Top PDF Effectiveness of prophylactic measures on deep vein thrombosis among post operative patients at Government Rajaji Hospital, Madurai

Effectiveness of prophylactic measures on deep vein thrombosis among post operative patients at Government Rajaji Hospital, Madurai

Effectiveness of prophylactic measures on deep vein thrombosis among post operative patients at Government Rajaji Hospital, Madurai

The study was conducted for six weeks from 20.03.2017 to 30.04.2017 among 60 post operative patients (30 in intervention group and 30 in control group) in Post operative ward at Government Rajaji Hospital, Madurai. Prior to data collection, Ethical clearance was obtained from the ethical committee and permission from the professor and HOD, Department of Surgery, Government Rajaji Hospital, Madurai to conduct the study. On the first day of procedure, samples were selected as per inclusion criteria by consecutive sampling technique. After maintaining initial rapport, purpose of the study was explained and a written informed consent was obtained from the study subject. Demographic data was collected and risk assessment was done to assess the level of risk of deep vein thrombosis by using Modified Capirini DVT risk assessment scale; then intervention group received prophylactic measures early mobilization i.e leg exercise- dorsiflexion (15-20 o ), plantar flexion(45-
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A Study to Evaluate the Effectiveness of Structured Teaching Programme regarding prevention of Selected Complications among immobilized orthopaedic patients in Government
Rajaji  Hospital, Madurai

A Study to Evaluate the Effectiveness of Structured Teaching Programme regarding prevention of Selected Complications among immobilized orthopaedic patients in Government Rajaji Hospital, Madurai

Lengthy periods of immobilization are emotionally stressful for patients. Immobility related problems include pressure ulcers, pneumonia, constipation, loss of appetite, urinary stasis, urinary track infections and venous stasis or deep vein thrombosis. When the complications due to immobilization are prevented it helps an individual to be physically, emotionally and psychologically sound. These complications can be prevented through simple basic patient care like skincare, active-passive exercises, changing position and deep breathing exercises. Nurses have a key role in prevention of these complications by educating the patients. Hence the study was conducted “To evaluate the effectiveness of structured teaching programme regarding prevention of selected complications among immobilized orthopeadic patients in Government Rajaji Hospital, Madurai.
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Effectiveness of early ambulation on post operative recovery among the women who has undergone abdominal hysterectomy at Government Rajaji Hospital, Madurai

Effectiveness of early ambulation on post operative recovery among the women who has undergone abdominal hysterectomy at Government Rajaji Hospital, Madurai

Common general postoperative complications include atelectasis, pneumonia, orthostatic hypotension, decreased cardiac output and stroke volume, urinary retention, negative nitrogen balance, depression and sensory deprivation, decrease tissue sensitivity to insulin, deep vein thrombosis, constipation and fecal impaction, loss of muscle tone and decubitus ulceration in the dependent areas that is subjected to pressure due to prolonged bed rest. Early postoperative ambulation has been practiced on the surgical services since August 1944. There were 500 abdominal surgery cases compared with the 500 similar cases, they were left in bed to the 10-14 days. The study group allowed walking as early as possible. The control group were not ambulated and used for comparison. In ambulated group there was a total 43 postoperative complications as compared with 93 for non-ambulated. Incidence of broncho pneumonia has been reduced from 6% to 3%, atelectasis from 1.2% to 0.4%, phlebothrombosis from 2.4% to 1% in ambulated group.
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Effectiveness of foot reflexology on fatigue among patients with chronic renal failure admitted in nephrology ward at Government Rajaji Hospital, Madurai.

Effectiveness of foot reflexology on fatigue among patients with chronic renal failure admitted in nephrology ward at Government Rajaji Hospital, Madurai.

Reflexology reduces fatigue, the work is documented in 27 studies including research showing impact on individuals of all ages and health states. Research shows that reflexology work helps individuals of all ages with 78 health concerns ranging from aggressive behavior in children to urinary concerns of the elderly. Improves blood flow: Separate studies show that reflexology work increases blood flow to the feet, brain, kidneys and intestines. Aids post-operative recovery: Reflexology work aids recovery after surgery as shown by several studies, reducing pain, fatigue and anxiety and lessening the use of post operative medications and has its impact on physiological measures (e. g. blood pressure and cholesterol; measurements by ECG, EEG). Reflexology helps for many like phantom limb pain sufferers, neuropathy patients, and hemodialysis patients to name a few. Benefits mental health.
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Effectiveness of Foot Massage on the level of pain and anxiety among the Neuro Post operative patient in Government Rajaji Hospital, Madurai.

