M. M. N., Mohan J, Arun B J, Pooja Kr, Mahnaaz Sultana
Need For Study Perioperative prediction of respiratory complications is important in patients undergoing laparoscopic surgeries under general anesthesia,. Spirometry- most frequently used method for perioperative evaluation of respiratory function, but it is effort dependent. Forced oscillation technique(FOT) overcomes this problem as it is a simple, effortless and non-invasive means of assessing the respiratory mechanics, The technique involves external application of pressure wave to the respiratory system while the patient is breathing normally at tidal volume followed by measurement of airow. It is capable of detecting respiratory changes due to endotracheal intubation, duration of general anesthesia and carbon dioxide insufation both in airway (blocks, narrowing, spasms) as well as parenchyma (consolidation, atelectasis or collapse) In our study, we intend to analyze these changes in patients undergoing laparoscopic abdominal surgeries under general anesthesia which may help in early detection and in turn guide to decerese the incidence of respiratory complications. Aim&objective1) To evaluate the changes in respiratory resistance and reactance in patients undergoing laparoscopic abdominal surgeries using Forced Oscillation Technique before and after surgery. 2) To evaluate the clinical prole of patients with signicant changes. Materials And Methods- This is a ongoing prospective-observational study started in November 2022 at hospitals attached to Bangalore Medical College and Research institute (BMCRI). After obtaining ethical committee clearence, an informed written consent was taken from 12 patients were enrolled into the study. FOT test was performed 24hours before and 24 hours after surgery and results were tabulated using SPSS version 27 and calculated with student t- test. Results:- Out of 12 cases, respiratory reactance at 5 Hz (R5) and respiratory resistance of R5-20 (small airway) changed signicantly in 4 patients (36%) who underwent surgery for more than 2 hours duration. Respiratory reactance (X5) changed signicantly in 6 (50%) patients who underwent laparoscopic surgery for more than 2 hours. The study is currently ongoing and the nal results will be displayed on the day of presentation. Conclusion:- The forced oscillation technique is a clinical tool that can be used to predict respiratory mechanics before and after surgery. However, it remains to be seen that, it plays a role in predicting clinical outcomes in terns of reducing postoperative morbidity
{"title":"A STUDY TO EVALUATE THE PERIOPERATIVE RESPIRATORY MECHANICS IN PATIENTS UNDERGOING LAPROSCOPIC ABDOMINAL SURGERIES USING FORCED OSCILLATION TECHNIQUE","authors":"M. M. N., Mohan J, Arun B J, Pooja Kr, Mahnaaz Sultana","doi":"10.36106/ijsr/1508427","DOIUrl":"https://doi.org/10.36106/ijsr/1508427","url":null,"abstract":"Need For Study Perioperative prediction of respiratory complications is important in patients undergoing laparoscopic surgeries under general\u0000anesthesia,. Spirometry- most frequently used method for perioperative evaluation of respiratory function, but it is effort dependent. Forced\u0000oscillation technique(FOT) overcomes this problem as it is a simple, effortless and non-invasive means of assessing the respiratory mechanics, The\u0000technique involves external application of pressure wave to the respiratory system while the patient is breathing normally at tidal volume followed\u0000by measurement of airow. It is capable of detecting respiratory changes due to endotracheal intubation, duration of general anesthesia and carbon\u0000dioxide insufation both in airway (blocks, narrowing, spasms) as well as parenchyma (consolidation, atelectasis or collapse) In our study, we\u0000intend to analyze these changes in patients undergoing laparoscopic abdominal surgeries under general anesthesia which may help in early\u0000detection and in turn guide to decerese the incidence of respiratory complications.\u0000Aim&objective1) To evaluate the changes in respiratory resistance and reactance in patients undergoing laparoscopic abdominal surgeries using Forced\u0000Oscillation Technique before and after surgery.\u00002) To evaluate the clinical prole of patients with signicant changes.