IJSS Journal of Surgery

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https://imsear.searo.who.int/handle/123456789/157948

Editor: Dr Mahesh M Pukar
ISSN: 2395-1893

Frequency: Once in two months

Language: English

Open Access Peer-reviewed journal

Web site: https://surgeryijss.com/

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Now showing 1 - 20 of 165

Abdominal Tuberculosis: Clinical-pathological Profile and Role of Surgery in its Management
(International Research Organization for Life and Health Sciences, 2018-07) Badkur, Mayank; Patel, Seema; Singh, Nisha
Background: Abdominal tuberculosis (TB) is an essential clinical element having a varied mode of clinical presentation. Diagnosis of abdominal TB is a troublesome and cautious way to deal with the patients, and strong examination and supportive investigations are important to make the last finding. Objectives of the study were to evaluate the clinic-pathological profile of patients with abdominal TB and the role of surgery in its management in a tertiary care center in northern India. Methods: This is a retrospective study conducted in the department of general surgery and medical college DOTS center of northern India. A total of 97 patients with abdominal TB diagnosed on the basis of clinical profile and supported investigation data were selected for this study. Radiological findings, diagnostic laparoscopy, laparotomy, and histological findings are taken into account. Results: Of the 97 patients, 56 were males and 41 females with age ranging 16–82 (mean 32.3) years. Abdominal pain was the most common presenting symptom in 84 (86.59%). The diagnosis of abdominal TB was confirmed by histopathology in 78 (80.41%). Remaining 19 (19.5%) cases were diagnosed microscopically and with supportive clinical and imaging background. All the patients were treated under DOTS. Conclusions: Early diagnosis is the key factor in avoiding systemic and local complications of intestinal TB. No clinical features, laboratory, radiological or bacteriological, and histopathological findings are gold standard in the diagnosis of abdominal TB. In emergency cases, prompt surgical exploration, anti-TB drugs, and vigilant care are met with good recovery
Accuracy of Ultrasonography in the Diagnosis of Acute Appendicitis
(International Research Organization for Life and Health Sciences, 2018-01) Laxman, Santhosh; Sangolgi, Pramod
Aims and Objectives: The aims of this study were to determine the accuracy of ultrasound in the diagnosis of acute appendicitis and to compare the ultrasound diagnosis with intraoperative diagnosis. Materials and Methods: Hundred cases of clinically diagnosed acute appendicitis patients were studied and compared with data from the literature. Result: Ultrasonography has sensitivity of 84.1%, specificity of 50%, positive predictive value of 92.5%, and negative predictive value of 30%. Conclusion: Ultrasonography is the investigation of choice for screening of acute appendicitis.
Adenomatoid Odontogenic Tumor: An Unusual Presentation.
(2015-09) Kalaria, Bharat; Agarwal, Surbhi; Narayan, Abhishek; Verma, Sankalp
Adenomatoid odontogenic tumor (AOT) is a not so common neoplasm of the odontogenic origin, accounting for around 3-7% of all odontogenic tumors. It is usually present in young females in the anterior maxillary region and thus commonly referred to as a two-third tumor. It is a benign (hamartomatous), usually non-invasive tumor which shows slow and progressive growth. Due to its rarity and varied clinical presentation it is often misdiagnosed. To add to confusion further, there are various lesions which mimic AOT closely. Herein this article, we present a case report of a young female patient with an unusual presentation of AOT tumor in the mandibular region focusing on the versatility of this rare entity.
Alkaline Phosphatase Levels in Tuberculous Cervical Lymphadenitis - Could it be a Predictor for Diagnosis and Monitoring Response to Anti-tuberculous Treatment.
