Online ISSN: 2515-8260

Keywords : complication


Complications Requiring Reoperation After Radio-Cephalic Arteriovenous Fistula Formation Surgery For Hemodialysis: Our Experience

Babar R. Zargar, Aaliya Tabasum .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 1840-1846

Background: Arterio-venous fistula is the preferred type of vascular access in patients requiring hemodialysis. (1-3) They have longer patency with low complication rates as compared to grafts. Still arteriovenous fistulas surgery can give rise to various complications
Objectives: this study was done to evaluate the various complications, early as well as late, arising from the arteriovenous fistula surgery.
Materials and Methods: This study was conducted over a span of 3 years from October 2019 to October 2022 comprising of 284 patients of chronic kidney disease who were on regular hemodialysis underwent surgery to create end to side radio-cephalic arteriovenous fistula formation for vascular access.
Results: out of 284 patients 22(7.74%) patients required reoperation. Thrombosis with failure of AV fistula requiring reoperation was seen in 19(6.69%) patients. Reoperation for bleeding, Aneurysm and ischemic steal syndrome was seen in 1 patient each.
Conclusion: Thrombosis with loss of AV fistula is the most common complication requiring reoperation after Radio-cephalic arteriovenous fistula surgery for vascular access in patients on hemodialysis.

Safety of Puncture in Deep Inspiration During Supracostal Access for PCNL

Dr. Devendra Choudhary; Dr. Om Kant Sharma; Dr. Hanuwant Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 184-187

Introduction: PCNL is most common procedure for renal calculi. Safety of PCNL puncture is very important to avoid complications. Also it should be the best target calyx punctured in best possible direction through the kidney parenchyma. Usually supracostal puncture is done at full expiration for fear of chest complications.
Method: Retrospective analysis of 300 cases of supracostal puncture done at deep inspiration is done in this study.
Results: It has shown similar complication rates like any other approach, Chest tube insertion in 1%, blood transfusion rates of 6.3%, similar length of hospital stay of average 2.02 days. Early chest tube insertion when chest complication is suspected is found to give early recovery. Conclusion:  Precautions to be taken are: Remain in lateral  part of intercostal space, remain just at superior border of lower rib and initial direction of needle to be kept vertically downwards till it passes well beyond the rib.

A Cross-sectional study on effect of Covid 19 infection among smokers in Chamarajanagar district

Girish B, Jithin Surendran, Prithvick BG, Damayanthi MN, Syed Tousif Ahmed

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 9207-9217

Background: Tobacco is one of the deadliest public health threats to humankind, killing more than eight million people a year globally. Combined with COVID-19, smoking is even more lethal, in which smoked tobacco damage the lungs tissue and reduces its function drastically. So, comparing to a non-smoker the smoker has more chance of developing severe COVID-19 infection and related complications.
Methods: This cross-sectional study was conducted in a tertiary care center of Chamarajanagar District. All Adult patients who attended the study settings with previous history of Covid 19 infection and history of smoking was administered a pre-tested semi structured questionnaire after meeting inclusion criteria. The questionnaire was structured into 4 parts to meet the expected objectives. The data obtained was entered into MS Excel and analysed.
Results: The study included 103 participants; out of which 65% belongs to the age group of more than 40 years. Majority of the study subjects were literate and semi-skilled workers which comprise 58% & 64% respectively. 81% of the study subjects were not vaccinated at the time of infection, but in contrast 97% were vaccinated at the time of interview. Majority of the subjects are current smokers (73%), and many of them prefers Beedis to smoke. A proportion of 44% are smokers for more than 15 years and half of total smokers are thinking it has ill effects on health. The major symptoms identified in our study were fever, cough & body ache.
Conclusion: Cause effect analysis shows direct relationship between number of cigarettes smoked per day and number of days require for institutional care during infection. This leads to the necessity to quit smoked tobacco products as soon as possible in high-risk individuals for better health outcome

