Dr. P S Pujari - Academia.edu (original) (raw)
Papers by Dr. P S Pujari
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021
Introduction: Hypospadias is a very common congenital anomaly noted in children with reported inc... more Introduction: Hypospadias is a very common congenital anomaly noted in children with reported incidence of 0.4-8.2% in 1000 live birth. Treatment of hypospadias is urethroplasty, but is a difficult procedure due to complex anatomy, nonavailability of adequate tissue for repair, prolonged postoperative course and increased incidence of complications even in experienced hands. Aim: To highlight the complications and functional outcome of various types of proximal hypospadias using standard surgical technique with intermediate vascularised flap. Materials and Methods: This was a retrospective cohort study conducted from on 31 children, between the age of 2-13 years from June 2020 to August 2020. The children had proximal hypospadias with or without chordee were operated using primary procedure Tubularised Incised Plate (TIP) and staged procedure with cover of intermediate vascularised flap. These children had peno-scrotal, proximal, mid and distal penile hypospadias with meatus placed ...
International journal of scientific research, 2019
Malrotation of gut is a congenital developmental anomaly of foetal intestinal rotation and mostly... more Malrotation of gut is a congenital developmental anomaly of foetal intestinal rotation and mostly present in early childhood as acute intestinal obstruction. Progression and presentation in adults is very rare and often silent. Delayed diagnosis is a common feature in many cases due to atypical presentation and leads to more complications. We present a case of 26 year old women who presented with repeated episodes of pain abdomen and preoperative evaluation on contrast enhanced CT Scan showed intestinal malrotation. Laparoscopic Ladd’s procedure was done successfully with division of Ladd’s band, adhesiolysis, widening of mesentry and appendicectomy. The patient had an uneventful postoperative recovery. Here we discuss the rarity of intestinal malrotation in adults and various treatment options available in literature review.
Salah satu sumber daya organisasi yang memiliki peran penting dalam mencapai tujuannya adalah sum... more Salah satu sumber daya organisasi yang memiliki peran penting dalam mencapai tujuannya adalah sumber daya manusia. Dan pelatihan merupakan salah satu proses pengembangan SDM. Dengan demikian, pelatihan dan pengembangan telah menjadi bagian dari kebutuhan. Penelitian ini bertujuan untuk menganalisis perbedaan kinerja karyawan sebelum dan sesudah pelatihan pada PT. Bank Rakyat Indonesia Kantor Cabang Serui. Penelitian ini merupakan penelitian kuantitatif. Populasi penelitian ini adalah karyawan PT. Bank Rakyat Indonesia Kantor Cabang Serui dan sampel dalam penelitian ini menggunakan teknik non-probality sampling, dengan jenis incidental sampling dengan jumlah responden sebanyak 6 orang responden yang sudah mengikuti pelatihan pada tahun 2017. Teknik analisis data yang digunakan adalah analisis deskriptif. Teknik pengumpulan data menggunakan data primer dan data sekunder. Analisis data yang digunakan adalah uji validitas, uji reliabilitas dan uji T (Paired Sample t-Test). Pengujian validitas, reliabilitas dan uji t dilakukan dengan menggunakan program SPSS 22 dan mengasilkan tingkat perbedaan kinerja karyawan sebelum dan sesudah pelatihan sebesar 3,176 dengan tingkat signifikansi 0,019. Berdasarkan pengujian hipotesis yang dilakukan dapat diketahui bahwa terdapat perbedaan yang kuat dan signifikan sebelum dan sesudah pelatihan terhadap kinerja karyawan.
International journal of scientific research, 2018
Laparoscopic surgery is preferred over open surgery for almost all abdominal pathologies because ... more Laparoscopic surgery is preferred over open surgery for almost all abdominal pathologies because of the obvious advantages it renders and relatively less wound related complications. However, port site complications in laparoscopic surgeries can enhance the morbidity and thus reduces its overall benefits. These occur due to improper asepsis or instrument sterilization, ornonadherence to safety measures during trocar placement or removal at port sites. A prospective study of 630 patients, who underwent laparoscopic surgeries for various diseases, reveals an overall incidence of port site complications in 26 cases(4.12%). Of the various known complications, portsite infectionwas thecommonest in 15 cases and port site herniation is the least common in onecase. Adoption of strict asepsis, adequate sterilization methods and adherence to safety measures during placement and removal of trocars at port sites, can significantly reduce the incidence of port site complications.
