Indira Gandhi Medical College, Shimla on selected patients of Renal pelvis stones admitted in institution Results: Mean hospital stay was 6.66 days in laparoscopic group and it was 8 days in laparoscopic completed by open method. Maximum no. of patients was discharged within 5 days. 6 (75 %) patients returned to normal activity in less than 30 days which included only successful laparoscopic group and 2 patients returned to normal activity in 40 days which included lap completed by open group. Conclusion: In the present study of Laparoscopic Transperitoneal Pyelolithotomy at Indira Gandhi Medical College, Shimla, the procedure showed a definite decrease hospital stay, early return to activity than who have undergone open surgery Keywords: Laparoscopic Transperitoneal Pyelolithotomy, Pelvic stone, Hospital stay.

TO EVALUATE COMPLICATION OF LAPAROSCOPIC TRANSPERITONEAL PYELOLITHOTOMY FOR MANAGEMENT OF RENAL PELVIC STONES

Background: To evaluate complication of laparoscopic transperitoneal pyelolithotomy for management of renal pelvic stones Methods: This study has been conducted in the Department of General surgery, Indira Gandhi Medical College, Shimla on selected patients of Renal pelvis stones admitted in institution Results: There were no major postoperative complications. Two patient developed mild low grade fever which subsided on oral antipyretic medication. One patient had a cough and one patient had ileus. Conclusion: We concluded that there were no major intraoperative or postoperative complications were seen in our study. Keywords: Laparoscopic Transperitoneal Pyelolithotomy, Pelvic stone, Complication

TO EVALUATE EFFICACY OF LAPAROSCOPIC TRANSPERITONEAL PYELOLITHOTOMY FOR MANAGEMENT OF RENAL PELVIC STONES IN TERM OF BLOOD LOSS

Background: To evaluate efficacy of laparoscopic transperitoneal pyelolithotomy for management of renal pelvic stones in term of blood loss Methods: This study has been conducted in the Department of General surgery, Indira Gandhi Medical College, Shimla on selected patients of Renal pelvis stones admitted in institution Results: Mean blood loss in successful laparoscopic surgery was 58.33 ml and in lap converted to open was 200 ml. Conclusion: Laparoscopic pyelolithotomy is a feasible and safe operation for patients with renal stones in centers with adequate experience in laparoscopy and well trained surgeons. It is found to be safe, effective and efficient with proper patient selection and adherence to standard laparoscopic surgical principles. Keywords: Laparoscopic Transperitoneal Pyelolithotomy, Pelvic stone, Blood loss

A cross sectional study to evaluate the clinical presentation in multisystem inflammatory syndrome in children

Background: MIS-C as a disease has varied symptoms and signs that affect multiple organs and systems in the body. The present study aimed to describe the clinical presentation among children admitted as a case of multisystem inflammatory syndrome in children in Indira Gandhi Medical College, Shimla.Methods: We conducted a cross sectional study of children with MIS-C from January to July 2021, in the pediatric ward of Indira Gandhi Medical College Shimla in Himachal Pradesh. All children admitted with a diagnosis of MISC were included in the study. Data regarding clinical presentation was extracted and analyzed using Epi Info V7 software.Results: In the present study, a total of 31 children diagnosed and admitted as a case of multisystem inflammatory syndrome in children (MIS-C) were included. Mean age of these children was 7.12±4.78 years. Among the total 16 (51.6%) were males while 15 (48.4%) were females. All 31 patients had presented with fever and 13 (41.9%) patients had fever with rash. 5 (16.1%) had cough, 1 (3.2%) child presented with hematemesis, 18 (58.1%) had tachypnea at presentation and 15 (48.4%) patients had respiratory distress. 16 (51.6%) children had complaints of vomiting, 1 (3.2%) presented with bleeding diathesis and 12 (38.7%) had hematuria, 5 (16.1%) had seizures and 8 (25.8%) presented with encephalopathy. 19 (61.3%) children had hypotension, 15 (48.4%) had hepatomegaly and 15 (48.4%) had splenomegaly.Conclusions: It is very essential to characterize this syndrome to fully understand its spectrum, therefore we need to be continuously watchful for its varied clinical presentations, both for ensuring an early diagnosis and treatment of patients suffering from MIS-C.

