VIMS Health Science Journal (VIMSHSJ)
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Editor-in-Chief: Dr. Sunil Natha Mhaske
ISSN: 2348-523X (Print); 2454-1982 (Online)
Frequency: Quarterly
Language: English
Open Access Peer-reviewed journal
Web site: https://www.vimshsj.edu.in/
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Item An analytical study of Comparison between Ketamine - Dexmedetomidine versus Ketamine - Propofol for Sedation in Children Undergoing Minor Cardiac Procedures in a Cardiac Catheterization Laboratory(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Mamde, Dr. Rahul; Mamde, Dr. AmbikaBackground: The management of children with heart diseases has been a major challenge for cardiac anesthesiologist. The anesthetic technique to be used should be easy, safer and provide cardiac stability throughout the operation. So interventional cardiologist prefer deep sedation with the patient breathing spontaneously and painlessly in the room. Propofol, Ketamine along with other combinations drugs have been used worldwide by cardiac anesthesiologist to achieve these goals. We carried out this study to evaluate the combination drugs for pediatric cardiac procedures which are Ketamine – Dexmedetomidine (KD) and Ketamine – Propofol (KP). Methodology:This study was conducted in the Department of Cardiology. A total number of 80 cases were selected, 40 from each comparative groups of Ketamine – Dexmedetomidine (KD) and Ketamine – Propofol (KP). Patient data was categorized into age, sex, procedure done and recovery time, analgesic boluses required and hemodynamic parameters during the surgery. Results: Mean age in KD group was 5.24 ± 1.25 years and in KP group was 4.95 ± 1.86 years. There were total 24 males (60%) and 16 females (40%) in KD group and total 22 males (55%) and 18 females (45%) in KP group. Most common procedures done in both the groups was ASD for device closure done in 12 patients (30%) in KD group and 13 patients (32.5%) in KP group. There was signi?cant difference between the mean recovery time and number of ketamine boluses consumption in both the groups. (p<0.05) Heart rate was signi?cantly lower in KD group at 5, 10, 15 and 20 min post induction when compared to KP group. No statistically signi?cance was found in difference between the Mean Respiratory rate and MAP. Conclusion:Our study concludes that the use of KD combination is relatively safe, practical alternative, we did not ?nd any hemodynamic or respiratory effects during the cardiac procedures but there was some delayed recovery.Item An analytical Study to Evaluate the correlation between Serum Uric Acid Levels and Deaths in Acute Myocardial Infarction Patients At a Tertiary Level Institute Catering to Rural Population of Western Maharashtra(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-09) Baravkar, Dr. Jalindar; Parkhe, Dr. Shivnath; Kopurwad, Dr. Satish M; Swami, Dr. Amrut A.Background: Cardiovascular diseases are the number one cause of mortality all over the world. Elevated serum uric acid is highly predictive of mortality in patients with heart failure or coronary artery disease. We conducted this study to assess serum uric acid levels on admission as a potential predictor of short-term mortality (7 days) in acute myocardial infarction patients. Methodology: Total of 200 patients diagnosed with the myocardial infarction (MI) in our hospital along with 200 age and gender matched controls were selected for this study. The clinical history, examination, ECG changes and biochemical markers were evaluated on day 0, 3 and 7. Association with Killips class and mortality in STEMI / NSTEMI cases was done. Results:The study had 200 cases and 200 controls. The mean age of cases was 62.54 ± 18.24 years and controls were 61.94±17.25 years. There were majority males among both cases 114 (57%) and controls 112 (56%). The patients were classified using Killip's class. Majority belong to class I 98 (49%) followed by II 42 (21%). There were 26 (13%) of class III and 34 (17%) into class IV. There is significant difference seen between uric acid levels of cases and control on day 1, 3 and 7 (p<0.001). There was 25% mortality (50 deaths) seen among the cases. There was association seen between Killips class III & IVand mortality, there was higher mortality seen in STEMI as compared to NSTEMI (i.e. p<0.05). Conclusion:Our study concludes that the serum uric acid (SUA) levels have significant association with Killip's class and mortality in Acute Myocardial Infarction cases.Item Antibiogram of Gram Negative Uropathogens in a Tertiary Care Hospital(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-06) Davane, Milind; Mundhe, SanjivaniBackground:In wide range, urinary