(2016-11) Kailas, C Kiran; Srikantaiah, H C; Ashok, A C; Vinay, B M
Introduction: Scrofula also known as tuberculous cervical lymphadenitis is one of the most common manifestations of tuberculosis (TB). India is a country that still remains plagued by this dreaded disease. The disease poses both diagnostic and therapeutic challenges because it mimics other pathologic processes and does not have consistent physical and laboratory findings. The monitoring of treatment in cases of cervical TB lymphadenitis is more complex due to the peculiar behavior of TB lymph nodes. Materials and Methods: The serum alkaline phosphatase (ALP) of all patients presenting with cervical TB lymphadenitis in the Revised National TB Control Programme (RNTCP) outpatient department (OPD) of MS Ramaiah Medical College was collected. An ALP level at the time of diagnosis was noted. Subsequently, serum ALP levels were measured when the patients come for Directly Observed Treatment Short to RNTCP OPD on 15th, 30th, and 60th day of starting anti-TB treatment (ATT). Results: It has been observed in the study that 72.2% of the patients with cervical tuberculous lymphadenitis had significantly elevated levels of serum ALP (>135 IU/L) at the time of presentation. Only 5.3% among the controls had high ALP, and the difference was statistically significant with a P < 0.001. With sensitivity = 72.2% and specificity of 94.5%, and assuming that the prevalence of TB is 3.2% the estimated positive predictive value is 30.3% and negative predictive value is 99.0%. Based on simple linear regression with ALP as dependent variable and time as independent variable, it is found that among the patients there is a decline in ALP values at an average of 33.4 in every 15 days. Conclusion: This study shows the significance of measurement of serum ALP as a supplementary tool in the diagnosis of cervical TB lymphadenitis. Serial monitoring of serum ALP can be used to monitor the response of ATT.
Analytic Study of Chest Injury.
(2015-01) Shah, Jigar V; Solanki, Mehul I
Background: Trauma is one of the leading causes of morbidity and mortality worldwide. Chest trauma constitutes about 10-15% of all cases and is responsible for 25% of deaths as a result of trauma. It is a major problem for India, where there is a very high incidence of vehicular accidents (6% of global vehicular accidents), along with crime and riots. In spite of that very few studies have been documented that assess the prevalence and management of these events. Hence, this retrospective study was carried out to determine the magnitude and management of patients with chest trauma in rural setup. Methods: A study of 100 cases of chest trauma admitted in Dhiraj Hospital, from May 2010 to September 2012 was carried out. The data collected included the patient’s demographic profi le; mode, type and severity of chest injuries, management scheme and outcome. Results: Of 100 patients who sustain chest trauma, 76% of cases were due to vehicular accident. Of 100 patients 64% had rib fractures, 17% had fl ail chest, 12% had pneumothorax, 24% had hemothorax, and 5% had hemopneumothorax and 24% had extra-thoracic injury. In 33% water seal intercostals tube insertion was done and 17% of patients having fl ail chest were treated with intermittent positive pressure ventilation. Conclusions: The present study reveals that the trauma commonly seen in young males was motor vehicle accident. The outcome and prognosis for the majority of patients of blunt chest trauma are excellent. Most require no invasive therapy or, at most intercostals chest drainage tube insertion.
Association of Alcohol use Disorder with Gastric or Duodenal Perforation.
(2015-11) Patil, Santosh M; Namratha, H
Background: Observational studies have suggested a complex relationship between alcohol consumption and gastrointestinal (GI) disorder. Long-term consumption of alcohol has detrimental effects on the human body, which can range from mild dependence to severe alcohol dependence and in some cases presenting as gastric or duodenal perforation. Aim: The aim of this study was to compare gastric or duodenal perforation in substantially high risk group (moderate or severe alcohol dependence) to low risk group (mild dependence). Methods: All patients in the study were screened with alcohol use disorders identification test and assessed for severity of dependence with severity of alcohol dependence questionnaire (SADQ). Severity of dependence grouped as low risk (below 16 score) and substantially high risk group (score 16 or above) by SADQ. Results: The present study showed occurrence of gastric or duodenal perforation is more commonly seen in substantially high risk group (moderate to severe dependence) when compared to low risk (mild dependence) group. Majority of the substantially high risk dependence seen in males (69.5%), illiterate or less than SSLC (49.9%), from rural area (58.69%), and farmers (56.52%) irrespective of their sex. Conclusions: These results indicate that substantially high risk dependence (moderate to severe dependence) increases the relative risk of gastric or duodenal perforation. High risk dependence patients should be adequately evaluated for GI disorders to reduce morbidity and mortality.