Effectiveness of Foot Massage on the level of pain and anxiety among the Neuro Post operative patient in Government Rajaji Hospital, Madurai.

Objective- Assess the effectiveness of foot massage on the level of pain and anxiety among the neuro post operative patient in government Rajaji hospital, Madurai. Conceptual frame work: Developed by the modified Roy adaptation model. Design: Non-equalant control group pretest – posttest by using purposive sampling technique. Setting: The study is been conducted in the neuro post operative ward in Govt. Rajaji Hospital, Madurai. Subjects: Total sixty samples are selected from the neuro post operative ward who underwent craniotomy. Intervention: Twenty minutes foot massage is provided for the experimental group for four days from the second post operative day. Main outcome measures: Using modified state anxiety scale and numerical pain scale patients are selected from the ward with pain scale more than three and anxiety score of mild and moderate. The subjects who were selected on the first fifteen days were assigned to experimental group and the subjects selected for the next fifteen day control group. For the experimental group foot massage was provided, the control group received the routine care. Post test score was assessed and compared between the experimental and control group. Result: The finding of this study found that there was a statistically significant difference on the level of post test pain score between the experimental and control group (t = 4.34, P = 0.001) and in anxiety it was ( t = 4.23,P = 0.001). Conclusion: It was found out that foot massage is more effective in reduction of neuro post operative pain and anxiety.
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Clinical Profile of Multiple Myeloma at Government Rajaji Hospital, Madurai

Clinical Profile of Multiple Myeloma at Government Rajaji Hospital, Madurai

The process of staging myeloma is crucial to developing an effective treatment plan. The staging system most widely used since 1975 has been the Durie-Salmon system, in which clinical stage of disease (stage I, II, or III) is based on four measurements: levels of M protein, the number of lytic bone lesions, hemoglobin values (a measure of the number of red blood cells in the blood), and serum calcium levels. Stages are further divided according to renal (kidney) function (classified as A or B; Table 3). There is somewhat of an overlap between the various myeloma categories and stages. For example, both patients with smoldering myeloma and patients with Stage I disease do not require immediate treatment, and patients with Stage II and III disease have active, symptomatic myeloma. Increasingly, physicians are relying less on the Durie-Salmon staging system and more on biologically relevant markers as prognostic indicators when making treatment choices.
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A Study of Surgical Wound Infection in Government Rajaji Hospital, Madurai

A Study of Surgical Wound Infection in Government Rajaji Hospital, Madurai

are common pathogens in surgical site infection after clean-contaminated surgery. The antibiotic chosen should be directed primarily against staphylococci for clean cases and high risk clean contaminated elective surgery of the biliary and upper gastrointestinal tracts. A first generation cephalosporin is the preferred agent for most patient, with a history of anaphylaxis to penicillin. Although methicillin resistant S. aureus Methicillin Resistant S. aureus (MRSA) has been isolated in the community from never hospitalized patients, vancomycin prophylaxis is appropriate only in institutions where the incidence of Methicillin Resistant S. aureus (MRSA) is high.
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A Study on Cases of Carcinoma Penis in Government Rajaji Hospital, Madurai

A Study on Cases of Carcinoma Penis in Government Rajaji Hospital, Madurai

Smegma is a byeproduct of bacterial action on desquamated cells that are within the preputial sac. Although a definite etiological role has not yet been established, its relationship to development of penile cancer has been widely observed. Improper hygiene leads to build up of smegma beneath the preputial foreskin leading to inflammation. Healing by fibrosis leads to phimosis, which tends to perpetuate the cycle. Phimosis is found in 25% - 75% of penile cancer cases. Smegma is a cheesy material rich in cholesterol, acid phosphatase, fructose & mucin, but not urea suggesting a contribution from seminal vesicles, Cowpers glands or gland of Litter, but not urine. It contains many bacteria, the significant one being Mycobacterium smegmatis. Data from large series show that penile cancer is rare in neonatally circumcised individuals, but more frequent if circumcision is delayed until puberty. Adult circumcision offers little or no protection. Thus they suggest that the critical period of exposure to certain etiologic agents may have already occurred at puberty and certainly by adulthood, rendering later circumcision relatively ineffective as a prophylactic tool for penile cancer. The preventive role of circumcision is not merely hygienic. It may also be due to removal of substantial part of the carcinoma prone area, the prepuce, which is one of the commonest site of onset of lesion.
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Effectiveness of endotracheal suctioning with normal saline Versus without normal saline on airway clearance among intubated patients at Government Rajaji Hospital, Madurai

