Indian Journal of Applied-Basic Medical Sciences
Permanent URI for this collection
Editor: Dr Janardan V Bhatt
ISSN: 0975-8917
Frequency: Semi-annual
Language: English
Published By: Basic Medical Sciences Forum
Peer-reviewed open access journal indexed in Index Medicus
Website: https://www.themedicalacademy.in/
Browse
Recent Submissions
Item Comparison of Ultrasound / Anatomical landmark guided technique for superior laryngeal nerve block along with Topical Anesthesia for awake nasal intubation in various Oral& faciomaxillary & Dental surgeries(Basic Medical Sciences Forum, 2022-06) Kapdi, Dr. Manisha; Patel, Dr. Vatsal; Dr. Roshni; Dr UrvashiABSTRACT:Background: Endotracheal intubation is gold standard of general anesthesia. various oral,Maxillofacial, Dental surgeries are carried out in high-risk patients having chances ofdifficult intubation. If we give sedation or general anesthesia, we can be trapped in criticalairway accidents.Aims & objectives: To access & compare efficacy of anatomical landmark guided/Ultrasound guided superior laryngeal nerve block associated with topical Anesthesia &transtracheal block for awake blind nasal intubation.Method:Group A: Anatomical landmark guided superior laryngeal nerve block given(n=30)Group B: ultrasound guided superior laryngeal nerve block(n=30)In both groups topical Anesthesia & transtracheal block for awake blind nasal intubation wasgiven.Results: upper airway block provide clinical ease to facilitate blind nasal awake intubation.ultrasound guided block has less adverse reactions.Conclusion: Both methods provide good quality of Endotracheal intubation, but ultrasoundguided block is more efficient & scientific method to block superior laryngeal nerve forawake nasal intubation.Item ANALYSIS AND COMPARATIVE STUDY OF TOPICAL CONSERVATIVEMEDICATION VERSUS OPERATIVE MANAGEMENT IN PATIENTS OFANAL FISSURE(Basic Medical Sciences Forum, 2022-06) Satasia, Dr. Ravi V.; Patel, Dr. Lakir; Vanvi, Dr. Kuldeep; Patel, Dr. Jaykumar; Panchal, Dr. Aarsh; Payala, Dr.Aimanhusen M.Introduction:Anal fissures or anal ulcers are considered one of the commonest causes of severe analpain. Surgical techniques like manual anal(lords) dilatation or lateral internalsphincterotomy, effectively heal most fissures within a few weeks, but mayresult in permanently impaired anal continence. This has led to the research foralternative non-surgical treatmentAIMS AND OBJECTIVES:The present study comprises the comparative study of 2% Diltiazem gel,0.2% Glyceryl Nitrate,2%lignocaine jelly application and need of surgical intervention in the treatment of chronic fissure inano.MATERIALS AND METHODS: This is a prospective study of fissure in ano during the period from September 2020 to September2021 in Sheth Lallubhai Gordhandas Municipal General Hospital, Ahmedabad. Clinical Data ofadmitted patient were collected by their detail history after stabilizing the patient, clinicalexamination with appropriate investigations.OBSERVATION AND DISCUSSION:Anal fissure is a very common problem across the world. It causes considerablemorbidity and adversely affects the quality of life. Therefore appropriate treatment ismandatory.In this study the commonest age group affected was 31-40 years agegroup (40%) and least affected were 51-60 years age groupThe incidence of fissure in males was slightly greater than females with MaleFemale ratio being 2.2: 1 in our study.CONCLUSION:Propper clinical examination and appropriate investigations helps in management of patient eitheroperative or non-operative which leads successful treatment in these patients.Item A PROSPECTIVE COMPARATIVE STUDY BETWEEN EARLY AND INTERVAL LAPAROSCOPIC/OPEN CHOLECYSTECTOMY IN PATIENTS OF ACUTE CHOLECYSTITIS(Basic Medical Sciences Forum, 2022-06) Gajjar, Dr. Jaimish; Patel, Dr. Nirav. B.; Patel, Dr. Tirth. D.; Parmar, Dr. Brijesh. V.OBJECTIVE: The present study is designed to compare early and interval laparoscopic/open cholecystectomy in patients of acute cholecystitis. The comparison was done on the basis of parameters such as intraoperative difficulty, perioperative bile duct injury and bile leak, time taken for operation, postoperative atelectasis, postoperative wound infection, duration of hospital stay and postoperative pain. METHODOLOGY: This is a prospective study conducted in Department of General surgery, GCS MEDICAL COLLEGE, HOSPITAL AND RESEARCH CENTRE from AUGUST 2018 to DECEMBER 2019. 