To study the clinical and histopathological findings on hysterectomy

Dr Razia Siddiqui, Dr Shruti Agarwal, Dr Priyanka Tiwari, Dr Girish Kumar Pathak

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 299-304

Background: Hysterectomyare mostlycommon performed in the gynecological procedure for clinical problem in its treatments includes fibroids, prolapse, adenomyosis, endometriosos. Hysterectomy is performed worldwide in women at 30- 55 years of age. Aim and objectives to indicate the diagnosis to performed hysterectomy in patients and complications associated undergoing hysterectomy.
Methods: Total 255 patients undergone hysterectomy in the hospital was studied and analysed it clinical indications of surgery and complication of it, surgical specimens were sent for histopathology and report.
Results: The study shows thathysterectomy was performed in the major diagnosis of uterine prolapse (33.50%), leiomyoma (45.50%), adenomyosis (12.50%) while the report specimens also showed it. The diagnosis before the hysterectomy was confirmed by histopathology. There was no major complications were observed in the patients undergoing hysterectomy as this procedure is widely used for gynecological problems.
Conclusions: The study shows the data of patients’ trends of the hysterectomy and diagnosis that leads to perform hysterectomy was analyzed by histopathological finding in the patients. Complications were negligible in the hysterectomy and safe procedure

COMPARATIVE STUDY OF FETOMATERNAL OUTCOME IN PATIENTS UNDERGOING SELECTIVE VS EMERGENCY C SECTION AT A TERTIARY CARE HOSPITAL

Togarikar Sopanrao malharrao

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1974-1982

Background: Caesarean section or caesarean delivery is defined as the birth of a fetus through incisions in the abdominal wall (Laparotomy) and the uterine wall (Hysterotomy). This definition does not include removal of the fetus from the abdominal cavity in the case of rupture of uterus or in case of an abdominal pregnancy. Caesarean section can be considered one the earliest forms of modern birth technology Aim & Objective: 1.To study the maternal morbidity, mortality, perinatal outcome in patients, undergoing elective and emergency C-section. 2.To compare the maternal morbidity, mortality, perinatal outcome in patients, undergoing elective and emergency Csection. Method: Study design: Prospective study. Study setting: Department of Obstetrics and Gynecology at tertiary care centre. Study duration:……..Study population: The study population included all the women undergoing elective c-section and emergency c-section. Sample size: Results: In Group A: 44% of patients are in the age group of 18-24years and in Group B: 74% of patients are in the age group of 18-24years. A statistically significant value of P=0.01, is obtained suggesting most of the patients undergoing C-section (elective/emergency) are in age group of 18-24years. Strongly significant (P value: P<0.01). The most common risk factor is Previous LSCS. 14(28%) patients had previous LSCS in Group A (Elective C-Section) and 7(14%) patients had previous LSCS in Group B (Emergency C-Section). From the above graph, it can be observed that the patients with risk factor of Previous LSCS are more common with Elective C-Section group compared to Emergency C-Section group. Post-operative complications in Caesarean section were more in Emergency Caesarean Section when compared to Elective caesarean section. PPH is the most common in Emergency group when compared to Elective group. Wound infection is the 2nd most common complication in Emergency group. Conclusions: The factors associated with caesarean section are age, parity, multiple pregnancy, maternal weight gain, and birth weight. Including these factors, the caesarean section is justified under certain circumstances such as cephalo pelvic disproportion and contracted pelvis, dystocia due to soft parts, inadequate uterine forces, antepartum hemorrhage, pre- eclamptic toxemia, eclampsia, fetal distress and prolapse of the cord, malpresentation, maternal distresses such as heart problems, bad obstetric history, habitual intrauterine death of the fetus and elderly primigravida.

To study the efficacy and safety between use of BICLAMP (bipolar coagulation forceps) in vaginal hysterectomy and conventional vaginal hysterectomy: A prospective study at tertiary care center, Maharashtra

Dr. Neha Chandraprakash Agrawal, Dr. Priyanka Kunal Purohit, Dr. Gaurav Kumar J Desai and Dr. Chintan M Upadhyay

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 784-790

Background: Bipolar vessel sealing systems (BVSS) are accepted to be safe and efficacious
with possible advantages over conventional methods, namely fewer requirement of postoperative
analgesics, less blood loss, shorter operative time and minimum hospital stay.
Objectives: To compare the efficacy and safety between use of BiClamp (Bipolar
Coagulation Forceps) in Vaginal Hysterectomy and Conventional Vaginal Hysterectomy.
Materials and Methods: This prospective study was done among 80 cases indicating
hysterectomy for benign diseases admitted in OBGY unit were selected randomly out of
which 40 cases underwent Conventional Vaginal Hysterectomy and 40 cases underwent
BiClamp Vaginal Hysterectomy at department of obstetrics & Gynecology in Government
medical college and hospital, Latur during November 2012 to September 2014.
Results: Mean duration of hospital stay required for participants of cases and control group
was 2.6 days and 4.2 days respectively (p<0.05). Mean duration of operation of cases and
control group participants was 70.9 min and 75.5 min respectively (p<0.05). Mean blood loss
during operation noted among the cases and control group participants was 90.1 ml and 115.9
ml respectively (p<0.05). During operation, three suture material required in in 0.0%
participants of cases group and 82.5% of control group respectively (p<0.05). Post- op
complications like fever, bladder injury, bowel injury & hemorrhage noted only in
participants of control group.
Conclusion: BiClamp Vaginal Hysterectomy post-operative pain was less, intraoperative
blood loss was less, operative time was significantly shorter, duration of hospital stay was
less and BiClamp Vaginal Hysterectomy was more Cost effective than the Conventional
Vaginal Hysterectomy

