Department Of Tertiary Care Hospital Research Articles

Utility of Fast Scan in Blunt Abdominopelvic Trauma Patients in Lahore District

Background: To evaluate the utility of fast scan in blunt abdominopelvic trauma patients in the emergency department of tertiary care hospitals in Lahore district. Focused assessment with sonography for trauma (FAST) has been used as the first assessment in diagnosing patients with trauma in the last decade, and we have heard people questioning its authenticity and reliability, and many other things. Methodology: The study design was cross-sectional .This study was conducted at various tertiary care hospitals of Lahore, in the time duration of 3 months from January 2022 to March 2022. One hundred and six (106) patients with blunt abdominopelvic trauma were assessed by Fast scan using 2-5MHz transducer. Results: Out of 106 patients 59(55.7%) were males and 47(44.3%) were females with ages ranged between 2 to 72 years. Road traffic accidents accounted for 50% cases, 17% were due to fight while 23.6% were due to fall and 9.4% were due to assault. Of the total patients, 69.8% had negative scan while 30.2% had positive scan. Majority (6.6%) of positive scans were of splenic injury. Of all the positive scans 17% of the cases had abdominal pattern of injury while pelvic and abdominopelvic cases were 9.4% and 2.8% respectively. Practical implication: Our aim of doing this research study was to learn the benefits of performing Fast scan in BAT patients. We were able to look through possible aspects of pathology of abdomen and pelvic of traumatic patients arriving.FAST Scan is the single most valuable imaging modality in the early assessment and diagnosis of blunt abdominopelvic traumas with an aspect of safety &cost-effectiveness. Conclusion: Fast scan can be used in the initial assessment of blunt abdominopelvic trauma patients and it is verily preferred in hemodynamically stable patients. Keywords: FAST Scan, Blunt traumatic patients, Emergency department, Hemodynamic stability.

Acne Vulgaris and Its Association with Dietary Habits at a Tertiary Care Hospital in Karachi, Pakistan.

Acne is a common skin disorder among younger age group. Dietary pattern are the key determinants among acne patients. The objective of this study is to determine the association of acne vulgaris with dietary habits among patients at tertiary care hospital in Karachi, Pakistan. it is a cross sectional study and participants were selected through simple random sampling from outpatient department of tertiary care hospital in Karachi, Pakistan. Patients presenting with acne irrespective of severity and treatment were included in the study. Bivariate analyses conducted at 95% CI and p=<0.05 considered statistically significant. Females gender (62%) and family history (61%) was significantly associated with acne. Face region was most (92%) affected by acne. GI upset most common co-morbid illness with Acne (p=0.006). After adjustment of covariate, those consume oily food [Daily oily food; Twice a weekly oily food)]; sugar rich food [Daily consumed sugar; Twice a weekly consumed] and less glass of water [8-10 glass per day; 6-8 glass per day; less than 6 glass per] were significantly associated with acne. Study found that un-healthy diet is significantly associated with acne. Common dietary predictors for acne were frequent use of oily food, sugary food, and less amount of drink water.

Possible Association of Female-Pattern Hair Loss with Alteration in Serum 25-Hydroxyvitamin D Levels