56 patients were enrolled in the study from which 26 patients were randomly assigned to early lap/open cholecystectomy and 30 were assigned to interval lap/open cholecystectomy group. RESULT: There was no significant difference observed between the two groups. However, the duration of hospital stay was less in early laparoscopic/open cholecystectomy. CONCLUSION: Both the methods, early and interval have no significant benefit over each other but through review of all literature, early lap/open cholecystectomy is found to be beneficial overall with less hospital stay.Item CASE SERIES OF AMNIOTIC BAND SYNDROME(Basic Medical Sciences Forum, 2023-06) Panchal, Dr. Nirali; Prajapati, Dr. Dipika; Patel, Dr. Anubhuti; Kapadia, Dr. Labdhi; Joshi, Dr. Jayun M.Item A STUDY OF IMAGING FINDINGS ON HRCT THORAX IN CORONA VIRUS DISEASE 2019 (COVID-19)(Basic Medical Sciences Forum, 2022-06) Doshi, Dr Forum v; shah, Dr Dipti AINTRODUCTION : In December 2019, a large outbreak of a novel coronavirus infection occurred in wuhan hubei province, china. The disease caused by the virus, named novel coronavirus disease (COVID-19) by the world health organization (WHO) can be spread through human to human contact. In human coronavirus can cause spectrum of diseases ranging from asymptomatic patient, simple cold cough to severe acute respiratory syndrome ( SARS). HRCT is very useful to see the extent of disease spread in lungs and to assess the severity of infection. It also helps in monitoring the response and therapeutic effectiveness and prognosis. AIMS AND OBJECTIVES: 1]To evaluate the various HRCT thorax Findings in RTPCR confirmed patients of covid-19 infection. 2] To correlate the findings of HRCT of thorax with patient’s clinical symptoms. METHODOLOGY: A retro- prospective clinical study was carried out on patients who were referred for HRCT thorax to the Department of Radiodiagnosis, Sheth L.G. general hospital having signs and symptoms of covid-19 and whose RT PCR report was awaited and who had undergone HRCT thorax and only patients who were RT PCR test positive within 72 hours were taken in the study. Total of 250 patients from May 2020 to January 2021, who confirmed covid-19 diagnosis with RT-PCR were taken. RESULTS In our study we found, the most common initial CT findings in COVID-19 pneumonia are bilateral, patchy or rounded ground-glass opacities that most frequently occur bilaterally and in the lung periphery with a subpleural basal predominance in left lower lobe. Most common finding were patchy bilateral ground glass opacity most commonly associated with inter and intralobular septal thickening giving crazy paving pattern. Consolidation was also seen with or without GGO suggesting infective etiology. CONCLUSION HRCT Thorax may be useful as a standard method for the rapid diagnosis of COVID-19 to optimize the management of severely ill PATIENTS.Item ClinicalManifestations ofSteven'sJohnson Syndrome/Toxic Epidermal Necrolysis(Basic Medical Sciences Forum, 2023-06) Mehta, Dr. Ria M.; Gupta, Dr. ArunaBACKGROUND: Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) both reflect extreme manifestations of the same clinical entity responsible for significant, life Threatening hypersensitivity mucocutaneous reactions, caused by intraepidermal cell death resulting in epidermal sloughing and blistering; often induced by medications. The mucous membranes of the mouth, stomach, lungs,skin, and genitourinary system are all major sites of Involvement. Despite receiving effective treatment at the local and systemic levels, some survivors may have major ocular consequences that might ultimately result in blindness. It is still unknown whether or not SJS/TEN can be effectively treated locally or systemically. If you want to improve your