scholarly journals Impact of Chest Pain Protocol Targeting Intermediate Cardiac Risk Patients in an Observation Unit of an Academic Tertiary Care Center

2016 ◽  
Vol 8 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Tariq Yousuf ◽  
Hesam Keshmiri ◽  
Jeffrey Ziffra ◽  
Ankur Dave ◽  
Shoeb Hussain ◽  
...  
Keyword(s):  
Chest Pain ◽  
Care Center ◽  
Tertiary Care ◽  
Cardiac Risk ◽  
Tertiary Care Center ◽  
Observation Unit ◽  
Risk Patients ◽  
Cardiac Risk Patients

scholarly journals To study the effectiveness of prophylactic use of ceftriaxone (single dose) in caesarean section in low risk patients in a tertiary care center, Moradabad, India

2017 ◽  
Vol 5 (12) ◽  
pp. 5278
Author(s):  
Ruby Kumari ◽  
Arti Sharma ◽  
. Sheetal ◽  
Pratibha Roy ◽  
. Anupriya
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Care Center ◽  
Tertiary Care ◽  
Infectious Complications ◽  
Low Risk ◽  
Tertiary Care Center ◽  
Site Infection ◽  
Risk Patients

Background: There is increasing incidence of caesarean section throughout the world. As caesarean section is associated with infectious complications which increase the rate of morbidity and mortality of mothers. For prevention of infectious complications antibiotics are used but careless use of antibiotics increasing incidence of antibiotic resistance. Many guidelines and studies recommend single dose antibiotic prophylaxis for women undergoing elective or non-elective caesarean section. The aim of this study was to assess the effectiveness of Ceftriaxone as prophylactic antibiotic (single dose) in caesarean section in low risk patients.Methods: A Prospective single blind study was carried out in the department of obstetrics and gynaecology, TMMC and RC Moradabad, a tertiary care center, in all low risk patients underwent for Elective and Emergency Lower segment caesarean section for 1 year from 1st June 2015 to May 2016 on 110 patients. Data was collected and analyzed by percentage and proportion.Results: Prevalence of caesarean section was maximum in women of 26-35years age group (52.72%),about 67.27% was emergency LSCS, most common indication of caesarean section was Fetal distress (29.09%),refusal for vaginal delivery after caesarean section (10.90%) was one of the cause for increasing rate of repeat caesarean section, 41.81% women in labour,72.27% cases were with intact membrane, in 9.09% cases, antibiotic had to change in post-operative period due to urinary tract infection and surgical site infection, most common post-operative complication was superficial surgical site infection with purulent discharge (2.72%). No major life-threatening complication occurred.Conclusions: Single dose of Ceftriaxone is effective for prevention of post-caesarean infectious complication.

scholarly journals Indications and outcome of patients undergoing cutaneous ureterostomy as a mode of urinary diversion after radical cystectomy: an experience from a tertiary care center

2018 ◽  
Vol 5 (9) ◽  
pp. 3038
Author(s):  
Shikhar Agarwal ◽  
Rajeev Sarpal ◽  
Shivam Dang ◽  
Yogesh Kalra ◽  
Manoj Biswas
Keyword(s):  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Operative Time ◽  
Care Center ◽  
Tertiary Care ◽  
High Morbidity ◽  
Tertiary Care Center ◽  
Viable Option ◽  
Risk Patients ◽  
Cutaneous Ureterostomy

Background: Radical cystectomy is associated with high morbidity, especially in elderly patients. Most of the associated complications are related to the urinary diversion. Cutaneous ureterostomy (CU) is usually an uncommon form of urinary diversion and is avoided because of the frequent complication of stomal stenosis.Methods: In this study the authors retrospectively analyzed 84 patients who underwent radical cystectomy. 17 Patients who underwent single stoma CU were included in the study who required lifelong monthly stent changes. Varied indication and outcome of these patients were analyzed.Results: Patients in which CU was used as a mode of urinary diversion had less blood loss, less operative time and discharged without ICU stay.Conclusions:  It seems that single stoma CU is a viable option in elderly, high risk patients and in post radiotherapy patients who require radical cystectomy. Although the patient requires lifelong stent changes, postoperative complications are reduced.        

scholarly journals Delayed Presentation of Acute Coronary Syndrome: A Challenge in its Early Management

2009 ◽  
Vol 48 (173) ◽  
Author(s):  
Pramod Acharya ◽  
RR Adhikari ◽  
J Bhattarai ◽  
NR Shrestha
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Care Center ◽  
Tertiary Care ◽  
Late Presentation ◽  
Delayed Presentation ◽  
Tertiary Care Center ◽  
Early Management ◽  
Coronary Syndrome ◽  
District Hospitals

INTRODUCTION:The time of presentation of acute coronary syndrome from the onset of chest pain determines the treatment modality and prognosis. Delayed presentation is associated with a poor outcome. In the present study, we tried to find out the causes of late presentation of ACS in a tertiary care center in the eastern part of Nepal.METHODS:It was a cross-sectional descriptive study that included 100 consecutive patients with ACS presenting to our institute over a period of 8 months. They were studied for their demographic profile, delay in presentation, the management done at the local centers and their final diagnosis.RESULTS:We found that patients living within Dharan City reached BPKIHS within 20 hours of the onset of chest pain while those from outside the city who came directly reached within 63 hours. Other patients reached their respective local centers (health posts, district hospitals and private clinics) within 39 hours. The commonest cause of delay was vehicular problem followed by unnecessary delay at the local centers. The work up for chest pain was inadequate in these centers. Late presentation to our institute significantly affected the optimal management.CONCLUSIONS: We found that significant number of patients with ACS from eastern Nepal presented late in our tertiary care center. In order to improve ACS outcome in this region, we advise equipping the local centers with electrocardiogram machines, improvement in ambulance services and a greater emphasis on coronary artery disease awareness programs as well as initiating preventive measures.KEY WORDS:acute coronary syndrome, chest pain, delayed presentation, electrocardiogram

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