A comparative study of on-lay mesh repair and retro-rectus mesh placement in incisional hernia repair

Dr. Dinesh Kumar Sharma, Dr. Shiv Kumar Bunkar, Dr. Naresh Kumar, Dr. Rahul Yadav, Dr. Poornima Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 480-487

Background: Incisional hernia continues to be one of the common post-operative complication of
abdominal surgery. Newer techniques have been added for hernia repair including prosthetic mesh repair
and the laparoscopic repair, which have been reported to produce better results. This study aimed to
compare on-lay mesh repair and retro-rectus mesh placement.
Material and Methodology: The current study was a prospective study conducted in the Department of
General Surgery, J.L.N. Medical College & Attached Group of Hospital, Ajmerwith an aim to evaluate
and compare the efficacy of on-lay mesh repair and retro-rectus mesh placement for repair of incisional
hernia in terms of VAS score for pain post-operatively, to compare the duration of the surgery, hospital
stay between the two repair techniques and to compare the early and late complications between the two
repair techniques on a total 50 patients (25 patients of onlay and 25 patients for retrorectus repair).
Results: There is significant lower complication i.e. blood loss, pain, seroma formation, surgical duct
infection, sinus formation and recurrence in sublay mesh repair and blood loss is also significantly lower,
while operative time and blood loss during surgery is higher in comparison to onlay mesh placement.
Conclusion: In our study there are significant lower complication in sublay repair than onlay repair.
Thus, proved the sublay repair a better approach for the ventral hernia repair than the onlay repair.

Impact of Bruxism on Dental Implant: A Systematic Review & Meta-Analysis

Dr Aishwarya Kadu; Dr Vikram V Khare; Dr. Tazeen Dawood; Dr. Nikhil Abbad; Dr. Savitri Ranjeri; Mohamed Fadul A. Elagib

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 6498-6508

Background: Bruxism was generally deliberated as a contraindication for oral implanting. The fundamental relationship amid bruxism and dental implant failure has remained debatable in current literatures

FEATURES OF DIAGNOSTICS OF CARDIOVASCULAR AUTONOMOUS NEUROPATHY OF CHILDREN WITH DIABETES MELLITUS TYPE 1

Dilfuza Ashurova; Azizakhon Sadirkhodjaeva; Malika Khaldarbekova; Zukhra , Shermatova

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2382-2392

Abstract. The presence of cardiovascular autonomic neuropathy (CAN) significantly
worsens the prognosis and course of the underlying disease. So in patients with diabetes
mellitus (DM) and CAN, the mortality rate for 5 years is five times higher compared to
patients without this complication. Due to the fact that CAN is closely associated with
cardiovascular pathology, many authors consider CAN as a significant factor in
cardiovascular risk. Purpose. To establish clinical, functional and metabolic changes in
diabetic autonomic cardiovascular neuropathy in children with type 1 diabetes. Materials and
methods research. The total number of patients studied by us was 114 children with type 1
diabetes mellitus aged 4 to 18 years. We conducted laboratory and instrumental research
methods. Laboratory methods: general clinical research (general analysis of blood and urine,
studies of blood sugar), biochemical methods (total blood protein, bilirubin, cholesterol,
triglycerides, creatinine, urea, electrolytes, glycated hemoglobin), 24-hour heart rate
monitoring with circadian index estimation was used and parameters of time and frequency
analysis of heart rate variability. Conclusion diabetic autonomic cardiovascular neuropathy in
children with type 1 diabetes is characterized by the development of tachyarrhythmic rhythm
disturbances, as well as the formation of rigidity of the heart rhythm and a decrease in the
sensitivity of the sinus node to parasympathetic influences according to a temporary analysis
of daily monitoring of heart rhythm.