long-term eye health, it's crucial to catch any problems early and treat them aggressively. Chronic ocular surface failure, including a lack of limbal cells and full keratinization of the ocular surface, may be detected by inspecting the eyelid edge,palpebral conjunctiva, and fornix. It is possible to lessen the danger of ocular surface failure using transplants of amniotic membrane or a cultured oralmucosal graft. AIM: The aim of this investigation is to learn more about the symptoms of SJS/TEN that emerge in the eyes. METHODOLOGY: Patients with ocular signs of SJS/TEN who sought treatment at C.U.Shah medical college and hospital, a tertiary hospital, via the OPD and IPD of skin and VD were included. Between January 2022 and May 2022, all patients had a documented ophthalmologic evaluation. RESULTS: The study had 17 participants. Ocular involvement was seen in 10 individuals, with 5 patients (50%) experiencing mild ocular indications, 2 patients (20%) experiencing moderate visual manifestations, and 3 patients (30%) experiencingsevere ocular signs. Two patients (20%) had involvement of the cornea, seven patients (70%) had involvement of the conjunctiva, and sixItem DON’T RUB; IT WILL BE EVIDENT- CORNEAL TOPOGRAPHIC CHANGES IN PATIENTS WITH VERNAL KERATOCONJUNCTIVITIS(Basic Medical Sciences Forum, 2022-06) Ambani, Dr Rushil; Diya, Dr Dharma Sanan; Purohit, Dr Deepali; Raval, Dr ReemaAim To study topographic findings in patients with established vernal keratoconjunctivitis (VKC). Materials and methods In a hospital based cross sectional study, 112 eyes of age group 11-22 years with established case of VKC were selected for topography. Result In 112 eyes with VKC; 69.64% (78 eyes) had significant history of eye rubbing. 14.28% (16 eyes) had Kmax values >=47.2D , 85.71%(96 eyes) had Kmax values <47.2D. 19.64%(22 eyes) had I-S Difference >=1.2D ; 80.36%(90 eyes) had I-S Difference <1.2D. Topographical patterns observed included 49.11%(55eyes) with round pattern, 20.54%(23 eyes) with oval shaped, 9.82%(11 eyes) with symmetric bowtie, 6.25%(7 eyes) with asymmetric bow tie with skewing of radial axis, 5.36%(6 eyes) with inferior steepening, 6.25%(7 eyes) with irregular pattern, 0.89%(1 eye) with crab claw pattern. ConclusionHigh occurrence of keratoconus-like topographic pattern seen in patients of VKC. Topographic analysis should be performed in all cases of VKC.Item SCLERAL LENSES – A BETTER OPTION FOR KERATOGLOBUS(Basic Medical Sciences Forum, 2023-06) Meman, Optom. Naeem; Memon, Dr. UsmanPURPOSE: To understand effect of Scleral lens on Keratoglobus cornea. CASE STUDY: Prospective Case Study METHOD: A 19-year old male diagnosed with RE Keratoglobus and LE Keratoconus was given a trial of Scleral contact lenses (Comfort- 15), to understand vision development and rehabilitation when no other corrective option was giving fruitful results for vision rehabilitation. Upon trial final lens was chosen with respect to comfort, vision improvement for distance and near and visual rehabilitation, and was dispensed lens with follow-up of 1-week, 1- month, 3-month & 6-months. RESULT: With final lens patient was comfortable with wearing hours of 10-12 hours comfortably with vision restoration to both eyes 6/6; N6 from RE 6/60 and LE 6/24; N10 both eyes. CONCLUSION: Scleral lenses have been proven to be better corrective option for keratoglobus and keratoconus.Item RETINA ON CORNEA IN CASE OF MECHANICAL OCULAR INJURY: A CASE REPORT(Basic Medical Sciences Forum, 2023-06) J, Dr. Mahant Anupama; Tank, Dr. Gunjan; Patel, Dr. Alisha; Gohil, Dr. Vaishali; Dangi, Dr. Mayur; Patel, Dr. PoojaOcular injuries are one of the major factors for mono-ocular blindness in adult population. Majority of mechanical ocular injuries occurs in factories. Our patient had injury with grinder blade. On examination, vision was no perception of light in right eye, corneoscleral tear along with lens and vitreous in the wound. Ocular trauma score was 1 with chances of visual recovery nil. After primary treatment, when we had taken patient under general anaesthesia, we found whole retina