ABSTRACT
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a well-recognized public health problem throughout theworld. The evolution of new genetically distinct community-acquired and livestock-acquired MRSA and extended resistance toother non-β-lactams including vancomycin has only amplified the crisis. This paper presents data on the prevalence of MRSAand resistance pattern to other antibiotics on the selected specimen from burn patients.Materials and Methods: This is a prospective study conducted in the burn unit of Shyam Shah Medical College and SanjayGandhi Memorial Hospital, Rewa (M.P.), from June 2018 to May 2019, where all patients with flame and scald burns wereincluded in the study who had up to a second degree or partial-thickness burns.Results: A total of 558 patients were admitted in the burn unit throu`ghout the year, the age ranged from 2 months to 85 years.About 56.10% were females and 43.90% were males. Pseudomonas aeruginosa (37.5%) was the most common isolatefollowed by S. aureus (18.75%). The prevalence of MRSA was 57.14% but all the MRSA isolates showed 100% sensitivity tovancomycin and linezolid closely followed by piperacillin and tazobactam combination. The prevalence of methicillin resistanceoverall among S. aureus and Staphylococcus epidermidis was found to be 51.72%.Conclusion: MRSA is prevalent among the burn wounds but is 100% sensitive to vancomycin and linezolid. To ensure earlyand appropriate therapy, routine microbiological surveillance and a regular update of their antimicrobial susceptibility patterncould help in the prevention of development of multidrug resistance.
ABSTRACT
Introduction: The aim of the study was to study the change in mortality pattern of surgical patients in government tertiary care hospital over a decade. Background: By analyzing the mortality pattern, we can identify the major reason for death in surgical wards. That will help to install our preventive strategies and allocate appropriate resources in terms of manpower and equipment where they are most critically needed. Materials and Methods: For our retrospective study, necessary data were obtained from the registration department due to permission from hospital authority. Out of all the admissions, data of the expired patients during the year 2008 and 2018 in detail using the proforma sheet have extracted. Then, a retrospective and descriptive observational study was done on all patients who have died in the surgery department during the year 2008 and 2018 of Sanjay Gandhi Memorial Hospital (S.G.M.H), associated with Shyam Shah Medical College, Rewa (Madhya Pradesh), during the year 2008 and 2018. Results: In 2008, there were 6286 admissions, of which 453 deaths were occurred, in contrast to 2018 there were 10,887 admissions, of which 702 deaths were noted and observed mortality rate (7.20%) in 2008 and (6.44%) in 2018. During our study, we observed that burn (26.04%) was the leading cause of the death in 2008 and (26.64%) in 2018, next was the road traffic accidents (RTA) specific to head injury (13%) in 2008 and (23.38%) in 2018 and, at third position, viscus perforation (16.78%) was the cause of death in 2008 and (16.39%) in 2018. The case fatality rate is overall decreased over a decade in all diseases. Conclusion: In our institute (S.G.M.H), surgical mortality has reduced from 7.20% (2008) to 6.44% (2018) almost by 1% over a decade. Burn and RTA were the leading causes of the deaths to reduce the incidence in this both groups, we need to work in both directions as one side we need to improve in our infrastructure and services, and on the other side, we need to focus in preventive strategy as these causes can be preventable by educating the preventive strategies to the people at ground level.
ABSTRACT
Objective: A comparative study between laparoscopic appendectomy and conventional open appendectomy (OA). Materials and Methods: Our study was carried out on 88 patients admitted in surgical wards of Sanjay Gandhi Memorial Hospital associated with S. S. Medical College Rewa, Madhya Pradesh. Patients of acute and/or recurrent appendicitis, or cases who came for interval appendectomy, admitted through casualty or transferred from other department or reported in OPD during the period of study were included in the study. Detailed history and clinical examination, baseline blood investigations, and radiological investigations were done. Initial conservative management, including IV fluid resuscitation with Ringer’s lactate solution/Foley’s catheterization/nasogastric intubation, was done as per need. Operative procedure (laparoscopic appendectomy or OA) was planned and performed as per the patient choice and patient’s consent of that particular operation and patient’s pre-operative condition. Both procedures were compared in relation to duration of operation, post-operative pain, postoperative hospital stay, complications, conversion rate, time taken for return to normal activity, diagnosis of additional pathologies, relief of symptoms, and cosmesis. Result: Laparoscopic appendectomy is better as compare to OA in relation to post-operative pain, post-operative hospital stay, early return to normal activity, diagnosis of additional pathologies (especially in female patients and patients with diagnostic uncertainty), and subjective cosmesis. Disadvantage of laparoscopic appendectomy is longer mean operating time and conversion into OA. Overall complication rate and relief of symptoms are similar in laparoscopic and OA group. Conclusion: Laparoscopic appendectomy is thus a safe, simple, and efficient technique for treatment of appendicitis in experienced hands. Cases with unsure anatomy due to adhesions were the most difficult to complete lap