IJSS Journal of Surgery

Permanent URI for this collection

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/

Browse

Now showing 1 - 20 of 165

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.
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%
Seasonal Trends in Appendicitis: A Retrospective Observational Study
(International Research Organization for Life and Health Sciences, 2019-03) Venkatappa, Sunil Kumar; Tharanath, Kavya; Mahadev, Kotagi Irappa; Kumar, Praveen; Vijayakumar, Lakshmi; C, Deepak
Introduction: Appendicitis is one of the most frequent surgical conditions of the abdomen, and appendectomy is one of the most commonly performed operations in the world. Age, sex, and seasonal variations have been observed, but the reasons for these variations are not yet known. Aims and Objectives: The present study was aimed to verify the possible existence of a seasonal variability in the onset of appendicitis. Materials and Methods: It’s a retrospective observational study done in hospitals attached to Bangalore Medical College and Research Institute (Victoria Hospital), in the Department of General Surgery. A study period is from May 2016 to June 2018. A total of 180 cases admitted with diagnosis of appendicitis, during various days or months of the year were included in the study. The demographic features such as age and sex variations, seasonal variations, and histopathological (HPE) variations in the appendectomy specimen were all observed. Results: Age-specific incidence was highest being in males aged 20–30 years, whereas in females, the incidence was from 18 to 24 years. Sex ratio M: F - 2:1, males are 64% of the sample size. Seasonal variations: The incidence of appendicitis and appendectomy showed clear seasonality, with a peak in summer, April–June. Complications: Of those correctly diagnosed, 76% had uncomplicated acute appendicitis, 18% appendicitis with perforation, and 6% with other associations. Conclusion: Appendicitis is more common in males, in those aged 20–29 years and during the summer months. The incidence of appendicitis was significantly higher during the warm time of the year, probably due to exposure to air pollution, consumption of low-fiber diet, and increasing incidence of gastrointestinal infections.
Effectiveness of Endoscopic Balloon Dilatation in Corrosive Esophageal Stricture
(International Research Organization for Life and Health Sciences, 2019-03) Shah, Jignesh; Chaudhari, Kaushik; Kachhadiya, Nilesh
Introduction: Esophageal strictures are a problem frequently encountered by clinicians. Corrosive injuries to the esophagus and stomach is one of the common conditions encountered in developing countries like India. It may result in major morbidity and mortality particularly in the younger age group. Material and Method: The material of study consists of 30 patients of corrosive esophageal stricture undergone endoscopic balloon dilatation. Patients of >12 year age group were taken in this study. Patients undergone endoscopic balloon dilation for corrosive oesophageal stricture of various lengths and at different sites. Observation : All patients have normal dietary intake including solid food at the time of discharge. All patients under study were followed after 1week, 3 weeks and 6 weeks interval. In our study out of 30 patients 24 patients (80%) had satisfactory oral diet and 6 patients (20%) developed recurrence of symptoms after 6 weeks of follow up. Conclusion : Endoscopic balloon dilatation found to be safe, effective and promising treatment for corrosive esophageal structure.
Study of Surgical Management Varicose Veins in a Tertiary Care Institution
(International Research Organization for Life and Health Sciences, 2019-01) Gorle, Vamshi Krishna; Rao, G Sambasiva
A total of 98 patients of both sexes aged between 30 and 65 years having varicose veins were studied with the involvement of 49 (50%) left leg, 41 (41.8%) right leg, and 8 (8.16%) both limbs were included in the study. The clinical manifestations were 27 (27.5%) had pain, 25 (25.5%) had dilatation of veins, 22 (22.4%) had ulceration, 8 (8.16%) had edema, 5 (5.10%) had itching and pigmentation, 6 (6.12%) had cramps, and 5 (5.10%) had heaviness legs. The occupation of the patients was as follows: 19 (19.3%) were farmers, 17 (17.3%) were shopkeepers, 21 (21.4%) were hotel/bar waiters (attenders), 14 (14.2%) were bus conductor, 16 (16.3%) were mason, and 11 (11.2%) were traffic police. The types of the involvement of venous system were 49 (50%) long saphenous venous system, 33 (33.6%) long saphenous and perforators, 9 (9.18%) had short saphenous system, and 7 (7.14%) had both long and short saphenous. The surgical procedures were 45 (45.9%) saphenofemoral flush ligation and ligation of constant tributaries, 33 (33.6%) ligation of perforator veins in addition to flush ligation, 6 (6.12%) ligation of saphenopopliteal flush ligation, 4 (4.08%) saphenofemoral and saphenopopliteal flush ligation with stripping of long and short saphenous vein, 8 (8.16%) flush ligation of saphenopopliteal with stripping of short saphenous, and 2 (2.04%) flush ligation of saphenopopliteal junction along with ligation of subfascial perforators.
