The post-operative wound complications can be defined as any negative outcome as perceived either... more The post-operative wound complications can be defined as any negative outcome as perceived either by the surgeon or by the patient. Objectives were to study the early and late post-operative wound complication of patients undergoing emergency and elective abdominal surgery, to find out and compare the incidence of postoperative wound complications following emergency and elective abdominal surgery and to find out and compare the factors associated with wound complications following elective and emergency abdominal surgery. Methods: The study was conducted at Dr. D. Y. Patil Medical College and Hospital, DPU University, for a period of 2 years (from July 2015-September 2017) and is a prospective type of study using 100 cases (Group A: Elective and Group B: Emergency abdominal surgeries -50 each). The study was approved by the Institute's Ethics Committee. Results: 100 patients were operated in our study. The type of collection from surgical site was seropurulent in 4 (8%) patients and purulent in 1 (2%) patient of Group A whereas it was seropurulent in 5 (10%) patients and purulent in 1 (2%) patient of Group B. The type of collection in Closed Suction Drain was Serous in 12 (24%) patients, Serosanguineous in 10 (20%) patients and Seropurulent in 1 (2%) patient of Group A whereas it was Serous in 13 (26%) patients, Serosanguineous in 10 (20%) patients and Seropurulent in 1 (2%) patient of Group B. The postoperative hospital stay for majority of the patients in Group A was ≤10 days (82%) while it was 11-14 days for Group B (54%). Conclusions: Possible complications following elective surgery and those following urgent/emergency surgery, a debatable issue was the possibility of significant differences between them. The emergency laparotomies are also more common than elective laparotomies especially at peripheral centers. These findings suggest that wound complications do occur in elective abdominal surgeries. These can be reduced to a certain extent by careful case selection, improving Hb levels prior to surgery, using adequate prophylaxis and better surgical practices.
One in four women is referred to a breast clinic at some time in her life for breast related prob... more One in four women is referred to a breast clinic at some time in her life for breast related problem. Four percentage of patient with breast symptom or lump reported as breast cancer. Even in palpable lesions large numbers of lesions turn out to be benign. Breast cancers represent one in four women of all cancer worldwide. It is most common cause of cancer death among women and most frequently diagnosed cancer worldwide. In India the age standard incidence rate of breast cancer varies 9-32 per one lakh women. More than 1 million new cases are diagnosed every year in India. Mortality due to cancer breast is also high as low rates of early stage detection and poor treatment outcome. Physical examination of breast is important for primary diagnosis. The role of mammography with palpable breast lump is to show benign cause for palpable breast lump, to support earlier intervention for a mass with malignant features, to screen remainder of ipsilateral and contralateral additional lesions and to assess malignancy when cancer is diagnosed. 5 American college of Radiology and other international organization with mutual consensus have adopted and recommended ABSTRACT Background: Breast cancer is most frequently diagnosed cancer among women and also most common cause of cancer death among women. Early stage detection is still low and is the major reason for poor treatment outcomes in our country. Most of the breast lumps are benign. However, it is important to rule out malignancy. This prospective clinical study is done to evaluate role of triple assessment (clinical examination, mammography and histopathology) in diagnosing breast lump. Methods: All women admitted with the symptoms and signs of breast lump at our hospital were studied in the period of 2 years from July 2014 to June 2016. The findings of physical examination and mammographic examination with histopathological diagnosis were noted n compared. Results: Physical examination of breast lumps is overall less accurate as compared to mammography. There is a tendency to over diagnose malignancy on physical examination. Mammography is more sensitive and specific in the diagnosis of palpable breast lumps as compared to physical examination. Histopathology confirms the diagnosis. Conclusions: It is better to do all three that is clinical examination, mammography and histopathology for all breast lumps diagnosis.
Background: Breast cancer is the most common cause of cancer in women and cancer related mortalit... more Background: Breast cancer is the most common cause of cancer in women and cancer related mortality all over the world. There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. At our center most of the patients with breast cancer presented as locally advanced breast cancer (LABC) which drew our attention to find out the reasons of delay and its association with different socio-demographic variables.Methods: We enrolled 50 histologically proven cases of LABC in this study. With help of semi structured interview, questions were asked from each patient which could reflect their understanding about the disease to find likely reasons for their delayed presentation, including socioeconomic status.Results: In present study most of our patients were more than 45 years, married. 88% presented late due to unawareness and ignorance about nature and severity of breast cancer disease, 86% had financial issues, 64% had shyness as reason, 20% wasted time b...
