International Archives of BioMedical and Clinical Research

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Roflumilast therapy in COPD − Update and Trials
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-07) Giri, Om Prakash; Giri, Vishal Prakash
Chronic Obstructive Pulmonary Disease (COPD) represents an important public health challenge that is both preventable and treatable. Pharmacological treatment regimen for COPD needs to be patient specific. Hence management of COPD should be based on strategy considering both disease impact and future risk of disease progression ( especially of exacerbation ). Risk of exacerbations significantly increases in GOLD 3 and GOLD 4 COPD. Exacerbations increase the decline in lung function , deteorriation in health status and risk of death. Roflumilast is a phosphodiesterase-4 (PDE4) inhibitor. It reduces risk of moderate to severe exacerbations in patients of GOLD 3 & GOLD 4 COPD. It has no direct bronchodilator activity, although it has been shown to improve FEV1 in patients treated with inhaled long-acting bronchodilator. Adverse effects may occur early during the treatment but these are reversible and diminish overtime with continued treatment .
Psychosomatic Disorders Pertaining To Dental Practice
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-07) Kanodia, Shubhra; M, Parvathi Devi; Ravindra, S. V.; Giri, Vishal Prakash; Parmar, Seema Singh; Vishwakarma, Kirti
Psychosomatic symptoms are by definition clinical symptoms with no underlying organic pathology. Psychosomatic disorders represent impaired adaptation or deficiencies that limit the capacity to adapt successfully to the demands of everyday life. The symptoms are thought to be a response to stress. Appropriate health consultation should be considered for further evaluation and treatment.
Do we really need multiple terms for a single concept in the field of Environmental Pharmacovigilance?
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-07) Rahman, Syed Ziaur
Environmental pharmacology is an emerging specialty of pharmacology. It is defined as the effect of pharmaceuticals and house care products on the environment and ecosystem. It involves the study of gene-environment interaction, drug-environment interaction and toxin-environment interaction, for which specific terminologies have been used very appropriately i.e. ‘Ecogeneology’, ‘Ecopharmacology’ and ‘Ecotoxicology’, respectively.
Role of Topical Acetic Acid in Comparison to Gentamicin for the Management of Chronic Suppurative Otitis Media
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-07) Vishwakarma, Kirti; Khan, Farhan Ahmad; Nizamuddin, Sheikh; Singh, Preeti; Yadav, Lalendra
Introduction: Chronic Suppurative Otitis Media (CSOM) is one of the diseases resistant to current antibiotics; persisting for more than two week; and capable of causing severe discharge, tympanic membrane perforation and deafness. This may cause distress and affect their quality of life and productivity. Aims: To assess the role of topical Acetic Acid in comparison to Gentamycin for management of CSOM. Methods: It was a Randomized, open label study. Patients diagnosed as CSOM (safe type) were randomly divided into two groups, group I - topical 1.5% Acetic acid and group II - topical 0.3% Gentamicin sulphate in a dose of three otic drops thrice daily. Follow up was done every week for two weeks and was compared on the basis of otological symptoms score. Results: The mean difference of otological symptom score at day 7 and day 14 from baseline in Group I was 1.90±1.01 and 3.40±1.08; and in Group II 1.96±0.57 and 3.12±0.74; p<0.05. Among the study groups, reduction of otological symptom scores at day 7 (Group I =3.22±1, Group II=2.66±1.76; p=0.14) and at day 14 (Group I = 1.72±1.76, Group II= 1.50±1.79; p=0.56) respectively. Also, “Treatment success” seen in 46 (92%) patients in the Acetic acid group and 44 (88%) patients in Gentamicin sulphate group. Moreover, cost of the treatment for Acetic acid was 102.94 and for Gentamicin sulphate was Rs.160.25 per person. Conclusion: Topical Acetic acid was found to be equally effective to Gentamicin sulphate for the treatment of CSOM.
