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Original article
Prafulla Govind Herode, Abhijeet Shroff, Vinod Nair, Krishan Yadav*, Jeegar Mohan Patel
Department of Orthopaedics, Dr. D.Y. Patil Medical College, Pimpri, Pune, Maharashtra
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*Dr. Krishan Yadav, Department of Orthopaedics, Dr. D.Y. Patil Medical College, Pimpri, Pune, Maharashtra, India
ABSTRACT
Background Surgical site infections are one of the most common nosocomial infections globally resulting in high morbidity and mortality.
Aim To determine the incidence and causing factors of surgical site infections at a tertiary care centre.
Materials and Methods This is a prospective study, which was conducted in the Department of Orthopaedics, Dr. D.Y. Patil Medical College, Pimpri, Pune, Maharashtra from October 2014 to October 2015. A total of 100 patients who underwent elective orthopaedic surgeries were included in this study. The aim of the study was to study the incidence of post-operative wound infections and its effect on orthopaedic surgeries by evaluating the effectiveness of usage of pre-operative and post-operative intravenous antibiotics, the role of sterile measures such as gowns, scrub, masks, sterile gloves, drapes and operation theatre environments, in reducing the surgical site infection and in assessing the efficacy of surgical asepsis (that is surgeons hand scrub, antibiotics used prior to surgery, shaving prior to surgery and use of antibiotics prior to surgery) in orthopaedic surgeries.
Results Out of 100 patients in this study, the overall incidence of infection was 4%. Sex incidence, marginal though, but statistically significantly higher in female sex. Significant
correlation was noted between antibiotic administration and timing of surgery. Correlation between duration of surgery and incidence of infection in major surgeries was found to be statistically significant with p value 0.028.
Conclusion This study did not show any statistically significant correlation between age, scrub time, spirit used with respect to incidence of infection. The incidence of infection by gram –ve bacteria was higher than that of gram +ve bacteria. Pathogens isolated are often resistant to commonly used antimicrobials.
KEYWORDS Wound infections, antibiotics, orthopedic surgeries.
References:
1.Howe CW, Marston AT. A study on sources of postoperative staphylococcal infection. Surg Gynecol Obstet.1962;115:266–75.
2. Burke JF. The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surgery. 1961:50:161–8.
3. Marston RA, Cobb AG, Bantley G. Stanmore compared with Charnley total hip replacement. A prospective study of 413 arthroplasties. J Bone Joint Surg Br. 1996;78:178–84.
4. Williams DN, Gustilo RB. The use of preventive antibiotic in orthopaedic surgery. Clin Orthop Relat Res. 1984;190:83–8.
5. Weick JA, Jackson JK, O-Brien TJ, Lurate RB, Russell JM, Dorchak JD. Efficacy of prophylactic antibiotic in arthroscopic surgery. Orthopaedic. 1997;20:133–4.
6. Woods RK, Dellinger EP. Current guidelines for antibiotic prophylaxis of surgical wounds. Am Fam Physician. 1998 Jun;57(11):2731–40.
Original Research
Luai Farhan Zghair*
Lecturer in Department of Surgery, College of Medicine, AL-Iraqia University, Baghdad, Iraq
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*Dr. Luai Farhan Zghair, MBChB, DGS,
FICMS, CABS, Lecturer in Department of Surgery, College of Medicine, AL-Iraqia University, Baghdad, Iraq
Article citation: Zghair LF. Cervical lymphadenopathy and its management: an interventional study. J Pharm Biomed Sci 2016;06(01):67–70. Available at www.jpbms.info
ABSTRACT
Background Cervical lymphadenopathy refers to lymphadenopathy of the cervical lymph nodes (the glands in the neck), the term lymphadenopathy strictly speaking refers to disease of the lymph nodes.
Objectives To diagnose the causes of the cervical lymphadenopathy and the management of this problem.
Methods This is an interventional study on 40 patients with cervical lymphadenopathy from January 2015 to December 2015.