Background: Surgical site infection (SSI) can be defined as infections which develops within 30 d... more Background: Surgical site infection (SSI) can be defined as infections which develops within 30 days after surgery involving the skin and subcutaneous tissue of the incision and/or the deep soft tissue and/or any part other than the incision handled during surgery. This study has been taken up to determine the incidence of SSI in abdominal surgery and to determine factors responsible for its occurrence.Methods: The study was conducted in Dr. D.Y. Patil Medical College, Hospital and Research Centre located in Pimpri, Pune between July 2017 to September 2019.It is a prospective longitudinal descriptive study. Information collected from the patients included patient’s age, gender, diabetes mellitus status, smoking status and haemoglobin and albumin levels.Results: Total 150 cases with abdominal operations were included in this study. Among them 29 patients developed SSI. Incidence of SSI among them was 19.3%. There was no significant difference among gender between both the groups. (p=...
The study aims to scale patients with diabetic foot ulcers according to Wagner's classification, ... more The study aims to scale patients with diabetic foot ulcers according to Wagner's classification, measure the various risk factors, study various outcomes and improve the treatment measures. Methodology The article presents materials on a prospective observational study of 50 diabetic foot patients with different presentations who underwent stage-specific intervention. Results Poor glycemic control, lifestyle factors, and smoking showed increased risks for foot ulcer complications. Diabetic neuropathy and vasculopathy have been significant outcome predictors. As a result, advanced Wagner's grades showed increased amputation risks and multimodal management. Conclusions Stratification of diabetic foot patients and appropriate management based on their Wagner's grade helps reduce amputation rates and mortality. In addition, multimodal management and exceptional attention to diabetes and lifestyle control improve long-term outcomes.
Foot infections in patients with diabetes mellitus are a major cause of morbidity, can lead to ga... more Foot infections in patients with diabetes mellitus are a major cause of morbidity, can lead to gangrene and ultimately amputation of the limb. Aim of the study was to determine the type of microorganisms isolated from the Diabetic foot ulcer and antibiotic resistance pattern. We have included 50 patients having diabetic foot ulcers of Wagner's grade 1 or above in our study. Debrided tissue, pus, or swabs from the base of the ulcers were subjected to aerobic and anaerobic culture. The organisms were identified, and further antibiotic sensitivity was conducted. Seventy-two aerobic and 13 anaerobic organisms were isolated. Among the aerobic and anaerobic bacteria isolated, most predominant organisms were S. aureus and Bacteroides spp.; respectively. Of the S. aureus, 77.8% were methicillin resistant, while 42.1% of gram-negative Enterobacteriaceae were extended spectrum beta-lactamase (ESBL) positive. Klebsiella spp. was the highest ESBL producer. Acinetobacter spp. was the highes...
The post-operative wound complications can be defined as any negative outcome as perceived either... more The post-operative wound complications can be defined as any negative outcome as perceived either by the surgeon or by the patient. Objectives were to study the early and late post-operative wound complication of patients undergoing emergency and elective abdominal surgery, to find out and compare the incidence of postoperative wound complications following emergency and elective abdominal surgery and to find out and compare the factors associated with wound complications following elective and emergency abdominal surgery. Methods: The study was conducted at Dr. D. Y. Patil Medical College and Hospital, DPU University, for a period of 2 years (from July 2015-September 2017) and is a prospective type of study using 100 cases (Group A: Elective and Group B: Emergency abdominal surgeries -50 each). The study was approved by the Institute's Ethics Committee. Results: 100 patients were operated in our study. The type of collection from surgical site was seropurulent in 4 (8%) patients and purulent in 1 (2%) patient of Group A whereas it was seropurulent in 5 (10%) patients and purulent in 1 (2%) patient of Group B. The type of collection in Closed Suction Drain was Serous in 12 (24%) patients, Serosanguineous in 10 (20%) patients and Seropurulent in 1 (2%) patient of Group A whereas it was Serous in 13 (26%) patients, Serosanguineous in 10 (20%) patients and Seropurulent in 1 (2%) patient of Group B. The postoperative hospital stay for majority of the patients in Group A was ≤10 days (82%) while it was 11-14 days for Group B (54%). Conclusions: Possible complications following elective surgery and those following urgent/emergency surgery, a debatable issue was the possibility of significant differences between them. The emergency laparotomies are also more common than elective laparotomies especially at peripheral centers. These findings suggest that wound complications do occur in elective abdominal surgeries. These can be reduced to a certain extent by careful case selection, improving Hb levels prior to surgery, using adequate prophylaxis and better surgical practices.