A Comparative Study between Intranasal Midazolam and Intravenous Midazolam In Control Of Seizure In Children
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-07) Rana, Md. Azmat; Touseef, Syed
Introduction: Seizures are one of the important reasons for children visiting the hospital. Febrile seizures are the most common type of seizures found in childhood. Earlier Diazepam was widely used for treating all types of seizures but due to short duration of action, newer drugs were tried and found better than diazepam. Aims: To compare midazolam given intranasally with midazolam given intravenously for the treatment of febrile seizures in children. Methods: This prospective study was conducted in children suffering from seizures at the Paediatric Emergency Department of Teerthanker Mahaveer Medical over a period of 12 months. 84 children between the ages of one months to fourteen years with febrile seizures lasting for at least 10 minutes were eligible for inclusion in our study. Treatment was considered successful if the seizure ceased within one hundred twenty seconds Results: In group A out of 44 patients, 20(45.5%) patients were responded to Intranasal Midazolam, whereas in group B 40 patients who were treated with IV Midazolam as first line treatment, 36 patients (90%) had responded to it. Time recorded for the commencement was more in IV Midazolam group (1.598 min) than IN Midazolam group (0.379 min), but average response time was lesser in group B (1.009 min) than group A (3.001 min). Conclusion: Midazolam given intranasally is a safe and effective treatment for prolonged febrile seizures in children and may be used in general practice and, with appropriate instructions, by the parents of children with recurrent febrile seizures at home.
Intraperitoneal Drainage Under Local Anaesthesia In Patients Of Perforation Peritonitis Before Definitive Management: Is It Justified?
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-07) Finan, Rafiul Imad; Ansari, M. M.; Shahabuddin, Shahab Faria
Introduction: Perforation peritonitis is one of the most frequently encounter surgical emergency around the world. In spite of advances in diagnosis, antimicrobial therapy, surgery, it remains a fatal affliction with high mortality rate. This high mortality rate makes way for innovation in techniques in addition to the persisting knowledge for a better outcome. Aims: A pilot study was conducted, to evaluate the efficacy of intraperitoneal drainage in patients of perforation peritonitis during the resuscitation period before definitive surgical treatment. Methods: This was a prospective control study, conducted on the patients of perforation peritonitis with gastro-intestinal perforation for a period of 2 years w.e.f. January, 2011 to November 2012. 100 patients were included in this study and were divided into two groups (50 each). Group I- patient with preoperative intraperitoneal drainage under local anaesthesia, group II- patient without preoperative intraperitoneal drainage, before definitive surgery. Results: The overall morbidity and mortality of the patients in group-I were comparable with those in group-II Conclusion: Intraperitoneal drainage under local anaesthesia, in patients of gastrointestinal perforation peritonitis seems to be effective in decreasing morbidity and mortality.
Phenytoin induced Stevens-Johnson syndrome in a 38 year male patient: A Case Report
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-07) Singh, Sukhpreet; Salman, Mohammad Tariq; Karauli, Ritu; Tewari, Sachchidanand; Rai, Rajni Kumari
Adverse drug reactions (ADRs) are one of the leading causes of death among hospitalized patients and occur in 0.3 to 7 per cent of all hospital admissions. These may vary from mild rashes to severe reactions such as Stevens-Johnson syndrome (SJS). Antiepileptic drugs-induced SJS is a life-threatening severe cutaneous adverse reaction. We report here a case of phenytoin induced SJS in a 38 year old male patient presenting at emergency room. The patient responded to the treatment and was prescribed tab. Levetrecitam and remained symptom free since then.
Ofloxacin and Nitrofurantoin sensitivity pattern In Patients of Urinary Tract Infection (UTI) at a tertiary care teaching hospital
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-07) Devmurari, Dharmesh; Kamal, Chand Miyaan; Singh, Shambhu Nath; Kumar, Amit
Introduction: UTIs are the second most common bacterial infection in present population. Women are more prone to UTI than Male. Uropathogenic Escherichia coli is responsible for >80% of community acquired UTIs. Aims: The present study was carried out to compare sensitivity / Resistance between Ofloxacin and Nitrofurantoin in UTI patients. Methods: This was a prospective, cross-sectional, observatory study conducted on patients (n = 200) suffering from Urinary Tract Infection from March 2014 to February 2015 at the Department of Microbiology and Department of Pharmacology, Teerthanker Mahaveer Medical College and Research Centre (TMMC & RC), at a tertiary care teaching hospital, in Moradabad, Uttar Pradesh, India. Results: UTI was much more common in females (61%, n=122) than in males (39%, n=78). The most common organism isolated was E. coli, 47%(n=94), followed by Klebsiella 34.5%(n=69), staphylococcus 7.5%(n=15), Proteus, pseudomonas 4%(n=8) and enterococcus 3%(n=6). E. coli was highly sensitive to the Ofloxacin 18% (n=36). Conclusion: Sensitivity pattern of the antimicrobial was found to be more in Nitrofurantoin (57%) was found to be more sensitive than Ofloxacin (40.5%) for the treatment of UTI.