Bacteriological Profile of Diabetic Foot Ulcers: A Clinical Study.
(2016-05) Shashanka, R; Rajanna, B
Introduction: Among all the chronic complications affecting a person with diabetes, foot disease is the most devastating. The majority of diabetic foot ulcers are often associated with diverse population of bacteria. Hence, the present study was undertaken to examine the bacteriological profi le associated with diabetic foot infections. Materials and Methods: This study included a total of 100 diabetic patients with foot ulcers. Two sterile swabs were used to collect the sample from the deeper portion of the ulcers, of which one was used for Gram-staining and another for culture and sensitivity. Results: A total of 120 bacterial isolates were obtained from 100 patients with diabetic foot ulcers. Gram-negative bacilli (68.4%) showed an increased prevalence than the Gram-positive cocci (31.6%), and the most common isolate was Pseudomonas spp. (26.2%). Conclusion: Variations in bacteriological profi le in different studies could be attributed to geographic locations or type and severity of the infection. Thus, a thorough knowledge on antibiotic sensitivity pattern of the isolates is required for planning the treatment of diabetic foot ulcers.
Basal Cell Carcinoma: A Case Report.
(2015-01) Madhura, Killedar M; Honeypalsinh, Maharaul H; Rinkan, Virani A
Basal cell carcinoma (BCC) is one of the most common skin cancers, which causes disfi gurement and destruction by invasion in surrounding tissue. However, it rarely metastasizes to distant tissue and cause death. It is a locally invasive tumor. The present case is of a BCC in a 62-year-old female presenting with non-healing ulcer above right eyelid. The patient had no history of arsenic intake, irradiation, herb medication, or exposure to chemical gases. No signifi cant past, personal and family history were observed. Histopathology revealed BCC. The patient was managed with wide excision of the lesion and then full thickness skin graft. At present, the patient is stable.
Benign Breast Lesions in a Teaching Hospital in Rural Bihar.
(2016-01) Singh, Shambhu Kumar; Ahmad, Khwaja Nasim; Pankaj, Deepak; Ansari, Mohammad Arif
Background: Breast diseases has captured attention of surgeons throughout the ages with its uncertain cause. Study of a pattern of benign breast diseases (BBDs) is a challenge due to variants in occurrence and presentation in different age groups and different geographical areas. The breast is a complex structure and any unnatural change affects the body and psyche of the person. Aim: The aim of this study was to observe age distribution, clinical signs, symptoms and pathology of benign breast lump and correlate them with pathological findings. Materials and Methods: A total of 124 cases of benign breast lump were included in this study. These cases were selected among patients visiting the outdoor clinic of Department of General Surgery in Katihar Medical College, Katihar, Bihar, India. The selected cases belonged to different etiology, age group and sex. Results: Maximum cases of benign breast tumors were observed in age group of 21-30 years (third decade). Fibroadenoma was the most common presentation. The majority of patients reported within 1 year of onset of disease. The painless lump was the most common mode of presentation. The right breast was involved in a more number of cases with maximum lesions noted in the upper outer quadrant. Conclusion: BBDs are common in female patients. Clinical, sonological, mammographical, and pathological studies need to be conducted in a systemic way to find answers of complexities posed by the confusing pattern of BBDs.
Benign Osteoblastoma of the Mandible: A Case Report
(International Research Organization for Life and Health Sciences, 2019-03) Bumb, Swapnil Sunil; Dodamani, Arun; Jain, Vardhaman
Osteoblastoma, a rare osteoblastic tumor, constitutes approximately 1% of all primary bone tumors. It is characterized by osteoid and bone formation with the presence of numerous osteoblasts. A 24-year-old female presented with a chief complaint of a painless swelling beneath the mandible, which was growing during the past 3 years. Radiological picture disclosed a well-circumscribed lesion with patchy radiopaque internal structure. After complete excision, the histopathological diagnosis was a benign osteoblastoma of the mandible. Differential diagnosis and immunohistochemical features potentially useful for refining diagnosis of osteoblastoma.
