ABSTRACT
Background: In the vast and ever-expanding field of surgery there are only few subjects which have provoked controversy; curiosity related to correct management of patients suffering from various condition of the abdomen. This becomes very true when the patient has a retroperitoneal mass clinically. The problem of retroperitoneal mass was intriguing, fascinating and certainly most perplexing. The present study was planned with the objective to study the various clinical presentations of retroperitoneal mass, and their radiological findings, and co-relation between these various findings.Methods: This was a prospective, cross-sectional study. The study included 30 patients clinically diagnosed having retroperitoneal mass, attending the department of general surgery.Results: The most common affected age group was of 40-50 years (9, 30.00%). The most frequent presenting symptoms were abdominal lump (28, 93.33%). Pallor was the commonest clinical sign (20, 66.67%). Retroperitoneal lymph node masses were the commonest (12, 40.00%) malignant lesions. Retroperitoneal lymphadenopathy was the most common lesion.Conclusions: The retroperitoneum has long been an area poorly visualised by conventional radiographic techniques and in this respect, computed tomography scan has great advantages over other modalities. Hence the modern surgeon should no longer be considered a ‘shadow-gazer' but an anatomist in-vivo.
ABSTRACT
Background & Aim: This study was carried out to demonstrate the efficacy and compare a dose of Granisetron with Dexamethasone and Palonosetron with Dexamethasone for prophylaxis against postoperative nausea and vomiting. Aim is to study the effectiveness of palonosetron and granisetron with aims of evaluating the efficacy of palonosetron and granisetron with dexamethasone in prevention of postoperative nausea and vomiting and to study associated adverse effects. The study was carried out in Civil Hospital, Ahmedabad with prior permission of ethical committee of the hospital. Methodology: This study was designed to evaluate the efficacy and compare a dose of study drugs in 60 patients of either sex and age ranging from 18 to 60 years and physical status ASA risk I or II undergoing general anaesthesia for various laparoscopic surgical procedures. Patients were divided into 2 groups(n=30), assigned to receive granisetron 1mg plus dexamethasone 8mg i.v and palonosetron 0.075mg plus dexamethasone 8mg i.v. A standard general anaesthesia technique and post operative analgesia were used throughout our study. The groups were compared with regards to the incidence of complete response, mean PONV score, mean nausea VDS scores and requirement of rescue anti emetics drug at various intervals (0-6,6-24,24-72hrs). Differences in continuous variables (age and duration of anaesthesia) across two dosage groups were compared using analysis of variance (ANOVA) test which is a parametric statistical test. Differences in categorical variables (gender, presence of complete response, use of rescue anti-emetics) across two dosage groups were compared using chi square test. Differences in ordinal variables (PONV scores and 4-point verbal descriptive nausea scores) across two dosage groups were compared using non-parametric Kruskal Wallis one-way analysis of variance. Mann Whitney U test was used to conduct sub-group analyses for comparing PONV scores and 4-point verbal descriptive nausea scale scores between two given groups. McNemar's test was done to compare differences in rates of complete response in a given dosage group across different time periods of assessment. Results: Our study results shows clear superiority of palonosetron with dexamethasone as a prophylactic drug for the prevention of PONV than that of granisetron with dexamethasone. Conclusions: Due to its longer duration of action, a single dose of palonosetron with dexamethasone before induction is effective in preventing PONV for upto 72 hours and hence can be termed as a prophylactic drug for PDNV also. It’s optimal and effective dose is 0.075mg i.v. with minimal side effects.
ABSTRACT
Introduction: Despite the statutory provision of Biomedical Waste Management, practice in Indian Hospitals has not achieved the desired standard even after years of enforcement of the law. In view of this, the present study on Knowledge, Attitude and Practice (KAP) on the subject was carried out in a tertiary level teaching hospital. Material and Methods: The hospital under scrutiny for KAP is a 250 bedded western regional M. & J. Institute of Ophthalmology. The study is based on a questionnaire designed to understand the KAP of the staff involved in direct patient care facility regarding the biomedical waste management practices. The KAP study enrolled 100 respondents, representing doctors and nurses. Result: Here, a significant gap was observed in the knowledge, attitude and practice of the medical and paramedical staff regarding biomedical waste disposal, their knowledge/understanding of the subject. Conclusion: Induction training and continuous in-service training of the staff regarding BMW disposals are required as it is very important for prevention of healthcare associated infection.