Background and Aim: Most women who experience diffuse hair loss suffer from female-pattern hair loss (FPHL). Several mechanisms other than androgen have been suggested as contributing to the process. Serum 25-hydroxy vitamin D [25-(OH) D] has been associated with other hair disorders. The present study aimed to assess the female-pattern hair loss possible association with variation in serum 25-hydroxyvitamin D levels. Patients and Methods: This case-control study was conducted on 72 FPHL diagnosed female patients attending dermatology department of Tertiary Care Hospitals in Jamshoro and Karachi from November 2021 to October 2022. Females aged 18-40 years with skin prototypes III and IV were enrolled. About 72 healthy females were considered as control group. Study protocol was approved by the institutional research and ethical committee. Careful history, socioeconomic status, FPHL family history, menstrual history, and drug intake were recorded from cases and control. Patients were classified as having stage I, II, or III FPHL based on a clinical evaluation of the pattern of hair loss using Ludwig's scale. 25-OHD levels over a period of 4 months were measured to minimize seasonal bias. Females with 25-OHD levels &lt;20 ng/ml were deficient, insufficient 21–29 ng/ml, sufficient &gt;30 ng/ml, and intoxication &gt;150 ng/ml. SPSS version 26 was used for data analysis. Results: The overall mean age was 28.6±2.4 years. Age-wise distribution of patients were as follows: 9 (12.5%) in 18-25 years, 24 (33.3%) in 26-30 years, 21 (29.2%) in 31-35 years, and 18 (25%) 36-40 years. Serum 25-(OH) D levels in FPHL patients were significantly lower (15.4 ± 8.25 ng/ml) than in controls (46.42 ± 19.92 ng/ml). The mean vitamin D level did not differ significantly between patients with and without family history (14.46 ± 8.62 and 13.9 ± 8.24 ng/ml, respectively. The mean vitamin D level differed significantly between the three Ludwig's degrees (13.15 ± 8.49, 14.23 ± 6.74, and 24.9 ± 6.42 ng/ml, respectively): between degrees I and III, as well as between degrees II and III. Conclusion: The present study showed that hair loss varied significantly across all age groups. Premenopausal women with vitamin D deficiency have higher rates of hair loss, which is most profound in the age groups 26-30, followed by 25-30. Furthermore, changes in serum 25-(OH) D levels, whether deficient or sufficient, may play a role in the etiology of FPHL. Keywords: Female Pattern Hair Loss (FPHL), Vitamin D, Serum 25-hydroxy vitamin D

Survey of the processes of the central sterile supply department in tertiary care hospital

Both patients and hospitals are harmed by hospital-acquired infection, sometimes known as “nosocomial infection.” To prevent these hospitals, require excellent disinfection and sterilization technologies, which are now integrated into a single department known as the central sterile supply department (CSSD).Aim is to study Organization, workload and the Quality Control Practices in CSSD. This descriptive, observational and hospital survey based study was carried out over a period of 6 months from November to April in Santosh Medical College &amp; Hospital Ghaziabad. Monitoring of CSSD is done to oversee the use of different sterilization methods and capturing indicators to monitor sterilization process and ensure technical maintenance of the equipment according to National standards and manufacture’s recommendation. CSSD of the institution is centrally located within the hospital. Various articles including linen, dressings, surgical instruments and trays are sterilized in the CSSD. Sterilization is done by steam sterilization and gas sterilization with a total of seven autoclaves and two ETO machines. Physical, chemical are regularly used during the process of sterilization. CSSD of institute with proper practices of sterilization methods helps in continuous improvement required to decrease hospital acquired infections (HAIs).

PREVALENCE AND ASSESSMENT OF PRESCRIPTION PATTERN ANALYSIS OF ACUTE FEBRILE ILLNESS PATIENTS IN TERTIARY CARE HOSPITAL: A PROSPECTIVE OBSERVATIONAL STUDY

Aim and Objective: Assessment of prescription patterns may help the identification of clinical use of drugs in fever patients. Rational use of drugs may control the utilization of selective drugs in acute febrile illness. Methodology: A Prospective observational study was conducted in the General Medicine department in tertiary care hospital. Wards inpatients and outpatients with or without past and personal history were included in the study. Results: A Total of 357 were admitted with fever patients. In this study, patients of the 21- 30 age group patients have shown more prevalence. A total of -357 patients who were prescribed antibiotics were included in the study. Out of 357 cases, female patients 148 (41.45%), and male patients 209(58.54%). in this study maximum number of diseases was found to be dengue 103(28.85%), Out of 1250 medications, the highly prescribed formulation was parenteral dosage forms 825 (66.00%). Conclusion: A specially designed protocol is important for fever patients before prescribing to the patients evaluation of fever with suitable criteria is required. In other words, without knowing the diagnosis or focus of the disease, treatment or medications does not stop the fever spikes.