tract infection (UTI) is a substantial and second most popular bacterial infection affecting individuals of overall ages worldwide. The chronicity of divergent bacterial isolates and their propensity to various antibiotics may contradict widely, peculiarly in hospitalized patients, this makes the survey of vulnerability pattern extremely mandatory for correct selection of antibiotics. Objective: To appraise antimicrobial susceptibility pattern of the Gram negative organisms identified from urine cultures of hospitalized patients. Methodology:Total 500 urine samples from hospitalized patients with significant bacteriuria were surveyed. Using Blood and MacConckey agar, samples were inoculated. Further identification and investigation of organisms was done by standard Microbiological methods. Antimicrobial Susceptibility pattern was interpreted by Modified Kirby- Bauer's disc diffusion method with the group of 15 drugs as per Clinical Laboratories Standard Institute (CLSI) protocols.Results:UTIs were frequent in females 290 (58%). Familiar organism found was Escherichia coli 260 (52%) further accompanied by Klebsiellaspp.120 (24%), Pseudomonas spp.40 (8%), Proteus spp. 38 (7.6%), Citrobacter spp.25(5%) and Acinetobacterspp. 17 (3.4%). Mass of the strains were found sensitive to nitrofurantoin followed by amikacin, piperacillin-tazobactamand cotrimoxazole. Commonly prescribed fluroquinolones were found least effective for treatment of UTI. All the strains were found sensitive to imipenem. Extended spectrum beta lactamase (ESBL) was noted in E.coli and in Klebsiella spp.Conclusion:To break the continuity of non selective use of antibiotics and to intercept further development of bacterial drug resistance, proper knowledge of susceptibility pattern of uropathogens in particular area is very important before prescribing any empirical antibiotic therapyItem Assessment of Cardiopulmonary Resuscitation Knowledge and Attitude Amongst Interns and Junior Residents of Tertiary Care Centre(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2022-06) Kshirsagar, Ms. Trisha; Kshirsagar, Dr. Roop; Kadu, Dr. SandeepIntroduction: Cardiopulmonary resuscitation (CPR) is a life saving procedure and adequate knowledge and skills related to CPR are essential for all medical students. This study was undertaken to compare knowledge and practice related to updated CPR guidelines by American Heart Association (AHA) 2020 between junior residents and interns. Methods:This is a questionnaire-based study prepared on Google form consisting of 22 questions on CPR. Total of 124 participants included 41 junior residents and 83 interns. They were advised to read questions carefully and allowed to tick one best response among the options. Results: An average overall correct response from both the group was 14.48 (65.81 %). Among theory knowledge-based questions junior residents had an average of 8.707 correct answers out of 11 (79.15%) which is more correct answers than interns who have average 5.90 correct (53.63%). Similarly, in terms of practical knowledge, junior residents had an average score 9.682 out of 11 (88.026%) compared to interns who had an average of 6.518 out of 11 (59.27%). Conclusion: The study showed poor knowledge about CPR among the interns. More practical based teaching should be employed in MBBS curriculum. Periodical reinforcement and refresher courses should be part of curriculum.Item Assessment of Rational Antibiotic Use in Pediatric Ward in A Teaching Hospital(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2022-03) Vahadane, Dr. Sachin; Dharma, Dr. Makarand; Waydande, Dr. Suresh; Shinde, Dr. AbhijitIntroduction:Antibiotics are a class of natural and synthetic compounds that inhibit the growth of or kill other microorganisms. These are among the most frequently prescribed medications in modern medicine. The use of antibiotics has contributed to the dramatic fall in morbidity from communicable and infectious diseases over the last 50 years globally. Overuse of antibiotic is one of the most important factors for the development and spread of resistance in the hospital, as well as in the community. Methodology:The present study was conducted in pediatric ward of a tertiary care institute. The study population included 250 children. The group consisted of 250 consecutive children admitted in one unit of the pediatric ward and they were analyzed for antibiotic use without any prior priming of the members of the unit regarding rationality of antibiotic use. Results: Age and sex wise distribution of 250 children included in the study. Of these 166(57%) were males and 84 (43%) were females. 60 received antibiotics for respiratory tract infections, this being the commonest disease for which antibiotics were received. 