ABSTRACT
OBJECTIVE- To study disposal of different types of biomedical waste and to studythe status of BMW management in different level of hospitalsMETHOD-Medical facilities were divided into 4 groups. 10 facilities from each groupwere selected by simple random sampling. Facilities were visited by surveying groupsand specific data about collection and disposal of waste were collected by askingmanagement personnels of hospitals, doctors and staff.RESULT- 90% of single speciality hospitals and 80% of multispeciality hospitals arefollowing proper storage and segregations of BMW.90% of super speciality hospitalshave transportation facilities.60% of super speciality hospitals , 30% of multispecialityand 20% of single speciality hospitals have incinerators. All super speciality hospitalshave autoclave machines, while 70% of single and 50% of multispeciality hospitalshave that. While only 2 out of 10 clinics have an autoclave machine.60% of both clinicsand Superspeciality hospitals are using land disposal as a method of BMWmanagement. 80% of small clinics and 70% of multispeciality hospitals are having dryand wet thermal management.CONCLUSION- Superspeciality hospitals and Single specialty hospitals are usingcostly methods like incineration and autoclave also following guidelines for storage ,segregation and transportation of BMW properly while amongst all most small clinicscan’t afford costly methods so uses cheaper techniques like chemical treatment and dryand wet thermal methods.
ABSTRACT
Background and Objectives: To evaluate the role and efficiency of vacuum dressing in thehealing of wounds and to assess the benefits and limitations of using vacuum dressing indifferent types/categories of wound.Methods: The study of 25 cases was conducted in the Department of Surgery of atertiary care teaching hospital over a period of 2 years.Results: Vacuum dressing had a significant effect on the final outcome of wounds.Wounds which seemingly needed a flap surgery in the first impression, withsuccessive application of vacuum dressing cycles, could be covered with a simplesplit thickness skin graft. Many patients were salvaged of a revision amputation asshowed by the decrease in overall amputation rates.Interpretation and Conclusion: Based on the data from the present study and otherstudies available, vacuum dressing results in better healing, with minimalcomplications, and thus looks to be a promising alternative for the management ofvarious wounds. Vacuum dressing leads to faster healing of the wounds, thereforedecreasing the overall hospital stay. Hence, it is cost effective also. It reduces theinconvenience and discomfort caused to the patient by frequent change in dressings.It helps in reducing size of the wounds, has profound effect on wound depth andgranulation as seen in our study. It promotes granulation tissue completely coveringthe tendon, thus enabling simple techniques (e.g., skin graft) rather than formal flapclosure in few cases. Wounds with exposed underlying bone and chronic nonhealing ulcers can be managed well with vacuum dressing. It reduces the number ofamputations and re-debridement required. More number of wounds can be managedsuccessfully with secondary closure or skin grafting after multiple cycles of vacuumdressing. This reduces patient morbidity and minimizes the overall effect on hisquality of life. Good outcome of vacuum dressing also depends on its properapplication.
ABSTRACT
Background: Hemodynamic stability is an important aspect to the anesthesiologist for patients. Laryngoscopy and endotracheal intubation can cause striking changes in Hemodynamics as result of intense stimulation of sympathetic nervous system. ProSeal LMA (PLMA)minimizes this response without compromising the airway. The aim of this study was to compare PLMA and Endotracheal tube with respect to intra-operative hemodynamic responses in patients undergoing general anaesthesia. Material and Methods: This prospective observational study was conducted on 30 patients of either sex, age group of 18-60 years, ASA (I or II), Mallam Pati (I or II) posted for elective surgery under general anaesthesia. They were randomly divided into two group 15 each. For group A, airway was secured with laryngoscopy and intubation with appropriate size endotracheal tube and for group B, appropriate size PLMA was inserted to secure airway. The hemodynamic responses like Heart rate and Blood pressure were recorded at base line, at insertion, after 1st min, 3rd min, 5th min and after extubation. Mean increase was statistically more after endotra Results: cheal intubation than PLMA insertion. The elevation in these hemodynamic parameters significantly persisted for a longer period of time in the ETT group, where it returned to the baseline value by 5 minutes as compared to the PLMA group where it returned by 3 minutes. The hemodynamic res Conclusion: ponse produced when PLMA was used for securing airway was less than the laryngoscopy and endotracheal intubation. Thus, PLMA proved to be a suitable alternative to endotracheal tube for airway management with stable hemodynamic.