Analysis of Antibacterial Usage Pattern as per ATC/DDD WHO Coding Methodology to Match in Various Clinical Department of Tertiary Care Hospital

The WHO advises using the Defined Daily Dose (DDD) as a unit of measurement and the Anatomical Therapeutic Chemical (ATC) classification system for tracking and researching drug use. The main objective of the study is to examine changes in drug utilization. Evaluate interventions on prescribing patterns of antibiotics at The Oxford medical college hospital and research Centre. Patient demographics and drug charts are collected using specified case report form for a period of 6 months using random sampling method. Case report form includes patient demographics, laboratory data, diagnosis, and drug chart with frequency, dose, dosage and route of administration. Out of 183 cases analyzes 45.4% were female and 54.7% were male. Most of the cases were in the group of 20 to 31. Average duration of hospitalization in our study population was around 5 days. A total of 299 antimicrobial were prescribed in 183 cases. Cephalosporins were the most preferred antibiotic followed by other antibiotic class. Ceftriaxone was the most common drug among the cephalosporin. Antibiotic prescribing in the hospital is empirical, we would like to recommend that antibiotic selection should be based on the results of cultural and sensitivity testing whenever possible. The percentage of drug prescribed in generic form was found to be less. We recommend larger scope prospective study to emphasize on ensuring of rational use of antibiotics.

Functional Ability and Health Problems of Stroke Survivors: An Explorative Study.

Background A stroke is an emergency medical condition that needs to be treated promptly. Patients who suffer from stroke frequently experience varying degrees of impairment, necessitating emergency hospital treatment and prolonged home care. It can lower the quality of life which leads to social isolation and makes it harder to function independently. The purpose of this research was to assess thehealth issues and functional capacityof individuals living with stroke. Methodology An exploratory study was conducted in the neurological outpatient departmentof tertiary care hospitals in Chennai. A total of 30 post-stroke participants were selected using a convenient sampling technique. Data were collected by structured interviews using the Post-Stroke Checklist and Barthel Index. The data were analyzed through descriptive and inferential statistics. Results The majority of the patients were (86.7%) men in the age group of 55-65 years. Regarding the health problems identified with the Post-Stroke Checklist, the activities of daily living (80%) were the most common, and spasticity (48%) and pain (34%) were the least common. However, 60% of the participants had new problems related to vision, 66% had problems with hearing, 76% had problems with getting around inside or outside, and 60% had a history of a recent fall. Further, 52% had problems with remembering and concentrating on things, 72% had problems sleeping, and 45% were worried about their relationship with their spouse after the stroke. The median Barthel Index score was 43.5. Conclusions More than half of all stroke survivors were dependent on others for everyday activities. We recommend that a well-designed and focused assessment is needed to identify the functional ability and stroke-related health problems among individuals by all healthcare professionals for the successful rehabilitation of stroke survivors.

Use of complementary and alternative medicines in ENT outpatient department of tertiary care hospital in Southern Rajasthan

Background: Complementary and alternative medicine (CAM) use is highly gaining popularity along with main treatment streams these days. Physicians cannot ignore this fact and should question and counsel patients about pros and cons of CAM for cure of different ailments. Aim and Objectives: The objective of the study was to know about use of CAM among patients visiting Ear, Nose, and Throat (ENT) outpatient department (OPD) in tertiary care hospital of Southern Rajasthan. Materials and Methods: An observational cross-sectional study was conducted in ENT OPD for 2 months. Two hundred and fifty patients were considered for the study. Semi-structured questionnaire was prepared and made to be filled by the patients during their visit to ENT OPD after taking informed consent. Various questions were asked like extent of use of alternative therapies, type of CAM used by the patients, patient’s knowledge about ADRs and drug interactions, reasons for which alternative medicine might have been used. Results: Among 250 patients, CAMs were used by 36 patients. The most common CAMs were either Ayurveda or Homoeopathy medicines or both. The majority of patients obtained their information from family and friends. Maximum patients used these alternative medicines for relief of cough and hoarseness of voice. Conclusion: The study throws light on use of alternative drug therapy and streams of medicine along with routine hospital treatment among patients visiting ENT OPD. This knowledge helps to understand about patients’ alternative approach to diseases, about self-medication, patient’s belief about different types of therapies and also ignorance of possible health hazards, side effects, and complications due to use of concomitant main and alternative medicines for treatment purposes.