55 (44%) children received antibiotics in rational way. Conclusion: From this study it is clear that there is lack of proper rational antibiotic usage by unit doctors. To conclude it can be stated that inappropriate use of antibiotics is increasing and is responsible for rapidly developing antimicrobial resistance. To increase rational use of antibiotics the members of the unit (treating physicians) should be motivated regarding correct uses of antibiotics and hazards of their inappropriate use. A proper workshop should be arranged for thisItem Association of Risk Factors with Maternal Outcomes In Abruptio Placenta at Tertiary Care Hospital(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-12) Jain, Dr. Disha; Patil, Dr. Pradeep; Choudhary, Dr. V. V.Introduction: Abruptio placenta is a serious condition that increases maternal and neonatal morbidity and mortality. The incidence of abruption placenta is between 0.49% -1.8%. Primary cause of abruption is not known but the main precipitating and predisposing factors of abruption are age, parity, anemia, poor nutrition, pregnancy induced hypertension, eclampsia, gestational diabetes mellitus, preterm premature rupture of membrane, and previous medical termination of pregnancy. Methodology:It is a retrospective observational study done by analyzing the case sheets of abruption placenta in tertiary care hospital from January 2020 to December 2020. All those patients of antepartum hemorrhage presenting directly as typical cases of abruption placenta were included. Also, those cases in which placenta previa and other causes were ruled out after clinical, per speculum examination and/or USG examination were ruled out. Result:The total number of abruption placenta collected during this period was 21. We found 38% patients with chronic hypertension, 33 % of patients with severe preeclampsia, 14% with eclampsia, 15% were normotensive. Advanced maternal age and multiparity were also the risk factors of abruption placenta. Conclusion: Antenatal care which identifies the risk factors like PIH plays an important role in decreasing the incidence of abruption placenta. Early detection and active management will reduce morbidity.Item Attitude of Health Care Workers On COVID 19 Care In a Selected Hospital Setting(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Bhattacharya, Chanu; Karandikar, Dr. Neeraj J.; Kadu, AmitIntroduction:From the First week of March 2020 till Nov 2020 the attitude of HCWs, mental health or perceptions changing regularly as the COVID-19 pandemic changing its image. New treatment, new information new training and practice changing attitude towards positivity as the death rate reducing and patient recovery rate increasing. Methods:A cross sectional study was done by a Likert type ?ve-point attitude scale by survey method and conveniently selected 120 health care workers from a single setting. Different categories of HCWs were participated namely doctors, nurses, physiotherapists, lab technicians and X-ray technicians. Results:result showed mean age of HCWs were 26.9. Female HCWs are more than male.80% HCWs attitude is favorable 20% neutral and no one have unfavorable attitude. Chai square test revealed that there is highly signi?cant association of attitude with marital status and residence area, signi?cant with age and year of experience. Conclusion:Generalization is not possible because this is single center data. But research showed maturity and better practice improves attitude. HCWs attitude improve care and recovery ratesItem Awareness and perception of Cradiovascular Physiotherapy in patients having Cardiac Condition residing in Pune city.(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2022-06) Gavate, Vaishnavi; Nagarwala, Dr. Raziya; Dabadghav, Dr. RachanaBackground:Cardiovascular diseases are the number one cause of death worldwide. As we know Cardiovascular Physiotherapy has undisputable role in management of these Cardiac Diseases. Yet evidences suggests that we can see lot of non- adherence of these patients towards therapy. Therefore, this study helps us to understand the awareness and perception of Cardiac Patients towards Cardiovascular physiotherapy as this will tell us patient's level of understanding about the importance and implications of it on their condition and what are their perceptions regarding this therapy.Method: Aself-made questionnaire was administered to people who are diagnosed of Cardiac Condition in various hospitals in Pune City and Descriptive data analysis was done using Microsoft Excel Software. Results:Only 35% subjects were aware of Cardiovascular Physiotherapy, 65% agreed that Cardiovascular