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.
Neonatal Intestinal Obstruction: A 9-year Experience in a Tertiary Care Hospital
(International Research Organization for Life and Health Sciences, 2019-01) Reddy, Jeeru Bhaskar; Prasad, Damisetti Kalyan Ravi
Aim: This study aims to study the clinical presentation, etiology, management, and outcome of neonatal intestinal obstruction in the newborn and neonates, over a period of 9 years in the Department of Pediatric Surgery, Rangaraya Medical College. Materials and Methods: It is a retrospective study of 191 cases over a period of 9 years within 28 days of birth with the diagnosis of neonatal intestinal obstruction, which was managed between 2008 to 2017 in the Department of Pediatric Surgery, Rangaraya Medical College, Kakinada, Andhra Pradesh. Cases of anorectal anomalies and Hirschsprung’s disease were excluded from the present study. Results: Male-to-female ratio was 1.5:1. Gestational age was variable from 32 weeks to 40 weeks and birth weight ranged from 1.2 kg to 3.75 kg. Age of presentation was few hours to 28 days. The most common etiology was intestinal atresia 112, followed by malrotation 35, meconium ileus 24, annular pancreas 10, and exomphalos minor with obstruction 6, apart from Meckel’s band and cecal web as being other rare causes of obstruction. Mortality rate was around 16% in our study. Conclusion: Jejunoileal atresia 58.6% was the most common cause of neonatal intestinal obstruction followed by malrotation 18%. Incidence was higher in male babies compared to females. Bilious vomiting, abdominal distension, and failure to pass meconium were the presenting symptoms. Higher mortality rate was noted in preterm and low birth weight babies associated with multiple atresia and perforation peritonitis, especially complicated meconium ileus.
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.
Study of Surgical Management of Diabetic Foot in Telangana Population
(International Research Organization for Life and Health Sciences, 2019-05) Khaja, Abdul Muqeet; P, Suresh
Introduction: The foot is highly entity to cope with a large degree of repetitive stress. Fatty tissue on the plantar surface and a thickened dermis and epidermis cushion and absorb repeated forces of compression, torsion, and shear during locomotion and standing. Materials and Methods: Eighty-nine patients between 35 and 65 years visiting MediCiti Institute of Medical Science, Ghanpur, Medchal-501401, Telangana, suffering from diabetic foot were selected for study. The patients belonged to middle socioeconomic status; due to illiteracy and poverty, they were not regularly taking antidiabetic drugs. Results: Clinical manifestations were the duration of onset of diabetic was 23 (25.8%) newly diagnosed, 17 (19.1%) had 1–5 years, and 49 (55%) had >5 years. Duration of diabetic foot ulcers was 21 (23.5%) had >4 weeks, 39 (43.8%) had 4–52 weeks, and 29 (32.5%) had >52 weeks. Anatomical sites were 44 (49.4%) had forefoot, 12 (13.4%) had mid foot, 9 (10.1%) had hind foot, 24 (26.9%) had whole foot, and foot affected were 45 (50.5%) right foot, 19 (21.3%) left foot, and 25 (28%) both foot. Types of ulcer were as follows: 52 (58.4%) were neuropathic, 26 (29.2%) had ischemic, 4 (4.49) had neuroischemic, and 7 (7.86%) was unclassified; Wagen’s classification was as follows: 3 (3.37%) had Stage I, 32 (35.9%) had Stage II, 26 (29.2%) had Stage III, 13 (14.6%) had Stage IV, and 15 (16.8%) Stage V. Types of operations were as follows: 33 (37%) had debridement, 44 (49.4%) had lower limb amputation, 23 (25.8%) had minor amputation, 21 (23.5%) had major amputation, 5 (5.6%) had skin grafting, and 7 (7.86%) had incision and drainage. Conclusion: A surgeon the having complete knowledge of foot anatomy can justify the proper management of diabetic foot surgery. Early recognition and proper treatment are mandatory to avoid poor outcomes. Surgery must always be combined with antibiotics and revascularization
A Peroperative Study on the Anatomical Variation at the Saphenofemoral Junction
(International Research Organization for Life and Health Sciences, 2019-05) R, Samadarsi; Prasad, T Srijith; Kumar, Santosh
