ABSTRACT
Background: Tympanoplasty is one of the commonest operations performed on the middle ear. Endoscopes are increasingly used for various middle ear surgeries. The objective was to determine merits and demerits of the endoscope as compared to the microscope in myringoplasty surgery and to compare the results of both group. Methods: Between the time period of January 2014 to September 2014, 44 patients underwent myringoplasty, 22 were endoscope assisted and 22 were microscope assisted. Results of surgery were compared at the end of 3 months post surgery. Results: In both groups, equal number of patients i.e. 15 (68.18%) had a successful outcome. Conclusion: Panoramic, wide angle, and magnified view provided by endoscope as well as ability to easily negotiate through EAC and provide uninterrupted image overcomes most of the disadvantage of microscope. In our study success rate was equal between endoscopic and microscopic technique. In terms of morbidity and postoperative recovery endoscope produced better results. Loss of depth perception and one handed technique are some of the disadvantage of endoscope that can be overcome with practice. Thus, Endoscopic tympanoplasty can be a good alternative of microscopic tympanoplasty.
ABSTRACT
Background: To study and describe the prevailing prescription trend in burns patients in a tertiary care rural hospital. Methods: This was a retrospective observational study. Total 100 patients diagnosed with burn injury and admitted during Jan 2012 to Dec 2013 were included in the study. The demographic details, details of burn injury & treatment received were obtained from the medical record section of Dhiraj General Hospital, Piparia. Drug prescriptions were analyzed using Microsoft Excel for total number of drugs per prescription, various classes of drugs prescribed and group of antibiotics commonly prescribed. Results: Most common age group affected was 20-40 years. The female to male ratio was 1.8:1. Average number of drugs prescribed was 6.8 with a range of 4-9 drugs per prescription. All prescriptions (100%) contain antimicrobials, analgesics and antiulcer drugs. Among antimicrobials, ceftriaxone was most commonly prescribed followed by amikacin and amoxicillin + clavulanic acid. Only 18% patients were immunized against tetanus. Conclusions: Females are more vulnerable to burn injuries. Polypharmacy was observed in prescriptions. Systemic antibiotic should be used with caution to prevent emergence of resistant microorganisms. Results of the present study indicate that some aspects of drug treatment need to be rationalized in order to achieve better patient care.
ABSTRACT
Each year many patients are hospitalized due to adverse drug reactions. Adverse reactions are the recognized hazards of drug therapy and they can occur with any class of drugs and many studies revealed that the incidence is more in case of antibiotics. Amoxicillin is a broad spectrum, bactericidal, beta lactam antibiotic, commonly used to combat various infections. Penicillin group of drugs are known to cause cutaneous drug eruptions especially in pediatric population. Most of the time, these eruptions are mild in nature, however, sometimes they represent the early manifestation of rare, severe drug-induced cutaneous reactions, such as Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). Toxic Epidermal Necrolysis (TEN) is a rare, life threatening dermatological disorder that is usually induced by medications. Seventy percent of the cases of TEN are drug induced, most commonly implicated drugs being anticonvulsants, antibiotics and Non-Steroidal Anti-Inflammatory Drugs (NSAIDS). Here, we report a case of toxic epidermal necrolysis induced by amoxicillin in a 16 year old female patient. Rigorous treatment with systemic corticosteroids and immunoglobulins helped in recovery of the patient. The case is being reported to emphasize the need for efficient pharmacovigilance in order to motivate adverse drug reaction reporting so as to gather more and more data regarding adverse drug reactions. Through this report, we also seek the support of everyone concerned to detect and, if possible, prevent adverse reactions to drugs.
ABSTRACT
Background: Poverty is a multi-faced wretched state of deprivation of basic need and facilities. There are different levels to its adverse influence on the individual, family and the community. Thus a Rashtriya Swasthaya Bima Yojana (RSBY) was launched to help these poverty stricken individuals. This study explores into the utilization of Rashtriya Swasthaya Bima Yojana card and their satisfaction. Aims & Objective: Our study explore the awareness level of RSBY beneficiaries with the aims and objective, (1) To analyze the socio-demographic profile and services utilized by beneficiaries; (2) To identify the problems experienced by the beneficiaries and measure the satisfaction level; and (3) Out of pocket expenditure of beneficiaries. Material and Methods: 198 patients were registered between the periods of 01/11/2012 to 28/02/2013 due to some reason 180 beneficiaries were telephonically interviewed about their experience by a pre-tested and pre-designed Performa. The data was collected and analyzed in epi info 7. Results: Male: Female ratio of beneficiaries is 1.4:1. Mean age of beneficiary was around 36 years. 80% beneficiaries were fully satisfied with the services. All the beneficiaries reported that they got the card easily without any hassle. They were not aware about all the benefits of RSBY so they had to spend out of pocket money for some services. Conclusion: RSBY beneficiaries were mostly satisfied with the services provided but there was a major lag in their knowledge regarding the benefits provided under RSBY. They were unaware regarding all benefits under RSBY which they can avail from the scheme. Thus IEC activities should be enhanced to increase the awareness among the RSBY card holders so that they can use better service for themselves and their families.
ABSTRACT
Background: Now a day’s mental and behavioural disorders are common in the community. Globally, some 450 million persons suffer from a mental or behavioural disorder contributing to 13% of global burden of disease.1TheServices are provided by psychiatric hospitals where assessments are carried out by psychiatrists, clinical psychologists and sometimes psychiatric social workers, using various methods but often relying on observation and questioning. Even this is done in the community. Thus on the basis of these observations we have drawn the conclusion of epidemiological variants among the patients. Aims & Objective: To assess the frequency of various epidemiological trends in patients in mental hospital and to study associated risk factors in them. Material and Methods: 118 patients out of 237 in mental hospital were selected on random basis. On predesigned Performa, various details were noted and the data was analyzed in epi info 7. Results: There were 48.3% females and 51.7% males. There were 87 cases of schizophrenia and 19 case of bipolar disorder in manic phase. The 57.98% of patients present with behaviour abnormality and 43.45% of patients have the abnormal BMI and 24.25% of patients of patients have primary education level. The 81.21% of people were not working. Conclusion: Resources and service for the mental disorder are comparatively low as compared to the burden of the disease. Thus by studying the various epidemiological correlations we can plan certain preventive measures so that mental disease burden could be decrease. Looking to the etiopathology, found in our study it is recommended that counselling should also be a part of management and importance should be given to environmental or social factors like education living standards etc. for prevention of mental disorders.
ABSTRACT
OBJECTIVE: To study neurological outcome of Moya Moya disease treated surgically with Encephaloduroarteriosynengopsis (EDAS). DESIGN: Prospective observational study. SETTINGS: Community and General with tertiary care facility. SUBJECTS: Eight children diagnosed with Moya Moya disease by Magnetic Resonance Angiogramover 4 years of period were selected for EDAS. Children who were not able to sustain surgery excluded from study. METHODS: Treatment modality selected were surgery in form of EDAS. After surgery subjects were followed up for minimum of 2 year period to know neurological out come. Outcome was reported as poor, fair, good and excellent. No statistical analysis performed due to small sample size. RESULTS: After surgery no episode of stroke or TIA was observed in any patient during 2 year follow up period and all patients are living without any new neurological deficit. CONCLUSION: Long term outcome of EDAS is promising.