Results Forty patients were studied, 30 female (75%) and 10 male (25%), and female to male ratio 3:1. The age ranged from 1 to 70 years, with a mean age of 20 years
+5 years. The majority being in the 1st decade of life constituting 10 patients (25%). Also our study showed that the causes of the cervical lymphadenopathy are reactive adenitis 12 patients (30%) followed by acute bacterial suppurative adenitis 10 patients (25%), Hodgkin lymphoma 4 patients (10%), non-Hodgkin lymphoma 3 patients (7.5%),
chronic non-specific adenitis 3 patients (7.5%), secondary metastases 2 patients (5%), tuberculosis adenitis 2 patients (5%), chronic lymphocytic leukemia 1 patient (2.5%), infectious mononucleosis 1 patient (2.5%), typhoid fever 1 patient (2.5%) and Castleman disease 1 patient (2.5%).
Conclusion Our study showed that the causes of the cervical lymphadenopathy are reactive adenitis, followed by acute bacterial suppurative adenitis, Hodgkin lymphoma,
non-Hodgkin lymphoma, chronic non-specific adenitis, secondary metastases, tuberculosis adenitis, chronic lymphocytic leukemia, infectious mononucleosis, typhoid fever and Castelman disease. In our study we considered the incisional or excisional biopsy with or without Fine-needle aspiration cytology before it, and it is the best diagnostic methods to diagnose the pathology of the lymphadenopathy, and all patients are treated according to his or her condition and there was no death rate during our study.
KEYWORDS cervical lymphadenopathy, neck, lymph gland.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Source of funding: None.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
Original article
Selvaraj Subashree1*, Saravanan Revathy2, Mukherjee Dipali3
1 Postgraduate, Department of Pharmacology, Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur, Puducherry, India
2,3Professor, Department of Pharmacology,Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur,Puducherry, India
The name of the department(s) and institution(s) to which the work should be attributed:
Department of Pharmacology, Sri Venkateshwaraa Medical College Hospital and Research Centre
Address reprint requests to
*Selvaraj Subashree, No. 9. Periyanayagi Amman Koil Street, Thiruppapuliyur, Cuddalore 607 002, Tamil Nadu, India
Article citation: Subashree S, Revathy S, Dipali M. Knowledge and compliance status among diabetes mellitus patients in a tertiary care teaching hospital. J Pharm Biomed Sci 2016;06(01):51–59.Available at www.jpbms.info
ABSTRACT
Introduction Diabetes mellitus a major and common metabolic disorder with serious health and economic adverse consequences. Apart from other known factors, non-adherence to medical advice and treatment are also important preventable factors that results in complications of diabetes. Hence the analysis of knowledge and adherence status to medical and other lifestyle changes, and their impact on controlling diabetes are needed.
Aim and Objectives To assess the knowledge and adherence status among Type 2 diabetic patients on treatment.
Methodology A pre-tested questionnaire having 24 questions in Tamil, to collect informations like demographic status, knowledge and adherence of the participants were used in 100 adult diabetic patients from both sex on treatment for the past 1 year after obtaining their informed consent by direct interview and were recorded. The data were analyzed with descriptive statistics using SPSS version 21. The interrelationship among knowledge, adherence and diabetic control were analyzed by chi-square test with significant
p < 0.05.
Results and Discussion Out of 58 (58.0%) male and 42 (42.0%) female participants, low knowledge score of less than 30% was seen in 25 (43.1%) males and 22 (52.4%) females, 53 (53.0%) participants had a moderate score of 31–60% [33 (56.9 %) male and 20 (47.6%) female]. High score of >60% was not observed. A poor adherent score of 18–26 was obtained by 19 patients [8 (13.8%) males and 11 (26.2%) females] and very poor adherent score of <18 was seen in 81 patients [50 (86.2%) males and 31 (73.8%) females]. Knowledge showed a statistically significant influence on adherence (p < 0.001). which was still poor and resulting in poor therapeutic outcome as evidenced by uncontrolled HbA1c level (p < 0.482).
Conclusion Our study has shown a weak relationship between knowledge and adherence resulting in the failure of long-term glycaemic control. Hence along with improving
knowledge by educational aids like media, SMS, handouts and educative programmes with removal of impending factors for adherence are suggested for achieving good glycaemic control and avoiding the complications where healthcare providers have an important role.
