Introduction: Following cardiac surgery, complications such as cardiac, pulmonary, renal, and neurological diseases, infections like pneumonia or sepsis, and extended stays in the intensive care unit (ICU) and hospital are signs of both the quality of care and the quality of life. Therefore, it's critical to pinpoint the complications that put patients at risk for substantial postoperative morbidity and extended lengths of hospital stay. Aims & Objectives: To study nature and incidence of perioperative complications in patients undergoing cardiac surgery under cardiopulmonary bypass. Material & Methods: This study included 151 patients, of any age, either sex, planned for cardiac surgery under cardiopulmonary bypass (like Valve replacement, valve repairs, CABG, myxoma excision, Congenital Heart Diseases like ASD, VSD, TOF). The data regarding demographic profile and postoperative complications were collected. RESULTS; There were total of 151 patients in our study including 66 males (43.7%) and 85 females (56.3%). Age of the subjects ranged from 1 to 70 years with a mean of 26.39 ± 18.67 years (Median of 25 years). Mean age of males was 26.27 ± 20.72 years and mean age of females was 26.49 ± 17.03 years. About 51 % patients in our study had at least one of the complications. The most common complication was rhythm disorder which was present in 34.4% of all patients. ARDS developed in 1.3% of patients. Infections were present in 27 patients (17.9%). Dyselectrolytemia was present in 11 patients (7.3%). Conclusion: Cardiac surgery under cardiopulmonary bypass is associated with as cardiac, pulmonary, renal, and neurological diseases, infections like pneumonia or sepsis. The most common complication was rhythm disorder which was present in 34.4% of all patients. ARDS developed in 1.3% of patients. Infections were present in 27 patients (17.9%). Dyselectrolytemia was present in 11 patients (7.3%). Keywords: Cardiopulmonary Bypass (CPB), Length of stay (LOS).
Introduction; The majority of researchers currently believe that the haemostatic anomalies in brain tumour resection patients undergoing surgery are caused by hyperfibrinolysis, either primary or subsequent to a condition of disseminated intravascular coagulation. This Study explored the changes in haemostatic profile occurring during surgery for primary brain tumours and effect on Tranexamic acid on coagulogram. Aims & objectives:To study effect of tranexamic acid on coagulation profile in brain tumour resection patients. Materials & methods: Patients of either sex, aged 18-65 years were randomly allocated to either group - the study group and the control group (30 patients in each group) using computer generated random numbers in sealed envelopes. The investigator was present during the procedure for data collection purpose only and was not involved in the conduct of anaesthesia. Blood samples were collected preoperatively, 6hrs postoperatively and 24hrs postoperatively for coagulogram; fibrinogen levels; platelet count; D-dimer levels Results: In our study we found that there were no significant differences in PT, INR, aPTT, D- dimer preoperatively and at 6 and 24 hrs postoperatively. However, fibrinogen levels increased in tranexamic group and significantly decreased in saline group as compared to preoperatively. Conclusion: Tranexamic acid prevented decrease in levels of fibrinogen and even increased levels fibrinogen significantly during the operative and postoperative period in brain tumour resection surgery. Keywords: Coagulation profile, Meningioma
INTRODUCTION: Intraoperative blood loss is considered to be one of the major complications in neurosurgical operations and neurosurgical procedures and is directly related to the postoperative morbidity and mortality. Administration of Tranexamic acid [TXA] by reducing blood loss has resulted in survival benefits in Traumatic Brain Injury [TBI] population, as shown in two recent meta-analysis. AIMS AND OBJECTIVES: To study the effect of tranexamic acid on blood loss in brain tumor resection surgery. MATERIAL AND METHODS: Patients of either sex, aged 18-65 years who were undergoing brain tumour resection were randomly allocated to either group - the study group and the control group (30 patients in each group). Patients in the study group received tranexamic acid intravenously @10 mg/kg body weight over 10 minutes after induction and then maintenance of continuous infusion @ 1mg/kg/hr intraoperatively till skin closure. Patients in the control group received the same volume of saline per kg body weight as the volume of tranexamic acid in study group. RESULTS: The average drop in haemoglobin and HCT was significantly lower in TXA group. Accordingly, amount of blood loss was less in TXA group compared to saline group. (332ml vs 576 ml; p = 0.011). CONCLUSION: From our study, it was concluded that the administration of TXA resulted in a significant reduction in blood loss. TXA can thus be suggested as a cost effective method of reducing mortality due to hemorrhage in brain tumor surgery. Keywords: Tranexamic acid [TXA], Traumatic Brain Injury [TBI].