lying over cornea which was a rare event. We excised that tissue and tear repair was done. None of the factors which can lead to expulsive haemorrhage was observed in patient. We have seen many patients with extensive corneoscleral tear but never seen retina coming out of the wound. We recommend to use all protective equipments for workers to prevent industrial ocular injuries.Item EVALUATION OF OUTCOME OF PROXIMAL HUMERUS FRACTURES MANAGED WITH PHILOS PLATE(Basic Medical Sciences Forum, 2023-06) Lil, Dr. Nadeem A.; Makwana, Dr. Vipul; Patel, Dr. Nirav B.; Patel, Dr. Drashtant; Juva, Dr. Nishant D; Patel, Dr. Arjav R.INTRODUCTION: Proximal humeral fractures account for 4 to 5 percentage of all fractures.minimally displaced can be managed non-operatively in adults. Displaced and unstable fractures should be treated surgically to achieve painless shoulder and good range of movement. AIM AND OBJECTIVES: Our study Is to evaluate the clinical, functional and radiological result of operative proximal humerus fractures managed PHILOS Plating. MATERIAL AND METHODS: 26 patients with displaced proximal humeral fractures that were treated by PHILOS plating between June 2018 to December 2019 were included in this study. The Constant-Murley score (CMS) was used to evaluate the outcome. RESULT: Out of 26 patients 9 were male and 17 were female. The mean age was 52 years. The mean surgical time was 88 min. The mean fracture union time was 11.5 weeks. Outcome was excellent in 17 cases, Good in 6 and Fair in 3 cases. CONCLUSION: Fixation with PHILOS is associated with good to excellent outcomes. It gives high rate of union, good range of movement and has minimal complications.Item ROLE OF ELECTRICALLY DRIVEN CPAP MACHINE WITH OXYGEN ENRICHMENT FOR OXYGEN CONSERVATION IN COVID ICU(Basic Medical Sciences Forum, 2023-06) Palkhiwala, Dr. Bindi B.; Gujjar, Dr. Heena R.; Shelat, Dr. Sejal D.; Shah, Dr. Ruchi A.; Ved, Dr. Shrutika P.INTRODUCTION: Acute respiratory distress syndrome (ARDS) is a major complication of COVID-19 that occurs in 20-41% of patients with severe disease. (7) SARS-CoV-2 patients present with a wide spectrum of clinical severity, ranging from asymptomatic to pneumonia to ARDS-like phenotypes. (8,9) During the early months of the COVID-19 pandemic unprecedented numbers of patients presented to hospitals with acute respiratory failure. With intensive care services at risk of being overwhelmed, strategies were soussght to reduce invasive mechanical ventilation (IMV). Whilst not previously a standard treatment for viral pneumonitis, early anecdotal accounts and preliminary data highlighted the use of continuous positive airway pressure (CPAP) in COVID-19. (7,10) Subsequently it gained traction as an intervention that could be delivered outside of the intensive therapy unit (ITU) and high-dependency unit (HDU) along with conservation of oxygen. Oxygen conservation posed a huge challenge in COVID ICU’s. HFNO being the major cause of oxygen consumption. Electrically driven CPAP machines • Use air to maintain Continuous positive airway pressure. • Decrease atelectasis. • Increase surface area of alveolus. • Improves V/Q matching. Thus, improving oxygenation and saving Oxygen with the use of electrically driven CPAP with oxygen supplement. CPAP has mostly been studied in relation to OSA and a lot is yet to be explored regarding its potential in COVID ICU’s. OBJECTIVES: I. To note the change in Spo2 II. To note if CPAP delivery system can reduce oxygen consumption as to HFNO III. To note if treatment is well tolerated IV. To note if use of CPAP can avoid/delay the use of HFNO/NIV METHOD: Patient’s vitals were noted before shifting to electrically driven CPAP machine and monitored throughout. Properly fitted vented Bi-pap mask was attached with the electrically driven CPAP machine and the oxygen was supplemented with the help of tubing connecting the Bi-pap mask vent to the flow-meter. The flow of oxygen was titrated according to patients requirements ranging from 8-12 liters/min.The pressure was set as per patients need and titrated as per the