KEYWORDS diabetes mellitus, knowledge, adherence, glycaemic control
Statement of originality of work: The manuscript has been read and approved by all the authors,the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of funding: Self.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the
official policy or position of the Department of Defense.
Acknowledgement: The authors are grateful to Dr. Hussain, Professor, Department of Diabetology,for his support and help during the study. We express cordial thanks to all participants for their kind cooperation. We would like to place our acknowledgement to the faculties of the Department of Pharmacology and the management of Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, for their voluntary participation and co-operation.
Research article
Rakesh Kumar Shahi1*,P. Nigam2
1 Professor of Medicine, B.R.D Medical College, Gorakhpur, UP, India
2 Ret. Professor and Head, Department of Medicine, B.R.D Medical College,Gorakhpur, UP, India
Address reprint requests to
*Dr Rakesh Kumar Shahi,
I-83 Rapti Nagar, Phase-IV Near BPCl, Gorakhpur, Uttar Pradesh 273001, India
Institution to which the research is associated with:
B.R.D Medical College, Gorakhpur
Article citation: Shahi RK, Nigam P. Analysis of prescribing patterns of antihypertensive and antidiabetic medications in patients. J Pharm Biomed Sci 2016;06(01):23–26.Available at www.jpbms.info
ABSTRACT
Background Prescription of irrational drug is now a day’s a common practice globally; it can result in increase on morbidity, mortality and economic burden on society. Aims and Objective To study on drug prescribing pattern of antihypertensive and antidiabetic medications. Materials and Methods A retrospective study on 150 diabetic patients attending OPD/ emergency/Indoor department of B.R.D Medical College and Nehru Chikitsalya Gorakhpur was done from May 2009 to October 2010. Results Most common antihypertensive and antidiabetic drug prescribed was calcium channel blockers in 71 (54%) and sulphonylurea in 108 (72%) patients.
KEYWORDS drug utilization, rational prescribing, fixed dose combinations, therapeutic audit, hypertensive patients
REFERENCES
1.Cheung BM.The hypertension-diabetes continuum. J Cardiovasc Pharmacol. 2010;55:333.
2.Landsberg L, Molitch M. Diabetes and hypertension: pathogenesis, prevention and treatment. Clin Exp Hypertens. 2004;26:621–8.
3.Gress TW, Nieto FJ, Shahar E. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med. 2000;342:905–12.
4.Cheung BM, Wat NM, Tso AW, et al. Association between raised blood pressure and dysglycemia in Hong Kong Chinese. Diabetes Care. 2008;31:1889–91.
5.Yuen YH, Chang S, Chong CK, Lee SC, Critchlev JA, Chan JC. Drug utilization in a hospital general medical outpatient clinic with particular reference to antihypertensive and antidiabetic drugs. J Clin Pharm Ther. 1998;23:287–94.
6.Guerci B, Drouin P. Self-monitoring of blood glucose significantly improves metabolic control in patients with type 2 diabetes mellitus: the Auto-Surveillance Intervention Active (ASIA) study. Diabetes Metab. 2003;29:587–94.
7.Mastura I, Chew BH, Lee PY, Cheong AT, Sazlina SG, Jamaiyah H, et al. Control and Treatment Profiles of 70,889 Adult Type 2 Diabetes Mellitus Patients in Malaysia–A Cross Sectional Survey in 2009. International Journal of Collaborative Research on Internal Medicine & Public Health. 2011;3:98–113.
8. Vengurlekar S, Shukla P, Patidar P, Bafna R, Jain S. Prescribing pattern of antidiabetic drugs in Indore city hospital. Indian J Pharm Sci. 2008;70:637–40.
9.Elliott WJ, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network metaanalysis. Lancet. 2007;369:201–7.
10.Tiwari H, Kumar A, Kulkarni SK. Prescription monitoring of antihypertensive drug utilization at the Panjab University Health Centre in India. Singapore Med J. 2004;45:117–20.
