scholarly journals APPENDICULAR MASS

2010 ◽  
Vol 17 (02) ◽  
pp. 180-184
Author(s):  
SARDAR ALI ◽  
HAFIZ MUHAMMED RAFIQUE
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Cost Effective ◽  
Female Ratio ◽  
Surgical Exploration ◽  
Group I ◽  
Variable Extent ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction ◽  
Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 to November 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying studentChi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

scholarly journals APPENDICULAR MASS

2010 ◽  
Vol 17 (02) ◽  
pp. 180-184
Author(s):  
SARDAR ALI ◽  
HAFIZ MUHAMMED RAFIQUE
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Cost Effective ◽  
Chi Square ◽  
Female Ratio ◽  
Surgical Exploration ◽  
Group I ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction ◽  
Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 toNovember 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying student Chi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

scholarly journals A COMPARATIVE STUDY BETWEEN EARLY EXPLORATIONS VERSUS CONSERVATIVE MANAGEMENT IN MANAGEMENT OF APPENDICULAR LUMP

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Sanjay Patidar ◽  
Kritika Kamal ◽  
Jaydip Sinh Kathota ◽  
Sudhanshu Tiwari ◽  
Prashant Nakrani
Keyword(s):  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Conservative Management ◽  
Research Centre ◽  
Age Group ◽  
Surgical Exploration ◽  
Hospitalization Time ◽  
Group I ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction

Background: Acute Appendicitis is one of the most common acute surgical conditions of the abdomen and appendicular lump is formed if treatment is delayed. Appendicular mass is one of its early complications developing in   2-6% cases within48 hours of attack. The traditional treatment of appendicular lump is conservative followed by delayed appendectomy. During conservative treatment 10-20% is not resolved and leads to gangrene or perforation followed by localized abscess or generalized peritonitis requiring early surgical intervention. Aim and Objective: To evaluate the outcome of early surgical exploration and its complications in respect to conservative management of appendicular lump. Material and Methods: Total of 48 patients admitted with diagnosis of appendicular lump were included in our study. This prospective study was conducted in Department of General Surgery of Index Medical College, Hospital and Research Centre, Indore, M.P over period of 2 years [August 2019 to July 2021] in all age group and both sexes. All cases were divided randomly into two groups. Group I, early surgical exploration and Group II, conservative approach with OCHSNER SHERREN REGIME followed by interval appendectomy after 6 weeks. Results: Total 471 patients admitted to hospital with diagnosis of acute appendicitis, out of which total 48 patients were having Appendicular lump suggestive of incidence of 9.81%. Maximum patients were found in age group 21-30 years. Average duration of symptoms was 2 days. Two methods were adopted for the management of appendicular lump. The first group included 24 patients who were operated immediately after investigations and second group of 24 patients were managed conservatively followed by delayed appendectomy. In the first group mean hospitalization time was 4 days. Residual abscess, adhesive intestinal obstruction, failure of treatment and readmission were not found. In the group II, mean hospitalization time 10 days, more chances of residual abscess, adhesive intestinal obstruction, failure of treatment and readmissions were noted. Conclusion: In our study, it can be concluded that early surgical exploration confirms diagnosis and cures the problem, reduce the cost of management, shortens the convalescence and hospital stay with reasonably satisfactory outcome. Key-Words: Appendicular Lump, Ochsner-Sherren Regime Appendectomy.