Bilateral Extradural Hematoma: A Case Report.
(2015-01) Patil, Anil B; Patil, Nandini A
The occurrence of bilateral extradural hematomas is an uncommon consequence of cranio-cerebral trauma. In the literature bilateral, extradural hematomas have rarely been reported. This article is about a case of 45-year-old female who was admitted in our hospital with a history of road traffi c accident. On admission, she was conscious but irritable having Glasgow coma scale 14/15. In stable condition, she was found to have visual agnosia for left eye. Her computed tomography scan showed a bilateral symmetrical site with asymmetrical dimensions. Patient underwent left occipito-posterio-parietal craniotomy with complete removal of extradural hematoma was done. Right occipital extradural hematoma was not removed.
Bladder Metastasis: An Unusual Presentation of Stomach Cancer.
(2016-07) Sima, Rahul R; Babu, G S Naresh; Rao, A Nagaraja; Malipatel, Renuka
Linitus plastica of the stomach is a type of gastric carcinoma usually diagnosed at a late stage due to a lack of early pathognomonic symptoms. A diagnosis is usually by endoscopy and biopsy, however, lack of mucosal involvement leads to false negative reports. Over 50% of patients present with distant metastasis. Metastasis to bladder is rare and synchronous detection of bladder metastasis along with the primary tumor has only been reported in 5 cases in English literature. We present a case where clinical suspicion of a gastric malignancy was made in retrospect after biopsy of bladder tumor confirmed metastasis from a gastrointestinal primary.
Breast Diseases - Clinicopathological Correlation: A Three Years Study
(International Research Organization for Life and Health Sciences, 2019-01) Sayanna, S Shengulwar; Shankar, Muvva Uday; Babu, K Ranjith
Introduction: To establish the early definite diagnosis in the cases of breast diseases, it is evaluated the relationship between clinical diagnosis, cytological, and histopathological findings. A definite diagnosis of breast disease at the proper time will lead to the correct and successful management. Breasts are the characteristic features of the mammalian family of the animal kingdom. Breasts are present in pairs in all animals. In human beings, mammary glands are present one on each right and the left side of the chest cage in both females and males. The diseases of the breast are more common in females. The common diseases are benign and malignant neoplasm’s, infections such as mastitis and breast abscess. The usual clinical presentation is with a breast lump, breast pain, and breast enlargement. Benign breast diseases are not life-threatening, but malignancyis dangerous for life. The most common cause of death in females, all over the world is breast cancer. Therefore, early detection of the malignant condition is essential for successful treatment and better results which increases survival rate. Materials and Methods: A total of 110 female and seven male patients who attended General Surgery Outpatient Department (OPD) of Maheshwara Medical College and Hospital, Chitkul of Telangana State with various types of clinical breast complaints are included in the present study. The data were collected from the outpatient register, operation theater, cytology, and histopathology register. All the patients who received treatment at this hospital from January 2016 to December 2018 are included in this study, after obtaining the Institutional Ethical Committee Clearance. The clinical provisional diagnosis was confirmed by investigations such as local ultrasound and fine-needle aspiration cytology before the definite line of management was planned. The patients who require surgical intervention were treated accordingly, and surgery under the necessary anesthesia was done. The excised specimen was sent for histopathological examination. The correlation between clinical diagnosis and histopathological findings was compared to evaluate accuracy. Results and Discussion: A total of 110 female patients and seven male patients were studied. The age range was from 13 years to 80 years. The youngest girl of 13 years of age was presented with a lump in the left breast and oldest patient was of 80 years female presented with a mass in the right breast. The maximum number of patients presented clinically with a lump in the breast and the second symptom was a pain in the breast. The common breast diseases were benign and malignant neoplasms. In the benign conditions, most common was fibroadenoma (69 patients 62.72%) in young females. In older age >40 years, the breast cancer is common. All the seven male patients with breast enlargement clinically, diagnosed as gynecomastia and histopathologically confirmed. Conclusion: In this series about 110 female and seven male patients who attended general surgery OPD in 3 years were studied. The provisional clinical diagnosis was compared with cytological and histopathological findings, which was found to be accurate in 86.3% of cases. The common clinical presentation with breast lump was histopathologically found to be fibroadenoma. The older females after menopause or above 50 years of age usually presented with a mass in the breast clinically diagnosed as cancer breast histopathologically proved in all cases 100%
Breast Tuberculosis - Experience of Cases in a Tertiary Care Institute.