Assessing the effectiveness of the full outline of unresponsiveness scale and the Glasgow coma scale in patients of traumatic head injury

Background: The Glasgow coma scale (GCS) is the most commonly used scale while the full outline of unresponsiveness (FOUR) score is a new validated coma scale in the evaluation of the level of consciousness in head injury patients. The aim of the study was to compare and assess the effectiveness of the FOUR score and the GCS in patients of traumatic head injury.Methods: This was a prospective observational study conducted in the department of surgery, Gandhi medical college, Bhopal during a 2 year period in which 100 patients of traumatic head injury were evaluated. The FOUR score and GCS score of these patients were assessed on admission and outcome followed for 2 weeks.Results: The mean age group of 100 patients was 25-45 years with 79% male and 21% female patients. The FOUR scale was found to have a marginally higher sensitivity of 65.6% while the GCS had a sensitivity of 64.2%. The FOUR scale however had a higher specificity of 71.5% compared to 66.4% of GCS. The Youden index showed that FOUR scale (46%) has a better prediction for death than GCS (35%). FOUR had a higher accuracy of 75% than GCS with an accuracy of 65%.Conclusions: Both FOUR score and GCS are valuable scales in assessment of traumatic head injury. The FOUR scale however is more accurate than the GCS in predicting outcome of head injury patients.

PREVALENCE OF METABOLIC SYNDROME IN COPD CASES IN CENTRAL INDIA AND ITS CORRELATION WITH BMI

BACKGROUND: COPD is the third leading cause of death worldwide with more than 90% of COPD deaths occuring in low and middle income countries. While metabolic syndrome is a cluster of the most dangerous cardiovascular risk factors , dened to be associated with prothrombotic and proinammatory states. About 20%- 25% adult population of the world have Metabolic syndrome and are three times more likely to have coronary artery disease or stroke . Increasing evidence shows association between Metabolic Syndrome in COPD. However, the frequency of Metabolic Syndrome and its individual components are not still been clearly shown especially in Indian population in central India . METHODS: This was a cross sectional study conducted at Department of Respiratory Medicine, Gandhi Medical College & Hamidia hospital, Bhopal. 100 spirometrically conrmed COPD cases were enrolled after permission from institutional ethics committee . Detailed history , clinical examination , laboratory parameters and anthropometric parameters were taken. RESULTS: Mean age of patients with COPD was 60.34±10.39 years .Mean weight, height and BMI of patients was 55.86±9.43 2. 2 kg, 160.47±7.58 m and 21.65±3.01kg/m .Majority - 57% patients had normal BMI (18.5 to 22.9 kg/m ). About 25% and 11% patients were overweight and underweight respectively. Metabolic syndrome was found to be present in 32% of the patients with COPD. BMI of patients with metabolic syndrome was signicantly higher as compared to COPD patients without metabolic syndrome (p<0.01). CONCLUSION: The prevalence of metabolic syndrome in COPD was 32% and BMI in COPD patients with metabolic syndrome was signicantly higher than those without metabolic syndrome .

A qualitative study of pulmonary function tests between smokers and non smokers in Telangana state