Introduction: The term varicose is derived from the Latin word meaning – “dilated.” Varicose veins are defined as dilated, usually tortuous, subcutaneous veins 3 mm in diameter measured in the upright position with demonstrable reflux .Although varicose veins were identified prehistorically, only in the present century, considerable knowledge has been gained concerning the anatomy of venous system of the leg, the physiological mechanism of venous return to heart against gravity, and pathology of the disorder, which has led to many newer treatment modalities. One of the pitfalls in venous surgery lies in inadequate knowledge of the venous physiology and anatomy. In contrast to the anatomy of the arteries, the anatomy of veins is characterized by numerous variations.Hence, a thorough and precise knowledge of the anatomical variations of the great saphenous vein (GSV) and SFJ determines the successful outcome of surgery. Materials and Methods: A descriptive study was carried out on 90 patients who were operated for varicose veins in the Surgery Department, Sree Gokulam Medical College and Research Foundation, Venjarmoodu, Trivandrum, during the period of October 2012– April 2014. All patients were examined clinically after taking a detailed history. They were investigated by ultrasonography venous Doppler to confirm the diagnosis. They were subsequently posted for surgery, the intraoperative findings of which were recorded by measurement and photographs. Patients with recurrent varicose veins and perforator incompetence without saphenofemoral incompetence were not included in the study. For those patients posted for surgery, written informed consent was obtained from each patient and basic patient data were recorded in the pro forma. During surgery, documentation of the following intraoperative findings was done: • Measurement of the SFJ from the pubic tubercle. • Description of the tributaries that drain into GSV. • Presence or absence of duplex veins. All details regarding SFJ and tributaries were documented through photography and further analysis was done using standard statistic techniques. Results: During the study period, 90 cases of varicose veins were enrolled in the study, of which 35 were male and 55 were female. These patients were evaluated by clinical examination, investigations, and peroperative recording of the findings in the pro forma and the following interpretations were made and compared with other studies. Conclusions: The purpose of the present study was to assess the position of the SFJ in relation to the pubic tubercle and identify the various tributaries draining into the terminal part of GSV. During the allotted period, 90 cases of varicose veins of the lower limb were studied in detail. Analysis of the findings recorded has enabled this study to arrive at the following conclusions: • The position of SFJ junction is highly variable and should always be marked preoperatively using Doppler. The average measurement of the SFJ from the pubic tubercle was 2.1 cm below and 4.4 cm lateral to the pubic tubercle. There was considerable variation in the number and anatomical course of the tributaries draining into the terminal part of GSV. The most common tributary identified in the study was the superficial epigastric vein and the least identified tributary was the posteromedial vein. Duplication of varicose veins was observed in 9% of the cases. In conclusion, adequate knowledge of the anatomy of the tributaries at the SFJ and ligating them in combination with GSV stripping is associated with a lower rate of the recurrence of varicose veins and a better quality of life. It is always imperative to explore the first 5 cm of GSV precisely to identify all tributaries at the SFJ (about four tributaries by average) to ensure appropriate surgical technique
Study of Cholecystitis in Telangana Population
(International Research Organization for Life and Health Sciences, 2019-05) Khaja, Abdul Muqeet; Ramanachary, T V