(2016-07) Raza, Mohd Arshad; Mukherjee, Sujoy; Mohan, Manjul; Mohan, Nitesh; Zahid, Mohamamd
Aim: The study was conducted with an aim to suspect and diagnose “breast tuberculosis (TB)” cases early to avoid unnecessary delay in their treatment. Materials and Methods: For this purpose, the cases of breast complaints presenting in the Department of Surgery were clinically examined, investigated with fine-needle aspiration cytology (FNAC) or biopsy along with other relevant investigations. FNAC or biopsy positive for breast TB cases were further investigated by chest X-ray and/or sputum acid-fast bacilli for any evidence of pulmonary TB. Results: A total of 9 cases of breast TB were collected. Out of these 9 cases, 7 cases were adult females in the age group of 24-40 years. Cases 1, 2, 5, 6, and 9 were non-lactating, while Cases 3 and 7 were lactating. Case 4 was a 12-year-old girl and Case 8 was 25-year-old male. All the cases were involving the right breast except Case 5, which was involving both breasts, and Case 6, which was involving left breast. Case 5 was also having active pulmonary TB. Case 7 was showing Ziehl-Neelsen staining positive for AFB in breast tissue sample. We treated all cases with first-line four drugs (HRZE) for initial 2 months and two drugs (HR) for another 4 months except in Cases 1 and 5 where the continuation phase was extended to 6 months. Conclusion: Histopathological diagnosis is a more reliable and accurate as compared to the bacteriological diagnosis of tubercular mastitis. Four drugs therapy for 6 months is adequate. The majority of the cases will heal without major surgery, and mastectomy should be reserved for extensive breast destruction and unresponsive cases.
Central Line-Associated Bloodstream Infection: A Case Study
(International Research Organization for Life and Health Sciences, 2019-03) Shah, Jignesh; Kachhadiya, Nilesh; Chaudhari, Kaushik
Introduction: Use of vascular catheters is common in both inpatient and outpatient care. In the United States, it is estimated that almost 300 million catheters are used each year; nearly 3 million of these are central venous catheters (CVCs), also known as central lines. Material and Method: Prospective observational study includes 50 patients aged more than 18 years admitted to SICU / surgical wards / transferred from either, in whom central line access inserted. During the study period the total number of patients admitted to the hospital was monitored daily and the patients meeting the inclusion criteria were enrolled in the study. The surveillance of CLABSI (central line associated blood stream infection) was performed in surgical intensive care unit, and all surgical wards, including burns wards. The data were collected using a standardized proforma. Observation: The incidence rate of central line catheter colonization of various studies ranges from 31.58% to 76 % . In all other studies, gram positive cocci were the predominant colonizers of central venous catheter, but in our study, we found gram negative bacilli like Klebsiella, E-coli, Pseudomonas aeruginosa, Acinetobacter species, species to be the predominant ones compare to gram positive cocci like Staphylococcus species. Conclusion: In present study incidence of CLABSI is 3.27% which almost equal to its global incidence. Commonest organism in present study is klebsiella followed by pseudomonas.
