RESUMO
OBJECTIVE: To find out the results of day case surgery at secondary health care hospital in terms of early complications, cost of surgery, hospital stay and patients compliance
DESIGN AND DURATION: Prospective descriptive study from July 2009 to December 2011
SETTING: Department of surgery civil hospital/ city medical centre Jacobabad
PATIENTS: Three Hundred Fifty [350] patients who underwent day case surgery were included in this study
METHODOLOGY: The patients work up and counseling were done before, and asked to come on given date and time on the day of surgery again evaluated and shifted to operation theatre. After surgery they were kept for an average time under observation for 05 to 23 hours sent to home and strictly advised to contact the surgeon or hospital in case of problem. There follow up were advised accordingly on the 3rd and 7th post operative days
RESULTS: Total number 350 patients, 233 cases were males and 117 were females. Their age ranged from 6 months to 73 year. All patients went to their home within 05 to 23 hours. During follow up 43 telephone calls [mobile] were received for complaints and medications, 12 [3.42%] of them advised to attend OPD before 3rd POD. On examination of these patients 6 [1.71%] had bleeding at the wound site, 5 [1.42%] had pain at the site of surgery one [0.28%] of them developed retention of urine, 3 [0.85%] of them were readmitted while remaining were treated as OPD cases. Five cases were apprehensive and continued admission for another 24 hours on their own request
CONCLUSION: In selected cases day case surgery is cost effective subject to availability of good communication approaching the surgeon in case of any complication and emergency with skilled hands day case surgery may be cost effective with shorter post operative stay in hospital
Thus district hospital may be utilized for day case surgery with appropriate measures following the international guide lines for day case surgery
RESUMO
Objectives: To find out the incidence of tuberculosis in cervical lymphadenopathy and patients characteristic
Study Design: Descriptive study
Place and Duration: This study carried out in surgical unit I Civil Hospital Jacobabad from January 2009 to December 2011
Methodology: Patients having cervical lymphadenopathy above the age of 12 years of both sexes were included in this study. Fine needle aspiration cytology [FNAC] of lymph nodes was done, and excision biopsy was also performed when ever required, apart from that complete history, physical examination ESR and other required haemotological test performed
Results: A total number of 180 patients with enlarge lymph nodes both male female adults were included, 68.88% [n=124] were below the age of 30 years, remaining 32.22% [n=56] were above this age group, 76.11% [n=137], patients had tuberculosis lymphadenitis. In 11.66% patients [n=21] reactive hyperplasia, 8.88% patients [n=16], chronic non specific lymphadenitis, 2.77% patient [n=05] lymphoma and 0.55% patient [n=1] metastasis to cervical lymph nodes were diagnosed. FNAC was conclusive in 87.77%, while ESR was raised in 26.66% cases. Constitutional symptoms were not significant, majority [n=119] of patients belong to poor class
Conclusion: Tuberculosis was most common diseases involving the cervical lymph nodes in both sexes who belong to poor socio economical class. Haemotological findings were inconclusive in majority of patients the FNAC diagnosis highly conclusive but few required lymph node biopsy in few cases