RESUMO
Background: Seroma, a clinically evident subcutaneous collection of serous fluid after breast cancer surgery, developing in approximately 30% of cases. To prevent seroma formation, it is important to estimate individual risk of seroma formation, i.e., the identification of predictive variables will be helpful in designing future trials aimed at reducing the incidence of this seroma. This study intends to find out the association between certain pre-operative, intra-operative, and post-operative factors related to MRM and incidence of seroma formation.Methods: It was an observational prospective on 100 females undergoing MRM at Department of Gandhi Medical College Bhopal, Madhya Pradesh, India. Patients were observed postoperatively for seroma formation and factors affecting it.Results: patients with seroma formation in this study tended to be older age (age, 62.60±10.40 years versus 56.13±10.31 years; p<0.001) and more obese (BMI, 26.95±4.2 versus 24.61±3.61; p<0.001). Higher amount of initial drain volume was directly related to seroma formation. Initiation of arm physiotherapy after surgery (3.14±0.23 days versus 2.17±0.74 days; p=0.043).Conclusions: The incidence of seroma is higher in older and in more obese patients. The incidence is decreased by flap fixation under muscles and early physiotherapy. Furthermore, few interventions in the operative period can help minimize the chances of seroma formation.
RESUMO
Background: Patients who have signs of malnutrition have a higher risk of complications and an increased risk of death in comparison with patients who have adequate nutritional reserves. It is common and occurs in about 30% of surgical patients with gastrointestinal diseases and in up to 60% of those in whom hospital stay has been prolonged because of postoperative complications. The serum albumin level is the most readily available and clinically useful parameter. A serum albumin level greater than 3.5 g% suggests adequate protein stores and it confers a protective effect through several biological mechanisms. It predicts perioperative morbidity and mortality.Methods: Our study was conducted on a cohort of 100 Patients admitted in Department of General surgery Hamidia Hospital for major elective surgery between October 2016 and September 2017. Sample size taken was 100.Results: The present study shows that patients with serum albumin less than 3 g/dl has more postoperative complications and patients with serum albumin >3.5 g/dl has less postoperative complications which was statistically significant. The study concludes that as the serum albumin level increases the complication rate decreases.Conclusions: Our study shows that sr. albumin is a good indicator of postoperative complications. The patients with sr. albumin <3.0 g/dl had a higher complication rate which was statistically significant (p<0.05). Patients with sr. albumin >3.5 g/dl had less complications which was statistically significant (p<0.05). The correlation between the serum albumin and complication rate was statistically significant in the malignant diseases when considered separately.
RESUMO
Background: Harbouring of potential pathogens in operationtheatres (OTs) and intensive care units (ICUs) of hospital is amajor cause of patient’s morbidity and mortality. Environmentalmonitoring by the microbiological testing of surfaces andequipments is useful to detect changing trends of types andcounts of microbial flora. High level of microbial contaminationindicates the needs for periodic surveillance aimed at earlydetection of bacterial contamination levels and prevention ofhospital acquired infections.Aim: The aims of the study were to count CFU (colony formingunit) rate of indoor air, to identify bacterial colonization ofsurface and equipments isolated from Operation theatres, ICUsand Labour room of a teaching hospital in district Kangra,Himachal Pradesh.Methods: This retrospective study, analyzing themicrobiological surveillance data from OTs over a period of 2years from January2017 to December2018 was conducted at atertiary care hospital. Air sampling of 8 OT’s, 4 ICU’s and 1 LRwere done by settle plate method. Swabs were taken fromdifferent sites, equipments and bacterial species were isolatedand identified from them as per standard guidelines.Result: A total of 105 air samples were collected for 2 yearfrom 8 OT’s, 4 ICU’s and 1 LR. The bacterial CFU/m3 /mincounts of air from all OTs ranged from Superspeciality OTSshowed less bacterial CFU rate of air (0-5 CFU/m3) followed byOpthalmology OT (5-8 CFU/m3) and highest in Gynae (30-46CFU/m3). CCU showed less bacterial CFU rate (10-15CFU/m3) followed by Surgery ICU (28-35 CFU/m3) and highestin PICU (38-42 CFU/m3), Labour room showed 42-51 CFU/m3.Bacterial species were isolated from 43.85 % out of total 157swab samples taken from all OTs and ICUs. The mostcommon isolate was Bacillus species 46% followed by CONS(22%). Pathogenic organisms isolated were 10% Gramnegative bacilli which included 3% Non-Fermenters, thecommon isolate was Klebsiella spp. amongst gram negatives.
RESUMO
Background: Enteric fever or Typhoid fever is caused mostlyby Salmonella enterica serovar Typhi and Salmonella entericaserovar Paratyphi is an important public health challenge forIndia, especially with the spread of antimicrobial resistance.The situation is further complicated by increased incidence insome parts of the country of S. Paratyphi A as a cause ofenteric fever. This serovar is not prevented by currentlyavailable typhoid vaccines and represents an increasing threatto human health.Purpose: The present study was undertaken to analyse thetrend in prevalence of culture-positive typhoid fever during thelast three years and to determine antimicrobial susceptibilityprofile of Salmonella Typhi and Salmonella Paratyphi Aisolated from patients of enteric fever in this part of the country.Material: This retrospective study incorporates a three years,(January 2015-December2018) laboratory data comprising52isolates of Salmonella. Cultures were identified by standardmethods. Antimicrobial susceptibility was done againstchloramphenicol, amoxicillin, co-trimoxazole, ciprofloxacin,ceftriaxone, cefixime and azithromycin as per correspondingCLSI guidelines for each year.Results: Salmonella enterica serotype Typhi (S. Typhi) wasthe more frequent serotype isolated i.e., 73% with theremaining 27% being Salmonella enterica serotype Paratyphi A(S. Paratyphi A). There was emergence of S. Paratyphi Aserotype in 2017-18. Antimicrobial susceptibility forchloramphenicol, amoxicillin and co-trimoxazole, ciprofloxacinand ceftriaxone was found to be 97.2%, 88.5%, 90.5%, 66.8%,99.4% for S. Typhi and 100%, 90.1% and 92.8%, 71.5%, 100%for S. Paratyphi A.Conclusion: The present study confers Salmonella ParatyphiA as the rapidly emerging pathogen of enteric fever. Theantibiogram of Salmonella Typhi and Salmonella Paratyphi Ashowed decreased susceptibility to fluoroquinolones and anotable decrease in the multi drug resistant strains ofSalmonella isolates with re-emergence of susceptibility to firstline antibiotics.