Acceptance of cord stem cell banking among pregnant women attending outpatient department of tertiary care hospital of Delhi

Acceptance of cord stem cell banking among pregnant women attending outpatient department of tertiary care hospital of Delhi

Informed Consent: How much information is enough? In a Obstetrics and Gynaecology Department in Tertiary Care Hospital – An Interventional Study

Permission granted in full knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with knowledge of the possible risks and benefits.A process in which patients are given important information, including possible risks and benefits, about a medical procedure or treatment, genetic testing, or a clinical trial.This paper was an interventional study it was conducted in the Department of Forensic Medicine and Toxicology,Sri Manakula Vinayaga Medical College and Hospital, Madagadipet, Puducherry to audit and to improve it was conducted in the Department of Obstetrics and Gynaecology. The deficiencies were identified and it was analysed. The results of both pre-interventional and post-interventional were recorded, which showed the significant improvement in the consent form of the major and minor procedures. It is essential that this information be discussed in simple terminology that can be easily readily understood and help the patient togive proper consent for the procedures

A cross-sectional study of prescription audit in outpatient departments of tertiary care hospital

Background: Prescriptions are medico-legal documents, and it is the duty of every physician to write a complete, legible, and valid prescription to ensure rational drug use and prevent the occurrence of medication errors. A periodic prescription audit is required for the identification of common deficiencies in the prescriptions and to undertake corrective measures for improving the prescribing practices. This is a quality improvement process that seeks to improve patient care. It supports health professionals in making sure their patients receive the best possible care. Aims and Objectives: To find out the common areas of noncompliance in prescriptions by using the prescription audit tool by the National Health Mission. Materials and Methods: A cross-sectional study of prescription audits was conducted using the prescription audit tool by the National Health Mission. Prescriptions were randomly taken from various clinical outpatient departments according to the percentage they contribute to the outpatient population. This tool contains both indicators to check the completeness of the prescription and indicators for the legibility and rationality of the prescription. 235 prescriptions were audited, and the parameters that scored low were identified. Results: The lowest score was seen with parameters like mentioning allergy status (4.89%), duly signing prescriptions (44%), recording follow-up advice and precautions (19%), and mentioning the review date (16.8%). Parameters that need improvement are recording the brief history and salient features of the clinical examination, to write the presumptive diagnosis. Conclusion: Conducting prescription audits frequently in all hospitals help in better understanding the prescribing behavior of the physicians, and followed by constant communication and training of the physicians, this is the most effective way to improve prescription practice within the hospital.

KNOWLEDGE AND PRACTICES RELATED TODIABETIC RETINOPATHY AMONG DIABETIC PATIENTS ATTENDING MEDICINE OUT PATIENT DEPARTMENT IN TERTIARY CARE HOSPITAL IN CHENGALPATTU DISTRICT

Aim: To assess the knowledge and practices related to diabetic retinopathy among diabetic patients attending medicine out patient department in tertiary care hospital in Chengalpattu district Design: hospital based cross sectional study Methods: study was conducted among 202 adult patients with diabetes between June 2021 to December 2021 , who attended medicine outpatient department in tertiary care hospital in Chengalpattu district. All patients were surveyed with a questionnaire regarding there Knowlegde and practices related to diabetic retinopathy. Statistical Analysis: SPSS software, CHI square test Results: A questionarre based responses was obtained from 202 patients diagnosed with diabetes .Age distribution of diabetes is predominantly high in 40 -60 years .75% of people are treated with oral hypoglycemic drugs .around 61% know that diabetes can cause eye disease .Regular eyecheck up is mandatory in diabetic patients was agreed by 52% patients.only 43% visit ophthalmologist for regular eye checkup in the contrary 83% visit physicians regularly for diabetic control. Conclusion: Our study emphasises the need for expanded educational programmes about DR, its risk factors, available treatments, and follow-up. In our study, the role of physicians was frighteningly minimal, which has to be emphasised.