A PROSPECTIVE COMPARATIVE STUDY BETWEEN EARLY AND INTERVAL APPENDICECTOMY FOR APPENDICULAR MASS

2021 ◽  
pp. 34-37
Author(s):  
Janni Laxman ◽  
R S Teja Reddy ◽  
Sivasai Krishnaprasad K
Keyword(s):  
Acute Appendicitis ◽  
Comparative Study ◽  
Intestinal Obstruction ◽  
Hospital Stay ◽  
Wound Infection ◽  
Group I ◽  
Interval Appendicectomy ◽  
Simple Mass ◽  
Group Ii ◽  
Appendicular Mass

Acute appendicitis remains the most common cause of acute abdomen requiring surgical intervention. Patients presenting late in acute appendicitis are complicated by the development of an inammatory mass in the right iliac fossa. The treatment of appendicular mass is controversial. However, 1 there are several other management options for appendicular mass. Traditionally, these patients are managed conservatively, followed by interval appendicectomy 4-6 weeks later. Advocates of the initial conservative approach claim a lower rate of complications compared to the early 2 operative approach. Objective: To study the safety and feasibility of emergency appendicectomy for appendicular mass by comparing the complications, morbidity and mortality with conservatively treated patients. Materials & Methods: This is a prospective and comparative study conducted at Gitam Institute of Medical Sciences and Research, Visakhapatnam, from January 2018 to December 2019. A total of 60 patients with appendicular mass were divided into two groups of 30 each. Group I included patients who underwent emergency appendicectomy, while Group II consisted of patients who were managed conservatively. Results:In this study, patients' mean age was 27.58 yrs with a male to female ratio of 2.66:1. Intraoperative ndings in Group I - 20(70%) cases had simple mass, 8(26.66%) had adhesions and loculated pus in 2(6%). In Group II, 14(53.84%) patients had normal ndings, 4(15.38%) cases had simple mass, 6(23%) had adhesions, 1(3.84%) had loculated pus and adhesive intestinal obstruction. Postoperatively, In Group I, 3(10%) patients had wound infection, and 1(3.33%) patient developed fecal stula, which was managed conservatively. In Group II, 2(6.66) patients had wound infection, 4(13.33%) had failure of conservative treatment, four had lost follow-up, 3 had respiratory tract infection, and one patient developed intestinal obstruction due to adhesions. Mean length of hospital stay was 5.3 days in Group I and 8.5 days in Group II. Fewer complications, reduced number of days of parenteral medication, and reduced duration of total hospital stay were noted in Group I compared to Group II, indicating that emergency appendicectomy is a safe and feasible method of managing patients with appendicular mass.

scholarly journals ALVARADO SCORE;

2012 ◽  
Vol 20 (01) ◽  
pp. 001-005
Author(s):  
SHAFAQAT ALI ◽  
ZAKA ULLAH MALIK ◽  
M. MUTTAHHAR ASIM NIAZ ◽  
Naveed Ahmed
Keyword(s):  
Acute Appendicitis ◽  
Gold Standard ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Female Ratio ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Negative Appendicectomy ◽  
Hospital Group

Objective: To determine the validity of Alvarado score in diagnosing acute appendicitis keeping histopathology of appendixas gold standard. Study Design: Cross sectional (Validation) study. Place and Duration of Study: Department of Surgery CombinedMilitary Hospital Rawalpindi from April 2009 to October 2009. Materials and Methods: 90 patients with clinical suspicion/diagnosis ofacute appendicitis were included in study. All were divided into two groups on the basis of Alvarado score. Group I with score 7-10, whounderwent open appendicectomy. Group II(a) with 5-6, who were observed in hospital. Group II(b) with< 4 were discharged. In alloperated cases appendix was sent for histopathology. Alvarado score was compared with histopathology (gold standard). Results: Maleto female ratio was 3.5 :1. Mean age was 25.34. Alvarado score had overall 88.13% sensitivity, 70.96% specificity, 85.24% PPV,75.86%NPV and 16.90% negative appendicectomy rate. Whereas in male patients it had 90.74% sensitivity, 75% specificity, 92.45%PPV,70.58%NPV and 6.89% negative appendicectomy rate. In female it had 60% sensitivity, 66.66% specificity, 37.5% PPV, 83.33%NPV and38.46% negative appendicectomy rate. Conclusion: Alvarado score is very accurate for acute appendicitis in male patients. Patients withscore 4 can safely be discharged home. USG should be performed routinely in female patients to improve the diagnostic accuracy ofAlvarado score.