\u0000Materials And Methods- This is a ongoing prospective-observational study started in November 2022 at hospitals attached to Bangalore Medical\u0000College and Research institute (BMCRI). After obtaining ethical committee clearence, an informed written consent was taken from 12 patients\u0000were enrolled into the study. FOT test was performed 24hours before and 24 hours after surgery and results were tabulated using SPSS version 27\u0000and calculated with student t- test. Results:- Out of 12 cases, respiratory reactance at 5 Hz (R5) and respiratory resistance of R5-20 (small airway)\u0000changed signicantly in 4 patients (36%) who underwent surgery for more than 2 hours duration. Respiratory reactance (X5) changed signicantly\u0000in 6 (50%) patients who underwent laparoscopic surgery for more than 2 hours. The study is currently ongoing and the nal results will be displayed\u0000on the day of presentation. Conclusion:- The forced oscillation technique is a clinical tool that can be used to predict respiratory mechanics before\u0000and after surgery. However, it remains to be seen that, it plays a role in predicting clinical outcomes in terns of reducing postoperative morbidity","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"82 S366","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141133648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aims to examine efcacy and safety of current regimen in comparison to novel therapeutic regimens with treat-to-target strategies and agents consisting of non-steroidal immunosuppressants, biologics, and nonpharmacologic treatment options. This study also highlights future treatment options under investigation, aiming to identify potential avenues for improved patient care and disease control. Novel therapies have shown greater improvements in treatment of SLE which would cause decrease in use of steroids and more patient specic targeted therapies. This will help in identifying any knowledge gaps and propose future research directions to address the same and contribute to the enhancement of patient outcomes and quality of life by providing insights into optimal approaches to SLE management.
{"title":"PROGRESSION AND PERSPECTIVE, A 20-YEAR RETROSPECTIVE ON SYSTEMATIC LUPUS ERYTHEMATOSUS THERAPEUTICS: A NARRATIVE REVIEW","authors":"Nixat Patel, Tirth Hinsu, Shivangi Sharma, Meetkumar Pipaliy, Dhruvin Patel, Jahanvi Kasodariya, Jetal Joshi, Yugam Rajeshkumar Oza","doi":"10.36106/ijsr/2608816","DOIUrl":"https://doi.org/10.36106/ijsr/2608816","url":null,"abstract":"This study aims to examine efcacy and safety of current regimen in comparison to novel therapeutic regimens with treat-to-target strategies and\u0000agents consisting of non-steroidal immunosuppressants, biologics, and nonpharmacologic treatment options. This study also highlights future\u0000treatment options under investigation, aiming to identify potential avenues for improved patient care and disease control. Novel therapies have\u0000shown greater improvements in treatment of SLE which would cause decrease in use of steroids and more patient specic targeted therapies. This\u0000will help in identifying any knowledge gaps and propose future research directions to address the same and contribute to the enhancement of patient\u0000outcomes and quality of life by providing insights into optimal approaches to SLE management.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"17 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141142908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Payal Jaiprakash Rana, Smitha S. G, Pranav Ayyappan
Osteomyelitis represents a severe and often debilitating inammatory condition characterized by the invasion of bone tissue by infectious microorganisms. It is a complex disease process that typically begins with the introduction of bacteria into the bone, leading to local inammation, necrosis, and the formation of abscesses within the affected bone. Osteomyelitis can occur in any bone in the body but is particularly challenging when involving the maxilla due to its unique anatomical features and potential complications, such as oroantral stula formation