Introduction: Cholecystitis is a potentially life-threatening condition which affects >20 million globally every year. Gall bladder (GB) stones are the major contributor to acute cholecystitis (AC). Materials and Methods: Eighty-six patients (32 males and 54 females) aged between 25 and 60 years who were regularly visiting MediCiti Institute of Medical Science Hospital having symptoms of cholelithiasis were selected for study. Results: The clinical manifestation was 100% tenderness in right hypochondrium, 28 (32.5%) had fever, 6 (6.97%) had jaundice, 23 (26.7%) had vomiting, and 29 (33.7%) had leukocytosis. The mode of presentation was as follows: 14 (16.2%) had emergency and 72 (83.7%) has elective presentation, and types of pathology were as follows: 75 (87.2%) had calculus cholecystitis and 11 (12.7%) had idiopathic. The organism cultured post-surgically were as follows: 29 (33.7%) had Escherichia coli, 14 (16.2%) had Staphylococcus aureus, 6 (6.97%) had Salmonella, 13 (15.1%) had no organism, and 24 (27.9%) were not done culture due to early healing. This pragmatic approach to the patients with different clinical manifestation with different organism culture study at different age in both sexes will be quite useful to surgeons and physicians to treat efficiently cholecystitis to prevent morbidity and mortality. Conclusion: Clinician at various levels needs to have good understanding of varied clinical presentations of AC, silent (chronic) cholecystitis, and different management options, their pros and cons to be able treat the conditions effectively
Study on Outcome of Karydakis Procedure in the Management of Intergluteal Pilonidal Sinus Disease
(International Research Organization for Life and Health Sciences, 2019-05) Isaiah, Jophin R; J, Rajan; Kumar, Santosh
Introduction: Pilonidal sinus is a cavity in the subcutaneous tissue lined by granulation tissue that contains hair and communicates with the surface by a track which is lined usually by squamous epithelium and continuous with the epidermis. It mainly affects the intergluteal furrow. Materials and Methods: It is a hospital-based descriptive study conducted in the Department of General Surgery, Sree Gokulam Medical College and Research Foundation from February 2017 to November 2018. Patients with clinically diagnosed pilonidal sinus disease admitted in the Surgery Department, Sree Gokulam Medical College and Research Foundation. Results: A total of 140 patients were evaluated postoperatively and for a mean period of 12 months (range 6–18 months), every 3 months during their review visit or over phone. Mean operative time was 54.3 min with a median hospital stay of 5 days. Postoperative pain lasted for a median duration of 2 days. Drains were removed at a median of 3 days and sutures at a median of 7 days. Three patients presented with serous wound collection and 12 patients presented with wound dehiscence. Conclusion: Karydakis flap procedure is a safe surgical treatment for sacrococcygeal pilonidal sinus disease due to the associated low complication rate, short hospital length of stay, rapid healing, and a high patient satisfaction rate.
Study of Role of Collagen in Healing Chronic Wounds
(International Research Organization for Life and Health Sciences, 2019-05) Shankar, M M Ram; M B, Satyaveni
Aim: To study the role of collagen in healing of chronic wounds. Materials and Methods: One hundred and twelve patients aged between 25 and 65 years were studied. The etiology of chronic wounds was as follows: 38 (33.9%) were diabetic, 33 (29.4%) had venous wound, 4 (3.57%) had arterial, 19 (16.9%) had trophic, 3 (2.67%) had tubercular, and 15 (13.3%) had traumatic wounds, and complications were as follows: 8 (12.6%) had gangrene, 19 (30%) had sloughing and exposure to tendon, 27 (42.8%) had eczema and dermatitis, 3 (4.76%) had bony changes, 2 (3.17%) had hemorrhages, and 4 (6.34%) had subcalcification of wound. Results: Organisms isolated from the wounds were as follows: 46 (41%) had Staphylococcus aureus , 12 (10.7%) had Streptococcus pyogenes , 15 (13.3%) had Escherichia coli , 7 (6.25%) had Klebsiella, 11 (9.82%) had Proteus mirabilis , and 21 (18.7%) had sterile (no organism). Conclusions: This pragmatic approach to chronic wounds having different etiologies and pathophysiologic conditions will be useful to surgeon to treat such patients efficiently because healing of chronic wounds without amputation (limb saving) is a great medical challenge globally.