International journal of scientific research, 2020
Polytrauma with traumatic brain injury due to road traffic accident involving multiple rib fractu... more Polytrauma with traumatic brain injury due to road traffic accident involving multiple rib fracture, long bone fracture , pneumothorax, surgical emphysema and rupture of the left hemidiaphragm poses a serious initial pathophysiologic challenge in the form of onset of “ Lethal triad” i.e., metabolic acidosis, hypothermia & coagulopathy. Such patients need a proper triage, admission into a well equipped and committed trauma care centre with multispecialty departments, a well equipped ICU and round the clock interventional radiology, laboratory facility. Adoption of “Damage control surgery” can prevent “Second hit” injuries and improve survival
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2008
The objectives of this study are to determine the key dimensions that affect user experience on t... more The objectives of this study are to determine the key dimensions that affect user experience on the website and evaluate a tool for measuring website quality. Two e-commerce websites, both from same business domain, were tested across the service quality dimensions identified in this study using a questionnaire. 15 subjects from a company group and 10 subjects from a student group participated the user testing. The results of user testing were then compared with website heuristic evaluation and indicated that the e-service quality dimensions could be used to capture user experience and evaluate quality of a website from a user satisfaction point of view. The results also have ramifications for designers of business websites.
International journal of scientific research, 2019
Stentolith also known as stent-stone complex of the common bile duct (CBD), is an extremely rare ... more Stentolith also known as stent-stone complex of the common bile duct (CBD), is an extremely rare long term complication of a forgotten or retained stent in the CBD, with only a handful of cases reported. A high index of suspicion is required to diagnose stentolith especially in patients presenting with cholangitis, with a history of ERCP done long before. We report a total of 3 patients, who presented with either non specific pain abdomen or features of biliary obstruction, admitted in the Department of General Surgery at KIMS, PBMH. They were diagnosed with choledocholithiasis on imaging (USG abdomen / MRCP). Intra operatively all the patients were found to have retained stents with de novo stone formation
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Introduction: In 1999, Gilbert described the technique of using a bilayer mesh device, Prolene He... more Introduction: In 1999, Gilbert described the technique of using a bilayer mesh device, Prolene Hernia System (PHS) for tension free repairs of inguinal hernias through an open anterior approach. This provides an anterior, posterior and plug repair, and hence successfully covers the myopectineal orifice, the lack of which is a glaring drawback for the Lichtensteins repair. This also confers the same benefit provided by the laparoscopic hernia repairs which uses the preperitoneal space to cover this same region that is, Transabdominal Preperitoneal Patch Plasty (TAPP) and Total Extraperitoneal patch Plasty (TEP). Aim: To observe the overall outcome of using the open bi-layered dual mesh in a population of Odisha, attending a tertiary care hospital. Materials and Methods: All patients admitted with inguinal hernias in the Department of General Surgery, Pradyumna Bal Memorial Hospital, KIMS, Odisha, India were included in the study. They all underwent the PHS bilayer mesh repair. The re...
International Surgery Journal
Hemobilia though rare, occurs due to abnormal vascular and biliary communication established as a... more Hemobilia though rare, occurs due to abnormal vascular and biliary communication established as a result of trauma, gallstones, neoplasms, inflammatory process and vascular disorders. It can rarely complicate a laparoscopic cholecystectomy as a result of hepatic artery injury, clip migration, clip erosion, diathermy and subsequent arteriobiliary fistula, or pseudoaneurysm eroding into the extra hepatic bile ducts. A 34 years female underwent laparoscopic cholecystectomy for cholelithiasis, suffered bile leak that settled on by 13th postoperative day, met with sudden right upper abdominal pain and hypovolemic shock on 15th postoperative day due to massive hemobilia arising out of rupture of pseudoaneurysm of the right hepatic artery into the biliary system. Urgent CT Angiography showed a large pseudoaneurysm of right hepatic artery branch with adjacent small collection, IHBR and CBD dilatation suggestive of hemobilia. Emergency CT guided trans-arterial hepatic artery embolization don...
