Effectiveness and use of prophylactic antibiotics in elective and emergency caesarean section at tertiary care hospital

Background: Post-operative infections in obstetrics and gynecological settings have been higher compared to other specialties. Women undergoing caesarean section have 5 to 20-fold greater risk for infection compared with vaginal delivery. Many studies reported antimicrobial prophylaxis prevent post-operative infections. Hence this study concentrates the evaluation of the prescribing antimicrobial use and to assess the frequency of post-operative morbidity related to infection in subjects undergoing caesarean section. The aim of the study was to analysis the effectiveness, prophylactic antibiotics (amoxicillin versus ceftriaxone) and to evaluate the post-operative (caesarean) infections in patients undergoing lower segment caesarean section (elective and emergency).Methods: This is a prospective observational study which assessed the effectiveness and use of prophylactic antibiotics in patients undergoing cesarean section at department of obstetrics and gynecology. The study was conducted over a period of one year.Results: The corresponding mean age of all the study population in amoxicillin group (n=113) was 56.5±28.5 and in ceftriaxone group (n=97) was 48.5±26.5 respectively. The participant who underwent previous cesarean section in amoxicillin group is 65.48% similarly in ceftriaxone group is 47.42%. The patients with fetal distress in ceftriaxone group are 14.77% and in amoxicillin group is 8.92%. Failed induction in amoxicillin group is 9.82% and in ceftriaxone group is 6.81%. The number of days in hospital stay in amoxicillin group is 42.42% and in ceftriaxone group is 45.94%. The post-operative complications in amoxicillin group reported, with Febrile Illness are 40% and wound Infection is 60%.Conclusions: Administration of pre-operative antibiotics significantly reduce post-operative infections. Use of ceftriaxone as a prophylactic antibiotic in patients undergoing lower segment caesarean section (elective and emergency) is more effective than Amoxicillin in preventing post-operative infections.

Baroreceptor reflex response in paraplegia during head-up tilt position.

Paraplegia is one of the most common spinal cord lesions seen in spinal cord injury patients below 4th thoracic vertebra and is associated with autonomic loss below the level of lesion with intact vagal cardiac nerves. It occurs due to lesion of spinal cord at an appropriate level. i.e., sparing superior extremities and involving inferior extremities. The common causes of paraplegia are accidents such as gunshot injuries, spinal cord injuries, autonomic injuries and dislocation of spine. The degree of cardiovascular control impairment is related to the level and severity of the lesion. This study was to investigate the autonomic control of cardio vascular functions in paraplegia patients in response to head up tilt following spinal cord injury. The parameter studies were in head up tilt response on resting heart rate and blood pressure changes in paraplegic subjects. The results show an abnormal response to head – up tilt in paraplegia patients with decrease in diastolic blood pressure but the heart rate showed normal response. Thus, in patients of paraplegia, sympathetic reflexes below the level of the lesion induce vasoconstriction. These results indicate that increased sympathetic activity in controls during Head up tilt and decreased sympathetic activity in paraplegia. This suggests that patients with paraplegia maintain cardiovascular homeostasis during Head up tilt without increase in sympathetic activity.