scholarly journals The impact of ureteral Double-J stent insertion following ureterorenoscopy in patients with ureteral stones accompanied by perirenal fat stranding

2018 ◽  
Vol 90 (1) ◽  
pp. 15
Author(s):  
Ercan Ogreden ◽  
Ural Oguz ◽  
Erhan Demirelli ◽  
Erdal Benli ◽  
Özkan Özen
Keyword(s):  
Ureteral Stone ◽  
Ureteral Stones ◽  
Stent Insertion ◽  
Female Ratio ◽  
Group I ◽  
Dj Stent ◽  
Group Ii ◽  
Fat Stranding ◽  
The Impact ◽  
Perirenal Fat

Objective: To evaluate the impact of ureteral stent insertion following semirigid ureterorenoscopy (URS) in patients with perirenal fat stranding (PFS) due to ureteral stones. Material and methods: Data of 600 patients who underwent URS were analyzed retrospectively. Seventy-two patients detected to have PFS accompanying ureteral stone were included. Patients who did not undergo double J (DJ) stent insertion following semirigid URS were classified as Group I (n: 52), while those who underwent stent insertion were classified as Group II (n: 20). Side distribution; localization of the stones, stone size, presence of fever, urinary tract infection (UTIs) and urosepsis rates were compared in the two groups. Results: The average age of the patients was 44.4 (20-71) years. Male/female ratio and side of the stone location showed similar distribution in both groups (p > 0.05). Fever occurred in 23 cases (44.2%) in Group I and in 15 cases (75%) in Group II (p = 0.038). UTIs occurred in 15 cases (28.9%) in Group I and in 12 cases (60%) in Group II (p = 0.03). Urosepsis presented in 3 (5.8%) and 5 (25%) of the patients in Group I and II, respectively (p = 0.033). Conclusions: According to our results, ureteral DJ stent insertion following URS in patients with PFS due to ureteral stone caused an increase on postoperative infection related complications.

scholarly journals The Effect of Parenteral Infusion of Amino Acids in Burn Patient

2013 ◽  
Vol 24 (1) ◽  
pp. 12-15
Author(s):  
Kamrun Nahar ◽  
Zeba-un Naher ◽  
Matira Khanam ◽  
Shaheen Akhter ◽  
Tahmina Bashar ◽  
...  
Keyword(s):  
Amino Acid ◽  
Serum Albumin ◽  
Total Protein ◽  
Burn Injury ◽  
Burn Patients ◽  
Serum Total Protein ◽  
Female Ratio ◽  
Group I ◽  
The Mean ◽  
Group Ii

Adequate nutritional support may prevent weight loss  following severe burn injury. However, persistently low  levels of serum albumin, transferring and serum total  protein in burn patients have suggested that a protein  deficiency may continue to exist which is out of proportion  to energy requirements.  This interventional study cross sectional study was done in  the Department of Biochemistry, Bangabandhu Sheikh  Mujib Medical University (BSMMU), Dhaka, Bangladesh  during January 2008 to December 2008. A total of 40 acute  burn injury (within 24 hours of burn) patients of 20-45  years age with 15%-30% burn were selected for this study  as case. The study subjects were divided into two groups:  Group I represent superficial burn & Group II represents  deep burn.  The mean age of 28.35±6.81 years and 30.85±7.32 years in  group I and group II respectively. The number of male in  Group-I was 08 and Group-II was 08 and male female ratio  was 2:3. The mean serum total protein before infusion of  amino acid in Group-I was 55.31±3.58 g/L and in Group-II  was 52.01±2.26 g/L (p<0.001). The mean serum total  protein after infusion of amino acid in Group-I was  68.02±2.04 g/L and in Group-II was 61.86±2.49g/L  (p<0.001). The mean serum albumin before infusion of  amino acid in Group-I was 27.6±2.88 g/L and in Group-II  was 25.57±1.89 g/L (p<0.001). The mean serum albumin  after infusion of amino acid in Group-I was 22.29±3.50 g/L  and in Group-II was 19.83±2.86 g/L (p<0.001). In group-I,  serum total protein was increased by 22.98% after infusion  and in group-II, that was increased by 18.94% (p<0.01).  In group-I, serum albumin was decreased by 19.24% after  infusion and in group-II, that was decreased by 22.45%  (p<0.05). Serum total protein significantly increased after  infusion of amino acid but serum albumin significantly  decreased after infusion of amino acid. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14107 Medicine TODAY Vol.24(1) 2012 pp.12-15