INTRODUCTION: After open heart surgery (OHS) using cardiopulmonary bypass (CPB), abnormalities in the circulating thyroid hormone levels are found in the absence of primary thyroid disease; this is collectively called the sick euthyroid syndrome (SES). AIMS ANDOBJECTIVES: To study thyroid function test in patients planned for cardiac surgery under cardiopulmonary bypass. MATERIALS AND METHODS: This study included a total of 150 patients, of any age, either sex, planned for cardiac surgery under cardiopulmonary bypass (like Valve replacement, CABG, myxoma excision, congenital Heart Diseases like ASD, VSD, TOF). To assess the levels of thyroid hormone, TSH, TT3 and TT4 were measured. The blood samples were collected at regular intervals: preoperatively, on 2nd postoperative day and on 7th postoperative day. CONCLUSION: In our study the levels of thyroid hormone (TT4 and TT3) decreased significantly after cardiopulmonary bypass. Keywords: Open Heart Surgery (OHS), Cardiopulmonary Bypass (CPB), Sick Euthyroid Syndrome (SES)
INTRODUCTION: Symptoms of hypothyroidism are often subtle and are easily overlooked specially in patients with a heart disease and symptoms are thought to be from the existing cardiac condition. There is a consensus that patients with known hypothyroidism should have thyroid screening before any major surgery including cardiac surgery and if indicated should be made euthyroid before surgery. AIMS AND OBJECTIVES: To study the correlation of thyroid function test status with postoperative course and outcome (total duration of hospital, duration of ICU stay, hours of mechanical ventilation and in hospital mortality). MATERIAL AND METHODS: This prospective study recruited 151 patients who underwent cardiac surgery under cardiopulmonary bypass, TSH was measured and compared with outcome in these patients. RESULTS: Hours of mechanical ventilation (35.20 ± 20.1 Vs 110.61 ± 71.9 hours), ICU stay (3.3 ± 2.30 vs 5.9 ± 5.56 days) and hospital stay (16.7±4.21 days vs 21.1 ± 6.95 days) was significantly less in euthyroid than patients whose TSH was raised before surgery , also postoperative in hospital mortality was more in patients with raised TSH preoperatively. CONCLUSION: We concluded that patients with Subclinical hypothyroidism (SCHT) and Overt Hypothyroidism (OH) planned for cardiac surgery on cardiopulmonary bypass should be treated and those on levothyroxine replacement should have fair control before undergoing surgery. Keywords: Subclinical Hypothyroidism [SCHT], Overt Hypothyroidism [OH], Cardiopulmonary Bypass, Atrial Fibrillation [AF].
Background: This study was conducted to find out the pattern of poisoning cases among the pediatric population in Srinagar and its Northwestern suburbs and compare it with what occurs elsewhere in India. Thereby we aimed to provide practical knowledge in dealing with these pediatric patients. Methods: The hospital records of children between the ages of 0-19 years admitted to the pediatric emergency ward of SKIMS Medical College Hospital Srinagar with poisoning from July 2016 to June 2018 were evaluated. Results: A total of 154 cases of poisoning were admitted in the study period, of which 89(57%) were males and 69(43%) were females. In the 0-12 year age group the poisonings were mostly in boys (68.26%) and were accidental whereas in the 13-19 year age group poisonings were mostly in girls (64%) and due to suicidal attempts. Organophoshorus poisoning was the most commonly ingested poison across all age groups (44.8%) followed by rodenticides (16.23%), kerosene (13.63%) and medications (11.68%). Interventions mostly commonly done were gastric lavage, induced vomiting. Mortaliy was seen in 2 cases over 2 years (1.29%). Conclusion: Knowledge on epidemiological and clinical features of poisoning in children according to age groups, establishing safety standards for sale and storage of harmful chemicals, and parental education can help to decrease the burden of childhood poisoning.
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