{"title":"CHRONIC OSTEOMYELITIS OF THE LEFT MAXILLA WITH OROANTRAL FISTULA","authors":"Payal Jaiprakash Rana, Smitha S. G, Pranav Ayyappan","doi":"10.36106/ijsr/1202837","DOIUrl":"https://doi.org/10.36106/ijsr/1202837","url":null,"abstract":"Osteomyelitis represents a severe and often debilitating inammatory\u0000condition characterized by the invasion of bone tissue by infectious\u0000microorganisms. It is a complex disease process that typically begins\u0000with the introduction of bacteria into the bone, leading to local\u0000inammation, necrosis, and the formation of abscesses within the\u0000affected bone. Osteomyelitis can occur in any bone in the body but is\u0000particularly challenging when involving the maxilla due to its unique\u0000anatomical features and potential complications, such as oroantral\u0000stula formation","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Laparoscopic Cholecystectomy (LC) has become the gold standard in the treatment of symptomatic gallstones and it is the most frequent operation now-a-days for gallbladder stones. At times laparoscopy becomes difcult and may need conversion to open cholecystectomy. The prediction of a difcult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Aim: To study the factors determining the preoperative predictability of difcult LC based on the patient's history, physical examination and abdominal ultrasonography. Methods: 359 patients diagnosed cholelithiasis, admitted to general surgery department, KPC MCH, Kolkata-32, West Bengal. All of them underwent elective LC, and were operated by experienced laparoscopic surgeons between July 2022 and November 2023. Study design: Observational study. Results: In our study out of 359 cases 221 are male and 138 are female, male are more predominant than females (61% vs 38%). Among 359 patients 76 (21%) patients were found for difcult cholecystectomy. On multivariate logistic regression revealed that male gender, older age, H/O acute attacks, positive Murphy´s sign, past H/O acute cholecystitis requiring hospitalisation, recent H/O jaundice, past H/O co-morbidities, H/O ERCP for choledocholithiasis, H/O gall stone pancreatitis, increased gall bladder wall thickness, peri-cholecystic oedema/ collection, brotic gall bladder, intra-operative ndings of dense adhesion at calot´s triangle were independent predictors of difcult LC. Conclusion: Pre operative prediction of possible difculties may help a surgeon in choosing the appropriate approach suitable for a particular patient. Patients can pre-op be informed about possible risk of conversion to open cholecystectomy
背景：腹腔镜胆囊切除术（LC）已成为治疗无症状胆结石的金标准，也是目前最常见的胆囊结石手术。有时腹腔镜手术会变得困难，可能需要转为开腹胆囊切除术。传统上，对困难胆囊切除术的预测是基于术前的某些临床和影像学因素。目的：根据患者的病史、体格检查和腹部超声检查，研究决定术前预测胆囊切除术难cult的因素。方法：西孟加拉邦加尔各答32区KPC MCH普外科收治的359名确诊为胆石症的患者。所有患者均接受了择期LC手术，并在2022年7月至2023年11月期间由经验丰富的腹腔镜外科医生进行了手术。研究设计：观察性研究。研究结果在我们的研究中，359 例患者中有 221 例为男性，138 例为女性，男性多于女性（61% vs 38%）。在 359 例患者中，76 例（21%）患者接受了双cult 胆囊切除术。多变量逻辑回归显示，男性、年龄较大、H/O 急性发作、墨菲氏征阳性、既往H/O 急性胆囊炎需要住院、近期H/O 黄疸、既往H/O 并发疾病、H/O ERCP 治疗胆总管结石、H/O 胆石性胰腺炎、H/O 胆囊切除术、H/O胆结石性胰腺炎、胆囊壁厚度增加、胆囊周围水肿/积水、brotic galladder、术中ndings of dense adhesion at calot´s triangle（卡洛氏三角区致密粘连）是胆囊切除术难cult的独立预测因素。结论：术前预测可能出现的困难可帮助外科医生选择适合特定患者的适当方法。患者可在术前了解转为开腹胆囊切除术的可能风险
{"title":"PREDICTING THE RISK FACTOR FOR DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY: AN OBSERVATIONAL STUDY","authors":"Manojit Barman, Diptangshu Das, Arunava Jana, Pathik Shit","doi":"10.36106/ijsr/9205053","DOIUrl":"https://doi.org/10.36106/ijsr/9205053","url":null,"abstract":"Background: Laparoscopic Cholecystectomy (LC) has become the gold standard in the treatment of symptomatic gallstones and it is the most\u0000frequent operation now-a-days for gallbladder stones. At times laparoscopy becomes difcult and may need conversion to open cholecystectomy.\u0000The prediction of a difcult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Aim: To study the\u0000factors determining the preoperative predictability of difcult LC based on the patient's history, physical examination and abdominal\u0000ultrasonography. Methods: 359 patients diagnosed cholelithiasis, admitted to general surgery department, KPC MCH, Kolkata-32, West Bengal.