Complicated Inguinoscrotal Hernia Management by Endoscopic Totally Extraperitoneal Mesh Repair
(International Research Organization for Life and Health Sciences, 2019-05) Rajaput, Santoshsing; Shah, Aashish; Khanna, Roopesh; Kartik, Somu
Introduction: The purpose of this study is to assess the safety and effectiveness of endoscopic totally extraperitoneal (TEP) mesh repair in the management of complicated inguinal hernia. Materials and Methods: This is 18-month retrospective observational study done in our department of minimal access surgery between January 2017 and June 2018. Patients demographic data, operative and post-operative course, and outpatient follow-up were studied. Results: A total of thirty patients with complicated inguinoscrotal hernia underwent TEP repair were studied, for a period of 18 months, with a follow-up period of 6 months. Out of the thirty operated cases, 28 were elective surgery and 2 were emergency. Demographic characteristics are shown in Table 1. All male patients , the mean age was 49.7 years. Chief complaint was irreducible swelling and pain in groin region. Diabetes mellitus was the major comorbidity. Conclusion: In an expert hand with few additional maneuvers complicated inguinal hernia can be successfully managed by TEP approach.
Study of Liver Abscess: Its Etiology and Treatment in Telangana Population
(International Research Organization for Life and Health Sciences, 2019-05) Ramanachary, T V; Khaja, Abdul Muqeet
Introduction: Liver (hepar) is a largest metabolic center in the body. It is said that the liver is the busiest port in the lake of life. Etiology of the liver abscess has changed to pyogenic abscess (PA). PA of liver remains a major diagnostic and therapeutic challenge despite advances in diagnostic technology and new strategies for treatment. Materials and Methods: Ninety-six patients aged between 25 and 65 years visiting MediCiti Hospital (MediCiti Institute of Medical Sciences), Ghanpur, Medchal – 501401, Telangana, were selected for study. Results: The clinical manifestation was as follows: 72 (75%) had fever, 72 (75%) had abdominal pain, 70 (72.9%) had nausea and vomiting, 48 (50%) had night sweats, 42 (43.7%) had weight loss, 9 (9.37%) had jaundice, 29 (302%) had diarrhea, and 38 (39.5%) had chest symptoms (cough, chest pain, and shortness of breath). Hematological and biological study had 54 (56.2%) 45–46 (u/I) alanine aminotransferase (ALT), 42 (43.7%) had 47–48 ALT, and 38 (39.5%) had 40–41 (u/I) ALT; 38 (39.5%) had 40–41 aspirate aminotransferase (AST) and 58 (60.4%) had 42–43 (u/I) AST; 62 (64.5%) had 470–471 alkaline phosphatase (ALP) (u/I) and 34 (35.4%) had 472–473 ALP (U/I); 52 (54.1%) had 11–12 serum bilirubin (Mm/I) and 44 (45.8%) had 13–14 serum bilirubin (Mm/I); 62 (64.5%) had 11–11.5 hemoglobin (Hb)% (gm/I), 62 (64.5%) had 11.6–11.7 Hb% (gm/I), and 34 (35.4%) had 11.6–11.7 Hb% (gm/I); 51 (53.%) had 17.2–17.3 white blood count (WBC) (× 109/I) and 45 (46.8%) had 17.4–17.5 WBC (× 109/I); and 53 (55.2%) had 14.45–14.46 neutrophils and 43 (44.7%) had neutrophils 14.47–14.48 (109/I). The isolated bacteria were as follows: 32 (33.3%) were Gram negative, 17 (17.7%) were anaerobic Bacilli, and 47 (48.9%) were streptococci. Conclusion: The initial diagnostic investigation, antibiotics as first-line treatment followed by antibiotic with PNA/PDA, and ultimately, surgery was effective treatment. Such types of approach will have better prognosis except in patients with malignant disease.