Prevalence and pattern of Hypothyroidism in patients attending the Outpatient department of a tertiary care teaching hospital.
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-07) Vaishnav, Rukmani; Alam, Md Faiyaz
Introduction: Among the endocrine disorders, Hypothyroidism is now believed to be the worldwide problem next to Diabetes. Aims: This study was carried out to ascertain the prevalence and pattern of Hypothyroidism. Methods: This prospective, epidemiological study was conducted in patients aged ≥20 years suspicion of thyroid disorders at a tertiary care teaching hospital from Jan 2012 to Dec 2013 in Bhuj, Gujrat. Thyroid abnormalities were diagnosed on the basis of laboratory results (serum FT3, FT4 and Thyroid Stimulating Hormone [TSH]). Results: Out of 425 patients enrolled in our study, only 345 patients completed left. Out of the 345 analysable subjects, Female [n=217 (62.89%)] predominance is seen. Around n=72 cases were confirmed having thyroid abnormalities, Out of n=72 cases, only n=32 (9.27%) participants were found to have Hypothyroidism, Subclinical hypothyroidism was detected in n=28(8.11%) cases. Only n=12 (3.47%) cases had signs and symptoms of Clinical hyperthyroidism. Conclusion: The prevalence of hypothyroidism was high, affecting approximately 9.27% study population. Hypothyroidism is found to have close association with Female gender and older age. Iodine intake ceases to be the sole etiological contender for thyroid disorders in urban areas.
Exploring Demographic Factors Influencing Acceptance of Family Planning Methods in Aligarh
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-10) Ansari, Mohammad Athar; Mehnaz, Saira; Abedi, Ali Jafar; Shah, Mohammad Salman; Khan, Zulfia
Introduction: Population of India has jumped to 1,290,974,613 (1.29 billion) on Dec 07, 2015. There are certain demographic factors, which affect the acceptance of family planning methods. Therefore this study was conducted to determine the extent of felt need of family planning methods and to assess the demographic factors influencing the contraceptive acceptance. Materials and Methods: This cross-sectional study was conducted in J.N. Medical College, AMU, Aligarh, for a period of two and half year. Only the mothers in the post partum period were interviewed. Those mothers who had already accepted family planning methods were not included in the study. 1383 mothers were interviewed. Data were tabulated and analysed using SPSS version 20. Chi-square test (χ2) was applied to know the statistical significance. Results: Significant number of mothers (39.6%) had planned to adopt family planning methods. Majority of the mothers (71.4%) were in the age group of 21-30 years. In this age group, 39.7% mothers wanted to adopt family methods. As the age of the mothers increased, the acceptance rate also increased. Majority of mothers (52.9%) admitted in the hospital were Hindus. Among Muslims, 40.3 per cent mothers had felt need of family planning methods. Mostly the mothers were illiterate (50.8%). 30.8 per cent of these illiterate mothers wanted to accept family planning methods. Similar felt need (36.4%) was observed in mothers with education up to primary level (V standard). As the birth order increased, felt need also increased. Conclusion: It may be concluded that significant number of mothers had planned to adopt family planning methods. Though the campaign to promote family planning methods in our country is being carried out, the message should be given more vigorously through information, education and communication (IEC) activities and involvement of non-governmental organisations (NGO). Concerted efforts are needed to find out the reasons for unmet need and its solution
Management of Nutoo-E-Rahm (Uterine Prolapse) by Pelvic Floor Exercises
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-10) Anees, Saman
Uterine prolapse is defined as when the uterus slips down into the vagina from its normal position, and in severe cases, outside the vagina. It is one of the most distressful gynaecological problem commonly seen among the menopausal and post-delivery women mainly due to the weakening of pelvic floor muscles. Pelvic floor muscles provide support or act as a “ floor” for the abdominal viscera including the rectum and constrictor or continence mechanism to the urethral, anal and vaginal orifices (in females). Weakening of these muscles not only lead to uterine prolapse, but may also lead to the prolapse of other pelvic organs as a complication that is Cystocoele (prolapse of Bladder) and Rectocoele (prolapse of Rectum). Pelvic floor exercises also called as Kegel exercises mainly works on strengthening the muscles and the ligaments that support the female genital tract which become slack and atonic, and improves their general muscular tone. It also increases the thickness of the vaginal wall and lubrication after menopause. Here, I will discuss briefly about the uterine prolapse, and mainly the importance and process of doing pelvic floor exercises, since it has been mentioned that initial degrees of uterine descent can be managed by it. Need of this paper is to spread the awareness about the conservative treatment, rather than looking for surgery.