A Review of Ocular Surgeries Performed in 2020 and 2021 at Tertiary Care Hospital

Objective: To review the types and total number of ocular surgeries performed at Tertiary Care Hospital in two consecutive years i.e.,2020 &amp; 2021. This study will also indicate the pattern of ophthalmic diseases in the catchment area of the hospital. Methods: It was retrospective study. Study center was Tertiary Care Hospital. Study duration was two years i.e., 1-1-2020 to 31-12-2021.Data was obtained from eye department of Tertiary Care Hospital. Collected data was analyzed by using SPSS version 25. Tables and graphs were made which presented total number and percentage of all data. Results: Only one ocular surgery i.e., enucleation was carried out in 2020 upon a female 31 years of age. In next year total number of ophthalmic surgeries performed was 60. 66.6 % surgeries were performed due to cataract. 60% of males were operated for cataract and 40% were females. 53.3 % of total surgeries were performed upon females . 10% of total surgeries were performed for squint, predominantly in females, 83.3 % of total squint surgeries. 60% of patients belonged to age group of 60-75years. Conclusion: Number of surgeries carried out in 2020 was only one. In 2021 it increased upto 60 surgeries. How to cite: Bhatti SA, Choudry TA, Asif M, Mushtaq R, Asif H. A Review of Ocular Surgeries Performed in 2020 and 2021 at Tertiary Care Hospital. Esculapio - JSIMS 2022;18(04):248-252

Spice Intake Among Chronic Gastritis Patients and Its Relationship With Blood Lipid Levels in South India.

Chronic gastritis is one of the most prevalent disorders affecting individuals. It affects hundreds of millions of people in different ways around the world. The objective of the study was to estimate the spice intake and its relationship with the blood lipid level among patients with chronic gastritis in the outpatient department of tertiary care hospital. The study design was a hospital-based cross-sectional study that was done in the Guntur district of Andhra Pradesh. The study population included 208 chronic gastritis patients between 20 and 60 years of age selected by systematic sampling. Detailed information on sociodemographic and lifestyle factors was collected using a questionnaire. Individual dietary intake data were collected by the detailed 24-hour dietary recall. Spice intake was calculated using Diet Calc Software. An independent t-test was used as a test for significance. The correlation was used to study the relationship between spicy food intake and dyslipidemia. P-value <0.05 was significant. A total of 208 patients were enrolled in the study with a response rate of 91%. The mean age of the studied patients was 45.15 ± 9.27years, with46.6% males and 53.4% females. Almost half (45.7%) of the participants had "mild" spicy food in their diet and almost two-fifths (39.9%) of participants had a "moderate or middle" degree of spice in their food. The mean dietary intake of condiments and spices by the participants was 34.19 (±22.18) gm/day.The current study showed higher spice intake was significantly correlated with impaired lipid profile levels with Kendall's tau_b correlation coefficient of 0.17 (p=0.01). Because of the excessive use of spices in the Guntur region of Andhra Pradesh, people have grown accustomed to eating spicy food since childhood and therefore is at a higher risk of developing chronic gastritis, and dyslipidemia.

Maternal Perspectives of Newborn Hearing Loss in Resource Constrained Settings of Rawalpindi Pakistan

Objective: The objective of this study was to assess knowledge of mothers regarding risk factors, early identification, and intervention for infant hearing loss and to determine association between hearing loss and consanguineous marriages in Pakistan.&#x0D; Study Design: Analytical cross-sectional study.&#x0D; Place and Duration of Study: Out Patient Department of tertiary care hospitals in Rawalpindi Pakistan, from Mar to Jun 2021.&#x0D; Methodology: 111 mothers consented to participate. Data was collected using a structured researcher administered questionnaire. It included four sections with 37 questions that were answered in yes, no, or unsure. Analysis was done using SPSS software.&#x0D; Results: Mothers' knowledge of two risk factors was high with most respondents being aware of head injury or slap to the ear (n=94) being a risk for hearing loss, followed by ear pain/discharge (n=88). 66.7%(n=72) of participants considered use of ototoxic drugs by mother during pregnancy to be a potent risk factor for neonatal hearing loss. The mothers' understanding of natal causes such as delayed birth cry and neonatal jaundice was poor. Their understanding of postnatal causes such as high fever, frequent hospitalization, and long stay in NICU was also limited. Mothers who were employed had significantly more awareness in certain factors than housewives. 45.4% (n=49) of the mothers believed being in a cousin marriage influenced infant hearing loss while 38.9% (n=42) disagreed, and 15.7% (n=17) were unsure.Conclusion: Only half of all participating mothers were fully aware of the possible risk factors and causes of infant hearing loss. Seminars and public awareness programs should be arranged to educate mothers about risks of infant hearing loss.