\u0000All of them underwent elective LC, and were operated by experienced laparoscopic surgeons between July 2022 and November 2023. Study\u0000design: Observational study. Results: In our study out of 359 cases 221 are male and 138 are female, male are more predominant than females\u0000(61% vs 38%). Among 359 patients 76 (21%) patients were found for difcult cholecystectomy. On multivariate logistic regression revealed that\u0000male gender, older age, H/O acute attacks, positive Murphy´s sign, past H/O acute cholecystitis requiring hospitalisation, recent H/O jaundice, past\u0000H/O co-morbidities, H/O ERCP for choledocholithiasis, H/O gall stone pancreatitis, increased gall bladder wall thickness, peri-cholecystic\u0000oedema/ collection, brotic gall bladder, intra-operative ndings of dense adhesion at calot´s triangle were independent predictors of difcult LC.\u0000Conclusion: Pre operative prediction of possible difculties may help a surgeon in choosing the appropriate approach suitable for a particular\u0000patient. Patients can pre-op be informed about possible risk of conversion to open cholecystectomy","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"24 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141034447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ischemic stroke occurs in a signicant subset of patients with blunt traumatic brain injury in pediatric age group. Increasing numbers of patients with ischemic stroke are being identied, largely due to the widening use of computed tomography angiography (CTA) for screening trauma patients. These patients are particularly difcult to manage because they often suffer from hemorrhagic stroke simultaneously. Presently, there is no consensus about optimal management. Because these patients are managed primarily by neurosurgeons, patients with ischemic stroke have been effectively hidden from view of pediatric intensivist and pediatric neurologists. We present a case of a boy who developed bilateral anterior cerebral artery infarct following traumatic brain injury. He presented with this fatal complication of traumatic brain injury in second week of illness. This case report is intended to bring this potentially fatal clinical entity to the attention of clinicians and investigators with specic expertise in pediatric neurology and stroke.
{"title":"FATAL UNUSUAL ISCHEMIC STROKE FOLLOWING MODERATE TRAUMATIC BRAIN INJURY IN A YOUNG CHILD: A CASE REPORT","authors":"S. K. Saini, A. Saini, Seema Kumari","doi":"10.36106/ijsr/9702464","DOIUrl":"https://doi.org/10.36106/ijsr/9702464","url":null,"abstract":"Ischemic stroke occurs in a signicant subset of patients with blunt traumatic brain injury in pediatric age group. Increasing numbers of patients\u0000with ischemic stroke are being identied, largely due to the widening use of computed tomography angiography (CTA) for screening trauma\u0000patients. These patients are particularly difcult to manage because they often suffer from hemorrhagic stroke simultaneously. Presently, there is no\u0000consensus about optimal management. Because these patients are managed primarily by neurosurgeons, patients with ischemic stroke have been\u0000effectively hidden from view of pediatric intensivist and pediatric neurologists. We present a case of a boy who developed bilateral anterior cerebral\u0000artery infarct following traumatic brain injury. He presented with this fatal complication of traumatic brain injury in second week of illness. This\u0000case report is intended to bring this potentially fatal clinical entity to the attention of clinicians and investigators with specic expertise in pediatric\u0000neurology and stroke.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"34 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141048097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bone is one of the commonest sites of metastasis due to advanced malignancy of breast, lung, prostate and rectal . Axial bones like vertebrae, skull, and ribs are most commonly involved in metastasis, while appendicular bones like bones of upper limbs and lower limbs are less often involved in metastasis due to these malignancies. Below knee metastasis are infrequently observed in literature and clinical setting. Herein, we report a case of a female diagnosed with adenocarcinoma lung and presented with a hard, painful swelling in her left leg at tibial region. She was planned for palliative radiotherapy and was assessed for pain relief.