11.Pai PG, Shenoy J, Sanji N. Prescribing Patterns of antihypertensives drugs in a south Indian tertiary care hospital. Drug Invention Today. 2011;3:38–40.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
Case Report
Bulegenova Minira G1*,Khairov Konstantin E2,Abdullaeva Gulgahan T3,Makhneva Anna F4
1 Professor, Head of Laboratory Department,Scientific Center of Pediatrics and Children Surgery, Al Farabi av, Kazakhstan
2 Executive Director, Surgery of Scientific Center of Pediatrics and Children’s Surgery, Al Farabi av, Kazakhstan
3 Head, Intensive Care Unit, Surgery of Scientific Center of Pediatrics and Children’s Surgery, Al Farabi av, Kazakhstan
4 Researcher, Laboratory of Pathomorphology, Surgery of Scientific Center of Pediatrics and Children’s Surgery, Al Farabi av, Kazakhstan
The name of the department(s) and institution(s) to which the work should be attributed:
Laboratory Department and Intensive Care Unit, Scientific Center of Pediatrics and Children Surgery
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*Minira Bulegenova,
Professor and Head of Laboratory Department, Scientific Center of Pediatrics and Children
Surgery, Al Farabi av., Kazakhstan
ABSTRACT
Blastopathy is a pathology that occurs during the blastula period, within the first 15 days from the moment of fertilization until embryo- and trophoblast ejection. Etiology of blastopathy is often unclear. This malformation is a variant of conjoined twins and occurs with a frequency of 1: 500,000 deliveries. Our article presents the clinical case of “Foetus in Fetu” in the practice of the Scientific Center of Pediatrics and Children Surgery, Almaty, Republic of Kazakhstan.
Newborn A was delivered from the perinatal centre on the 10th day of life. Prenatally, the ultrasound investigation of the foetus at the gestational age of 27–28 weeks diagnosed “pseudoomphalocele, ascites”. Mother was counseled by the geneticist on the recommended abortion, but she refused. At the age of 9 days the child was transferred to the Scientific Center of Pediatrics and Pediatric Surgery, where he was diagnosed as:congenital malformations, blastogenesis violation, asymmetric parasitic omphalopagus, foetus in fetu, congenital heart disease, interatrial septum defect (complete), globular heart, right-sided pneumonia, respiratory failure 1st stage, ischemic encephalopathy 2nd stage, prematurity 35–36 weeks and morphofunctional immaturity. The visible part of the parasitic foetus is presented with torso, pelvis, two lower limbs, vestigial appendage – the only “arthrogrypose” upper limb. On the basis of the clinical data, it was suggested that the parasitic foetus and the main foetus have a single blood circulatory system. A certain interest, in our opinion, was the study of changes in the homeostasis parameters of this patient, as the vital organs were single to both organisms.
KEYWORDS foetus in fetu, pseudoomphalocele, congenital malformations, internal homeostasis
REFERENCES
1. Ben-David U, Benvenisty N. The tumorigenicity of human embryonic and induced pluripotent stem cells. Nat Rev Cancer. 2011;11(4):268–77.
2. Anup Mohta, Nita Khurana. Fetus-in-fetu or well-differentiatedteratoma-a continued controversy. Indian J Surg. 2011;73(5):372–4.
3. Chi JG, Lee YS, Park YS, Chang KY. Fetus-in-fetu: report of a case. Am J Clin Pathol. 1984;82(1):115–9.
4. Kuno N, Kadomatsu K, Nakamura M, Miwa-Fukuchi T,Hirabayashi N, Ishizuka T. Mature ovarian cystic teratoma with a highly differentiated homunculus: a case report. Birth Defects Res A Clin Mol Teratol. 2004;70(1):40–6.
5. Arlikar JD, Mane SB, Dhende NP, Sanghavi Y, Valand AG, Butale PR. Fetus in fetu: two case reports and review of literature. Pediatr Surg Int. 2009;25(3): 289–92.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Source of funding: None.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents,and royalties through this collaborative research.All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the
official policy or position of the Department of Defense.