condition of the patient. During meal times the patients were shifted to HFNO. RESULT: Out of the total 30 patients in our study, 25 patients were successfully treated with the Electrically driven CPAP machine with O2 enrichment and did not require stepping up to further modalities of oxygen therapy. Around 1700 - 1900 L/hr of oxygen was being used by HFNO whereas only 600 - 720 L/hr of oxygen was used by use of CPAP which helped us to save about 29-80% of oxygen by the use of CPAP machine. CONCLUSION: From our limited study we can only conclude that the CPAP when used with Oxygen enrichment in COVID ICU’s can help in conservation of Oxygen by improving the respiratory mechanics of the COVID affected lung, which becomes an essential aim in a pandemic to serve maximum patients with limited resources.Item Intestinal Stomas - Complications, Prevention and Management: Our Experience in Tertiary Hospital(Basic Medical Sciences Forum, 2023-06) Patel, Dr Sagar D.; Hakda, Dr Riyazhussein Y; Desai, Dr Harshiv B; Chauhan, Dr Krutarth H; Brahmbhatt, Dr. Rutu A; Bajaj, Dr. Varun B.INTRODUCTION: A stoma is defined as an opening into a hollow viscus either natural or surgically created which connects a portion of body cavity to the external environment[1]. Ileostomy or colostomy creation is a crucial part of numerous surgical procedures carried out for a variety of gastrointestinal problems. Despite the frequent occurrence of intestinal stomas, stoma-related problems are still frequent and are associated with high morbidity and expense. OBJECTIVE: The objective if this article is to understand these frequent issues, go into depth about how to prevent or avoid them, and provide management advice. METHOD: Prospective RESULTS: Peristomal skin complications and parastomal hernia were the most common complications. End colostomy had the highest incidence of morbidity, followed by loop colostomy and loop ileostomy. CONCLUSIONS: Ileostomy and colostomy forms are frequently done procedures, but sadly they are linked to high morbidity and stoma-related complication rates that range from 21 to 70%. It has been demonstrated that preoperative entero-stomal therapy consultation and stoma site labelling by either an entero-stomal therapist or skilled surgeon lessen postoperative problems. In addition, it is crucial to pay close attention to the technical aspects of stoma production. In order to definitively address concerns concerning the optimal trephine size, the use of prophylactic mesh, and other aspects of stoma creation, additional randomized trials are required. Clinical wound ostomy nurse specialists are extremely helpful following surgery, and the use of standardized protocols has further helped to reduce the frequency of common problems and readmissions for dehydration.Item A STUDY OF OUTCOMES OF DISTAL END RADIUS FRACTURES MANAGED BY EXTERNAL FIXATOR(Basic Medical Sciences Forum, 2023-06) Lil, Dr. Nadeem A.,. Bhingradiya, Dr. Prashant C; Patel, Dr. Arjav R.; Makwana, Dr. Vipul R.BACKGROUND: Fractures of the distal radius continue to be the most common skeletalinjuries treated by the orthopedic surgeon. Unstable fractures of the distal part of the radiushave shown an inherent tendency towards loss of reduction after non-operative treatment.External skeletal fixation has been popular for the treatment of displaced, unstable fracturesof the distal part of the radius because it combines a minimally invasive procedure withreduction by ligamentotaxis.METHOD: A retrospective study of 70 patients of fracture of distal end radius treated withexternal fixator came to OPD at tertiary care hospital during the study period of 2 years fromJuly 2020 to June 2022, were included in the study after obtaining permission frominstitutional review board.RESULT: All 70 patients were assessed in the form of the functional and radiologicaloutcome based on Subjective evaluation by Modified Demerit Point System of Gartland andWerley (Functional) and Lidstorm and Frykman Criteria modified by Sarmiento(Anatomical). We obtained “excellent” results in 47.15%; “good” in 