{"title":"CLINICAL PRESENTATION OF TIBIAL BONE METASTASIS: A RARE CASE REPORT","authors":"Ashutosh Mishra, Sanjay Singh Chandel","doi":"10.36106/ijsr/9001879","DOIUrl":"https://doi.org/10.36106/ijsr/9001879","url":null,"abstract":"Bone is one of the commonest sites of metastasis due to advanced malignancy of breast, lung, prostate and rectal . Axial bones like vertebrae, skull,\u0000and ribs are most commonly involved in metastasis, while appendicular bones like bones of upper limbs and lower limbs are less often involved in\u0000metastasis due to these malignancies. Below knee metastasis are infrequently observed in literature and clinical setting. Herein, we report a case of\u0000a female diagnosed with adenocarcinoma lung and presented with a hard, painful swelling in her left leg at tibial region. She was planned for\u0000palliative radiotherapy and was assessed for pain relief.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"63 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141052571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The hernial sac does not play a crucial role in the problem of hernia. Hence ligation of this sac should not be taken as an axiomatic step. We have operated on 30 patients (Continuous study) aged between 6 months to 60 years, where the hernial sac has not been ligated but has only been divided at the level of deep inguinal ring. The peritoneum was then allowed to fall back and a standard Bassini's repair using 2/0 Prolene was done in each case except in 5 children where no such repair was done. In this study, the severity of pain was divided into mild pain requiring no drug, moderate pain requiring only oral drugs and severe pain requiring injectable analgesics. On the rst postoperative day 25 out of 35 patients had severe pain and they required injectable analgesics. There was dramatic change on the second day only 4 patients had severe pain. There was only one complication in the form of wound infection on third postoperative day but it cleared off by the 10th day and no complications were observed during follow up. 19 patients turned up in the follow up and no recurrence was noted in any of the patients.
{"title":"LIGATION OF THE INDIRECT INGUINAL HERNIA SAC: IS IT AXIOMATIC? A CONTINUED STUDY","authors":"Sudhanshu Sharma, Obaidulla Obaidulla, Renu Kumari","doi":"10.36106/ijsr/4703272","DOIUrl":"https://doi.org/10.36106/ijsr/4703272","url":null,"abstract":"The hernial sac does not play a crucial role in the problem of hernia. Hence ligation of this sac should not be taken as an axiomatic step. We have\u0000operated on 30 patients (Continuous study) aged between 6 months to 60 years, where the hernial sac has not been ligated but has only been divided\u0000at the level of deep inguinal ring. The peritoneum was then allowed to fall back and a standard Bassini's repair using 2/0 Prolene was done in each\u0000case except in 5 children where no such repair was done. In this study, the severity of pain was divided into mild pain requiring no drug, moderate\u0000pain requiring only oral drugs and severe pain requiring injectable analgesics. On the rst postoperative day 25 out of 35 patients had severe pain\u0000and they required injectable analgesics. There was dramatic change on the second day only 4 patients had severe pain. There was only one\u0000complication in the form of wound infection on third postoperative day but it cleared off by the 10th day and no complications were observed\u0000during follow up. 19 patients turned up in the follow up and no recurrence was noted in any of the patients.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141056435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabethkingia meningoseptica is a gram-negative bacillus which is a rare cause of opportunistic infections. Literature shows that this bacillus may cause early onset neonatal sepsis and meningitis in neonates however it is a rare cause of late onset sepsis or meningitis in neonates. We hereby discuss two cases of sepsis – one late onset and another early onset neonatal sepsis meningitis and the environmental surveillance done afterwards to locate the source of infection. Both the neonates were managed in same NICU. Initial laboratory investigations revealed sepsis and meningitis caused by E menigoseptica. E menigoseptica is a multidrug organism which is linked to high mortality cases and neurological sequelae so early detection, multidisciplinary intervention and involvement of infection control team plays a crucial role for effective management and prevention.