One in four women is referred to a breast clinic at some time in her life for breast related prob... more One in four women is referred to a breast clinic at some time in her life for breast related problem. Four percentage of patient with breast symptom or lump reported as breast cancer. Even in palpable lesions large numbers of lesions turn out to be benign. Breast cancers represent one in four women of all cancer worldwide. It is most common cause of cancer death among women and most frequently diagnosed cancer worldwide. In India the age standard incidence rate of breast cancer varies 9-32 per one lakh women. More than 1 million new cases are diagnosed every year in India. Mortality due to cancer breast is also high as low rates of early stage detection and poor treatment outcome. Physical examination of breast is important for primary diagnosis. The role of mammography with palpable breast lump is to show benign cause for palpable breast lump, to support earlier intervention for a mass with malignant features, to screen remainder of ipsilateral and contralateral additional lesions and to assess malignancy when cancer is diagnosed. 5 American college of Radiology and other international organization with mutual consensus have adopted and recommended ABSTRACT Background: Breast cancer is most frequently diagnosed cancer among women and also most common cause of cancer death among women. Early stage detection is still low and is the major reason for poor treatment outcomes in our country. Most of the breast lumps are benign. However, it is important to rule out malignancy. This prospective clinical study is done to evaluate role of triple assessment (clinical examination, mammography and histopathology) in diagnosing breast lump. Methods: All women admitted with the symptoms and signs of breast lump at our hospital were studied in the period of 2 years from July 2014 to June 2016. The findings of physical examination and mammographic examination with histopathological diagnosis were noted n compared. Results: Physical examination of breast lumps is overall less accurate as compared to mammography. There is a tendency to over diagnose malignancy on physical examination. Mammography is more sensitive and specific in the diagnosis of palpable breast lumps as compared to physical examination. Histopathology confirms the diagnosis. Conclusions: It is better to do all three that is clinical examination, mammography and histopathology for all breast lumps diagnosis.
Background: Breast cancer is the most common cause of cancer in women and cancer related mortalit... more Background: Breast cancer is the most common cause of cancer in women and cancer related mortality all over the world. There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. At our center most of the patients with breast cancer presented as locally advanced breast cancer (LABC) which drew our attention to find out the reasons of delay and its association with different socio-demographic variables.Methods: We enrolled 50 histologically proven cases of LABC in this study. With help of semi structured interview, questions were asked from each patient which could reflect their understanding about the disease to find likely reasons for their delayed presentation, including socioeconomic status.Results: In present study most of our patients were more than 45 years, married. 88% presented late due to unawareness and ignorance about nature and severity of breast cancer disease, 86% had financial issues, 64% had shyness as reason, 20% wasted time b...
Background: Surgical site infection (SSI) can be defined as infections which develops within 30 d... more Background: Surgical site infection (SSI) can be defined as infections which develops within 30 days after surgery involving the skin and subcutaneous tissue of the incision and/or the deep soft tissue and/or any part other than the incision handled during surgery. This study has been taken up to determine the incidence of SSI in abdominal surgery and to determine factors responsible for its occurrence.Methods: The study was conducted in Dr. D.Y. Patil Medical College, Hospital and Research Centre located in Pimpri, Pune between July 2017 to September 2019.It is a prospective longitudinal descriptive study. Information collected from the patients included patient’s age, gender, diabetes mellitus status, smoking status and haemoglobin and albumin levels.Results: Total 150 cases with abdominal operations were included in this study. Among them 29 patients developed SSI. Incidence of SSI among them was 19.3%. There was no significant difference among gender between both the groups. (p=...
The study aims to scale patients with diabetic foot ulcers according to Wagner's classification, ... more The study aims to scale patients with diabetic foot ulcers according to Wagner's classification, measure the various risk factors, study various outcomes and improve the treatment measures. Methodology The article presents materials on a prospective observational study of 50 diabetic foot patients with different presentations who underwent stage-specific intervention. Results Poor glycemic control, lifestyle factors, and smoking showed increased risks for foot ulcer complications. Diabetic neuropathy and vasculopathy have been significant outcome predictors. As a result, advanced Wagner's grades showed increased amputation risks and multimodal management. Conclusions Stratification of diabetic foot patients and appropriate management based on their Wagner's grade helps reduce amputation rates and mortality. In addition, multimodal management and exceptional attention to diabetes and lifestyle control improve long-term outcomes.
Foot infections in patients with diabetes mellitus are a major cause of morbidity, can lead to ga... more Foot infections in patients with diabetes mellitus are a major cause of morbidity, can lead to gangrene and ultimately amputation of the limb. Aim of the study was to determine the type of microorganisms isolated from the Diabetic foot ulcer and antibiotic resistance pattern. We have included 50 patients having diabetic foot ulcers of Wagner's grade 1 or above in our study. Debrided tissue, pus, or swabs from the base of the ulcers were subjected to aerobic and anaerobic culture. The organisms were identified, and further antibiotic sensitivity was conducted. Seventy-two aerobic and 13 anaerobic organisms were isolated. Among the aerobic and anaerobic bacteria isolated, most predominant organisms were S. aureus and Bacteroides spp.; respectively. Of the S. aureus, 77.8% were methicillin resistant, while 42.1% of gram-negative Enterobacteriaceae were extended spectrum beta-lactamase (ESBL) positive. Klebsiella spp. was the highest ESBL producer. Acinetobacter spp. was the highes...
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Papers by Dr. Priti Shah