Kumar M.,MMIMSR |
Bangladesh Journal of Medical Science | Year: 2017
Background: Operating room (OR) like casualty room is the most productive area of a hospital. Turnover time although is a non-productive time in the operating room, yet it is important. Its efficient utilisation require multidisciplinary team work especially supporting services which play a major role in reducing turnover time in the operating room. Since present medical college where study was being conducted is still in its evolving stage, it was considered desirable for its quality improvement to study various factors which are contributing in turnover time delay so that appropriate measures can be taken to prevent the undue turnover time delay. Materials and methods: Present prospective observational case study aims at measurement of turnover time delays during 100 working days which were completed over four months for two operation theatres. The variable chosen was the delay of turnover time from the benchmark time taken. The data were collected, compiled and analysed. Results: In orthopaedics OR 77% of turnovers were found within benchmark limits. Only in 23% cases turnovers were delayed. 47% of times hospital related issues were responsible. In surgery OR 79% of turnovers were within benchmark limits. 21% cases were delayed; of this hospital related problems caused delayed turnovers in 53% cases. Conclusions: The study concluded that reasons for delays centred on multifactorial reasons which were unavoidable and unpredictable. But if those problems that can be easily fixed are attended to, valuable time can be saved, which will ultimately keep the surgeries on schedule and will prevent cancellation of elective cases. The utilization of OT complex can be optimized by team effort, multitasking and parallel processing. © 2017, Ibn Sina Trust. All rights reserved.
Rana S.,SHKM |
Sharma P.,SHKM |
Singh P.,SHKM |
Iranian Journal of Pathology | Year: 2015
Leiomyomas are benign tumors that originate from smooth muscle cells. Leiomyomas are well known to be the commonest neoplasm arising from the uterus but leiomyomas originating from the scrotum is a rare entity. They originate from the subcutaneous tissue or tunica dartos and can be solitary or multiple. We present a case of solitary scrotal leiomyoma in a 75 years old male who presented with a slowly growing, painless, firm, mobile 4cm lump in right side of scrotum. Clinically, it was provisionally diagnosed as sebaceous cyst and was excised. Histopathology and Immunohistochemistry (IHC) showed findings consistent with Leiomyoma. There was no cytological atypia or mitosis. The final diagnosis of scrotal leiomyoma was given. © Iranian Society of Pathology. All rights reserved.
Bains S.P.S.,SHKM |
Singh V.,SHKM |
Gill M.K.,SHKM |
Jain A.,SHKM |
Journal of Clinical and Diagnostic Research | Year: 2014
Necrotizing fasciitis of the perineum and external genitalia is a life-threatening infective gangrene, primarily seen in adults. It may be seen at any age but it is relatively uncommon in children. Here, we report a case of Fournier's gangrene in a two year old male child who was treated aggressively with broad spectrum antibiotics and early surgical debridement with hemodynamic stabilization. Even though no obvious precipitating cause was identified, hygiene was thought to be the inciting factor. Early surgical debridement with appropriate antibiotics and aggressive supportive care gave good results.
Rana S.,SHKM |
Gill M.K.,SHKM |
Kalhan S.,SHKM |
Satarkar R.N.,SHKM |
And 2 more authors.
Iranian Journal of Pathology | Year: 2016
Malignant mixed germ cell tumors,though rare overall, are the most common type of malignant ovarian neoplasms in young and adolescent girls. These tumors are rapidly growing and can metastasize. We report a case of 13-yr-old girl who presented at SHKM GMC, Nalhar, Mewat, Haryana, India in December 2013 with huge abdominal lump of a malignant mixed germ cell tumor comprising both immature teratoma and embryonal carcinoma. This report illustrates the aggressiveness of this tumor and emphasises the need of early diagnosis and treatment. © 2016, Iran J Pathol. All rights reserved.
PubMed | SHKM and Medicity
Type: Journal Article | Journal: Anesthesia, essays and researches | Year: 2016
Efficacy of caudal bupivacaine plus ketamine on postoperative pain in children.The aim of this study was to compare the analgesic efficacy and safety of caudal block with mixture of bupivacaine and ketamine to bupivacaine alone for postoperative analgesia in pediatric patients undergoing infraumbilical surgery.A prospective randomized study was conducted in a tertiary care teaching hospital.Data were collected; mean value and standard deviation were computed for age, weight, duration of surgery, and duration of analgesia. Then, the mean values of the two groups were compared using ANOVA. A total of 60 American Society of Anesthesiologists I and II pediatric patients of either sex, aged 1-10 years, undergoing herniotomy, orchidopexy, and urethroplasty were randomly allocated to receive one of the two analgesic regimens. Group A (30 patients) received caudal bupivacaine 0.25% in a dose of 1 ml/kg, and Group B received caudal block with 0.25% bupivacaine 1 ml/kg and preservative-free ketamine 0.5 mg/kg; duration of analgesia was recorded by objective pain scale to equate pain and discomfort in young children with changes in standardized behavioral and physiological parameters.Mean duration of analgesia in Group A was 5.63 0.98 h while the mean duration of analgesia in Group B was 10.18 2.24 h with On the basis of results derived from this study, it is concluded that addition of ketamine 0.5 mg/kg to caudal bupivacaine 0.25% in a dose of 1 ml/kg significantly prolonged the postoperative analgesia compared with administration of caudal bupivacaine 0.25% in a dose of 1 ml/kg alone.
PubMed | SHKM
Type: Journal Article | Journal: Iranian journal of pathology | Year: 2016
Malignant mixed germ cell tumors,though rare overall, are the most common type of malignant ovarian neoplasms in young and adolescent girls. These tumors are rapidly growing and can metastasize. We report a case of 13-yr-old girl who presented at SHKM GMC, Nalhar, Mewat, Haryana, India in December 2013 with huge abdominal lump of a malignant mixed germ cell tumor comprising both immature teratoma and embryonal carcinoma. This report illustrates the aggressiveness of this tumor and emphasises the need of early diagnosis and treatment.
PubMed | Health Science University and S.H.K.M.
Type: Journal Article | Journal: Anesthesia, essays and researches | Year: 2015
ProSeal laryngeal mask airway (PLMA) efficacy in pediatric anesthesia.The aim of this study was to compare PLMA size 2 and 2 in anesthetized paralyzed pediatric patients weighing 20-30 kg undergoing elective surgery.A prospective randomized study was conducted in a tertiary care teaching hospital.A total of 60 American Society of Anesthesiologists I pediatric patients of either sex having body weight between 20 and 30 kg undergoing elective surgeries were randomly allocated to PLMA of either size 2 or 2. Standardized anesthetic technique with propofol, sevoflurane, vecuronium bromide, nitrous oxide was used in all patients. Parameters such as number of attempts, time to achieve an effective airway, hemodynamic parameters, drain tube test, oropharyngeal leak pressure (OPL), gastric tube placement, and postoperative adverse events were noted. Statistical analysis by Kolmogorov-Smirnov analysis, Mann-Whitney U-test, Students t-test, Wilks lambda test and power analysis was done.There were no significant differences in demographic variables, ease of insertion and ventilation, number of insertion attempts, hemodynamics, and postoperative complications. OPLs were slightly higher in PLMA size 2 (27.38 6.36 vs. 22.62 2.85 cm H2O, respectively; P = 0.001) than size 2.Both PLMA size 2 and 2 provided adequate seal pressures that would allow positive pressure ventilation in healthy children. Thus PLMA of either size 2 or 2 can be used as a reliable airway device in children weighing 20-30 kg.