ABSTRACT
BACKGROUND: Intestinal obstruction is a surgical emergency that causes confusion both in the diagnosis and the management. It is related by important disease and mortality. The goal of this study was to classify the etiology, to analyse the methods of performance of acute duodenal obstruction in different age groups, various therapeutic modalities of treatment, to accomplish operative management, anticipate the post-operative complications and outcomes of patients with acute intestinal obstruction. MATERIAL& METHODS: 82 patients of all age groups (except infants) presenting with acute intestinal obstruction were studied between June 2017 and December 2018 in a multispeciality hospital in Eastern India. Patients with history of subacute intestinal obstruction and paralytic ileus were excluded from this study. RESULTS: Males were found to be affected much more than females. Pain abdomen was the most common symptom found in 94% cases followed by distension and vomiting in 86.6% and 68.3% cases respectively. Most common etiology of intestinal obstruction was due to adhesion and bands (40.3%) followed by obstructed hernia (22%) and malignancy (17%). The most common procedure done in intestinal obstruction in present study was release of adhesions and bands (37.8%) followed by resection and anastomosis (26.8%). CONCLUSION: Bowel obstruction continues to be one of the most common abdominal problems faced by general surgeons. Success in the treatment of intestinal obstruction depends largely upon early diagnosis, skilful management and treating the pathological effects of the obstruction just as much as the cause itself.
ABSTRACT
Background: Every drug has the potentiality to cause an adverse drug reaction (ADR). ADRs are a major problem in drug therapy .The aim of this study was to assess the incidence and causality of ADRs to antihypertensive agents used for the essential hypertensive patients attending at the general medicine out patients departments of Hi-Tech Medical College and Hospital, Bhubaneswar Odisha, during the time period of November 2016 to October 2018.Methods: This prospective-observational study was carried out in general medicine outpatient department of Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha.Results: Out of 254 patients, 78 (30.71%) patients were developed ADRs to antihypertensive drugs. 51 (65.38%) were female and 27 (34.62%) were male. Calcium channel blockers were the commonest therapeutic class of antihypertensive drugs associated with ADRs (n = 50, 64.10%). According to WHO causality assessment scale most of the ADRs were “probable” 41 (52.56%), followed by “possible” 21 (26.92%), unclassifiable 13 (16.67%) and unlikely 3 (3.85%).Conclusions: The results of this study concluded that antihypertensive drugs able to induce the development of adverse drug reactions, which were significant cause of increase burden on health care system and decrease the quality of life, the health care professionals should take care about the rational use of antihypertensive agents. Thus, to minimize the incidence of adverse drug reaction and to increase the quality of life.
ABSTRACT
Background: Nosocomial infections are one of the leading causes of morbidity and mortality in hospitalized patients especially the critically ill patients in the intensive care unit (ICU) where a large number of drugs are administered to the patient’ which in turn leads to the generation of antibiotic resistant pathogens. The present study was conducted to identify the prevalence of predominant bacterial microorganisms and their drug sensitivity and resistance in ICU of a teaching hospital in Eastern India. Methods: A retrospective record based study was conducted in the ICU of Hi-Tech Medical College and Hospital, Odisha, Eastern India from November, 2011 to October, 2012. Patients who were clinically suspected of having acquired any infection after 48 hours of admission to the ICUs were included in the study. The clinically suspected laboratory samples were collected from the patients and subjected to testing and antibiotic sensitivity. Results: The rate of nosocomial infection was 28.2%. Urinary tract infection was the most common infection (54.9%). The predominant isolate was E. coli (52.7%) followed by P. mirabilis (15.4%) and Ps aeruginosa (13.2%). E. coli was highly sensitive to Polymyxin B, Gatifloxacin and Ceftriaxone and showed high degree of resistance to Cephalexin, Cefadroxil, Tobramycin and Prulifloxacin. Conclusions: Most of the bacterial isolates were resistant to third generation Cephalosporins and Aminoglycosides. Regular surveillance of antibiotic susceptibility pattern, judicious use of antibiotics are very important for reducing the nosocomial infection rate and antimicrobial resistance.