{"title":"MONITORING MULTIDRUG RESISTANT ELIZABETHKINGIA MENINGOSEPTICA IN NICU- A MALEFACTOR OF NEONATAL SEPSIS AND MENINGITIS","authors":"Meghna Chauhan, Vijaya Swarnim, Nandita Hazra, Kavita Bala Anand","doi":"10.36106/ijsr/3600924","DOIUrl":"https://doi.org/10.36106/ijsr/3600924","url":null,"abstract":"Elizabethkingia meningoseptica is a gram-negative bacillus which is a rare cause of opportunistic infections. Literature shows that this bacillus\u0000may cause early onset neonatal sepsis and meningitis in neonates however it is a rare cause of late onset sepsis or meningitis in neonates. We hereby\u0000discuss two cases of sepsis – one late onset and another early onset neonatal sepsis meningitis and the environmental surveillance done afterwards\u0000to locate the source of infection. Both the neonates were managed in same NICU. Initial laboratory investigations revealed sepsis and meningitis\u0000caused by E menigoseptica. E menigoseptica is a multidrug organism which is linked to high mortality cases and neurological sequelae so early\u0000detection, multidisciplinary intervention and involvement of infection control team plays a crucial role for effective management and prevention.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"16 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141047740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background:Locally advanced breast cancer (LABC) poses a substantial clinical challenge, particularly in regions like India where it accounts for a signicant proportion of breast cancer cases. Neoadjuvant chemotherapy (NACT) has emerged as a promising strategy to downstage tumors and increase the feasibility of breast conservation surgery (BCS), thus improving patient outcomes. This prospective observational study aimed to comprehensively investigate the clinical characteristics of LABC patients and evaluate the impact of NACT on tumor downstaging and the feasibility of BCS. Methods:Atotal of 100 consecutive female LABC patients (Stage III) aged 25 to 70 years were enrolled in the study. Clinical and histopathological data were collected, including age, menstrual status, family history, symptom duration, tumor characteristics, and receptor status. NACT regimens were administered as per institutional protocols. Tumor and axillary lymph node size changes were measured, and clinical responses were evaluated using RECIST 1.1 criteria. Statistical analyses were conducted using SPSS software. Results: The study population exhibited a mean age of 49.43 years, with 61% of patients being premenopausal. The predominant histopathological subtype was invasive ductal carcinoma (91%), and common receptor statuses included ER+ PR+ HER2- (29%) and triple-negative (28%). Post-NACT, 82% of patients exhibited a partial response, while 10% achieved a complete response. Notably, BCS feasibility was observed in 60% of cases following NACT. Histological subtype and ER/PR status signicantly inuenced response rates (p < 0.05). Conclusion: Neoadjuvant chemotherapy demonstrated its efcacy in downstaging LABC tumors, resulting in a higher feasibility of breast conservation surgery. Receptor status emerged as an important predictor of chemotherapy response. The study underscores the potential of a multimodal approach involving NACT and BCS to optimize treatment outcomes for LABC patients, particularly in resource-constrained settings.
{"title":"RESPONSE OUTCOME OF NEO ADJUVANT CHEMO THERAPY AND FEASIBILITY OF BREAST CONSERVATION SURGERY AMONG LOCALLY ADVANCED BREAST CANCER PATIENTS: A PROSPECTIVE EVALUATION","authors":"Seraj Ahmed, Soham Patra, Nabarun Manna, Santanu Sinha, Tirna Halder","doi":"10.36106/ijsr/2506533","DOIUrl":"https://doi.org/10.36106/ijsr/2506533","url":null,"abstract":"Background:Locally advanced breast cancer (LABC) poses a substantial clinical challenge, particularly in regions like India where it accounts for\u0000a signicant proportion of breast cancer cases. Neoadjuvant chemotherapy (NACT) has emerged as a promising strategy to downstage tumors and\u0000increase the feasibility of breast conservation surgery (BCS), thus improving patient outcomes. This prospective observational study aimed to\u0000comprehensively investigate the clinical characteristics of LABC patients and evaluate the impact of NACT on tumor downstaging and the\u0000feasibility of BCS. Methods:Atotal of 100 consecutive female LABC patients (Stage III) aged 25 to 70 years were enrolled in the study. Clinical\u0000and histopathological data were collected, including age, menstrual status, family history, symptom duration, tumor characteristics, and receptor\u0000status. NACT regimens were administered as per institutional protocols. Tumor and axillary lymph node size changes were measured, and clinical\u0000responses were evaluated using RECIST 1.1 criteria. Statistical analyses were conducted using SPSS software. Results: The study population\u0000exhibited a mean age of 49.43 years, with 61% of patients being premenopausal. The predominant histopathological subtype was invasive ductal\u0000carcinoma (91%), and common receptor statuses included ER+ PR+ HER2- (29%) and triple-negative (28%). Post-NACT, 82% of patients\u0000exhibited a partial response, while 10% achieved a complete response. Notably, BCS feasibility was observed in 60% of cases following NACT.