In a few examinations, low spirometric levels have been displayed to expand the achievement paces of smoking discontinuance, while different investigations have demonstrated that aspiratory work affects stopping smoking. Given the way that there are conflicting outcomes regarding this matter, we expected to research the impact of distinguishing aviation route obstacle by means of spirometry and its clarification to subjects on the achievement pace of smoking discontinuance temporarily. The current study was led in Gandhi Medical College, Hyderabad, India, Subjects who were conceded to the smoking discontinuance out-patient facility, went through pneumonic capacity tests (PFTs) and finished somewhere around 90 days of the suspension program following their induction were remembered for the investigation. The mean age of the 563 subjects was 41.9 ± 12.1 y 340 subjects (60.4%) were male. An aggregate of 162 subjects (28.8%) went to the subsequent visits following the primary meeting. The accomplishment of smoking suspension for 90 days was 11.3% for all subjects and 39.5% for subjects who came to follow-up visits. Of the subjects with impediment on PFT; 22.8% quit smoking, while 8.4% of the subjects without block did as such (P &#60; .001). The level of subjects with impediment on PFT was altogether higher (P &#60; .001) and the FEV1 % (P = .005), FEV1/FVC (P &#60; .001), and constrained expiratory stream 25–75% (P = .008) levels were fundamentally lower in the weaklings contrasted and the non-slackers. Strategic relapse investigation showed that age (P = .001) and the presence of impediment on pft (p = .029) were autonomous factors. Old age and the presence of impediment on PFT increment the accomplishment of smoking end. Aspiratory work tests ought to be performed on all patients who apply to smoking end out-patient facilities, and patients ought to be educated with regards to their condition.

Evaluation of Angiogenesis and Pathological Classification of Extrahepatic Cholangiocarcinoma by Dynamic MR Imaging for E-Healthcare

For staging cholangiocarcinoma and determining respectability, MR is an accurate noninvasive method which provides size of tumor and vascular patency information. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a noninvasive inspection method for evaluating the vascular structure and functional characteristics of tumor tissue. However, some limitations should be noted about the technology. At present, the technology cannot be used alone, which is just an assisted method during the conventional MRI examination. 50 ECC patients, admitted to Indira Gandhi Medical College and Hospital between 2016 and 2019, were selected as research subjects. They were classified pathologically according to the Steiner classification system. After image processing, regions of interest (ROIs) were selected from the image to measure the rate constant (Kep), extravascular space volume fraction (Ve), and tissue volume transfer constant (Ktrans). There were 15 cases with highly differentiated carcinoma, 23 cases with moderately differentiated carcinoma, and 12 cases with lowly differentiated carcinoma. Non-VEGF expression was noted in 21 cases, with low expression noted in 15 cases, moderate expression noted in 14 cases, and no high expression case noted. The relevant parameters in the dynamic MRI image can quantitatively reflect the angiogenesis and pathological classification of ECC, which is suggested in the clinical treatment of ECC. The Ktrans, Kep, and Ve values of the ECC patients were all not associated with the pathological classification, with no significant difference ( P < 0.05 ). Besides, due to the fact that the patient cannot completely hold his breath, the air leak reduces the image quality.

A prospective study of post-operative surgical site infections after abdominal surgeries

Background: Surgical site infections have plagued surgeons since time immemorial. There is significant morbidity and mortality associated with surgical site infections. In this study we tried to identify the incidence, various patient and procedure related factors, which could have led to SSIs, the various organism associated with the SSIs and their pattern of sensitivity and resistance to various antibiotics.Methods: This study was conducted in the department of general surgery, Gandhi medical college and Hamidia hospital Bhopal. In this prospective study, we included all patients more than 12 years of age undergoing abdominal surgeries between 2018-2020. Patient data was recorded in a case recording form and all patients were examined post-operatively for soakage along with culture and antibiotic testing.Results: A total of 299 patients were included. Overall incidence of SSI was 23.07%, elective surgeries showed 19.5% incidence and elective showed 26.08% incidence. Higher incidence of SSI was found in, male patients (25.9%), contaminated and dirty surgeries, higher ASA scores, smokers, alcoholics diabetics, anaemics, and malnourished patients. E. coli and klebsiella were the most common organisms isolated in both elective and emergency setting. Organisms isolated were highly sensitive to colistin, meropenem, imipenem, gentamicin and amikacin. Amoxycillin, ceftriaxone, doxycycline were fairly resistant in the current study.Conclusions: Modifiable risk factors like smoking, alcoholism, anaemia, malnourishment, contaminated wound class and emergency surgeries should be addressed systematically along with judicious use of antibiotics and tailoring then according to culture profile whenever possible is needed to reduce SSI rate.