Physiotherapy is important for their recovery, 55% thought it has positive effect on their Cardiac Condition yet 87.5% never consulted a Cardio physiotherapist, 25% thought there are no barriers where other considered barriers as follow- 28% were of opinion that PTis high cost, according to 14% it is time consuming, 17.5% says commute is difficult, and 10% gave barrier as Fear. Conclusion: This study concludes that the awareness is poor in patients having cardiac condition from Pune city. However, there is positive perception regarding Cardio physiotherapy most of them never consulted physiotherapist for their cardiac condition. Some of the factors were identified for this low adherence like high cost, commute, fear, time.Item Beta Thalassemia Major with Diabetes Mellitus: A Case Report(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-06) Mhaske, Dr. Sneha; Shinde, Dr. Abhijit; Shinde, Dr. Sonal; Kothari Dr. Ramesh; Misal, Dr. Ganesh; Kumar, Dr. Sushruta; Mhaske, Prof. Dr. Sunil NathaThalassemia occurs due to defects in normal hemoglobin production. Globally it is most common inherited anaemia. Diabetes is a complication of b-thalassemia major. We report a case of Diabetes mellitus in a known case of beta thalassemia major. Patient had undergone splenectomy 1 year back. Patient is taking chelating agent Defasirox 1000mg orally once a day in the morning. Family history reveals, born through third degree consanguineous marriage. The patient was then subjected for laboratory examination reveals BSLwas 490, urine ketone 2+, urine sugar 3+, ABG was normal, HbA1c was 13 & 3 month old report of serum ferritin 1200 ng/dl. TFTand GH studies normal. Multidisciplinary management was instituted. Blood sugar level got controlled over subcutaneous insulin. Patient may have landed in Diabetic ketoacidosis but was promptly diagnosed & treated. This case is presented for its rarity. Due to increase in life expectancy of patient with thalassemia major, patient will expose more years of hyperglycemia and diabetes. Sustaining metabolic control and controlling cardiovascular risk factors helps to prevent future complications.Item Caesarian Vs Vaginal Delivery: From A Human Microbiota Perspective(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2022-09) Shinde, Dr. Mahesh; Shinde, Dr. Abhijit; Mhaske, Prof. Dr. Sunil NathaThe route of the birth delivery influences new born's health. Children born via Cesarean section are at increased risk of developing asthma, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel disease, immune deficiencies and leukemia. Part of these diseases is believed to be related to maturation of neonatal immune system. During vaginal delivery, the contact with the maternal vaginal and intestinal flora is an important source for the start of the infant's colonisation. During Caesarean delivery, this direct contact is absent, and non-maternally derived environmental bacteria plays an important role for infant's gastro-intestinal colonisation. The primary function of microbial colonisation during the foetal period, intrapartum and after the birth is crucial in maturation and development of new-bornimmune system. This review supports the choice of the route of birth delivery and consequently favours a decrease in unnecessary Cesarean sections. It is crucial to provide this information to pregnant women and/or couples and health workers to make informed and educated decisionsItem Calcifying Aponeurotic Fibroma in the left pectoral region in an adult: A Case report.(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2022-09) Patel, Dr. Dhananjay; Kachewar, Dr. SushilCalcified aponeurotic fibroma is a rare benign fibroblastic tumor. The lesion has property of local invasion and high recurrence. Because of this property, tumor should be accurately diagnosed pre-operatively. We report a case of 29 years old male, with a palpable painful mass on the anterior chest wall near left pectoral region, describes radiographic and MR findings. No skin defect was detected but patient feels discomfort. An excision procedure was done. The excised tissue was sent for biopsy and calcified aponeurotic fibroma was diagnosedItem Challenges in the Diagnosis & Management of Neonatal Sepsis(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-12) Bhate, Dr. Shreya; Tambe, Dr. Pranita; Misal, Dr. GaneshNeonatal sepsis is the main cause of neonatal mortality and a major public health problem, especially in underdeveloped countries. Although recent medical services have improved neonatal care, but still challenges remain in the diagnosis and management of neonatal infections. The diagnosis of neonatal sepsis is complicated by the frequent presence of non-infectious conditions