Effectiveness of endotracheal suctioning with normal saline Versus without normal saline on airway clearance among intubated patients at Government Rajaji Hospital, Madurai

This chapter deals with detailed discussion of the data and results interpreted from the statistical, inferential analysis. The present study was focused to evaluate the effectiveness of endotracheal suctioning with normal saline versus without normal saline, on airway clearance among intubated patients admitted in Intensive Medical Care Unit at Government Rajaji Hospital, Madurai. The endotracheal suctioning is a method of clearing the secretion from the airway and is performed through an artificial airway (endotracheal tube) either nasotrachealy or orotrachealy. It promotes optimal exchange of oxygen and carbon dioxide into and out of lungs and to prevent pneumonia resulting from the collection of the secretion and hypoxia related problems due to the blockage of tubes. In this study, Researcher adopted a Quantitative approach, True experimental - pre-test post test design, 60 subjects were selected by Non probability (consecutive sampling) technique and assigned 30 subjects into groups I and 30 subjects into group II. Pre test was done and an airway clearance was done by suctioning without normal saline for group I and with normal saline to group II every second hourly and on demand basis. 10 minutes after the last endotracheal suctioning (approximately between 7pm to 7.30 pm) post test was done with the same observational check list.
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Effectiveness of slow stroke back massage on reduction of anxiety and shoulder pain among stroke patients in medical ward, government rajaji hospital, madurai

Effectiveness of slow stroke back massage on reduction of anxiety and shoulder pain among stroke patients in medical ward, government rajaji hospital, madurai

Giles E.et.al. (2002) conducted a prospective study among 123 stroke patients from a consecutive cohort of 205 patients presenting with stroke in Walton hospital in UK. This study described the incidence of post stroke shoulder pain prospectively, in an unselected stroke population in the first 6 months after stroke and identifies risk factors for developing pain. This cohort, with a mean age of 70.6 years, was examined at 2 weeks, 2, 4, and 6 months. Patients were assessed by interview, full rheumatological and neurological examination in 14 days of post stroke for a history of shoulder pain according to predetermined criteria. In addition, Barthel Index had score and pain scores were also recorded. 52 (40%) patients developed shoulder pain on the same side of their stroke. There was a strong association between pain and abnormal shoulder joint examination, ipsilateral sensory abnormalities and arm weakness. There was a statistically significant association with ipsilateral sensory impairment (p<0.005), abnormal rheumatological examination (p<0.001) and depression score (p<0.005).The study concluded that post stroke shoulder pain is more common than previously realized and in addition to abnormal shoulder joint examination may also be associated with upper limb sensory impairment.
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Clinical study on Carcinoma Esophagus in Government Rajaji Hospital, Madurai

Clinical study on Carcinoma Esophagus in Government Rajaji Hospital, Madurai

In an otherwise fit patient subtotal resection of esophagus with esophageal gastric anastomosis at the neck level should be the sensible approach of achieving best form of palliation. For this removes the near total esophagus, reducing the recurrence rate and restoring their swallowing act. This goal is achieved with admirable success rate by Transhiatal esophageal resection (THE) as compared to other approach, which is known for higher morbidity and mortality. If there is an anastomotic leak patients do not end up with mediastinitis. It is easily managed by drainage and wound care. The patient will be fit for discharge within 2 weeks after THE. Few cases are also gifted with a bonus of cure.
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Effectiveness of oral hygiene on dry mouth among nasogastric tube children in pediatrics ward at Government Rajaji Hospital, Madurai

Effectiveness of oral hygiene on dry mouth among nasogastric tube children in pediatrics ward at Government Rajaji Hospital, Madurai

were selected based on the inclusion criteria. Consent was obtained from the care givers of the participate and confidentiality of their responses was assured. Subjects for the study were undergone the pre assessment of dry mouth by using modified Beck oral assessment scale. Then investigator administered the Oral care to children with nasogastric tube with the use of baby brush with Bass technique (an angle of 45 0 between the brush and teeth) with fluoride paste less than 1000ppm, rinse with normal saline and application of oral glycerine in lips for 3 times (6 am, 12 pm, 6 pm) per day for 3 consecutive days and after that the investigator was assessed the level of dry mouth on nasogastric tube children by means of post test using modified Beck oral assessment scale on forth day morning . Proposed study duration is 4 to 6 weeks.
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Memory impairment among severe hypothyroid patients in endocrine outpatient department at Government Rajaji Hospital, Madurai

Memory impairment among severe hypothyroid patients in endocrine outpatient department at Government Rajaji Hospital, Madurai