Predicting the prognosis of Conservative Treatment in Acute Cholecystitis using an Artificial Neural Network
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-10) Rasool, Tariq; Quadri, S MK; Iqbal, Mir Javaid; Dar, Parvez Ahmad
Introduction: In majority of the cases clinicians usually choose the conservative mode of treatment as the first line of treatment in case of acute cholecystitis. But studies have shown that in most of the cases patients do not show any significant improvement and eventually are referred to cholecystectomy. This delay in referral catalyses complications like septic conditions and development of gangrenous cholecystitis. Computational structures like artificial neural networks are excellent tools for predicting outcomes apriori. So a neural network was employed to predict the prognosis of conservative treatment mode in cholecystitis and avoid the otherwise imminent complications. Materials and Methods: A neural network was developed and trained on clinically significant data from a set of 150 medical records pertaining to patients who presented themselves with diagnosis of acute cholecystitis at a tertiary care hospital. The performance of the network was tested on this training set and a separate validation set comprising of data from 100 such patients. Results: The developed network demonstrated excellent prognostic capabilities with respect to the success/failure of conservative treatment in acute cholecystitis. Conclusion: A neural network can predict the outcome of conservative treatment in cholecystitis with significant accuracy and could prove to be an indispensable tool to clinicians
Prescription Auditing of Patients Admitted at Psychiatry ward of a Tertiary Care Hospital of Western UP
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-10) Anwer, Adnan; Rahman, Syed Ziaur; Singh, Piyush Prakash; Usmani, Mohammad Amir
Introduction: The World Health Organization (WHO) proposed core-prescribing indicators for prescription audit and drug utilization studies. The focus of Indian studies has mainly been on the WHO core-prescribing indicators such as the range and number of drugs per prescription. Critical evaluation of prescriptions including rational auditing of prescriptions of patients admitted at Psychiatry Ward of Jawaharlal Nehru Medical College Hospital, A.M.U., Aligarh, from the period of 31/05/2013 to 30/05/2015. Materials and Methods: Permission for retrospective study to access medical records of the past 2 years of all patients admitted in the Psychiatry ward from 31/05/2013 to 30/05/2015 was obtained from the competent authority. Prescriptions of 44 patients (26 female, 18 male) were available in the Central Record Section during this period. The following parameters were taken to analyse and audit prescriptions as per WHO prescribing indicators: 1) Patient details, 2) Mention of diagnosis, legibility & spelling mistakes, 3) Details of the consultant, 4) Use of antibiotics/antipsychotics by various routes, 5) Provision of proper instructions to patients and 6) Additional parameters - Percentage of prescriptions with nutritional supplements and antacids. Results: Only 36% of prescriptions contained the full names of patients, while age, sex and address were present in 84.09% of the prescriptions. 100% prescriptions were found written with complete diagnosis and contained the signature of the concerned doctor. None of the prescription had the doctor’s contact number. A mean number of 3.18 drugs were written per prescription. All prescriptions were legible and 2.27% contained spelling mistakes. Insufficient instructions for both oral and injectable drugs were mentioned on all prescriptions. Conclusion: As per WHO laid guidelines, study related to drug use indicators are simple as a supervisory tool to assess prescribing patterns by individual doctors. These prescription studies provide scope to improvement in prescribing patterns and promotion of rational use of drug among practitioners.