that resemble sepsis, especially in preterm infants, and by the absence of optimal diagnostic tests. Since neonatal sepsis is a high-risk disease, especially in preterm infants, clinicians are compelled to empirically start antibiotics to infants with risk factors with and without signs of suspected sepsis. Unfortunately, both broad-spectrum antibiotics and prolonged treatment with empirical antibiotics are associated with adverse outcomes and increase antimicrobial resistance rates. Given the high incidence and mortality of sepsis in preterm infants and its long-term consequences on growth and development, efforts to reduce the rates of infection in this vulnerable population are one of the most important interventions in neonatal care. In this review, we discuss the most common questions and challenges in the diagnosis and management of neonatal sepsis, with a focus on developing countriesItem Chemical injury to eye- A case report(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-12) Murade, Dr. Sneha; Biradar, Dr. Sonali; Waghmare, Dr. PoojaChemical burns represent blinding ocular injuries and constitute an ocular emergency requiring immediate assessment and initiation of treatment. The majority of patients are of young age groups and exposure will occur anywhere as an accident and in association with criminal assaults too. Alkali injuries occur more frequently. Chemical injuries of the eye produce extensive damage to the conjunctiva, cornea, anterior segment and limbal stem cells resulting in unilateral or bilateral visual impairment. This article reviews the emergency management to improve the prognosis of patients with chemical injuriesItem Clinical Profile of Polycystic Ovarian Syndrome Patients In Tertiary Care Hospital(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-09) Gavali, Dr. Urmila; Pawar, Dr. Mayuri; Aher, Dr. Gautam; Shinde, Dr. SuhasBackground: Polycystic ovarian syndrome (PCOS) is common gynecological endocrinopathy characterized by chronic anovulation and hyperandrogenism affecting 5-10% of women worldwide. It is a heterogenous, multifactorial, complex genetic disorder with uncertain etiology and is one of the most common treatable cause of infertility. Aim:To study the various clinical presentations in polycystic ovarian syndrome. Methodology: Present study is cross sectional observational study carried out in tertiary care center. This study was performed in the Out Patient Department of Obstetrics and Gynecology. Results: The mean age of 41 patients in the study was 23.6 years. Most common presenting symptom in patients is menstrual irregularities (89%) followed by infertility and hirsutism. USG (abdomen & pelvis) showing polycystic ovarian syndrome ovaries. Around 39% patients with PCOS developed insulin resistance. Conclusion:PCOS is more prevalent disorder among women of reproductive age with lifelong complications. Most challenging aspects of this syndrome is its ambiguous diagnostic criteria and wide complexity of characteristicsItem Clinical Study of Risk Factors for Diabetic Maculopathy(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Bangal, Dr. Surekha V; Patil, Dr. Bhushan; Sharma, Dr. AkshitaAim:To determine the association between various systemic risk factors with diabetic maculopathy. Methodology:A prospective observational study was conducted on 50 patients having diabetic maculopathy. Patients with maculopathies secondary to Vitreous Haemorrhage, Ocular disorders like Glaucoma, Uveitis, Advanced Diabetic Eye Disease, Vitreo-macular traction, maculopathy along with proliferative diabetic retinopathy, ischemic maculopathy, and history of laser treatment in last six months were excluded from the study. Data was collected using a structured proforma that included name, age, sex, occupation, height, weight, history of other systemic diseases like hypertension, investigations and treatment taken in past, family history, duration of DM, smoking, hyperlipidemia, hyperglycemia and nephropathy. Results:Out of 50 patients, 38 (76%) were males and 12 (24%) were females suggestive of male predominance. Mean age of the patient was 57.36±11.65 years in males and 56.67±10.17 years in females. Among 50 patients, 19 patients had diabetes mellitus for 6-10 years duration, 14 patients had diabetes mellitus for 1-5 years, in 12 patients for 11-15 years, in 2 patients for 16-20 years, in 2 patients for 21-25 years and only 1 patient more than 25 years. Mean duration of DM was 12.2±6.1 years. Majority of patients having maculopathy had duration of DM up to 20 years. Among 50 patients, 27 patients (54%) had systemic hypertension, 37 patients (74%) had uncontrolled blood sugar level, 29 patients (58%) were found to have