Title: Memory impairment among severe hypothyroid patients in endocrine OPD at Govt. Rajaji Hospital, Madurai. Objectives: To assess the level of memory impairment among male and female severe hypothyroid patients in endocrine OPD at GRH Madurai. To associate the level of memory impairment among male and female severe hypothyroid patients in endocrine OPD at Govt. Rajaji Hospital, Madurai and their selected socio demographic and clinical variables. Hypotheses: There is a significant association between the level of memory impairment among male and female severe hypothyroid patients in endocrine OPD at Govt. Rajaji Hospital, Madurai with their selected socio demographic and clinical variables. Methodology: Non experimental (descriptive) research design was used, 100 severe hypothyroid patients were selected by Non-probability (consecutive) sampling and assessed through PGI memory assessment tool. Results: The study revealed that majority of subjects in male 15 (60.00%) and in female 42 (56.00%) had above average memory and is associated with T4 level respectively. Conclusion: The study finding evidenced that severe hypothyroid patients had varying level of memory impairment, females had more memory impairment comparing with male severe hypothyroid patients.
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Clinical study of Patients with Abdominal Wound Dehiscence at Government Rajaji Hospital, Madurai Medical College, Madurai

Clinical study of Patients with Abdominal Wound Dehiscence at Government Rajaji Hospital, Madurai Medical College, Madurai

Preventing wound dehiscence is largely a function of careful attention to technical detail during the fascial closure. The technical details of fascial closure include such things on proper spacing of the sutures, adequate depth of bite of the fascia, relaxation of the patient during fascial closure and closing the fascial layer only when there isnot excessive tension on the closure. For very high risk patients an interrupted figure-of-eight closure is often the wisest choice while retention sutures were used extensively in the past, their use is less common today with many surgeons opting to use n absorbable mesh interrupted closure Reduction of massively distended bowel by milking air and fluid brake up into the stomach also may facilitate a tension free closure.
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Effectiveness of music therapy on postpartum blues among primi postnatal mothers in postnatal ward at Government Rajaji Hospital, Madurai

Effectiveness of music therapy on postpartum blues among primi postnatal mothers in postnatal ward at Government Rajaji Hospital, Madurai

Fleoy ysmael,lagrimas elizon(2010)This study determined the effects of music on the duration of the second stage of labor among primigravida or women in their first pregnancy at Cebu City Medical Center. An experimental design was utilized in this study with experimental and control group. A random sampling was utilized.All respondents had Normal Spontaneous Vaginal Delivery (NSVD). Each qualified respondent was chosen randomly to three conditions. A total of forty-five respondents (15 for classical music group, 15 fast music group and 15 for silence or control group) was selected. The shorter the second stage of labor, the more effective is the treatment provided. Findings revealed that the group of mothers who had no music has the shortestduration of the second stage of labor, followed by the group using fast music and the longest duration was that of the group using slow music. ANOVA computation was done which was significant at p=.05. Scheffe’s Test further showed that fast music is more effective in hastening the second stage of labor than slow music and a significant difference between the slow music group and the no music group was also identified.
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Effectiveness of  Ichthammol Glycerin dressing and Hirudoid Ointment on Infiltration and Phlebitis among patients with intravenous Infusion in the selected wards of Government Rajaji Hospital, Madurai

Effectiveness of Ichthammol Glycerin dressing and Hirudoid Ointment on Infiltration and Phlebitis among patients with intravenous Infusion in the selected wards of Government Rajaji Hospital, Madurai

Wei XL, Feng R., Zhao, ZQ., Jing. ZP.,(2011).conducted a study on efficacy of Chinese herbal medicine Mailuo shutong granule and Hirudoid cream for chronic venous disorder induced pigmentation in lower extremities among 108 patients in shanghai Changhai Hospital.. The study objectives was to evaluate the clinical efficacy of Mailuo Shutong Granule, a compound traditional Chinese herbal medicine, and Hirudoid cream (heparinoid), in treatment of patients with dermal hyperpigmentation of skin caused by CVD. The study found out Thirty-three cases in the Mailuo Shutong group, 34 cases in the Hirudoid group and 31 cases in the combined therapy group were included for analysis. After treatment, area of pigmentation decreased and average gray value of pigmentation declined in all the 3 groups (P<0.05). The reductions of area and average gray value in the combined therapy group were more significant than those in the Mailuo Shutong group and Hirudoid group (P<0.05). There were no differences in improvement of pigmentation between the Mailuo Shutong group and Hirudoid group (P>0.05). The Researcher concluded that, these data suggest that both Mailuo Shutong Granule and Hirudoid cream can improve CVD-induced hyperpigmentation, and combined treatment of the two drugs results in better clinical efficacy.
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A Descriptive study about abdominal Tuberculosis in Government Rajaji Hospital, Madurai