35.72% cases; “fair” in14.28% and “poor” in 2.85% cases with a mean G & W score of 6.35.CONCLUSION: Finding of this study shows that external fixator is an easy, cost effective,reliable and most suitable treatment in treating intraarticular and unstable extraarticular distalend radial fractures by the principle of ligamentotaxis.Item OBSERVATIONAL PROSPECTIVE STUDY OF DIFFERENT RECONSTRUCTIVE SURGERY IN ORAL CAVITY CARCINOMA(Basic Medical Sciences Forum, 2023-06) Chaudhari, Dr. Dhaval S; Akruwala, Dr. SushilOBJECTIVES & AIMS:• To evaluate the outcome of different Reconstructive surgery in oral cavity carcinoma• To determine the factors which increase the complication in post op reconstructive surgery(like – diabetes, hypertension, smoking etc.)• The effect of flap transfer on complication or on post op rehabilitation of patients in oralcavity carcinoma.MATERIALS AND METHODS: This is a prospective study conducted at GCS hospital,Ahmedabad between oct. 2021 to June 2022. Sample size is 40 patients with case of oral cavitycarcinoma, out of which some cases underwent for PMMC Flap, Radial forearm free flap, ALTfree flap, fibula flap, forehead rotational flap, deltopectoral flap and local flap.CONCLUSION:Risks have not increased complications in PMMC or Free flap group in our study. Various otherstudies have similar results however a larger patient pool may be needed to assess them. ThePMMC flap is more favorable for patients with possibly lethal pre-op morbidities, when a longoperation is not advisable and a small defect is expected as compared to the longer operationduration of ALT free flap & Radial free flap.Though the flap related complications & donor site related complications are more with foreheadrotational flap as compared to PMMC. ALT & Radial forearm free flap, statistically there is nosignificant difference. Also, in the functional post-op outcomes there is minimally statisticallysignificant difference with PMMC flap, ALT free flap or Radial free flap, local flaps and otherreconstructive surgery.Item STUDY OF ADNEXAL MASS IN REPRODUCTIVE AGE GROUP WOMEN AND THEIR OUTCOME(Basic Medical Sciences Forum, 2023-06) Toshniwal, Dr Nisha; Trivedi, Dr Yamini; Deliwala, Dr Kruti; Pandya, Dr Janki; Shah, Dr Siddhi; Vaidya, Dr RutviBACKGROUND: Adnexal masses is a significant condition commonly seen in women’sreproductive age. Most common masses arise from ovaries due to their complexembryologic & histologic origin. For diagnosis, ultrasonography is the gold standard.Laproscopy is the gold standard surgical intervention.METHODS: This study was a prospective study that was conducted at a tertiary carehospital in the obstetrics and gynecology department from October 2021 to December2021.RESULTS: In this study, No. 31% of the patients were between the ages of 26 and 35.Of the patients, 12.90% came from the upper socioeconomic class, 72.58% from themiddle, and 14.51% from the lower socioeconomic class. The most common complaintwas abdominal pain (41.93%) followed by menstrual irregularities (25.80%). 46.77% ofpatients were managed medically. In 32.25% of patients, laparoscopy was performed andin 20.96% of patients, laparotomy was performed.CONCLUSION: Adnexal masses are a very common gynecological problem, Presentwith abdominal pain / other symptoms /an incidental finding on ultrasonography done forother purposes. So, the basic approach should be early diagnosis and appropriate medicalor surgical treatment, to minimize morbidity and avoid mortality.Item STUDY OF BIOMEDICAL WASTE MANAGEMENT IN DIFFERENT TYPES OF MEDICAL FACILITIES(Basic Medical Sciences Forum, 2023-06) Manek, Dr. Kavan; Patel, Dr. Jay; Painter, Dr. Zahra; Kuswaha, Dr. Manoranjan R; Nayak, Dr.ShraddhaOBJECTIVE- To study disposal of different types of biomedical waste and to studythe status of BMW management in different level of hospitalsMETHOD-Medical facilities were divided into 4 groups. 