Clinical Evaluation of Soft Tissue Sarcoma: An Observational Study on 26 Cases in a Tertiary Care Teaching Hospital
(International Research Organization for Life and Health Sciences, 2019-03) Padmasree, Gaddam
Introduction: “Sarkoma” (Greek) means fleshy growth. Tumors that arise from common embryonic ancestry, the primitive mesoderm, are known as sarcomas. The aim of this observational study is to evaluate the demographic distribution, histopathological presentation, clinical presentation, and various modes of management of soft tissue sarcomas (STS). Materials and Methods: The present study is a descriptive hospital-based study conducted in the Department of General Surgery in a tertiary care hospital from November 2013 to November 2015. Patients of all ages and both genders presenting to the outpatient department of general surgery with malignant soft tissue tumors were included in the study. After clinically diagnosing as a case of STS, each patient was subjected to various necessary clinical and biochemical investigations pertaining to confirmation of the diagnosis and the patient was treated according to the standard management protocol following in this institution. Observations and Results: Clinical parameters of evaluation such as incidence of STS, gender distribution, time of presentation of tumors, anatomical and histopathological distribution, presence of lymphadenopathy, occurrence of distant metastasis, mode of treatment, recurrence rate, and follow-up were evaluated in each patient and conclusions were drawn. Data were expressed in absolute numbers and percentages and tabulated statistically. Conclusion: STS is a rare malignancy with poor prognosis. With the advent of immunohistochemistry and combined therapies, survival rate and quality of life can be improved significantly.
The Clinical Presentation and Management of Hollow Viscus Perforation
(International Research Organization for Life and Health Sciences, 2018-01) Kumar, Kondoju Suresh; Vattekunta, Bharath
Introduction: Perforation of a hollow viscus is an acute abdominal emergency. Following perforation, there is spillage of gastrointestinal contents into the peritoneal cavity resulting in peritonitis, fluid and electrolyte imbalance, hypovolemia, circulatory insufficiency, septicemia, and finally death. Gastrointestinal tract perforations represent one of the most common acute abdominal emergencies in the surgical field. Materials and Methods: The present study was conducted in the Department of General Surgery, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, for 24 months from October 2014 to September 2016. A total of 133 cases of hollow viscus perforations were studied during the period. Results: Majority of the cases of perforations were the complications of peptic ulcer disease, and anatomically perforations were more common in the duodenum (59.3%) and least common in colon (1.1%). Duodenal perforations were more common in the age group of 30–39 years (26.58%). The youngest case was 17 years and the eldest case was 80 years. The average was 44 years. Male:female ratio in duodenal ulcer perforation is 12:1. Peptic ulcer perforation is more common in low socioeconomic group 91.13%. Smoking and alcohol are the most common etiological factors for duodenal perforation, as it was present in 74.7% of patients. Conclusions: The actual mortality was higher than the mortality in the study group since cases of delayed presentation with shock and septicemia did not warrant anesthesia and were excluded from the study group. Duodenal ulcer perforation was the most common cause of gastrointestinal perforation with a male preponderance. More common in the fourth decade of life.
A Clinical Study of Acute Subdural Hematoma: A Prospective Study
(International Research Organization for Life and Health Sciences, 2018-03) Valluru, Siva Rama Krishna; Ray, M Premjit; Lingolu, Chandu
Background: Acute subdural hematoma (ASDH) is seen in approximately one-third of patients with severe traumatic brain injury and in half to more than two-thirds of those undergoing hematoma evacuation. ASDH is associated with high rates of mortality, ranging from 40% to 90%. The aim of this study is to analyze the clinical spectrum and to evaluate the outcome. Methods: It is a prospective study conducted at the Department of Neurosurgery, Rangaraya Medical College, Kakinada, over a period of 2 years from December 2015 to December 2017. 100 cases are taken for study with head injury, diagnosed to have traumatic ASDH. A detailed clinical history, clinical examination, and computed tomography (CT) scan performed in all cases. Patients segregated as mild, moderate, and severe types of head injuries and studied various factors such as age, sex, mode of injury, Glasgow coma score at admission, pupillary reactivity, surgical/conservative management, and Glasgow outcome score. Results: About 49% of patients are in 3rd–5th decade, percentage of mortality is increasing with age. Male predominance is seen. Rural population is more affected than urban. Road traffic accidents are the most common mode of head injuries. Glasgow coma scale (GCS) between 9 and 12 was found in 46% of patients. Moderate type of TBI is the most common type of neurological presentation at the time of admission. CT images of 53 patients showed <5 mm thickness, 23 patients showed 5–10 mm, in 24 patients, it is >10 mm. Of 100 patients, surgical approach is considered in 50 patients while the remaining 50 patients were managed conservatively. Conclusions: GCS between 9 and 12 was found most common mode of presentation at the time of admission GCS <8 showed highest mortality of 80%, GCS 13–15 showed no mortality. Prognosis is worse in patients with pupillary abnormalities than those without. Early surgery leads to better prognosis.