Test Tube or Computed Tomography Gantry - The Better Diagnostic Indicator of Severe Pancreatitis: A Retrospective Cohort Study
(International Research Organization for Life and Health Sciences, 2019-01) Prabakaran, Roshini Antony; Mitta, Nivedita; Jayakumar, Vivekanandan; Kannan, Karthikeyan; V, Anirudh; S G, Subramanyam
Background: Various studies have been done to assess the use of serum amylase, serum lipase, and amylase/lipase (A/L) ratio to differentiate between the causes of pancreatitis. Scoring systems (Ranson’s, Glasgow, and APACHE II) have been developed to assess the severity of pancreatitis. Computed tomography (CT), a gold standard for prognosticating pancreatitis, is expensive and affordability is a concern in developing country like ours. Methodology: We did a retrospective study in a tertiary care hospital to assess the use of A/L ratio to predict the severity of acute pancreatitis and to correlate with the presence on necrosis in comparison to that given by CT. Results: The median A/L ratio was higher among those with severe and necrotizing pancreatitis, 0.19 (interquartile range [IQR] 0.124–0.304) and 0.183 (IQR 0.117–0.300), respectively. Cutoff of 0.14 was taken, based on the receiver operating characteristic curves, which could predict severity with 75% sensitivity and 53% specificity and necrosis with 73% sensitivity and 55% specificity. Higher A/L ratio correlated with a decrease in hematocrit (P = 0.08), blood glucose (P = 0.042), and aminotransferase (P = 0.03), which are indicators of clinical severity. Increase in A/L ratio had an increased trend to a longer duration of stay and a higher chance of detecting multiorgan dysfunction syndrome. Conclusions: A/L ratio of >0.14 can be used as a predictor of severity as it indicates the presence or absence of necrosis, which further aids in referral and the need for a CT scan in low-resource settings
Study of Hemorrhoids – Clinical Features and Risk Factors
(International Research Organization for Life and Health Sciences, 2019-05) Shankar, M M Ram; M B, Satyaveni
Aim: To study the clinical features and risk factors of Hemorrhoids. Materials and Methods: One hundred and eighty-nine adult patients aged between 35 and 65 years were studied. The history of patients was as follows: 57 (30.1%) had constipation, 19 (10%) had chronic cough, 33 (17.4%) had straining, 24 (12.6%) were alcoholic, 17 (8.99%) were smokers, and 39 (20.6%) had sedentary behavior. Result: The clinical manifestations were as follows: 51 (26.9%) had bleeding through rectum, 52 (27.5%) had prolapse, 32 (16.9%) had pain during defecation, and 19 (10%) had pruritis. The hemorrhoids were classified as per their grades. 51 (26.9%) had Grade I, 31 (16.4%) had Grade II, 38 (20.1%) had Grade III, and 69 (36.5%) had Grade IV. Conclusion: This pragmatic approach toward different ages in both sexes will be useful for surgeon to treat efficiently to prevent morbidity and mortality of the patients.