Outcome of Laparoscopic Repair in Ventral Hernia

Aim: To determine the outcome of laparoscopic repair in ventral hernia. Study design: Prospective observational study. Place and duration of study: General Surgery Department of Tertiary Care Hospital, Liaquat University of Medical &amp; Health Sciences (LUMHS), Jamshoro Sindh from 1st March 2017 to 30th June 2020. Methodology: Eighty six patients with ventral wall hernia were enrolled. Hernia was approached laterally and ports were placed from farther side of abdomen. In all cases three trocars were used one for 10mm and 2 ports for 5 mm. polypropylene mesh was used for hernia repair. Mesh was placed using intracorporeal mesh fixation technique. Results: The mean age of patients was 46±8.3 years. Fifty two (60.4%) were females and 34 (39.5%) were males. The ratio of females with ventral wall hernia is higher than males requiring surgery. The mean BMI of study participants was 30.8±4.3 kg/m2. Bowel perforation is characterized to be the most severe complications of laparoscopy and it affected 3.4% of the participants. The most common complication post-operatively was severe pain in 26.7% of patients, controlled by I/V pain killers for two to three days followed by seroma formation Conclusion: Laparoscopic ventral hernia repair is an excellent technique as compared to conventional techniques and has fewer complications but it requires surgical expertise and specific instruments. Although it is an ideal procedure for simple ventral wall hernias, it is not used for complex hernia. Key words: Laparoscopic repair, Ventral hernia, Mesh repair

Evaluation of risk factors and clinical presentation of adenoid hypertrophy among children attending the pediatric outpatient department of tertiary care hospital in Dhaka division

Background: Adenoid hypertrophy (AH), also known as enlarged adenoid, refers to the unusual growth of the adenoids. AH and its consequences are common in the entire childhood period. The adenoids are small masses of lymphatic tissue located in the upper airway, between the nose and the back of the throat.Methods: This cross-sectional study was conducted from January 2021 to December 2021 over a period of 12 months. All the children aged 1-18 years attending the pediatric outpatient department (OPD) who had known risk factors or sign-symptoms of AH underwent a lateral nasopharyngeal x-ray to confirm the presence of an enlarged adenoid. Those children who had enlarged adenoids were analyzed in this study.Results: A total of 1289 children aged 1-18 years attended the pediatric OPD over 1 year of the study period, out of them, 118 had evidence of enlarged adenoid on lateral nasopharyngeal x-ray, giving a prevalence of 2.3%. Among the 118 radiologically proved AH cases, 112 (95%) were symptomatic and 6 (5%) were asymptomatic having risk factors only. The peak age of diagnosis of AH in this study was between 12-72 months (43.4%). The mean age of presentation was 100.6±58 months. There was a male predominance with male to female ratio of 1.6:1. AH may be presented without symptoms in 5% of cases or may be presented with complications such as OSA (27%), adenoid facies (14%), and otitis media with effusion with or without hearing impairment (13%).Conclusions: The prevalence of AH among children attending the pediatric outpatient department was 2%, of them 18% had an indication for adenoidectomy. The most common two clinical presentations were mouth breathing and nasal obstruction and the most common complication was obstructive sleep apnea.

Helicobacter Pylori Infection among Patients Attending the Gastroenterology Department in Tertiary Care Hospital, Kathmandu, Nepal.

Helicobacter pylori is one of the most pathogenic organisms that cause gastritis, peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma in humans. The main aim of this study was to determine the H. pylori infection among patients undergoing upper GI endoscopy and to compare the efficacy of the diagnostic method of H. pylori infection including invasive tests (biopsy-based tests like the rapid urease test (RUT), direct smear, and culture) and the noninvasive test (HpSA). A total of 100 stool samples and 200 gastric biopsy specimens were collected (2 samples from each patient) from June to November 2019. Stool samples were processed for the detection of an H. pylori stool antigen (HpSA) by a kit method. One biopsy specimen was processed for the RUT, and another was transported to the laboratory in an Eppendorf tube containing normal saline for preparation of the smear and culture. Out of 100 participants, 26% were found to be H. pylori positive by the RUT, 11% by the direct smear, 6% by the culture, and 17% by the stool antigen test. The prevalence of H. pylori infection was found to be 14%, considering at least two of the three biopsy-based tests that gave positive results. H. pylori infection was found to be higher in the age group of 46-55 years. The overall prevalence of H. pylori infection was higher in gastric ulcer cases, followed by erosive pangastritis and gastroduodenitis. Tea drinking habits and the frequency of meal consumption more than twice a day were found to be significantly associated with H. pylori infection (P < 0.05). Hence, the RUT was found to be more efficient than the direct smear and the culture method for finding H. pylori in the biopsy sample. However, none of these methods can be considered to be the gold standard alone. Thus, the RUT combined with other tests is preferable for the detection of H. pylori.

