Background: Postoperative infectious complications which results in prolong hospital stay carries a significant risk to patients and burdanise health care system as well. Many risk factors are known to increase the incidence of post operative infectious complications and length of hospital stay. The aim of present study is to determine the association of time duration of surgeries with post operative infectious complications and length of hospital stay. Methodology: This prospective observational study was conducted on 462 patients who underwent various major surgical procedures in the Department of General Surgery in PIMS Hospital, Islamabad from January 2020 to December 2021. Patients <16 years and admitted for trauma were excluded. The time duration of various surgeries from incision to closure was recorded. Post operative complications sepsis, pneumonia, wound infection, urinary tract infection and length of hospital stay was recorded as well. Data was analyzed by spss version 22 .Any Correlation between time duration of surgeries with post operative complications and length of hospital stay determined. Results: Of the total 462 patients who underwent various surgical procedures, the post operative infectious complication rate increased linearly with operation duration at 2.5% per ½ hours ranging from 2.5% to 30.6% in 1 hour to 6 hours respectively. Infectious complications such as UTI, wound infection, pneumonia, and sepsis showed positive correlation with time duration of surgeries. The post operative infectious complications increased after one hour of surgery compared to half hour. Conclusion: As the time duration of surgeries increase the chances of post operative infectious complications also increase, hence increasing the length of hospital stay as well. Keywords: Post operative infectious complications, Hospital stay, Duration of surgeries.
Background: There is a risk of different complication after the surgery but delaying in wound healing or infection is one of most common risk. Oxidative killing is a process of tissues partial pressure of oxygen throughout the observed values ranges. The main defense against foreign particles in result of surgery is oxidative killing through neutrophils. In a study by Greif et al4 indicated oxygen 80% during the surgery and after 2 hours later of surgery 50% risk get lesser as compared to the patient who had administrated with 30% oxygen.4 Another study proved that chances of risk for infection get increase in patients who were administrated oxygen 11 % as compared to the patients with 25% oxygen administration.5 The current study was conducted to test the hypothesis that supplemental oxygen decreases the risk of post-operative wound infection. Objective: The objective of the study was to determine the effects of supplemental oxygen on risk of surgical wound infection. Materials and Methodology: A randomized Clinical Trial- double- blinded was conducted at DHQ hospital, Karachi from March 1, 2011 to October, 31, 2016. A total of 300 subjects with age around 18 to 80 years who underwent elective colorectal surgery and satisfying the inclusion and exclusion criteria were recruited in the study. Non-probability Purposive sampling technique was used to collect the data. Double-blinded technique was used. Blinded investigators diagnosed the wounds infection by following the criteria of centers of disease control and prevention. Patients were randomly allocated in two groups by sealed-envelope method. Baseline assessment was performed on each patient which included patient’s medical history, physical examination and Lab tests i.e. complete blood picture and biochemical analysis. Characteristics for patient’s baseline and aesthetic treatment were confound factors. 3rd generation antibiotics cephalosporin were administrated 1 to 2 hours before of surgery. Patients of Group 1 received oxygen fraction of inspired oxygen FIO2 of 30 and group 2 of 80 percent. Randomly chosen concentration flow of oxygen 16l/min was given. Patient was breathing ambient air. Supplemental oxygen was given to maintain the patient’s oxygen saturation to 92% that is measured by pulse oximetry. Patient’s treatment was slandered with antibiotics and anesthesia administration. For wound evaluation, tools used were National nosocomial infection surveillance scale 6 and Efficacy of infection control,7 Wounds were checked for infection on daily basis by surgeons who were blinded. And wound thought to be infected when they full fill the criteria of Centers for Disease control and prevention standard. Main outcome measure was surgical site for infection and secondary outcomes were recovery of bowl function, duration of hospital stay, ambulation and ability to absorb the solid food. Statistical Analysis: Analysis was done on SPSS by applying parametric and non-parametric test according to normality. Results: Results showed no significant difference in %age Surgical infection site, Daily ASEPSIS value ≥20 at any time (p-value<0.06), Admission in ICU (p-value= 0.74), Bowel function recovery (p-value=0.74), Solid food intake (p-value=0.54), Walking (p-value=0.57), Removal of Staples( 0.72), Duration of post-surgery hospitalization(p-value=0.09) of both the groups as p-value >0.05 of all variables. Practical implication: If we provide pre-operative supplemental oxygen it will be helpful to decrease SSI. Conclusion: Patients who received supplemental oxygen showed significantly decrease in the risk of wound infection. Hence, Pre-operative supplemental oxygen proved to be an effective intervention to decrease SSI in the patients having rectal or colon surgery. Keywords: ASEPSIS, Surgical Wound, Infection, Supplemental Oxygen
One of the most common surgical condition is hemorrhoids and estimated that one-fourth of all adults are affected. Four-grade hemorrhoids are resistant to non-surgical treatment and typically needed surgical intervention. Aim: The current study's goal was to evaluate the effectiveness of closed hemorrhoidectomy for the treatment of third-degree haemorrhoids. Methods: Following approval from the hospital's ethical and research committee, this case series study was held in the surgical department of Lady Reading Hospital, Peshawar from July 2021 to July 2022. The study included 100 patients in total with third-degree haemorrhoids of both genders. Patients were subjected to a proctoscopic examination following a digital rectal examination for diagnosis and closed hemorrhoidectomy was performed in appropriate patients. To assess the effectiveness of the procedure, these patients were followed up with one week after surgery for post-operative pain. The 10-point Visual Analogue Score (VAS), with 0 exhibiting no pain and 10 the most intense agony, was used to measure post-operative pain. The gender, age and post-operative pain parameters were documented in a proforma. SPSS version 22.0 was used for data entry and analysis. Results: The study included 100 individuals who underwent closed hemorrhoidectomy. The patients' ages ranged from 20 to 65 years, with 42.58 years of mean age and 12.18 of S.D. 82 patients (82%) done with successful closed hemorrhoidectomy and exhibit good outcome in terms of postoperative pain. Conclusion: In patients with third-degree haemorrhoids, closed hemorrhoidectomy was helpful in terms of postoperative pain. Keywords: Hemorrhoids, Hemorrhoidectomy, Efficacy
The aim of the current study was to identify the hidden stances and discursive ideologies of Pakistani and Indian English newspapers’ editorials on the special status of Kashmir through abolition of Article 370 and 35A. For the current study the Van Dijk Ideological Square Model (2005) as theoretical framework was chosen for positive self-presentation and negative other-presentation for the examining of discourse. The study analyzed linguistics traits in thirty newspapers’ editorials from six newspapers. Three English newspapers were selected from Pakistan and three from Indians. The data analysis revealed that different micro strategies such as hyperbole, authority, lexicalization, illustration, comparison, euphemism, etc. were used in these editorials. Besides these micro strategies, also the macro strategies like negative other-presentation positive self-presentation were also used. The study further revealed that how the polarity and racial agenda were projected by the use of language by two countries in their editorials. The micro strategies in Pakistani editorials were used more than that in the Indian editorials, while the macro strategies used in the Indian editorials were more than in the Pakistani editorials. The positive self-presentation was mostly used in Pakistani editorials whereas India editorial mostly focused on negative other- presentation.
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