Online ISSN: 2515-8260

Keywords : comorbidities


STUDY ON EFFECT OF LOCAL APPLICATION OF VANCOMYCIN POWDER ON SURGICAL SITE INFECTION RATE IN PATIENTS UNDERGOING INSTRUMENTED SPINAL FUSION SURGERIES

Dr. Ramesh Chandra VV, Dr.MohanaSasank Deevi, Dr. BCM Prasad

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 65-78

Aim:To determine the effect of local application of vancomycin powder on surgical site
infection rate in patients undergoing instrumented spinal fusion surgeries.
Methodolgy:This is a prospective, cohort study which was conducted at SVIMS, a tertiary care
hospital. Informed consent was obtained from all the patients recruited in the study. The study
conducted during July 2015 to July 2016 with follow up of patients for 1 year post
operatively.The study cohort included consecutive patients undergoing posterior spinal fusion for
various etiologies. All patients received standard systemic antibiotic prophylaxis consisting of 1
g IV ceftriaxone within 1 hour of surgical incision followed by 1 g IV ceftriaxone every 8 hours
for 1 day. All patients underwent preoperative preparation with betadine solution.
Results:Total of 120 patients who underwent instrumented spinal fusion procedures were
included in the study with or without topical application of vancomycin powder.Mean age of
presentation in test group was 38.3 yrs whereas in control group it is 45.2 yrs.Most of the
patients who underwent operation for listhesis in the present study were females with F:M ratio
being 3.6:1.Only 4 of the patients from test group and 3 patients from control group gave history
of smoking and alcoholism. SSI developed in only one of the patients with both smoking and
alcoholism as risk factors.8 patients from test group and 9 patients from control group had
comorbidities like diabetes, hypertension, rheumatoid arthritis, hepatitis B.None of the patients
in the present study gave history of previous lumbar surgeryMost of the patients presented with
symptoms of low back ache and the most common neurological deficit encountered was motor
weakness related to respective spinal segment. In the test group 53 single level fusions and 7 two
level fusions were done whereas in control group 55 single level fusions, 3 two level fusions and
2 three level fusions were done .Mean operative time in test group was 239.6 mts and mean
estimated blood loss was 87.4 ml whereas in control group it is 221.25 mts and 88.08 ml
respectively.Two patients in the test group had deep SSI of which one required implant removal
on readmission and the other patient was managed conservatively when he was diagnosed to
have spondylodiscitis post operatively with appropriate antibiotics.

CLINICAL AND EPIDEMIOLOGICAL PROFILE OF COVID-19 PATIENTS ADMITTED AT A TERTIARY CARE CENTRE OF NORTH INDIA

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4748-4759

Background & objectives: The COVID-19 pandemic emerged as a major public health emergency affecting the healthcare services all over the world. It is essential to analyse the epidemiologicalandclinicalcharacteristicsofpatientswithCOVID19indifferentpartsofourcountry.Thisstudyhighlights clinical experience in managing patients with COVID-19 at a tertiary care centre in northernIndia.
Methods:Clinicalcharacteristicsandoutcomesofconsecutiveadultpatientsadmittedtoatertiarycare hospitalatAll India Institute of medical Sciences, Patna, Bihar,India,from August12020 toJanuary 31,2021werestudied.ThediagnosisofSARS-CoV-2 infection was confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) on throat and/or nasopharyngeal swabs. All patients were managed according to the institute’s consensus protocol and in accordance with Indian Council of Medical Researchguidelines.
Results: During the study period, 283 patients with SARS-CoV-2 infection were admitted. The history of contact with COVID-19-affected individuals was available in only29 patients. The median age of the patients was 53.85 years (15-95 years), and there were 217 (76.67 %) males. Of the total enrolled patients, only 19 patients (7%)were asymptomatic and rest 264 patients (93%) were symptomatic.Thecommonpresentingcomplaintswerefever in 231 patients(81 %),cough in 217 patients(76 %) and shortness of breath in 204 patients (72%). Out of 283 patients enrolled for the study, 113 patients (39%) had Hypertension as an accompanying comorbid illness, 122 (43%) had Diabetes mellitus, CKD and Hypothyroidism each in 8% of patients, CAD & COPD in 7% and 6% patients respectively
Agemorethan60yearsandpresenceofdiabetesandhypertensionweresignificantlyassociatedwith severeCOVID-19disease.Mortalityof 65 patients ( 23%) wasobserved.
Interpretation&conclusions:MajorityofthepatientswithCOVID-19infectionpresentingtoourhospital were elderly and symptomatic. Fever was noted only in three-fourth of the patients and respiratory symptoms in more than half of the enrolled patients. Patients with comorbidities were more vulnerable to complications. Certain Inflammatory markers like serum CRP, Ferritin, LDH, & D-Dimer have define prognostic value. Triaged classificationofpatientsandprotocol-basedtreatmentresultedingoodoutcomesandlowcasefatality.

ASTHMA CORRELATES AMONG ADOLESCENCE IN COUNTRY: AN ORIGINAL RESEARCH

Dr. Sanjay D. Gabhale; Dr. Preetha Anand; Dr. Rahul VC Tiwari; Dr. Heena Tiwari; Dr.Savitri Ranjeri; Dr. Abhinav Vilas Lambe

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 6606-6612

Aim: Purpose of our research is to establish the increased incidence of asthma with adolescent age group
Methodology: A cross-sectional, school-based study carried out amongst 1200 children. In
our study, we took into consideration about various demographic patterns like lifestyle
patterns, health issues, as well a comparison between asthmatics and non- asthmatics.
Comparison between the two groups was done by analysing data using Statistical Analysis
Software 25.0.
Results: Among a final sample of 1198 participants, the prevalence of self-reported asthma
was found to be 8.2%. Various characteristics were found significantly different between
the 2 groups including the gender, the weight and dietary patterns. Self –reported
asthmatic were more likely to be males, overweight or obese.
Conclusion: Asthma disease remains prevalent among adolescents and requires higher
awareness and better guidance for its prevention and treatment. Further efforts should
focus on health promotion and as well as improved quality of life so as to prevent this
chronic disease.

A pathophysiological review on understanding multiorgan effects of COVID-19

Satish Kumar Sharma; Iqra Rahat

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 6, Pages 1037-1044

COVID-19, the global pandemic affecting economic developments has been regarded as severe pulmonary dysfunction disease. The disease has caused significant mortalities all around the world. The reports suggest that major reason for patients’ death are multiple organ failure, sudden cardiac arrest, severe respiratory dysfunction and body shock. These clinical conditions are majorly linked with COVID-19 comorbidities which are severely affecting disease severity. The present study describes pathophysiological findings associated with multiorgan effect of COVID-19. The study describes possible transmission route of the virus, responsible for gastro intestinal problems. The review of pathophysiological findings in COVID-19 provides a perspective to focus our therapeutic research strategies towards controlling the effect of pathogenic virus on indirectly targeted body organs. The present study will help in controlling disease morbidities as well as preventing long term effects of COVID-19.