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021
Introduction: Hypospadias is a very common congenital anomaly noted in children with reported inc... more Introduction: Hypospadias is a very common congenital anomaly noted in children with reported incidence of 0.4-8.2% in 1000 live birth. Treatment of hypospadias is urethroplasty, but is a difficult procedure due to complex anatomy, nonavailability of adequate tissue for repair, prolonged postoperative course and increased incidence of complications even in experienced hands. Aim: To highlight the complications and functional outcome of various types of proximal hypospadias using standard surgical technique with intermediate vascularised flap. Materials and Methods: This was a retrospective cohort study conducted from on 31 children, between the age of 2-13 years from June 2020 to August 2020. The children had proximal hypospadias with or without chordee were operated using primary procedure Tubularised Incised Plate (TIP) and staged procedure with cover of intermediate vascularised flap. These children had peno-scrotal, proximal, mid and distal penile hypospadias with meatus placed ...
International journal of scientific research, 2019
Malrotation of gut is a congenital developmental anomaly of foetal intestinal rotation and mostly... more Malrotation of gut is a congenital developmental anomaly of foetal intestinal rotation and mostly present in early childhood as acute intestinal obstruction. Progression and presentation in adults is very rare and often silent. Delayed diagnosis is a common feature in many cases due to atypical presentation and leads to more complications. We present a case of 26 year old women who presented with repeated episodes of pain abdomen and preoperative evaluation on contrast enhanced CT Scan showed intestinal malrotation. Laparoscopic Ladd’s procedure was done successfully with division of Ladd’s band, adhesiolysis, widening of mesentry and appendicectomy. The patient had an uneventful postoperative recovery. Here we discuss the rarity of intestinal malrotation in adults and various treatment options available in literature review.
Salah satu sumber daya organisasi yang memiliki peran penting dalam mencapai tujuannya adalah sum... more Salah satu sumber daya organisasi yang memiliki peran penting dalam mencapai tujuannya adalah sumber daya manusia. Dan pelatihan merupakan salah satu proses pengembangan SDM. Dengan demikian, pelatihan dan pengembangan telah menjadi bagian dari kebutuhan. Penelitian ini bertujuan untuk menganalisis perbedaan kinerja karyawan sebelum dan sesudah pelatihan pada PT. Bank Rakyat Indonesia Kantor Cabang Serui. Penelitian ini merupakan penelitian kuantitatif. Populasi penelitian ini adalah karyawan PT. Bank Rakyat Indonesia Kantor Cabang Serui dan sampel dalam penelitian ini menggunakan teknik non-probality sampling, dengan jenis incidental sampling dengan jumlah responden sebanyak 6 orang responden yang sudah mengikuti pelatihan pada tahun 2017. Teknik analisis data yang digunakan adalah analisis deskriptif. Teknik pengumpulan data menggunakan data primer dan data sekunder. Analisis data yang digunakan adalah uji validitas, uji reliabilitas dan uji T (Paired Sample t-Test). Pengujian validitas, reliabilitas dan uji t dilakukan dengan menggunakan program SPSS 22 dan mengasilkan tingkat perbedaan kinerja karyawan sebelum dan sesudah pelatihan sebesar 3,176 dengan tingkat signifikansi 0,019. Berdasarkan pengujian hipotesis yang dilakukan dapat diketahui bahwa terdapat perbedaan yang kuat dan signifikan sebelum dan sesudah pelatihan terhadap kinerja karyawan.
International journal of scientific research, 2018
Laparoscopic surgery is preferred over open surgery for almost all abdominal pathologies because ... more Laparoscopic surgery is preferred over open surgery for almost all abdominal pathologies because of the obvious advantages it renders and relatively less wound related complications. However, port site complications in laparoscopic surgeries can enhance the morbidity and thus reduces its overall benefits. These occur due to improper asepsis or instrument sterilization, ornonadherence to safety measures during trocar placement or removal at port sites. A prospective study of 630 patients, who underwent laparoscopic surgeries for various diseases, reveals an overall incidence of port site complications in 26 cases(4.12%). Of the various known complications, portsite infectionwas thecommonest in 15 cases and port site herniation is the least common in onecase. Adoption of strict asepsis, adequate sterilization methods and adherence to safety measures during placement and removal of trocars at port sites, can significantly reduce the incidence of port site complications.