Gossypiboma: To Err is Human – A Case Report
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-10) Ali, Wasif Mohammad; Ansari, M M; Khanam, Deeba; Faridi, Shahbaz Habib
Gossypiboma (retained surgical sponge) is one of the identities that can be a disaster not only to the carrier of operating surgeon but also for the hospital as far as the financial burden and the reputation is concerned. The patient may have severe morbidity and in worst of the event can have mortality. The aim of this article is to highlight the fact that the incidence is not as rare as has been reported in different literatures and to discuss its various –clinico-radiological features, predisposing factors, measures to avoid it and how to manage when such a calamity has occurred. This article increases the awareness about the problem thus avoiding unnecessary morbidity/mortality to the patient as well as save the surgeon from malpractice law suits, great psychological trauma and negative publicity.
Role of Vitamin D in Prediabetic Individuals – Update
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-10) Giri, Vishal Prakash; Giri, Om Prakash
Vitamin D deficiency and diabetes have one common trait of being pandemic. Association between insulin sensitivity and serum 25-OHD levels is clear. Patients with diabetes and Vitamin D deficiency have increased insulin resistance. Vitamin D supplementation may decrease the incidence of diabetes mellitus and may improve the metabolic control in the diabetes state
Indicator Based Assessment of Medicine Storage and Inventory Management Practices in various Public Sector Hospitals of District Srinagar
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-10) Iqbal, Mir Javid; Geer, Mohammad Ishaq; Dar, Parvez Ahamd
Introduction: The role and relevance of medicines, vaccines and other health supplies are critical, as they are considered important building blocks of the health care system. Well-located, well-built and secured storage facilities are an essential component of a pharmaceutical supply system. Methodology: This study was carried out at various public sector hospitals of District Srinagar using a set of 138 assessment indicators to study the drug storage and inventory management practices in terms of storage facilities and procedures, inventory and stock management practices and daily, monthly, yearly storage and inventory related activities. Results: Indicator based assessment for drug storage and inventory management practices revealed highest percentage adherence of 80% in managing expired drugs followed by 55.4% in daily, monthly, yearly storage and inventory control activities, 48% adherence in storage procedures, 46.1% in receiving supplies, 42.5% in stock positioning, 40.9% in storage space, 38% in stock management, 26% in stock-outs and the lowest percentage adherence of 22.9% was observed in inventory management. Facility-wise assessment revealed highest overall percentage adherence of 64.1% at Children’s Hospital (CH) followed by 54.3% at District Hospital (DH), 49.3% at Medical College (MC), 29.6 % at Sub-District Hospital (SDH) and 24.4% at Primary Health Centre (PHC). Overall percentage availability of indicator medicines was found to be 32.5% (CH=56.2% & DH=18.6%). Stock cards were not found in any of the health care facility and no expired products were found stocked in CH, MC and DH. Average indenting frequency was found to be 31 days (PHC=60; MC=10) whereas average numbers of medicines indented in one go were found to be 24. Average lead time was found to be 15 days (CH=15; MC=60) whereas average no of stock out days was found to be 66.6 days (CH=10 & PHC=115). Conclusion: Overall adherence towards various storage conditions was found to be less than 50% and lack of adherence to the basic inventory management principles was found to be common
A Rare Case of Salbutamol Induced Tetany Pooja Shukla1*, Mohd Tariq Salman1, R K Dixit2, Shiv Sagar Gupta3, V K Verma1, Ali Ahmad1
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-10) Shukla, Pooja; Salman, Mohd Tariq; Dixit, R K; Gupta, Shiv Sagar; Verma, V K; Ahmad, Ali
A 25-year-old female, housewife, Nonsmoker, with complains of Dysnoea and pain in chest was diagnosed with Bronchial asthma in the Out Patient Department of Pulmonary Medicine of our institute. As per the GINA guidelines she was prescribed nebulization with Salbutamol 5 mg for confirming the diagnosis of bronchial asthma. Within minutes of nebulization she started to have involuntary contraction involving all four limb and developed hand posture associated with tetany. The nebulization was stopped and symptoms were relieved after 15 minutes of the calcium administration. The causal relationship between the suspected drug and the adverse event was assessed to be probable and thus clinicians should always be aware of the possibility of tetany due to salbutamol
