No abstract

Background Surgical site infections (SSI) are the most common nosocomial infection in surgical patients, accounting for 38% of all such infections, and are a significant source of postoperative morbidity resulting in increased hospital length of stay and increased cost. Objectives To find out the incidence of wound infection in patients following elective surgery and the most likely causative organisms and their resistance pattern. Methods Prospective data were collected on 496 surgical patients admitted in the surgery department in BSMMU from January 2010 to June 2010. All preoperative risk factors were evaluated. Patients operated were followed in the post operative period and if any wound infection noted, swab from the site of infection was sent for culture and sensitivity and antibiotics were given accordingly. Results Following 496 elective operations 20.16 % patients developed wound infection. Highest numbers of infection were seen in the fifth decade with slight female preponderance. Wound infection progressively rises with the degree of contamination and increasing operative time. The common risk factors for development of surgical wound infection were anemia (52%), malnutrition (44%), diabetes (38%), jaundice (30%), contaminated operation (44%) dirty operation (38 %), obesity and smoking. The most predominant isolated organism was Escherichia coli (43%) followed by Staphylococcus aureus (33%) and Pseudomonas aeruginosa (11%). Ceftriaxone still remains the most effective antibiotic although the incidence of resistance is rising. Conclusion Despite a good numbers of variables influence surgical site infections; it is still possible to reduce the infection rate by correcting modifiable risk factors, reducing degree of contamination and duration of operation. To battle the emerging resistance of pathogens a definitive guideline is essential. DOI: http://dx.doi.org/10.3329/jbsa.v24i2.19804 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(2): 65-69

Background: EF is an important measurement in determining how well the heart is pumping out blood and in diagnosing as well as tracking the heart failure (HF). Normal EF varies at 55% to 70%, while EF 40% to 55% may indicate damage perhaps from previous heart attack, but may not indicate HF. However, measurement under 40% may show evidence of HF or cardiomyopathy and patient with EF< 35% may be at the risk of life threatening irregular heartbeats. Such patients are considered to be at high risk for anaesthesia as life threatening irregular heartbeats lead to sudden cardiac arrest and sudden death.Objectives: The aim of this study was to find out the characteristics of patients, identifying of the risk factors, better understanding of pathophysiology, pre-operative optimization of the patients, uses of stable drugs & anesthetic techniques, reduces intraoperative or early postoperative complications & perioperative morbidity, mortality.Methods: In this retrospective study we described our experiences of 236 cases of very low ejection fraction (20% - 35%) from 1st July 2014 - 30th June 2017. We reviewed their medical history and noted age, sex, type of operation & anesthesia, pattern of operation either elective or emergency, preoperative investigation and preparation, as well as details of anaesthetic management, were also recorded.Results: General anaesthesia was performed in 176 (74.58%) cases and rest of 60(25.42%) cases were regional where spinal 42(17.80%) cases & epidural 18(7.62%) cases. The age of the patients were in the range of 20 to 70 years, with majority of the patients were in 60 to 69 years age group. The majority of the patients about 46.19% were in LVEF 26 - 30% group, 36.01% patients were in 31 - 35% group and rest of 17.80% patients were in 20 - 25% group. Average duration of operation incase of general anesthesia 66.5(±2.28SD) min and incase of regional 44.2(±3.25SD) min. The mortality rate only 1.27%.Conclusions: Preoperative patient optimization, intraoperative haemodynamic stability and postoperative care have contributed to the success of very low ejection fraction patients in our hospital.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 114-120

Background: Renal transplantation is the preferred treatment for end stage renal disease. Patients undergoing renal transplant surgery have several high risk features like cardiovascular diseases, diabetes mellitus and need for haemodyalysis. Renal transplant anaesthesia requires a thorough understanding of the metabolic and systemic abnormalities in end stage renal disease, familiarity with transplant medicine and expertise in managing and optimizing these patients for the best possible outcome. The aim of this study was to find out the characteristics of patients, causes of ESRD, anaesthetic management and the impact of pre-existing diseases on intraoperative or early postoperative complications of the recipients.Methods: In this retrospective study we described our experiences of 124 cases of living transplants from November 2004 – December 2016. We reviewed their medical history and noted age, sex, blood groups, causes of ESRD and history of dialysis. Preoperative investigation and preparation, as well as details of anaesthetic management, were also recorded.Results: General anaesthesia was performed in almost 97% of patients and for the rest of them, combined epidural and general anesthesia were done. The age of the patients was in the range of 15 – 65 years, with the majority of 30 - 39 years group. The mean of surgery duration was 4.5 (±1.20SD) hours. The most significant point during surgery is keeping the mean arterial pressure > 90mm Hg.Conclusions: Preoperative patient optimization, intraoperative haemodynamic stability and postoperative care of renal transplant patients have contributed to the success of renal transplant programmed in our hospital.Birdem Med J 2018; 8(2): 167-171