International journal of scientific research, 2020
Polytrauma with traumatic brain injury due to road traffic accident involving multiple rib fractu... more Polytrauma with traumatic brain injury due to road traffic accident involving multiple rib fracture, long bone fracture , pneumothorax, surgical emphysema and rupture of the left hemidiaphragm poses a serious initial pathophysiologic challenge in the form of onset of “ Lethal triad” i.e., metabolic acidosis, hypothermia & coagulopathy. Such patients need a proper triage, admission into a well equipped and committed trauma care centre with multispecialty departments, a well equipped ICU and round the clock interventional radiology, laboratory facility. Adoption of “Damage control surgery” can prevent “Second hit” injuries and improve survival
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2008
The objectives of this study are to determine the key dimensions that affect user experience on t... more The objectives of this study are to determine the key dimensions that affect user experience on the website and evaluate a tool for measuring website quality. Two e-commerce websites, both from same business domain, were tested across the service quality dimensions identified in this study using a questionnaire. 15 subjects from a company group and 10 subjects from a student group participated the user testing. The results of user testing were then compared with website heuristic evaluation and indicated that the e-service quality dimensions could be used to capture user experience and evaluate quality of a website from a user satisfaction point of view. The results also have ramifications for designers of business websites.
International journal of scientific research, 2019
Stentolith also known as stent-stone complex of the common bile duct (CBD), is an extremely rare ... more Stentolith also known as stent-stone complex of the common bile duct (CBD), is an extremely rare long term complication of a forgotten or retained stent in the CBD, with only a handful of cases reported. A high index of suspicion is required to diagnose stentolith especially in patients presenting with cholangitis, with a history of ERCP done long before. We report a total of 3 patients, who presented with either non specific pain abdomen or features of biliary obstruction, admitted in the Department of General Surgery at KIMS, PBMH. They were diagnosed with choledocholithiasis on imaging (USG abdomen / MRCP). Intra operatively all the patients were found to have retained stents with de novo stone formation
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Introduction: In 1999, Gilbert described the technique of using a bilayer mesh device, Prolene He... more Introduction: In 1999, Gilbert described the technique of using a bilayer mesh device, Prolene Hernia System (PHS) for tension free repairs of inguinal hernias through an open anterior approach. This provides an anterior, posterior and plug repair, and hence successfully covers the myopectineal orifice, the lack of which is a glaring drawback for the Lichtensteins repair. This also confers the same benefit provided by the laparoscopic hernia repairs which uses the preperitoneal space to cover this same region that is, Transabdominal Preperitoneal Patch Plasty (TAPP) and Total Extraperitoneal patch Plasty (TEP). Aim: To observe the overall outcome of using the open bi-layered dual mesh in a population of Odisha, attending a tertiary care hospital. Materials and Methods: All patients admitted with inguinal hernias in the Department of General Surgery, Pradyumna Bal Memorial Hospital, KIMS, Odisha, India were included in the study. They all underwent the PHS bilayer mesh repair. The re...
International Surgery Journal
Hemobilia though rare, occurs due to abnormal vascular and biliary communication established as a... more Hemobilia though rare, occurs due to abnormal vascular and biliary communication established as a result of trauma, gallstones, neoplasms, inflammatory process and vascular disorders. It can rarely complicate a laparoscopic cholecystectomy as a result of hepatic artery injury, clip migration, clip erosion, diathermy and subsequent arteriobiliary fistula, or pseudoaneurysm eroding into the extra hepatic bile ducts. A 34 years female underwent laparoscopic cholecystectomy for cholelithiasis, suffered bile leak that settled on by 13th postoperative day, met with sudden right upper abdominal pain and hypovolemic shock on 15th postoperative day due to massive hemobilia arising out of rupture of pseudoaneurysm of the right hepatic artery into the biliary system. Urgent CT Angiography showed a large pseudoaneurysm of right hepatic artery branch with adjacent small collection, IHBR and CBD dilatation suggestive of hemobilia. Emergency CT guided trans-arterial hepatic artery embolization don...