scholarly journals Socket preservation by beta-tri-calcium phosphate with collagen compared to platelet-rich fibrin: A clinico-radiographic study

2016 ◽  
Vol 10 (02) ◽  
pp. 264-276 ◽  
Author(s):  
Swati Das ◽  
Rajesh Jhingran ◽  
Vivek Kumar Bains ◽  
Rohit Madan ◽  
Ruchi Srivastava ◽  
...  
Keyword(s):  
Calcium Phosphate ◽  
Cost Effective ◽  
Cortical Plate ◽  
Socket Preservation ◽  
Platelet Rich Fibrin ◽  
Tissue Replacement ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Insight Into

ABSTRACT Objectives: This study was primarily designed to determine the clinico-radiographic efficacy of platelet-rich fibrin (PRF) and beta-tri-calcium phosphate with collagen (β-TCP-Cl) in preserving extraction sockets. Materials and Methods: For Group I (PRF), residual sockets (n = 15) were filled with autologous PRF obtained from patients’ blood; and for Group II (β-TCP-Cl), residual sockets (n = 15) were filled with β-TCP-Cl. For the sockets randomly selected for Group II (β-TCP-Cl), the reshaped Resorbable Tissue Replacement cone was inserted into the socket. Results: Clinically, there was a significantly greater decrease in relative socket depth, but apposition in midcrestal height in Group II (β-TCP-Cl) as compared to Group I (PRF), whereas more decrease in buccolingual width of Group I (PRF) than Group II (β-TCP-Cl) after 6 months. Radiographically, the mean difference in socket height, residual ridge, and width (coronal, middle, and apical third of socket) after 6 months was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). The mean density (in Hounsfield Units) at coronal, middle, and apical third of socket was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). There were statistically significant apposition and resorption for Group I (PRF) whereas nonsignificant resorption and significant apposition for Group II (β-TCP-Cl) in buccal and lingual/palatal cortical plate, respectively, at 6 months on computerized tomography scan. Conclusion: The use of either autologous PRF or β-TCP-Cl was effective in socket preservation. Results obtained from PRF were almost similar to β-TCP-Cl; therefore being autologous, nonimmune, cost-effective, easily procurable regenerative biomaterial, PRF proves to be an insight into the future biofuel for regeneration.

Fistulogram after Arteriovenous Dialysis Graft Thrombectomy Should be Mandatory

2008 ◽  
Vol 74 (12) ◽  
pp. 1154-1158
Author(s):  
Shakthi D. Kumar ◽  
Krishna M. Jain ◽  
Shikha Jain ◽  
John S. Munn ◽  
Mark C. Rummel
Keyword(s):  
Graft Patency ◽  
Clinical Findings ◽  
Primary Patency ◽  
Surgical Exploration ◽  
Significant Stenosis ◽  
Group I ◽  
Dialysis Graft ◽  
Group Ii ◽  
Significant Lesion

