Evolving Experience in The Management of  Empyema Thoracis

Shrestha, Kiran; Shah, Sangam; Shrestha, Sundar; Thulung, Suraj; Karki, Binod; Pokhrel, D P

doi:10.3126/kumj.v9i1.6253

Cited by 7 publications

(17 citation statements)

References 14 publications

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“…Thus, early decision of TDC definitely reduces the major perioperative complications as well as morbidity and mortality. [24] Rib crowding occurs early in the course of empyema. Resection of one or two ribs provides a wide window for proper pleural toileting under supervision, easy collection of pleural tissue for biopsy and proper placement of adequately sized chest tube.…”

Section: Discussionmentioning

confidence: 99%

Empyema thoracis in children: A 5-year experience in a Tertiary Care Institute

Mandal

Halder

et al. 2019

J Indian Assoc Pediatr Surg

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Objective: Empyema thoracis (ET) in children is a disease of significant morbidity and mortality. In the event of failure to resolute following intercostal chest tube drainage (ICD), thoracotomy decortication (TDC) remains the treatment of choice. We have reviewed the outcome of management of 96 cases of ET with the intent to establish the scope of ICD as primary form of the management. Materials and Methods: This is a retrospective study of 96 patients of ET who were managed in pediatric surgery department over a period of 5 years (April 2013 – March 2018). Ninety-six patients at a single center met inclusion criteria for having ET and underwent ICD. We excluded the cases where video-assisted thoracoscopic surgery was provided as primary treatment. The patients were categorized into complicated and uncomplicated groups. Those with pyopneumothorax, encysted empyema, multiloculated empyema, and bilateral ET were assigned as complicated group. There were two treatment groups: (I) those responded with ICD alone (II) those with ICD followed by TDC. Results: All 96 cases received ICD as primary management. There were 54 uncomplicated cases and 42 complicated cases. Out of 42 complicated cases, 26 patients recovered with ICD alone and 16 patients needed TDC. A total of 80 (83.33%) patients (54 uncomplicated ± 26 complicated) recovered with ICD alone. Significant complications were encountered in follow-up of patients who underwent delayed thoracotomy in the form of overriding of the ribs ( n = 3) and postoperative air leak ( n = 4). There was no mortality in our series. Conclusion: Early initiation of management of ET with intercostal tube drainage is simple, safe, effective even in complicated cases, and has less complications. Thoracotomy with decortication should be reserved for ICD failure cases.

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Section: Discussionmentioning

confidence: 99%

Empyema thoracis in children: A 5-year experience in a Tertiary Care Institute

Mandal

Halder

et al. 2019

J Indian Assoc Pediatr Surg

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“…They are usually round or polygonal in shape with small sizes of 1–5 mm or more in diameter. The lesions are usually asymptomatic 3,4 . The face and extremities are the most common affected sites, especially the forehead, cheeks, nose, and particularly the area around the mouth and the backs of the hands, but the lesions can occur anywhere, including the neck, wrists, elbows, or knees 5 and on shaved areas such as the beard area in men and the lower legs in women.…”

Section: Introductionmentioning

confidence: 99%

Treatment of plane warts with long pulse ND – YAG laser 532 nm

Al‐Sabak,

Jaafar

2023

Skin Research and Technology

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BackgroundWarts are one of the contagious viral diseases that may cause disturbing cosmetic problems. Plane warts represents a common self‐limiting viral infection of the skin caused by the Human Papilloma Virus, however, those that do not disappear by themselves can be very difficult to treat with no uniformly effective treatment modality.ObjectiveTo assess the efficacy of long pulsed 532 nm ND:YAG laser in the treatment of plane warts.Patients and MethodsIn this therapeutic clinical trial study, 34 patients with plane warts were enrolled. Each patient was eligible for up to three treatment sessions administrated at 2 weeks intervals with long pulsed ND:YAG laser at a spot size 3 mm; wavelength 532 nm; pulsed duration 20 ms; and fluence 30 J/cm2. The patients were assessed before each treatment session and at 3 months after the last treatment session.The response to treatment was graded using four points scale:Scale 1 = poor: <25%,Scale 2 = fair: 25%–50%,Scale 3 = good: 51%–75%,Scale 4 = excellent: >75%.ResultsTwenty‐two patients only with a total of 478 lesions, completed the study; their ages ranged from (6–45) years with a mean ± SD 19.95 ± 13.142 years. Thirteen patients (59.09%) were female and nine (40.90%) were male. The results from this study showing that long pulsed ND:YAG laser 532 nm led to an excellent response in 19 patients (86.36%) in which 15 of 19 patients showed a complete response (78.94%); one patient showed a good response (4.545%), one showed a fair response (4.545%) and one showed a poor response (4.545%) at the end of three‐months follow up. The difference was statistically significant; the P value at the three months follow‐up was 0.002. The cumulative clearance rate after the first, second, and third treatment sessions was 58.4%, 77.7%, and 89.9% respectively. Recurrence was seen in only one patient (4.545%). Side effects were generally mild and didn't prevent normal activity.ConclusionLong pulsed ND:YAG laser 532 nm appears to be an effective method for treatment of plane warts.

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“…evaluating an employee's current and/or past performance relative to his/her performance standards (Dessler, 2011) is very important. Through performance appraisal qualities like spirit of cooperation, self-confidence, initiative, intelligence can be appraised (Shrestha, 2004). It helps to know the current performance level of teachers as well as students which helps to develop a plan for correcting any weakness present in them by counseling and coaching, training and development, improving communication etc.…”

Section: Introductionmentioning

confidence: 99%

Performance management system in educational institution using Management by Objectives (MBO) and 360° appraisal method

Shrestha¹

2022

Shanti J.

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Performance management is the management activity through which an institution ensures that employees are working effectively and efficiently towards achievement of institutional goal. To ensure that, performance appraisal i.e. evaluating employee’s current or past performance relative to the standard set by institution, is carried on. The data obtained from appraisal is used to take decision of promotion, salary, training and development and for other purposes too. The appraisal is generally done using different appraisal methods or tools like graphic rating method, essay method, critical incident method MBO, 360° appraisal method etc. MBO is now one of the most used a popular tool which is used as appraisal tool, motivational technique as well as planning and control device. Likewise, 360 degree appraisal method is another popular method which is gaining popularity nowadays where all round feedback is taken from all the staffs around the staff going to be appraised. Whatever the method is used, if the appraisal is carried on properly by minimizing common problems like biasness, unclear standards, halo effects etc., any institution can achieve goal through motivated staff with good working environment.

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Evolving Experience in The Management of Empyema Thoracis

Cited by 7 publications

References 14 publications

Empyema thoracis in children: A 5-year experience in a Tertiary Care Institute

Empyema thoracis in children: A 5-year experience in a Tertiary Care Institute

Treatment of plane warts with long pulse ND – YAG laser 532 nm

Performance management system in educational institution using Management by Objectives (MBO) and 360° appraisal method

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