Mixed Medullary and Papillary Carcinoma Thyroid in a Young Female- A Rare Case Report
(Ibn Sina Academy of Medieval Medicine & Sciences, 2015-10) Siddiqui, Bushra; Khan, Roobina; Nasreen, Tausia; Faridi, Shahbaz Habib; Harris, S Hasan; Ahmed, S Shamshad
The medullary thyroid carcinomas (MTC) comprise 5-10% of all thyroid carcinomas. It is known to show many cyto-architectural variations. The WHO classification of thyroid tumors includes an entity called mixed medullary-papillary carcinoma, a rare malignancy known to represent <1% of all thyroid malignancies. Fewer than 40 such cases have been reported so far and include tumors showing morphological features of both medullary carcinoma and papillary carcinoma with immunoreactivity for calcitonin and CK19 &thyroglobulin respectively. We report a case of a 27-year-old female with complaints of gradually increasing neck swelling for 2 years, with difficulty in swallowing in the last 2 months. The swelling was more localized towards left. Ultrasound neck revealed a nodule in the left lobe of thyroid with benign features most likely nodular colloid goiter. Thyroid profile of the patient was normal. FNA revealed sheets and follicles lined by both hyperplastic and involutional follicular cells. Few micro follicles showed pleomorphic cells having hyperchromatic nuclei and mild anisonucleosis. A diagnosis of colloid goiter was given on cytology; however, on grounds of suspicion of a neoplastic process, histopathology was advised. The patient underwent total thyroidectomy. Hematoxylin & Eosin stained sections showed features of mixed medullary-papillary carcinoma of the thyroid which was further confirmed on Immunohistochemistry and raised serum calcitonin levels. It is important to know about this entity due to its prognostic implications, association with other endocrine disorders and to prevent any diagnostic dilemmas.
To study the Prevalence and Antibiotic Sensitivity Pattern of Isolated Bacteria from the Blood, Urine, CSF and Pus Samples in a Tertiary Care Teaching Hospital
(Ibn Sina Academy of Medieval Medicine & Sciences, 2016-01) Mishra, Madhubala; Banjare, Sanjay; Thaware, Prafulla P; Mishra, Pallavi; Farooq, Umar
Introduction: The worldwide escalation in both community- and hospital-acquired antimicrobial-resistant bacteria is threatening the ability to effectively treat patients, emphasizing the need for continued surveillance, more appropriate antimicrobial prescription, prudent infection control, and new treatment alternatives. Objective: To study the prevalence of bacteria from the different samples (Blood, Urine, CSF, PUS) and to examine the antibiotic sensitivity pattern of isolated organisms. Methods: Around n=150 samples of Urine, Blood, CSF and Pus sample were collected from the patient attending Teerthanker Mahaveer medical Hospital college and Research Centre. Results: Out of 150 clinical samples, highest number of isolates were gram-positive, Staphylococcus aureus n=47 (31.33%) followed by E. Coli n=37(24.66%), Klebseilla n=33(22.00%), Pseudomonas n=11(07.33%). S. aureus was highly sensitive to Gentamycin (88.09%) and least sensitive to Co-trimoxazole (14.28%). Tobramycin & Linezolid were 95.23% sensitive followed by Amikacin (90.47%), Meropenem (90.47%), Levofloxacin (88.09%). Conclusion: In our study Staphylococcus aureus to be most common isolates followed by Escherichia coli, Klebseilla, Pseudomonas, Citrobacter, Proteus.
Remote Acute Extradural Hematoma Formation after Ventriculoperitoneal Shunt - A Rare Occurrence
(Ibn Sina Academy of Medieval Medicine & Sciences, 2016-01) Ali, Yawar Shoaib; Dagar, Amit; Reyaz, Abraq Asma; Gupta, L. N.
Formation of acute epidural hematoma after Ventriculoperitoneal shunt insertion is rare in adults, more so at a site remote from the site of shunt insertion. We are presenting such a rare occurrence and discussing possible factors involved in this complication. A 35-year-old male was diagnosed with a third ventricular colloid cyst with hydrocephalus. A Ventriculoperitoneal medium pressure shunt was placed through right Keen point burr hole and the patient developed a right frontal extradural hematoma on the 4th post-operative day which was subsequently evacuated by craniotomy and the patient recovered fully thereafter. Acute extradural hematoma is a potentially life threatening complication. High index of suspicion, precautions during shunt insertion and early detection can prevent mortality and severe morbidity in these cases.

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