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Background: Burn injuries and deaths pose a major public health concern globally, especially in developing and underdevelopedcountries. As burn patients have lost their primary barrier and exposed to microorganism invasion continually and chronically,Staphylococcus aureus becomes one of the greatest causes of nosocomial infection in burn patients though it is a normalskin flora. The cases of antibiotic resistance have increased, and resistant species such as methicillin-resistant S. aureus(MRSA) provide additional challenges in the form of virulence factors. Multimodal infection control concept is required to limitthe spread of infection with multidrug-resistant organism including MRSA in a burn unit. The common pathogens isolated fromburn wounds are S. aureus, Pseudomonas aeruginosa, Streptococcus pyogenes, Acinetobacter baumannii, and various coliformbacilli. Hence, antimicrobial susceptibility pattern of bacterial isolates in burn patients plays a key role in the management ofthese patients.Materials and Methods: This prospective observational study involved the collection of wound swabs from burn patientsfrom June 2018 to May 2019. All patients with burn wounds irrespective of age and sex, admitted through surgery outpatientdepartment or casualty, during the period of study were included in the study.Results: Maximum prevalence was found for P. aeruginosa, i.e., 37.5% followed by S. aureus, for which the prevalencewas found to be 18.75%. The organism least commonly cultured was Acinetobacter; the prevalence of MRSA was found tobe 57.14% and the prevalence of methicillin resistance was found to be 42.8% in patients with Staphylococcus epidermidis.Overall, the prevalence of methicillin resistance was 51.72%. The drugs most effective against P. aeruginosa, the most commonisolate, were meropenem (97.62%) and piperacillin/tazobactam (90.48%) followed by gentamicin (64.29%). Meropenem andpiperacillin/tazobactam showed 100% efficacy against the other Gram-negative bacilli isolated as well. MRSA isolates showed100% sensitivity to vancomycin and linezolid closely followed by piperacillin-tazobactam combination. Klebsiella pneumoniaeshowed 100% sensitivity to meropenem and piperacillin/tazobactam.Conclusions: The overall isolation rate was 75%. Only solitary isolates were studied. Overall, Gram-negative organisms(66.66%) were more common than Gram-positive organisms (33.33%). P. aeruginosa (37.5%) was the most commonisolate followed by S. aureus (18.75%). The prevalence of MRSA was 57.14%, but all the MRSA isolates showed 100%sensitivity to vancomycin and linezolid. On antibiotic sensitivity testing, piperacillin/tazobactam (95.24%) was found to bethe most effective drug against all the organisms isolated. Meropenem (99.40%) was the most effective drug against theGram-negative organisms. Vancomycin (100%) and linezolid (100%) were the most effective drugs for the Gram-positiveorganisms.
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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.
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Background: Centchroman has been studied earlier and literature mentions it to be a novel non-steroidal, selective estrogenreceptor modulator, antiestrogen, and mild anti-inflammatory drug with a significant decrease in size of fibroadenoma. Ourstudy aims to check the reduction in the size of fibroadenoma in response to centchroman.Materials and Methods: A prospective observational study was carried out in patients of fibroadenoma attending surgeryoutpatient department and wards of Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa(Madhya Pradesh) from August 2015 to July 2016. Patients were included in the study after obtaining an informed consent.Patients were followed up for 12 weeks.Results: In our study, the maximum number of fibroadenomas was found in the left upper outer quadrant; of 102 patients,total lesions (fibroadenoma) were 130. Of 102 patients studied for the effect of centchroman on fibroadenoma, there was aresponse in 36 patients, which accounted for 35.29%. In 66 (64.8%) patients, there was no response after the treatment withcentchroman and they were subjected to excision and biopsy. The mean difference in volumes of fibroadenoma was statisticallyinsignificant. However, there was a reduction in size of mean volume of fibroadenoma which was 4.085 at the presentation andwhich was 3.24 at the end of the 12th week.Conclusion: Fibroadenoma was common in the age group of 21–30 years. The left breast was more involved in fibroadenomas.The most common site for fibroadenoma was the left upper outer quadrant. The effect of centchroman on decrease in volume offibroadenoma was seen in 35.29% of patients. Reduction in volume of fibroadenoma was statistically insignificant. More than 50%reduction in volume of fibroadenoma was seen only in 3 patients (2.94%). Surgical excision and biopsy were the preferred modalityof treatment for fibroadenomas in patients where the drug centchroman showed no response in regression in volume (64.8%).