10 facilities from each groupwere selected by simple random sampling. Facilities were visited by surveying groupsand specific data about collection and disposal of waste were collected by askingmanagement personnels of hospitals, doctors and staff.RESULT- 90% of single speciality hospitals and 80% of multispeciality hospitals arefollowing proper storage and segregations of BMW.90% of super speciality hospitalshave transportation facilities.60% of super speciality hospitals , 30% of multispecialityand 20% of single speciality hospitals have incinerators. All super speciality hospitalshave autoclave machines, while 70% of single and 50% of multispeciality hospitalshave that. While only 2 out of 10 clinics have an autoclave machine.60% of both clinicsand Superspeciality hospitals are using land disposal as a method of BMWmanagement. 80% of small clinics and 70% of multispeciality hospitals are having dryand wet thermal management.CONCLUSION- Superspeciality hospitals and Single specialty hospitals are usingcostly methods like incineration and autoclave also following guidelines for storage ,segregation and transportation of BMW properly while amongst all most small clinicscan’t afford costly methods so uses cheaper techniques like chemical treatment and dryand wet thermal methods.Item SURGICAL WOUND MANAGEMENT WITH VACUUM ASSISTED DRESSING(Basic Medical Sciences Forum, 2022-12) Shah, Dr. Dhruvi J.; Patel, Dr. Jay M.; Shah, Dr. Jainam K.; Patel, Dr. Soham H.; Painter, Dr Zahra Z.Background and Objectives: To evaluate the role and efficiency of vacuum dressing in thehealing of wounds and to assess the benefits and limitations of using vacuum dressing indifferent types/categories of wound.Methods: The study of 25 cases was conducted in the Department of Surgery of atertiary care teaching hospital over a period of 2 years.Results: Vacuum dressing had a significant effect on the final outcome of wounds.Wounds which seemingly needed a flap surgery in the first impression, withsuccessive application of vacuum dressing cycles, could be covered with a simplesplit thickness skin graft. Many patients were salvaged of a revision amputation asshowed by the decrease in overall amputation rates.Interpretation and Conclusion: Based on the data from the present study and otherstudies available, vacuum dressing results in better healing, with minimalcomplications, and thus looks to be a promising alternative for the management ofvarious wounds. Vacuum dressing leads to faster healing of the wounds, thereforedecreasing the overall hospital stay. Hence, it is cost effective also. It reduces theinconvenience and discomfort caused to the patient by frequent change in dressings.It helps in reducing size of the wounds, has profound effect on wound depth andgranulation as seen in our study. It promotes granulation tissue completely coveringthe tendon, thus enabling simple techniques (e.g., skin graft) rather than formal flapclosure in few cases. Wounds with exposed underlying bone and chronic nonhealing ulcers can be managed well with vacuum dressing. It reduces the number ofamputations and re-debridement required. More number of wounds can be managedsuccessfully with secondary closure or skin grafting after multiple cycles of vacuumdressing. This reduces patient morbidity and minimizes the overall effect on hisquality of life. Good outcome of vacuum dressing also depends on its properapplication.Item EFFECT OF PRONE POSITIONING WITH HFNO IN MODERATE TO SEVERE ARDS(Basic Medical Sciences Forum, 2023-06) Shah, Dr. Shruti M.; Gandhi, Dr. Timsi J.; Gandhi, Dr Mauli K; Mehta, Dr Mahendi P; Ved, Dr Shrutika PINTRODUCTION: The WHO, broadcasted COVID 19 as a public health emergency onJANUARY 30th ,2020 and subsequently declared a pandemic on MARCH 11th2020.Acute respiratory distress syndrome (ARDS) is a major complication of COVID-19that occurs in 20-41% of patients with severe disease.The pathophysiology of ARDS andCOVID-19 lung injury share many of the same aspects of reduced lung parenchymalcompliance, vasculopathy, alveolar flooding, and gas exchange impairment arising fromdirect infectious causes and noninfectious injuries.In patients with pneumonia,HFNOallows improved mobilisation of secretions,minimises oxygen dilution,meets inspiratorydemands and improve end-expiratory