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Background: The WHO in 2009 published the surgical safety checklist (SSC) for reducing the surgical complications. For its successful implementation it is imperative to identify the current knowledge, attitude and practices of the involved personnel and explore the anticipated barriers. Objective of this study was to evaluate the knowledge, attitude and practices of the participants about the SSC and determine the possible challenges in its implementation.Methods: This study is a descriptive, cross-sectional study involving the use of a pre-tested questionnaire carried out in a teaching hospital. All personnel involved in the operation theater who gave their written consent were enrolled.Results: Awareness regarding the SSC is high and existing practices are favorable towards patient safety amongst Hospital personnel. Attempts should be made to educate all personnel to gain complete knowledge regarding the checklist. The anticipated barriers, of which lack of knowledge was found to be the most prominent, should be dealt with.Conclusions: A strategy aimed at proper education, stepwise implementation, alleviating the hindrances and regular feedbacks can result in decreasing the surgery related complications and morbidities through implementation of the surgical safety checklist.
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Background: Alteration in the pattern of serum lipid profile has been associated with a variety of cancers and precancerousconditions. Low levels of serum lipid serve as a prognostic marker in the early detection of oral precancerous and cancerousconditions because lipid plays an important role in new membrane biogenesis and maintains cell integrity.Aim: The aim of our study is to evaluate the alteration in serum lipid profile in oral squamous cell carcinoma (OSCC) andcompared it with control group.Materials and Methods: A total of 80 subjects were selected from the Department of Oral Pathology and Microbiology,RUHS College of Dental Sciences, Jaipur (GDC-Jaipur). Among 80 subjects, 40 individuals were diagnosed with squamouscell carcinoma and other 40 individuals were taken in healthy control group selected randomly from other departments. Thetotal parameters assessed include total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), low-density lipoproteincholesterol (LDLC), very LDLC, and triglycerides (TGLs). Statistical analysis was carried out by Chi-square and one-wayANOVA test to evaluate parameters.Results: There was a significant decrease in TC, HDLC, and TGL in the oral cancer group as compared with the control group.Conclusions: There was an inverse relationship between serum lipid profile and OSCC. The lower serum lipid status may beconsidered a useful prognostic biochemical indicator for initial changes occurring in the neoplastic proliferating cell.
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Background and Objectives: Though medical expulsive therapy for ureteric stones is increasingly used these days, some recent randomized controlled trials have questioned its benefit. This study evaluates the result of treatment of ureteric stones with tamsulosin. Materials and Methods: This prospective study involved ultrasonographically confirmed cases of uncomplicated unilateral ureteric stones. All patients received tamsulocin 0.4 mg daily for 2 to 6 weeks. The primary end point was stone expulsion. The secondary endpoints were the use of analgesics and adverse events. Results: One hundred and sixty two patients completed the study. Ninety seven patients were male and male to female ratio was 3:2. The mean age was 34.9 ± 9.8 (range: 18-71) years. The mean stone size was 6.17 ± 1.68 (range: 3.3-11.2) mm. By the end of 2, 4 and 6 weeks, cumulative stone expulsion rate was 110 (69.1%), 121 (74.7%) and 126 (77.8%) respectively. For the 49 stones of size £ 5 mm, the expulsion rate was 47 (95.9%) by the end of 6 weeks. The expulsion rates for stones of size > 5 - 7 mm, > 7 – 9 mm and ³ 9 mm were 59 (85.5%), 17 (53.1%) and 3 (25%) respectively by the end of 6 weeks. Lower ureteric stones had the highest expulsion rate of 106 (87.6%) by the end of 6 weeks, and the rate was lowest for upper ureteric stones (34.6%). Ten (6.1%) patients required additional analgesics during the course of treatment. Eleven (6.8%) patients complained of mild light-headedness and dizziness which subsided in a few days. Conclusion: Tamsulocin appears to facilitate expulsion of ureteric stones especially the distal ones. The benefit of tamsulocin seems to be maximum for the stones of size up to 9 mm. Further large scale randomized controlled trial should better define the real benefit and more rationale use of tamsulocin in routine clinical practice.
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Background and Objectives: Early appendectomy in presence of appendiceal mass (AM) is controversial. We present the results of our experience that contribute to safe appendectomy in AM.Material and Methods: A total of 135 patients who underwent early surgery in presence of AM were reviewed. The diagnosis of AM was made clinically, using abdominal ultrasound and/or intra-operatively. All surgeries were done by qualified surgeons with variable experiences.Results: Mean operative day since onset of pain was 5.64 ± 2.1 (range: 3-15) days. A hundred and twenty patients underwent appendectomy, 116 (96.7%) of which was done within 7 days of pain. Two other patients operated on the 6th day had only drainage of abscess and no appendectomy. Remaining 4 (3.3%) appendectomies were performed on the 8th day. Two other patients operated on the 8th day had failed attempt of appendectomy and had just drainage of abscess. Two patients, operated on 12th and 15th day had just open-close. Both had given misleading history of duration of pain. Remaining 9 patients, from the 9th day onward underwent only just drainage of abscess. Only significant complication was injury to ileum during early years of experience when appendectomy was attempted on the 10th day. He fared well in two weeks.Conclusion: With experience we have developed confidence that experience and clarity of safe time limit makes early appendectomy in AM predictably safe. Few other patients who present later and need surgical intervention may be more safely managed by limited procedure like drainage of abscess without precarious attempt of appendectomy.