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Background: Perforation peritonitis is a commonly encountered surgical emergency and it is defined as inflammation of theserosal membrane that lines the abdominal cavity and the visceral organs. The aim of this study is to analyze the demographicpattern and site of perforation of non-traumatic hollow viscus perforation peritonitis in Vindhya region.Materials and Methods: A total of 209 cases were studied with hollow viscus perforation peritonitis admitted in the surgicalwards in Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa (MP), India, in the period fromJune 1, 2018, to May 31, 2019. All necessary investigations were carried out. X-ray, Ultrasonography abdomen, and bloodinvestigations were done. The patient underwent emergency exploratory laparotomy and a careful record of pre-operative andpost-operative findings was made and was carefully filled in the pro forma. All the patients were advised to attend the surgicaloutpatient department for follow-up.Results: Of 10,887 patients admitted to Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa(MP), India, from June 1, 2018, to May 31, 2019, in which non-traumatic hollow viscus perforation peritonitis was diagnosedin 209 patients (1.9%), among which most of the patients were male (177) and rest were female (32). Most of the patientsbelonged to the low-socio-economic status of 21–40 years of the age group. From this study, the duodenum was found to bethe most common site of perforation, followed by stomach.Conclusion: Patients were admitted in the Department of Surgery, Shyam Shah Medical College and Sanjay Gandhi HospitalRewa, the Vindhya region in the Madhya Pradesh, patients diagnosed as a case of non-traumatic hollow viscus perforationperitonitis were included in the study. The majority of the patients of the perforation peritonitis belonged to 21–40 years ofage group. 41–60 years of age group was the second most common age group of patients who presented with perforationperitonitis with a male-to-female ratio of 5.5:1. The most common site of perforation was duodenum followed by gastric andappendicular and the least common site of perforation was colon.
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Introduction: Chest trauma is one of the most serious injuries of the chest and also a common cause of significant disabilityand mortality. Chest trauma is the leading cause of death from physical trauma after head and spinal cord injury. Thoracicinjuries are primary or a contributing cause of about one-fourth of all trauma-related deaths. Traumatic chest injuries are onthe rise mainly due to increased frequency of road traffic accidents (RTAs) and rise in community disharmony. Chest injuriesare one of the common causes of major mortality and morbidity. The management of traumatic chest injuries depends on theseverity of injury, patient accessibility to nearby hospital, and availability of resources at tertiary care center.Materials and Methods: It is a prospective study of a total of 134 patients presenting to the emergency department with chest injuriesof varying severity in Sanjay Gandhi Memorial Hospital from 1 June 2018, to 31 May 2019 had been carried out. Data collectedregarding common injury modes, age and gender distribution, pre-hospitalization practices, clinical presentations, associated injuries,severity of injuries, and management options from the hospital record section and these data were analyzed with descriptive statistics.Results: Chest trauma is most common in males in their thirties with mean age of presentation 33.47 years. The most commonmode of injury was RTA 69.4%, followed by fall from height 14.9% and assault 11.1%. Pain in chest (53%) was the most commonsymptom of blunt trauma chest in the patients of our study sample followed by dyspnea (31%) and asymptomatic (9%). Clinicalsign was tenderness over chest. About 61.2% of patients found with collection in pleural cavity, in which hemothorax (23.9%)was the most common collection followed by pneumothorax (22.4%) and hemopneumothorax (15.7%).Conclusions: Chest injury is seen commonly in RTA patients. Most of the patients of chest injury had soft tissue trauma overchest in the form of abrasions and majority of these patients can be managed by symptomatic care and simple life-savingintervention, i.e. intercostal drainage. With increased RTAs, it is needed to have public awareness regarding road safetymeasures and educating them about the first aid measures for trauma patients.