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Introduction: According to WHO definition, "Rational use ofdrugs requires that patients receive medications appropriate totheir clinical needs, in doses that meet their own individualrequirements for an adequate period of time, at the lowest costto them and their community".Methodology: 200 randomly prescription were included in thisstudy. This study was conducted in Department of Surgery inthe Government Medical College, Badaun. The duration ofstudy was over a period of six month.Result: 200 randomly prescription were included in thisstudy.115 fixed combination of different drug were prescribed.These 115 drugs were prescribed for a total of 1159 times/drug encounters. In our study, the route of administration ofdrug 44.1% by oral, 47.4% injectable and rest were by otherlike inhalation, subcutaneous & tropical routes.Conclusion: This study concludes that polypharmacy,overuse of injectable and prescribing by brand names were thechallenges identified
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Background: Haemorrhoids are common pathology of anal canal. Over the last few years, because of new surgical techniques, increased attention has been laid on Surgical Management of hemorrhoids, still open Haemorrhoidectomy remains the mainstay of treatment. Postoperative pain is one of the most common complications of open Haemorrhoidectomy. In our study we decided to compare the incidence of postoperative pain in open Haemorrhoidectomy with or without lateral sphincterotomy. Methods: To compare the incidence of post-operative pain in patient of open Haemorrhoidectomy with lateral sphincterotomy versus open Haemorrhoidectomy without lateral sphincterotomy. Results: In our study group A in which open Haemorrhoidectomy along with lateral sphincterotomy was done had statistically significant less postoperative pain at 6 hours and 24 hours postoperatively and on postoperative day 7 at the time of follow up with Chi square test (P<0.0001). Conclusion: Addition of lateral sphincterotomy decreased post-operative pain and also reduced the need for post-operative analgesia in a significant number of patients. Hence through this study, we concluded that in conventional open Haemorrhoidectomy, addition of lateral sphincterotomy is an effective, convenient, and simple way to reduce post-operative pain.
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Background: Both General and Regional anaesthesia can be used for lower Lumbar Disc surgery but SPINAL ANAESTHESIA is also a better alternative as it is accompanies by less blood loss and haemodynamics instability. Materials & Methods: 60 patients were randomly assigned to receive either General Anaesthesia( GA group) or Spinal Anaesthesia(SA group). Patients were supplemented with i.v. Propofol sedation in Spinal anaesthesia group. The values were recorded preoperative, intraoperative & postoperative. HR, MAP, amount of blood less, surgeon Satisfaction were noted. The severity of nausea, vomiting, duration of recovery and total analgesic use was also recorded. Results: Total anaesthesia, surgical time and blood loss is less in spinal anaesthesia group as compared to general Anaesthesia group. Intraoperative hypertension and tachycardia is more in GA group. Surgeon satisfaction and cost effectiveness is more in SA group. Postoperative nausea ,vomiting is more in GA group. Conclusion: Spinal anaesthesia is better ,safe and economical alternative to general anaesthesia for lower spinal surgery
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Background: Brain Trauma Foundation recommends EDH volume of greater than 30 cm3 warrants surgical evacuation irrespective of Glasgow Coma Scale. Often it is observed that Not all cases of acute EDH require immediate surgical evacuation, cases with lesser than 5 mm midline shift, no focal neurological deficits and GCS>8 and can be managed conservatively provided the patients are closely observed for any deterioration in GCS. For EDH with a volume more or less than 30ml in the supratentorial space and, a midline shift 6-10 mm, with a GCS score > 10, was attempted non-surgical management, with close observation and serial CT scanning. Aim: The aim of this study was to discover the most important factors influencing the management strategy and outcome of EDH. Methods: 70 adult patients treated for EDH were included in this retrospective study, 26 cases (37%) underwent urgent surgery, 44 cases (62.8%) were managed conservatively out of which one third of patient required delayed surgery. Results: Our study showed that out of 62 % of the patients who were conservatively managed, 72 % had a favorable outcome despite the presence of a midline shift of 6- 10 mm and an EDH volume of >30 ml but having a good GCS score. Conservatively managed patients with GCS >10, 77% had Good Recovery. Those with high EDH volume, 61% had a good outcome. 84 % of the patients having a midline shift between 6-10 mm had a good recovery. Patients with GCS < 8 had a poorer outcome than patients in good neurological status, regardless of the therapy. Conclusions: Hence we conclude, EDH must be promptly diagnosed by CT scan and considered as an emergency lest misdiagnosed and should be admitted into a neurosurgical care unit. Close neurological monitoring, appropriate follow up CT scans in the setting of improved GCS score resulting in good outcome in patient on conservative management.
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Background: Breast cancer is the second most common malignancy in Indian women. Among the members of the steroid receptor superfamily the role of estrogen and progesterone receptors (ER and PR) is well established in breast cancer in predicting the prognosis and management of therapy, however, little is known about the clinical significance of androgen receptor (AR) in breast carcinogenesis. The present study was aimed to evaluate the expression of AR in breast cancer and to elucidate its clinical significance by correlating it with other hormonal receptors and clinical parameters. Methods: It was a prospective study which include 30 patients of histopathologically proven breast cancer admitted to department of surgery at S.N Medical College Agra .Expression of AR, ER, PR, HER2/ neu receptor by immunohistochemistry (IHC) and clinical parameters were studied. Results: AR expression is related to ER(P<0.015), PR(p<0.008) and triple negative breast cancer patients (p <0.008). There is significant correlation between AR and menopausal status(p<0.006) while no significant correlation was found with age and parity. Conclusions: Since there is significant association of AR in triple negative and post-menopausal women so we can say that AR expression possibly help in confirming their predictive role for therapeutic response in breast cancer patients