Clinical Study of Etiology, Age, Sex Distribution, and Management of Right Iliac Fossa Mass.
(2016-11) Purnaiah, M; Rajinikanth, M
Introduction: Right iliac fossa mass is one of the common causes for admission under the Surgery Department at GMC/GGH Nizamabad. The various pathologies, multiple and varied modes of presentation of each disease entity, the difficulties encountered in investigative modality, diagnosis, and treatment make masses presenting in right iliac fossa, a difficult entity to treat. Hence, this study is undertaken to unravel the mystery of right iliac fossa mass and to establish the management protocol for each differential diagnosis that presents as right iliac fossa mass to our hospital. Materials and Methods: This is a prospective study of 40 treated at the GGH Hospital for right iliac fossa mass between the period of 1st April 2015 and 31st March 2016. The data regarding patient particulars, diagnosis, investigations, and surgical procedures are collected. Results: In our series of 40 patients, 75% cases among right iliac fossa mass were related to appendicular pathology. Most common cause of right iliac fossa mass is appendicular mass. Mean age group of right iliac fossa mass was 40.6 years. Pain abdomen was a common symptom; 60% patients were treated conservatively and 40% patients with surgery. The most common cause of right iliac fossa mass is appendicular mass. Male: female ratio is 55:45. Mean age of presentation of right iliac fossa mass is 40.6 years. The most common presenting symptom of appendicular mass is pain abdomen. Subacute intestinal obstruction is the most common presentation of ileocecal tuberculosis. Ultrasound sonography abdomen is the first investigation of choice in patients with right iliac fossa mass. Conclusion: The choice of management for appendicular mass is conservative followed by interval appendicectomy. The management of choice in patients with ileocecal tuberculosis with features of intestinal obstruction is surgery under coverage of ATT. Surgery is the management of choice in carcinoma cecum. Mainstay of treatment in retroperitoneal sarcoma is surgery followed by radiotherapy.
Clinical Study of Surgical Problems in Geriatric Patients in Vindhya Region, Sanjay Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India.
(2016-07) Ahirwar, Sandeep Kumar; Sharma, Priyank; Swaroop, Brajendra; Jain, Mayank
Background: Geriatric patients having surgical problems are more vulnerable for devastating resulting in higher morbidity and mortality rates. Because of comorbid medical illness and low immunity power management of surgical problems in a geriatric patient at the initial stage is necessary. Materials and Methods: It was a prospective 1 year study. On admission, every patient was interrogated about name, age, sex, address, occupation, religion, and residence. They were also inquired for chief complaints with duration, past history, drug history, personal history, and family history. Their findings were recorded in a pro forma and master chart. The information obtained was tabulated and analyzed. Results: Incidence of surgical problems in the geriatric patient was 19.18% out of total surgical ward admission. The majority of patients were male (70.35%) with male:female ratio of 2.4:1. The majority of patients were in age group 60-64 years (31.89%). A number of patients in the age group 80 years and above was also significant (15.28%). The eldest patient was 102-year-old male. The majority of patients were from a rural area (83.39%) followed by urban (16.61%). The majority of elderly patients admitted were suffering from medical illness associated with surgical problems most common being anemia (28.79%) followed by diabetes mellitus (19.54%), hypertension (18.96%), and tuberculosis (9.71%). The majority of elderly patients in both sexes were suffering from gastrointestinal tract disorders (28.79%). In males, the second common system involved was genitourinary system (24.67%) followed by skin and soft tissue lesions (18.87%), central nervous system (8.98%), and hernia (8.66%). In females, the second common system involved was skin and soft tissue lesions (21.12%) followed by hepatobiliary system (17.44%), central nervous system (11.43%), and breast lesions (8.72%). Conclusion: For healthy old age life, it is advised to take balanced diet and do physical activity for prevention of functional decline, increased survival and also avoids smoking, tobacco chewing, and alcoholism to reduce cardiovascular and other diseases risks.

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