\u0000Histological subtype and ER/PR status signicantly inuenced response rates (p < 0.05). Conclusion: Neoadjuvant chemotherapy demonstrated\u0000its efcacy in downstaging LABC tumors, resulting in a higher feasibility of breast conservation surgery. Receptor status emerged as an important\u0000predictor of chemotherapy response. The study underscores the potential of a multimodal approach involving NACT and BCS to optimize\u0000treatment outcomes for LABC patients, particularly in resource-constrained settings.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"16 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141141140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction:Injections of any kind can hurt; children know that pain is predictable. Preparation for an intramuscular injection should be done just before giving the injection, so that children do not have time to build up their anxieties about the procedure. Almost any form of play can be used for diversion and recreation, but the activity should be selected on the basis of the child's age, interests and limitations. Methodology: This study was based on Johnson's Behavioral System Model. The study adopted a pre-experimental research approach. Sampling technique:-Non-probability purposive sampling technique Sample:- 60 toddlers, 30 each in experimental (Group I) and control group (Group II). Result:- The mean (19.63), mean % (93.49), median(20), mode(20) of experimental group was signicantly higher than the mean(8.43), mean %(40.14) , median(8), mode(8) of control group. But SD of experimental group (0.85) was little despaired from the control group(0.86) & mean difference was 11.2. Unpaired 't' test computed between the control group and experimental group, & the 't' value (50.773) statistically found to be signicant ('t'58 -2.02 , p>0.05). Hence, the null hypothesis was rejected and research hypothesis was accepted. So, it established that play materials were effective divertional therapy in terms of gaining scores in behaviour. Which indicate play therapy was effective. Conclusion: From the ndings of the present study it can be concluded that the play materials are effective divertional therapy during intramuscular injection.
{"title":"A PRE EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF PLAY MATERIALS AS A DIVERSIONAL THERAPY AMONG THE TODDLERS DURING INTRAMUSCULAR INJECTION IN A SELECTED HOSPITAL, AGARTALA, WEST TRIPURA","authors":"Munmun Mahajan","doi":"10.36106/ijsr/0806603","DOIUrl":"https://doi.org/10.36106/ijsr/0806603","url":null,"abstract":"Introduction:Injections of any kind can hurt; children know that pain is predictable. Preparation for an intramuscular injection should be done just\u0000before giving the injection, so that children do not have time to build up their anxieties about the procedure. Almost any form of play can be used for\u0000diversion and recreation, but the activity should be selected on the basis of the child's age, interests and limitations. Methodology: This study was\u0000based on Johnson's Behavioral System Model. The study adopted a pre-experimental research approach. Sampling technique:-Non-probability\u0000purposive sampling technique Sample:- 60 toddlers, 30 each in experimental (Group I) and control group (Group II). Result:- The mean (19.63),\u0000mean % (93.49), median(20), mode(20) of experimental group was signicantly higher than the mean(8.43), mean %(40.14) , median(8), mode(8)\u0000of control group. But SD of experimental group (0.85) was little despaired from the control group(0.86) & mean difference was 11.2. Unpaired 't'\u0000test computed between the control group and experimental group, & the 't' value (50.773) statistically found to be signicant ('t'58 -2.02 , p>0.05).\u0000Hence, the null hypothesis was rejected and research hypothesis was accepted. So, it established that play materials were effective divertional\u0000therapy in terms of gaining scores in behaviour. Which indicate play therapy was effective. Conclusion: From the ndings of the present study it\u0000can be concluded that the play materials are effective divertional therapy during intramuscular injection.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"47 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141139966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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