hyperlipidemia and 20 patients (40%) had nephropathy. Among 50 patients, pseudophakia was noted in 7 patients (14%), obesity was noted in 21patients (42%). Eleven patients (22%) were found to have anemia, 6 patients (12%) had family history of DM and 13 patients (26%) had history of smoking. Conclusion: Hyperglycemia, hypertension, duration of DM, hyperlipidemia are the major risk factors for the development and progression of diabetic maculopathy. While anemia, smoking, obesity and family history of DM is the less signi?cant risk factorsItem Cloverleaf Skull Syndrome: A Rare Case Report(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2022-03) Reddy, Dr. NaveenCloverleaf deformity is an extremely rare skull deformity that happens when mutiple joints (sutures) between a baby's skull bones begin to fuse too premature. Also known as Kleeblattschädel syndrome, the cloverleaf deformity causes bossing at the front and sides of the skull, resembling a cloverleaf shape. Cloverleaf skull syndrome is an abnormal configuration of the calvaria classified as Craniosynostosis, consisting of premature ossification of cranial bones. It is a deformity characterized by a remarkable enlargement of the head, with a trilobed configuration of the frontal view, resembling a three leaved clover .The first report about such a syndrome in the literature occurred in 1973 and, over the years only some tens of cases have been documented worldwide. The present report describes a case of a severe craniofacial condition that is known as "cloverleaf skull syndrome". On Physical examination multiple malformations were observed, with altered craniofacial configuration, low set ear, hypertelorism, exopthalmos, syndactyly, closed anterior fontanelle, high arched palate, bilateral CTEV. The vast majority of patients with kleeblattschädel have mentalretardation and hydrocephalus. It is usually seen in thanatophoric dysplasia: classically type II only, severe Apert syndrome, severe Crouzon syndrome, Boston-type craniosynostosis & Carpenter syndrome. Craniosynostosis has an overall incidence of 1 in 2100 to 1 in 2500 live births with multi-suture craniosynostosis constituting about 5% of all the casesItem Comparative outcome study between simple closure and flap technique in Pilonidal sinus disease(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2022-03) Magar, Dr. Ram; Magar, Dr. RupaliIntroduction:Pilonidal sinus disease (PSD) is a disease of natal cleft in sacrococcygeal region. The main goal of treatment is low recurrence rate, short hospital stays, early return to work and decrease post-operative work. Present study was undertaken to compare and find clinical outcome between simple closure and flap techniques. Methodology:30 patients of Pilonidal sinus disease (PSD) which were fit to undergo surgery were included. 15 patients undergone simple closure and 15 undergone flap technique (Limberg). Result: Wound Infection, Post-operative discharge and Recurrence rate was found higher in group I patients (20 %, 23.33 %, 30 % and 26.66 % respectively) compared to Group II cases. Difference is statistically significant (p Value 0.03, 0.04, 0.008 and 0.02 respectively). Discussion:Recurrence of the sinus probably depend mainly on the ability of the procedure to obliterate the depth of natal cleft. In the present study we found flap procedures superior in combating the disease recurrence than excision with simple closure. Conclusion: It is recommended that Limberg flap method should be used in the treatment of pilonidal sinus disease over other modalitiesItem A Comparative Study of Single Dose and Multiple Dose Antibiotic Prophylaxis In Caesarean Section(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-09) Agarwal, Dr. Poorvi; Nimbannavar, Dr. Harshal; Khose, Dr. Prajakta; Subramanian, Dr. Supraja; Bal, Dr. HimadriBackground: Rampant antibiotic use brought about its own set of problems like the rise in incidence of antibiotic resistant strains, allergies and other complications of antibiotic use. Unfortunately, in many of our set ups we are still stuck in prolonged post-operative antibiotic regimes. This study aims to fill those lacunae and thereby aid our gradual shift away from over reliance on prolonged antibiotic usage in prevention of surgical site infection (SSI). Hence, we decided to investigate the efficacy of the use of a single prophylactic intravenous dose of antibiotic vis a vis multiple doses in reducing post-operative infective morbidity in caesarean sections. Methodology:The study included 200 patients at term, satisfying the inclusion and exclusion criteria, reporting to the labour room and undergoing caesarean section. The patients were then divided into two groups of 100 