lung volumes.According to the present theories,prone positioning, by reducing ventral alveolar expansion and dorsal alveolar collapse,results in ventilation that is more homogeneous.OBJECTIVE: The goal of our study is to evaluate the reduction in consumption of oxygenby using proning as an adjunct to HFNO in patients of COVID 19 admitted in ICU.METHOD: This is an observational cross sectional type of study, which includes patientswho were hemodynamically stable and required HFNO to maintain oxygenation. Allpatients were counselled for the benefits of proning. Proning was done with the help ofnursing staff. All vitals were noted before proning and all throughout proning. We keptpatients in a prone position till patients were comfortable and duration of proning wasnoted. We titrated oxygen requirement (FIO2 and flow) to target spo2 level of 93-95%.RESULT: We studied in 26 patients on HFNO with proning, we found that proning helpsin 11-50% reduction in oxygen requirement to achieve target Spo2 level.The mean value ofoxygen consumption was 20833.27 L/HR with only use of HFNO which was more than15996.92 L/HR when patients were encouraged to be prone along with the use ofHFNO.The collected data was analysed and unpaired t test was applied after which p valueof 0.0154 was obtained, which is statistically significant.CONCLUSION: Based on this study it is concluded that there is significant reduction inconsumption of oxygen by using the prone position as an adjunct to HFNO in patients ofCOVID 19.Item OUTCOME OF USE OF PLASTIBELL DEVICE FOR CIRCUMCISION IN PAEDIATRIC PATIENTS(Basic Medical Sciences Forum, 2022-12) Masu, Dr. Shakib J.; Chauhan, Dr. Sanjay R.; Sharda, Dr. Bhimansu T.; Shah, Dr. Chaitya S.; Sampat, Dr. Naishal R.Introduction – Circumcision is one of the oldestsurgical procedure practiced to remove shaft skinand inner foreskin to uncover the glans.Among various techniques for the circumcision, wehave described Plastibell method which has becomepopular and more preferable for its advantages suchas minimal tissue trauma and better cosmesis.Aim - This article aims to analyse the safety, efficacyand outcome of plastibell circumcision in paediatricpatients.Material & Methods – This study includes 30inpatient cases who satisfied the inclusion criteriaand underwent circumcision using plastibell device atsheth L.G. hospital, AMC MET Medical college,Ahmedabad. Data on operative time, intra op andpost op complications, post operative hospital stay,cosmetic outcome and parent satisfaction wasobtained and analysed.Results – Total of 30 patients were circumcised withplastibell device with average operative time of 9±3mins. Most common post-operative complication waspain which was observed in 8 patients (26.67%).Post-op bleeding was seen in 1 patient (3.33%) dueto detachment of ring. 28 out of 30 parents weresatisfied with the cosmetic outcome.Conclusion – Based on our study, plastibellcircumcision is effective technique for circumcisionoffering lesser operating time, post-operative pain,Item Outcome of Pediatric shaft Radius-Ulna Fractures managed with Titanium Elastic Nailing System(Basic Medical Sciences Forum, 2022-12) Nishant, Dr. Juva; Nadeem, Dr. Lil; Vipul, Dr. MakwanaAims and objectives: To study the functional outcome of TENS in Pediatric shaft radiusulna fracture.Introduction: Symmetrical bracing action of elastic nails inserted into the metaphysis, thatbears against the inner bone at three points is the principal of the titanium elastic nailing.Early stability to the involved bone fragments is the benefit of this method and it permitsearly mobilization and returns to the normal activities of the patients, with very lowcomplication rate.Materials and methods: A retrospective study of 40 pediatric patients with closed and opengrade 1 shaft radius-ulna fracture carried out at our institute between 2018-2019 treated withTENS and observed for a period of minimum 1.5 years.Conclusion : It can be concluded that TENS nailing in pediatric shaft radius-ulna fractures isan excellent modality of treatment and has very low complication rate.