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: Large liver abscess requires drainage by pigtail catheter. These catheters tend to get blocked frequently and thus takes long period of time to completely drain. So we wanted to study whether inserting a large bore catheter would drain the abscess faster thus decreasing the stay and requirement of antibiotics. Aim: To study the effectiveness of wide bore PVC catheter (20 Fr) in drainage of large peripheral liver abscess as compared to the use of pigtail catheter (10 Fr). Methods: The study was prospective comparative study done at a tertiary care hospital. Over a period of 22 months, 60 patients of amoebic liver abscess were assigned to undergo pigtail catheter drainage by 10 Fr. Versus wide bore 20 Fr PVC catheter drain and the outcomes were compared. Results: Use of wide bore (20 Fr) PVC catheter significantly decreased the duration of treatment, led to faster drainage of abscess and decreased incidence of recurrence in large amoebic liver abscess, as compared to pigtail catheter drainage by the standard 10 Fr pigtail catheter. Conclusion: 20 Fr PVC catheter is safe and efficacious for evacuating large solitary peripheral liver abscesses and should be preferred to narrow bore pigtail catheter.
Background: Patients with dyspeptic symptoms are subjected to ultra-sonography by many practitioners and post for Cholecystectomy, if there is a finding of cholelithiasis. Many of these patients continue to have post operatively similar pain which they experienced before the cholecystectomy surgery. This made us think of doing upper gastrointestinal endoscopy to find any upper gastrointestinal disease in oesophagus, stomach or duodenum. So that if we get any positive endoscopic finding we can treat those conditions before posting the patients for cholecystectomy. Aim of the study was to study outcome of upper gastrointestinal endoscopy in patient with dyspeptic symptoms having gall stones, to evaluate whether there is any other cause of dyspepsia apart from cholelithiasis.Methods: This study was conducted at a single teaching hospital in Mumbai over a period of 3 years. Prospectively, 60 patients were studied for upper endoscopy findings associated with dyspepsia in a patient of cholelithiasis.Results: Abnormal findings of upper gastrointestinal findings on endoscopy were seen in 65% of patients.Conclusions: All Patients with dyspepsia should undergo upper gastrointestinal endoscopy before subjecting to any other radiological investigations.
Background:The purpose of this study was to test the effectiveness and safety of Hyperbaric Oxygen HBOT group (HBOT) in improving brain function in Traumatic brain injury patients suffering acute neurocognitive impairments. Aims: To study efficacy & safety of hyperbaric oxygen HBOT group on mortality and morbidity in acute traumatic brain injury with respect to degree of recovery, speed of recovery, length of stay in the hospital. Methods: In this prospective study we present 100 cases of head injuries. Patients were included in the study according to inclusion criteria. Fifty of them assigned to the control group and 50 to the HBO treatment group. Allocation is done by chit method in control and HBOT group. Glasgow coma score was obtained pre HBOT and post HBOT. The outcome was assessed by two blinded independent examiners. Results: All patients were assessed for improvement in GCS score. The average improvement in GCS score was 5.29% and 3.87% in HBOT and control group respectively. Similarly the average hospital stay was 12.26% days in the HBOT and 27% in the control group. Conclusion: Hence we would like to conclude that, HBOT is safe and effective for acute brain injury. Section: Surgerytreatment of severely brain-injured patients with hyperbaric oxygen. Journal of Neurosurgery. 1992; 76(6):929-34. 13. Isakov Iu V, Anan'ev GV, Romasensko MV, Aide Kh B.Hyperbaric oxygenation in the acute period of craniocerebral injuries. Zhurnal nevropatologii i psikhiatrii imeni SS Korsakova. 1982; 82(5):7-12.
Background and Objectives: Most of the patients of Esophageal Malignancy present in advanced stage. These patients receive palliative treatment. We wanted to evaluate whether combination of SEMS and RT improves the grade of dysphagia. Methods: 165 patients diagnosed with Advanced Esophageal Malignancy in middle third of Esophagus with grade III dysphagia were enrolled for the study. Demographic data, grade of dysphagia, improvement in the grade of dysphagia, complications and survival were studied. Follow up was done for a period of 1 year. Results: All patients grade of dysphagia improved from grade III- IV to grade I-II. One patient had stent migration. Thirty patients died in one year Followup. Conclusion: SEMS along with RT may provide survival benefit in advanced Esophageal Malignancy.
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