A Descriptive study about abdominal Tuberculosis in Government Rajaji Hospital, Madurai

lymphocytes, and erythrocytes. Its concentration in body fluids correlates with the number and degree of stimulation of lymphocytes, and is a marker of host immune response. Several studies have shown that ADA activity is an extremely useful diagnostic test for tuberculous ascites, with specificity and sensitivity of over 95 per cent. However, in the presence of cirrhosis, seen in more than 50 per cent of patients with peritoneal tuberculosis in the West, the sensitivity of ADA drops to 30 per cent; this is related to the abnormal T-lymphocyte activation and proliferation in those with cirrhosis. For similar reasons, ADA activity is likely to be less useful in HIV-positive patients, limiting the effectiveness of this test in subgroups of patients who are highly susceptible to tuberculosis. However, in those without these predisposing conditions, ADA is extremely useful and should be a first-line investigation, obviating the need for more invasive and expensive diagnostic tests 13,14,15 . Another test that may prove useful is assay of interferon (produced by T-lymphocytes) in the ascitic fluid 16 .
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A Study of Surgical Management of Abdominal Tuberculosis in Government Rajaji Hospital Madurai

A Study of Surgical Management of Abdominal Tuberculosis in Government Rajaji Hospital Madurai

Isolates resistant to any other combination of anti-TB drugs but not to INH & RMP are not classified as MDR-TB. MDR-TB develops when the course of antibiotics is interrupted in between and when the levels of drugin the body are insufficient to kill 100% Bacteria during treatment of fully sensitive TB. The reasons for drug resistance are when the patients feelsbetterand halt their antibiotic course, or when drug supplies may run out orwhen they becomes scarceor when the patient forgets to take their medication in time. MDR-TBspreadsfrom person to person as in the same manner as drug sensitive TB. Treatment of MDR-TB should be started on the basis of sensitivity testing. Before the sensitivity results are known suspected MDR-TB, they must be startedon SHREZ(Streptomycin + isonicotinyl Hydrazine + Rifampicin + Ethambutol + Pyrazinamide) + MXF + cycloserine.
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Effectiveness of brisk walking exercise on glycemic level among patients with Type-2 Diabetes Mellitus in diabetic outpatient department at Government Rajaji Hospital, Madurai

Effectiveness of brisk walking exercise on glycemic level among patients with Type-2 Diabetes Mellitus in diabetic outpatient department at Government Rajaji Hospital, Madurai

Snowling& Hopkins et. al.(2006). The study was conducted in US, to evaluate the structured aerobic exercises such as walking reduces the absolute hemoglobin A1c value by about 0.6% and improves insulin sensitivity. The study proves that aerobic training such as walking combined with resistance training improves glycemic control suggests that daily walking combined with diet therapy is useful for obese patients and can likewise work with type 2 diabetes. Although it is evident that physical activities such as walking helps control type 2 diabetes, 60-80% of the adult population in the US do not meet the recommended levels of physical activity. Much of this low engagement in physical activities such as walking is correlated to the fear of walking alone and the risk of danger while walking outside. Lack of interest in physical activity being part of lifestyle particularly in the US prevents people with type 2 diabetes to engage in walking or exercise. People who engage in physical activities including walking have a lower risk of chronic diseases including diabetes. Brisk walking was associated with low risk of type 2 diabetes compared with regular walking. Higher levels of walking are associated reduced mortality risk and help control glucose levels of people with type 2 diabetes.
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A study on the correlation of serum cholecalciferol level and vitiligo in patients attending Government Rajaji Hospital, Madurai

A study on the correlation of serum cholecalciferol level and vitiligo in patients attending Government Rajaji Hospital, Madurai

CHOLECALCIFEROL LEVEL AND VITILIGO IN PATIENTS ATTENDING GOVERNMENT RAJAJI HOSPITAL, MADURAI is a bonafide work done by me at Government Rajaji Hospital during 2015 2018 under the guidance and supervision of Prof. Dr. G. GEETHARANI M.D., D.D., Professor and Head of the Department of Dermatology, Madurai Medical College, Madurai. I also declare that this bonafide work or a part of this work was not submitted by me or any other for any award, degree and diploma to any university, board either in India or abroad. The dissertation is submitted to The Tamilnadu Dr.M.G.R. Medical University, towards partial fulfilment of requirement for the award of M.D.Degree in Dermatology, Venereology and Leprosy (BRANCH XX).
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