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Background: Management of pain is a primary clinical concern for any pathology in medical field. Addiction liability of opioids and troublesome gastrointestinal side effects of NSAIDs leads to intensive research for compound with lesser side effects.The aim of the study to evaluate the anti-nociceptive activity of Acacia Tortilis Seed Extract (ATE) in experimental animals.Methods: First of all, animals were randomly allocated into four groups of six animals each. In acetic acid induced writhing test model, Group I (NC) served as vehicle control received saline/Tween 80 0.1%, 10ml/kg BW orally, group II (ATE-100) and III (ATE-200) received ATE in dose of 100 and 200mg/kg BW orally respectively and group IV received the standard drug diclofenac sodium in dose of 50 mg/kg BW orally. Group I to IV were same in rest of three experimental models. One additional group of standard drugs (group V) morphine sulfate in dose of 5 mg/kg BW subcutaneously (SC) was allocated for screening method hot plate and tail flick tests. In Formalin induced paw licking test, three additional groups (group V) morphine sulfate in dose of 5mg/kg BW SC, group VI- morphine+naloxone (5mg/kg SC +2mg/kg intra-peritoneally (IP) and group VII - ATE+ naloxone (200mg/kg BW orally +2mg/kg BW IP) were also made.Results: The ATE when administered orally in dose of 100 and 200mg/ kg body weight (BW), produced significant analgesic activity (P <0.01) in acetic acid induced writhing syndrome and late phase of formalin test. In the hot plate test in mice and tail flick test in rats, ATE in same doses also showed significant analgesic activity (P <0.05) which is almost equally efficacious to standard drug diclofenac sodium (50mg/kg BW orally) but far less efficacious than morphine sulfate (5mg/kg BW subcutaneous).ATE (200mg/Kg BW orally) activity did not blocked by naloxone (2mg/kg intra-peritoneal).Conclusions: ATE possesss significant anti-nociceptive activity as evidenced in all the animal models of nociception. It might exert its effect through the peripheral mechanism of analgesic action possibly by interference in biosynthesis, release and/or action of prostaglandins and leukotrienes.
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Background: Prolongation of labor is one such dilemma that every obstetrician tries to avoid. The ultimate aim of the obstetrician is to accomplish the delivery in the shortest possible time without compromising maternal and fetal safety. Prolonged labor often ends up in great suffering to the parturient because of dehydration, confusion, and infection. This study aims to compare the efficacy of drotaverine hydrochloride with hyoscine butyl bromide for increasing the rate of cervical dilatation and to compare their duration of labor. Methods: This was a prospective interventional study conducted on 60 women who were randomly allocated to Group I, which was control group, women in Group II were injected hyoscine butylbromide one ampoule (20 mg) and the women in Group III were injected drotaverine hydrochloride one ampoule (40 mg) intramuscular at 3 cm dilatation of cervix. The data collected was statistically analyzed using SPSS version 15. Results: When compared to Group I (control group), Group II and Group III took lower time for all the three stages of labor. However, intergroup difference was significant only for Stage I (p<0.001). However, no significant difference was observed between Groups II and III (p=0.964). A significant difference among group was observed in total duration of labor too (p<0.001). Between group comparisons for Stage II and Stage III did not show a statistically significant intergroup difference for any of the comparisons (p>0.05). Conclusions: The finding in this study suggested a significant impact of both the drugs in first stage as well as total duration of labor as compared to control group. However, no significant difference between two study groups was observed. Thus, both drotaverine hydrochloride and hyoscine butylbromide could effectively reduce first stage as well as total duration of labor.
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The present study was performed to study the antibiotic prophylaxis pattern in patients admitted in Surgery and Obstetrics and Gynaecology wards of a Tertiary Care Teaching hospital in North India. It was an observational, non interventional and analytical study used to evaluate the patients undergoing surgery through period of one and half years. Information concerning demographic data, type of surgery, and parameters of antibiotic therapy (selection of antibiotic, dose, route and duration of therapy as well as cost) was collected from case records of 400 patients. Third generation cephalosporins were the most commonly prescribed class of antibiotics. No consistency was noted in the timing of administration of prophylactic antimicrobials agents which were prescribed 30 minutes to 6 hours before surgery. The dose was not repeated during surgery. Majority of antibiotics were prescribed from Essential Medicines List. Surgical prophylaxis was inappropriate in terms of choice of antimicrobial agent, timing of administration as well as the total duration of prescription, in majority of the cases. Interventions are warranted to promote the development, dissemination and adoption of evidence based guidelines for antimicrobial prophylaxis.
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Effects of xylose on xylanase production by a thermophilic Bacillus sp showed diverse patterns on corn cob (CC) and wheat bran (WB) as sole carbon sources in solid- state fermentation (SSF) and submerged fermentation (SmF). Supplementation of these media with either mineral salt solution (MSS) or yeast extract peptone (YEP) also exerted variable effects. While under SSF, xylose stimulated xylanase synthesis by 44.01 percent, on wheat bran supplemented with MSS, it decreased the enzyme activity by 12.89 percent with YEP supplementation. In SmF, however the enzyme synthesis was stimulated by xylose on supplementation with both MSS and YEP by 41.38 percent and 27.47 percent, respectively. On corn cob under SSF, xylose repression was significant both with MSS (26.92 percent) and YEP (23.90 percent) supplementation. Repression by xylose also took place on corn cob and YEP (19.69 percent) under SmF, while significant stimulation (28.55 percent) was observed by MSS supplementation. The possible role of media composition and fermentation conditions in the regulation of xylanase synthesis by xylose is discussed.