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Papers by Megha Sharma
Perioperative Medicine
Background Single-dose perioperative antibiotic prophylaxis (PAP) is recommended for clean, non-i... more Background Single-dose perioperative antibiotic prophylaxis (PAP) is recommended for clean, non-infectious surgeries to prevent surgical site infections. However, the common practice of unindicated use and prolonged use of antibiotics contributes to the development and spread of antibiotic resistance (ABR). The present study explores the perioperative use of antibiotics among inpatients with surgical indications at surgery departments of a teaching (TH) and a non-teaching (NTH) tertiary care hospital in Madhya Pradesh, India. Methods Data was collected manually for all inpatients for 3 years (April 2008–August 2011). Patients with non-infectious surgical indications were selected for detailed analysis at the diagnosis group level. Results Out of 12,434 enrolled inpatients (TH 6171 and NTH 6263), the majority (> 85%) received antibiotics. None of the inpatients received the recommended single-dose PAP. The average duration of antibiotic treatment was significantly longer at the TH...
Objectives The aim of the study was to see the clinical, histological and immunological correlati... more Objectives The aim of the study was to see the clinical, histological and immunological correlation of various immunobullous diseases and to evaluate the sensitivity of direct immunofluorescence (DIF) in specific diagnosis of various immunobullous diseases. Methods 29 patients of immunobullous diseases attending skin OPD and IPD of a tertiary care hospital in Ujjain were included in the study and were thoroughly examined. Results Out of 29, 26 cases showed DIF patterns concordant with histologic diagnosis. The sensitivity of DIF was 92.3% (12/13) in the pemphigus group, 75% (3/4) in bullous pemphigoid, 66.7% (2/3) in dermatitis herpetiformis, while it was 100% (3/3) each in linear IgA disease and chronic bullous dermatosis of childhood. Conclusion DIF is essential for diagnosing autoimmune blistering diseases with the clinical and the histopathological overlap.
Background: Tuberculosis continues to be the biggest health problem in India. Tuberculosis involv... more Background: Tuberculosis continues to be the biggest health problem in India. Tuberculosis involves respiratory, gastrointestinal tract as well as extrapulmonary site. Tubercular lymphadenopathy is the most common form of extrapulmonary tuberculosis. FNAC plays a vital role in diagnosis of tubercular lymphadenopathy. FNAC is not only used for cytological diagnosis but also used for other ancillary tests like Ziehl-Neelsen staining and AFB culture. Methods: The study was conducted in the department of pathology, Government Medical College, Jammu over a period of 6 months and included 450 cases presenting with superficial lymphadenopathy. FNAC was performed in the cases and smears in each case, were stained with May Grunwald Giemsa (MGG), Papanicolaou and Z-N stain. Results: Out of 450 cases,160 cases (35.5%) showed features of tubercular lymphadenitis. The most common site of presentation, being cervical region with 75% cases. Females outnumbered males by ratio of 1.46:1. In cytomorphology 93 cases (58.1%) showed epithelioid granulomas with caseous necrosis,37 cases (23.1%) showed caseous necrosis only while only epithelioid granulomas were seen in 30 cases (23.1%). AFB positivity was seen in 82 cases with maximum AFB positivity (78.3%) seen in cases with necrosis only. Conclusions: FNAC is a rapid diagnostic technique because of its simplicity, cost effectiveness, early availability of results and minimal invasion. FNAC is a reliable and sensitive first line investigation in diagnosis of tubercular lymphadenitis combined with AFB staining.
Perioperative Medicine
Background Single-dose perioperative antibiotic prophylaxis (PAP) is recommended for clean, non-i... more Background Single-dose perioperative antibiotic prophylaxis (PAP) is recommended for clean, non-infectious surgeries to prevent surgical site infections. However, the common practice of unindicated use and prolonged use of antibiotics contributes to the development and spread of antibiotic resistance (ABR). The present study explores the perioperative use of antibiotics among inpatients with surgical indications at surgery departments of a teaching (TH) and a non-teaching (NTH) tertiary care hospital in Madhya Pradesh, India. Methods Data was collected manually for all inpatients for 3 years (April 2008–August 2011). Patients with non-infectious surgical indications were selected for detailed analysis at the diagnosis group level. Results Out of 12,434 enrolled inpatients (TH 6171 and NTH 6263), the majority (> 85%) received antibiotics. None of the inpatients received the recommended single-dose PAP. The average duration of antibiotic treatment was significantly longer at the TH...
Objectives The aim of the study was to see the clinical, histological and immunological correlati... more Objectives The aim of the study was to see the clinical, histological and immunological correlation of various immunobullous diseases and to evaluate the sensitivity of direct immunofluorescence (DIF) in specific diagnosis of various immunobullous diseases. Methods 29 patients of immunobullous diseases attending skin OPD and IPD of a tertiary care hospital in Ujjain were included in the study and were thoroughly examined. Results Out of 29, 26 cases showed DIF patterns concordant with histologic diagnosis. The sensitivity of DIF was 92.3% (12/13) in the pemphigus group, 75% (3/4) in bullous pemphigoid, 66.7% (2/3) in dermatitis herpetiformis, while it was 100% (3/3) each in linear IgA disease and chronic bullous dermatosis of childhood. Conclusion DIF is essential for diagnosing autoimmune blistering diseases with the clinical and the histopathological overlap.
Background: Tuberculosis continues to be the biggest health problem in India. Tuberculosis involv... more Background: Tuberculosis continues to be the biggest health problem in India. Tuberculosis involves respiratory, gastrointestinal tract as well as extrapulmonary site. Tubercular lymphadenopathy is the most common form of extrapulmonary tuberculosis. FNAC plays a vital role in diagnosis of tubercular lymphadenopathy. FNAC is not only used for cytological diagnosis but also used for other ancillary tests like Ziehl-Neelsen staining and AFB culture. Methods: The study was conducted in the department of pathology, Government Medical College, Jammu over a period of 6 months and included 450 cases presenting with superficial lymphadenopathy. FNAC was performed in the cases and smears in each case, were stained with May Grunwald Giemsa (MGG), Papanicolaou and Z-N stain. Results: Out of 450 cases,160 cases (35.5%) showed features of tubercular lymphadenitis. The most common site of presentation, being cervical region with 75% cases. Females outnumbered males by ratio of 1.46:1. In cytomorphology 93 cases (58.1%) showed epithelioid granulomas with caseous necrosis,37 cases (23.1%) showed caseous necrosis only while only epithelioid granulomas were seen in 30 cases (23.1%). AFB positivity was seen in 82 cases with maximum AFB positivity (78.3%) seen in cases with necrosis only. Conclusions: FNAC is a rapid diagnostic technique because of its simplicity, cost effectiveness, early availability of results and minimal invasion. FNAC is a reliable and sensitive first line investigation in diagnosis of tubercular lymphadenitis combined with AFB staining.