Post Covid-19 Acute Invasive Fungal Rhinosinusitis (AIFR): A Study of Histopathological Findings After FESS in Radiologically Diagnosed AIFR.

COVID-19 pandemic has led to a concerning surge of post-COVID-19 AIFR. Mucormycosis (BLACK fungus) is a rare but severe and life-threatening fungal infection occurred by mucormycetes, a family of moulds. More than 49,000 cases of AIFR were reported in three months in India. It primarily affects diabetics and spreads from the nasal cavity and paranasal sinuses (PNS). It also involves eye, palate, or brain. It is diagnosed clinically followed by radiological and pathological findings. We aimed to compare and analyse the pre-operative imaging with postoperative histopathological findings. The study was conducted in ENT department of tertiary care hospital, Rajkot. 200 patients were randomly selected who were presented to ENT OPD with clinically suspected Post COVID-19 AIFR. All patients underwent detailed ENT examination and radiological modality like MRI PNS, Brain, and Orbit. After proper pre-op evaluation, all patients underwent Functional Endoscopic Sinus Surgery (FESS). MRI findings were confirmed with that of histopathological findings done on KOH mount. All the patients were showing AIFR on MRI findings whereas 49% of patients had mucormycosis on Histopathology. Various other fungal infections like aspergillosis (7%), candidiasis (1.5%) were also found on HPE. 9% of patients showed combined infection with mucor and aspergillus species. Rest of the patients showed non-fungal rhinosinusitis. Inflow of the epidemic, plenty of patients were shown invasive fungal sinusitis in MRI patterns whereas many of them were HPE negative. Thus this study was done to know the efficacy of radiological features with pathological diagnosis. We have considered both procedures standard in our study.

Bacterial Flora and Antibiotics Sensitivity Pattern in Chronic Rhinosinusitis Outpatient Cases in Tertiary Care Hospital

Background Chronic rhinosinusitis is a disease that afflicts a significant percentage of the population and causes considerable long-term morbidity. The initial treatment is clinical evaluation followed by starting empirical antibiotics. With the use of empirical antibiotics there is a possibility of aggravating the disease and leading to the persistence of chronic sinusitis. In order to start a protocol for rational use of antibiotics, we need to have the bacteriological profile in cases of chronic rhinosinusitis along with the sensitive group of antibiotics.&#x0D; Objective To determine the bacterial flora in nasal swab of patients with chronic rhinosinusitis and identify the sensitive antibiotics for the bacterial isolate.&#x0D; Method A prospective, cross-sectional study was conducted in ENT Head and Neck Department of tertiary care hospital. The study population was the patients with clinical diagnosis of chronic rhinosinusitis whose nasal swabs were taken during nasal endoscopy and sent for culture and sensitivity. The data were entered in Microsoft Excel and analyzed using statistical computer program Statistical Package for the Social Sciences (SPSS). The ethical approval for the study was taken from Ethical Committee of Kathmandu Medical College.&#x0D; Result There were 60 (87%) bacterial isolate growths out of 69 samples of which 49 (82%) were gram positive and 11 (18%) were gram negative. The most common bacteria isolated was S aureus (42%) followed by Cogaulase neagative Staphylococcus (25%).&#x0D; Conclusion Among gram positive isolates, amoxycillin was the most sensitive antibiotic and among gram negative isolates, ceftriaxone, levofloxacin, imipenem, meropenem and piperacillin were most sensitive antibiotics. In this study, we have determined the bacterial flora from endoscopic nasal swab of the sinuses in chronic rhinosinusitis patients and identified the sensitive antibiotics. This study would help us prescribe rational antibiotics in cases of chronic rhinosinusitis.