Despite increased pre and postoperative care including screening procedures, improvement in the operating room environment, and controlled prophylactic antibiotic therapy, the health burden of Surgical Site Infections (SSIs) in India is far more escalated than that in developed countries. SSIs ranging from superficial skin infection to life threatening septicemia affect one third of the patient population undergoing surgery, thereby contributing to morbidity and mortality. One of the most dominant bacterial species that causes SSIs is Staphylococcus aureus, wherein Methicillin Resistant S.aureus (MRSA) alone contributes to a significant increase in both the cost and the length of hospitalisation along with an increased mortality rate among patients with SSIs. The rising resistance pattern among pathogens coupled with the concerns over the tolerance and safety of currently available agents against MRSA limits treatment options available for patients with SSIs. Levonadifloxacin and its oral prodrug alalevonadifloxacin are novel benzoquinolizine anti‑MRSA agents which have recently been approved in India to tackle gram positive ‘super‑bugs’. Herein, the aim of this review article was to collate the possible factors contributing toward SSIs, its implications on health and economy, antibiotic resistance, possible preventive measures, and the need for new antimicrobial agents.
Background: Surgical drains of various types have been used, with the best intentions, in different surgeries for many years. It is often open question whether they achieve their intended purpose despite many years of surgery. There is paucity of evidence for the benefit of many types of surgical drainage and many surgeons still ‘follow their usual practice’. The dictum ‘when in doubt, drain’ from Lawson Tait, is well known to surgeons’. But many studies we find routine placement of drain has been shown to be ineffective or potentially harmful in various abdominal surgical procedure. We thus performed a systematic review of the studies of outcomes of with or without peritoneal drain in abdominal surgeries.Methods: A comparable study was conducted in between two groups with and without drain in patient belonging to all age undergoing small and large bowel surgeries. A random patient selection was done. Pooled estimates of mortality, morbidity, wound infection, blockage, pain, anastomotic leak, re-intervention and length of hospital stay were calculated.Results: With drain; duration of stay is more than without drain with p value found to be 0.0087. Drain is ineffective due to blockage in 38% patient. Wound infection is more with drain with p (0.003). Pain is more with drain with p (0.0001). There is no difference in anastomotic leak, distension, re-intervention and mortality with or without drain.Conclusions: After a century of scientific investigation and research, all surgeons should recall the words of Halstead ‘no drainage at all is better than ignorant employment of it’ rather than the advice of Lawson Tait ‘when in doubt, drain.
Introduction: In the modern era, it is not only the right of every patient to demand best possible medical care in Government runs Hospitals, but it is the moral and legal obligation of every health care provider as well, to deliver his optimum efforts to the entire satisfaction of the patient. Methods: A pre formed questionnaire and personal interview of 350 patients was carried out to determine the level of satisfaction among patients. Results: Most of the patients were found to be more than satisfied in most of the categories of questions asked. Conclusion: Overall assessment of the whole process through this study gave us an opportunity to find loopholes and deficiencies in our services for any future remedial action. The response given by the patients at the end of the data collected enabled us to make any suggestions so as to improve the quality of the services rendered at the hospital.
Malignant peripheral nerve sheath tumor (MPNST) is a malignant spindle cell tumor of the soft tissue thought to be derived from the components of nerve sheath. MPNSTs are mainly located in the buttocks, thighs, brachial plexus, and paraspinal region. The objective of this article is to describe a case of neurofibromatosis type 1 who developed neurofibrosarcoma of the right lateral thoracic nerve with thoracic meningoceles, a rare coincidental finding which has not yet been reported in the English medical literature, and how both the conditions were managed in the same sitting.
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