IMJ Health : May 2015

International Medical Journal

Post-operative Wound Infection in Cases operated in a Tertiary Level Hospital Jaipur (Rajasthan) India

Abstract Wound infection is the second commonest nosocomial infection and most troublesome disorder of wound healing. This study was carried out on 100 post-operative cases of Surgical Unit 1st of General Surgery Department of Sawai Man Singh Hospital, Jaipur (Rajasthan) India in years 2014.

After interview of these, swab from post-operative wound was taken and sent for culture and sensitivity test in Microbiology. Results were inferred by Chi-square test and unpaired‘t’ test. Among all operative cases 21% were found infected. Cases, who were operated in emergency have significantly more post-operative wound infection. Mean age and mean postoperative stay of cases with post-operative infected wound was significantly higher than in cases without post-operative infected wound. But mean pre-operative stay, mean duration of operation and type of operation was not associated with post-operative wound infection. Pre-operative antibiotics lowered the occurrence of post-operative wound infection. Maximum proportion of causative agent found in post-operative infected wound was Staphylococci (90.48%) followed with Streptococci, E. Coli, Klebsella and Pseudomonas.

Keywords Post-operative wound Infection, Hospital stay

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Association of Treatment Outcome of Tuberculosis with type of Category of Tuberculosis

Abstract Tuberculosis is the third major cause of adult mortality i.e. 15-59 years of age group on which the nation’s economy depended on. In treatment of tuberculosis, failure of treatment and defaulters of treatment are the main hurdles. So this study was carried out with the aim to find out association of treatment outcome with category of case and diagnosed in various four quarters of year. For the study purpose 160 case sheets of tuberculosis patients attended at District Tuberculosis Centre, Jaipur were taken, by identify 40 cases randomly from each of four quarter. Chi-square test was used to find out association. It was found in this study that maximum cases were of category II followed by I and II. Cure rate was found 44.38% with maximum in category III (60.42%). Defaulter rate was found 32.5% with maximum in category II (35.48%). Failure rate was found 9.38% with maximum in category I(14%). And Case Fatality Rate was found 32.5% with maximum in category II(20.97%).This variation in treatment outcome was found significantly associated for Cure rate and CFR not for Defaulter and Failure rate.

Key words: Tuberculosis, Cure rate, Defaulters, Failure rate and Case Fatality Rate

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Profile of Post partum Female Sterilization at Tertiary care Government Hospital, Jaipur

Abstract One of the most important and indirect cause of maternal deaths is multiparity of women and that too from unwanted conception. Female sterilization is one of the adopted contraceptive methods to limit the number of children. So this study was done to find out the profile of females adopting sterilization. A record base analysis was done on records of women who underwent sterilization in Mahila Chikitsalay Jaipur in year 2014 were analysed. Women who underwent sterilization were studied with respect to parity and educational status. Out of 15911 total deliveries were conducted in year 2014, 1002 women got sterilized i.e. 6.30% post partum sterilizations were done. Out of these women who went for sterilization, 10.58% got sterilized in puerperal period after normal delivery, 59.98% were sterilized with LSCS and 16.87% women went for sterilization with MTP. After hysterotomy and ectoic pregnancy women went for sterilization significantly more than normal delivery. Maximum sterilizations were done after 2nd para and more than 4th para. Education and preference of male child was also found to be associated with acceptance of sterilization i.e. as the education increases the acceptance for sterilization also increases.

Keywords Sterilization, contraceptive method, Primigravida, Multigravida

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Association of Hypertension and Pulmonary Functions

Abstract Association between cardiac dysfunction and abnormal pulmonary function has remained controversial since long. The objective of this study is to find out the association of hypertension and its severity on pulmonary functions. Study was conducted on 30 hypertensive (study group) and 30 non hypertensive (control group) subjects identified from Medical OPD of SMS Hospital, Jaipur. Pulmonary functions were assessed of both hypertensive (study group) and non hypertensive (control group) subjects by Medspiror). Among pulmonary function tests, difference in means of FVC, FEV1 PEFR, FEF25-75%, MVV and FVC/ FEV1 were found less with significant difference in cases group with predominantly restrictive type of effects are observed. Female’s shows lower values than male hypertensive subjects. Furthermore, FVC, FEV1, PEFR, FEF25-75%, MVV, FVC/ FEV1 were not found to be associated with severity of illness. An inverse relation is found between hypertension and pulmonary functions predominantly restrictive type of pattern. While non significant effects are observed with severity of illness.

Keywords Pulmonary function tests, Hypertension, Restrictive disease, Medspiror

Abbreviations: PFT Pulmonary function tests, HT Hypertension, FVC forced vital capacity, FEV1forced expiratory volume in Ist second, PEFR peak expiratory flow rate, FEF25-75% forced expiratory flow during middle half of FVC, MVV maximum voluntary ventilation

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Comparison of pre-mixed and sequentially intrathecal administration of Clonidine with hyperbaric Bupivacaine in caesarean sections

Abstract Adjuvant and hyperbaric Bupivacaine mixing in a single syringe before injecting the drugs intrathecally is an age old practice. It may cause intraoperative hemodynamic changes. Administering local anesthetic and the adjuvant separately may minimize these side effects. So this study was aimed to compare effect of administering hyperbaric Bupivacaine and Clonidine intrathecally as a mixture and sequentially in cases undergoing caesarean section (CS). This study conducted at a District Hospital of Rajasthan in year 2013. Cases undergoing elective caesarean sections were divided into two groups by chit box method each of two groups consists of 30 cases. One group (Group A) is given mixture of Clonidine (75 mcg) and hyperbaric Bupivacaine 0.5% (10 mg) intrathecally, whereas other Group B received Clonidine (75 mcg) followed by hyperbaric Bupivacaine 0.5% (10 mg) through separate syringes. It was found that duration of analgesia was significantly longer in Group B (466 ± 18.2 min) in which the drug was given sequentially than in Group A (334 ± 16 min). Likewise, the time to achieve highest sensory and complete motor block was significantly less in Group B than Group A. So it can be depicted that administering Clonidine and hyperbaric Bupivacaine in a sequential manner is better than mixing of the two drugs.

Key words: Clonidine, Hyperbaric Bupivacaine, Spinal Anaesthesia, Adjuvants, Caesarean Section

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Spiritual Health Assessment of Geriatric Population of Jaipur City (Rajasthan) India

AbstractSpiritual health is not given its due importance since long time. But nowadays modern medicine is seen in relation to spiritual health and studies were conducted to find out its effect in various diseases. So this study was conducted on elderly aimed to assess the spiritual health and its association with psycho wellness. For study purpose, 30 cluster technique to identify houses with elderly (≥60 years) in Municipal Corporation area of Jaipur City. After collecting general information Spiritual Health Assessment Scale (SHAS) was used to assess spiritual health and Modified Mini Screen (MMS) was used to assess psycho-wellness in elderly. Data were anlysed and inferred by Chi-square test and ANOVA with Post-hoc Tukey test. Majority of elderly were having poor spiritual health and this spiritual health was strongly associated with psycho-wellness in elderly. Poorer the spiritual health of elderly leads to poorer the psycho-wellness in elderly.

Keywords Spiritual health, Psycho-wellness, Spiritual Health Assessment Scale (SHAS), Modified Mini Screen (MMS), Elderly

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