Study of Intestinal Obstruction in Telangana Population
(International Research Organization for Life and Health Sciences, 2019-05) P, Suresh; Khaja, Abdul Muqeet
Introduction: Intestinal obstruction occurs when there is an interruption in the forward flow of intestinal contents. This interruption can occur at any point along the length of the gastrointestinal tract and clinical symptoms often vary based on the level of obstruction. Materials and Methods: A total of 86 patients between 19 and 68 years were regularly visiting the hospital (Mediciti Institute of Medical Sciences, Ghanpur, Medchal-501401, Telangana) were selected for study because the clinical evaluation of intestinal obstruction is a surgical emergency and treatment would largely depend on early diagnosis and skillful management. Results: The clinical manifestations were 100% pain in abdominal, 100% distention of abdomen 72 (83.7%) had vomiting, 69 (80.2%) had tenderness, 62 (72%) had constipation, 64 (74.4%) had dehydration, 16 (18.6%) had fever, 24 (27.9%) had palpable mass, 63 (73.2%) had increased bowel sound, and 11 (12.7%) had decreased bowel sounds. The etiology of intestinal obstruction was, 30 (34.8%) had adhesion and band, 16 (18.6%) had hernia, 15 (17.4%) had tuberculosis (TB) stricture, 13 (15.1%) had volvulus, and 12 (13.9%) had malignancy. Types of operations were 21 (24.4%) had resection and end to end ileo-ileal anastomosis, 24 (27.9) had release of adhesion band, 16 (18.6%) had hernia repair, 6 (6.97%) had 13 (15%) had untwisting volvulus, 4 (4.65%) had resection and end to end jejunoileal anastomosis, and 2 (2.32%) had tube caestomy. Post-operative had were 7 (8.13%) had wound infections, 5 (5.18%) had respiratory infections, 3 (3.48%) had entero-cutaneous fistula, 4 (4.65%) had prolonged ileus, 8 (9.30%) deaths due to septicemia. Conclusion: Intestinal obstruction, which still remains an important surgical emergency, obstructions due to adhesions is increasing due to abdominal and pelvic surgeries; obstruction due to TB stricture will have post-surgical complications. Early operation is mandatory to avoid development peritonitis and systemic sepsis associated with multi-organ failure.
Clinical Study on Assessment of Post-Surgical Complications According to Clavien–Dindo Classification after Major Abdominal Surgery
(International Research Organization for Life and Health Sciences, 2018-07) Hanumanthappa, B N; Sagar, K; Hebsur, Narayan I
Aims and Objectives: Surgical complications occur in every surgical department. The absence of a definition and a widely accepted ranking system to classify surgical complications has hampered proper interpretation of the surgical outcome. This study aimed to define a simple and reproducible classification of complications following abdominal surgery based on a therapy-oriented severity grading system and to validate the Clavien–Dindo grades and categorize complications in elective major abdominal surgeries. Materials and Methods: This is a prospective study of 80 patients, who were diagnosed and admitted for major elective abdominal surgery in KIMS hospital, Hubli, from December 2012 to May 2014. Patients underwent definitive treatment. Data related to the objectives of the study were collected and post-operative complications were classified according to Clavien–Dindo grades and managed. Results: Ages between 30 and 39 years were the most common in our present study; there were 46 male patients and 34 female patients. Of 80 cases, 24 cases were cholelithiasis cases (predominate group) among which 17 were free of complications and 7 developed complications, 21.25% developed wound complications in the form of superficial surgical site infection followed by basal atelectasis (18.75%). 46 cases (57.5%) had complications in their post-operative course, among which Grade 1 constitutes 25 cases (31.25%), Grade 2 constitutes 12 cases (15%), Grade 3 A constitutes 2 cases (2.5%), Grade 3 B constitutes 2 cases (2.5%), Grade 4 A constitutes 1 case (1.25%), Grade 4 B constitutes 1 case (1.25%), and Grade 5 constitutes 3 cases (3.75%), and rest of 34 cases (42.5%) were free of complications and had normal post-operative course. In our study, Grade 1 complications were the most common complications. Conclusion: We conclude that the Clavien–Dindo classification is based on the therapeutic consequences of complications constitutes a simple, objective, and reproducible approach for comprehensive surgical outcome assessment. In this study, Clavien–Dindo Grade 1 complication is the most common complication.
Protective Lip Guard for Prevention of Lip Injury during Third Molar and other Intraoral Surgeries
(International Research Organization for Life and Health Sciences, 2018-09) Ansari, Mohammad; Mutha, Ankita; Oswal, Rajesh
Aim: Soft tissue injury, especially lip burns, is very common complications seen during the third molar and other intraoral surgical procedures. To overcome this complication, we have devised a custom-made protective lip guard which is beneficial for the patient as well as surgeon. Conclusion: It is simple device, very easy to fabricate, does not require any special armamentarium or material to fabricate, not time consuming, and eco-friendly. It is comfortable and readily accepted by the patient.

Browse

Recent Submissions