each by simple randomization. Patients in Group Awere given a single dose IVantibiotics 30 minutes before the skin incision and Group B cases were given the first dose of IVantibiotics 30 minutes before the skin incision and continued for next 2 days, after that patient received oral antibiotics for next 3 days. Results: The present study did not show any significant difference in the post-operative infection incidence between the single dose and multiple dose schedule. Conclusion: Our study noted, there was no difference in the outcome as regards post-operative infectious morbidity in patients of both the groups. Hence, based on the findings of our study we conclude that single dose prophylactic antibiotic should be the norm for caesarean sections.Item A Comparative Study To Evaluate The Outcome Of Sutures Versus Fibrin Glue In Conjunctival Autograft Technique For Primary Pterygium Excision(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Biradar, Dr. Sonali; Tammewar, Dr. Ajay; Naik, Dr. RoopaBackground:Pterygium is degenerative condition of the subconjunctival tissue which proliferates as vascularized granulation tissue and is characterized by formation of a triangular fold of conjunctiva encroaching on the cornea leading to visual impairment, restriction of ocular motility, chronic in?ammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem. Now, Fibrin glue is being tried since few years to secure grafts in place of the sutures. The objective of this study was to compare duration of surgery, immediate postoperative complications which includes an in?ammation, subconjunctival haemorrhage, patient comfort, graft stability between the uses of ?brin glue versus sutures. Methods:A total of 40 patients having primary pterygium were included in the study. 20 patients were underwent pterygium excision surgery and conjunctival autografting using absorbable vicryl 8-0 suture and 20 patients underwent pterygium excision surgery and conjunctival autografting using ?brin glue. These 2 groups were compared in terms of duration of the surgery, in?ammation, degree of postoperative discomfort, subconjunctival haemorrhage and graft stability at postoperative day 1. Results:The mean surgery time in ?brin glue group was 15 minutes and mean surgery time in suture group was 28 minutes (p=0.000). Fibrin glue group had signi?cantly lesser in?ammation (p=0.001) as well as postoperative discomfort (p=0.000) compared to suture group at postoperative day 1. There was no signi?cant difference found in the degree of subconjunctival haemorrhage between the ?brin glue versus sutures groups (p=0.887 and p=0.797 at day 1). The grafts secured with ?brin glue were as stable as those secured with the sutures (p=0.745, 0.644 at day 1). Conclusion:The ?brin glue group in conjunctival autografting had signi?cantly less surgery time, which also produces signi?cantly less postoperative discomfort as well as in?ammation with grafts being as stable as those secured with sutures. Fibrin glue can be used regularly if patients can be pooled together and operated on, by making it cost effective procedureItem Correlation between D-dimer and HRCT in Covid-19(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2022-09) Patel, Dr. Dhananjay; Kachewar, Dr. SushilBackground: To retrospectively determine the correlation between CTseverity score & D-dimer. Methodology: This is retrospective original research of 227 patients (IPD & OPD) during April 1 to May 31, 2021 for Covid-19. Patients CTseverity scores, HRCTThorax findings, D-dimer, Platelet count and Demographic variables were recorded. The correlation between CTseverity score & D-dimer were determined. Results:Between the mentioned dates, 227 patients are taken into study which includes 146 Males & 81 Females. Mean of CTseverity score was 6.7, D-dimer was 0.46mg/l. Higher CTscore is seen in males (mean -7.1) as compare to females (mean -6.12). D-dimer are seen higher in males (mean =0.52mg/l) as compare to females (median=0.37mg/l). The study of 227 patients has shown positive correlation between CTscore & D-dimer (r=0.38, p<0.05). Males showed relatively stronger positive correlation (r=0.4, p<0 .05) than females (r=0.3, p<0.05). Patients with age less than equal to 45 has shown relatively stronger positive correlation between CTscore & D-dimer (r=0.4, p<0.05) than patients with age more than 45 (r=0.35, p<0.05). Conclusion:Pulmonary lesion induced by SARS-CoV-2 infection was associated with raised inflammatory response, impairment in exchange of gases, and end organ damage. In study, we can conclude that lung lesion may exert important role in COVID-19 pathogenesis & clinical presentation
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