The purpose of this study was to determine if fistulogram after prosthetic arteriovenous dialysis graft thrombectomy would reveal underlying lesions, which need correction, and if revision would improve graft patency. One hundred and ninety-two open thrombectomy procedures in 61 patients from January 1, 2000 to July 31, 2005 were reviewed retrospectively. All of the study patients were divided into two groups: In Group I fistulogram was carried out and in Group II no fistulogram was performed. Based on the fistulogram or clinical findings, appropriate intervention was carried out. In Group I, of 99 thrombectomy procedures, a significant lesion was identified and revision was carried out in 77 cases (78%). In Group II, of 93 thrombectomy procedures, a significant lesion was identified and revised in 53 cases (57%). A significant abnormality was more likely to be encountered by routine fistulogram than surgical exploration alone, 78 per cent versus 57 per cent (P < 0.05). Assisted primary patency is significantly increased in Group I and II when revision was performed (4.84 months) compared with when no fistulogram and no revision was performed (2.9 months), P < 0.05. Routine fistulogram after thrombectomy of an arteriovenous dialysis graft increases the likelihood of identifying a significant stenosis. Revision of the graft increases the longevity. We recommend routine use of fistulogram during thrombectomy.

scholarly journals CARDIOSYNCHRONOUS ELECTROMYOSTIMULATION IN PATIENTS WITH ACUTE HEART FAILURE

2013 ◽  
Vol 12 (6) ◽  
pp. 15-20
Author(s):  
G. G. Ivanov ◽  
M. Yu. Orkvasov ◽  
G. Khalabi
Keyword(s):  
Heart Failure ◽  
Conservative Treatment ◽  
Acute Heart Failure ◽  
Clinical Symptoms ◽  
Impedance Measurement ◽  
Pharmacological Therapy ◽  
Group I ◽  
Group Ii ◽  
One Year ◽  
The One

Aim. To study the effectiveness of the external cardiosynchronous electromyostimulation (ECSEMS) in patients with different variants of acute heart failure (AHF).Material and methods. The study included 62 AHF patients: Group I — those receiving only standard pharmacological therapy; and Group II — those in whom standard pharmacological therapy was ineffective after 12 hours, and who were also administered ECSEMS sessions for the next 7 days. The examination included multi-frequency bio-impedance measurement and dispersion mapping.Results. Clinical symptoms were less severe in Group I. In 64% of the Group II patients, the combination treatment was associated with a positive dynamics of the water balance parameters. The 7-day ECSEMS, as a part of the complex management of AHF patients, significantly reduced the one-month lethality, although did not change the one-year survival.Conclusion. The ECSEMS method could be used in order to increase the effectiveness of the conservative treatment of AHF patients. 

scholarly journals Evaluation of outcome of early appendectomy in appendicular lump

2020 ◽  
Vol 8 (1) ◽  
pp. 7
Author(s):  
A. S. M. Rezbanul Haque ◽  
Bablu Kumar Saha ◽  
M. Mahfuzul Haque ◽  
M. Abdus Sattar ◽  
Upendra Nath Ray ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Recovery Period ◽  
Medical College ◽  
Group I ◽  
Perforated Appendix ◽  
Early Exploration ◽  
The Mean ◽  
Group Ii ◽  
Surgery Department ◽  
The Cost

Background: Appendicular lump is a well-known sequalae of acute appendicitis encountered in 2-6% of patients. Successful management of appendicular lump is controversial with different approaches. This study aims to evaluate the outcome of early appendectomy in an appendicular lump.Methods: A total of 210 patients were admitted in surgery and pediatric surgery department of Rangpur medical college and hospital with the diagnosis of acute appendicitis and its sequalae over two years.Results: In this study, sixty patients were included who were presented with an appendicular lump. Maximum patients (50%) were found in the age group of 21-30 years. Males (66.67%) were more affected. Eighty percent of patients were coming from below-average socio-economic conditions. In group I, early appendicectomy had done and outcomes were satisfactory and favorable. In group II, eighteen patients were operated who were admitted at 6 to 8 days after an attack of acute appendicitis, and twelve patients were continued the conservative treatment. In group II, who had done surgery, among them, fourteen patients (77.78%) were found an appendicular abscess, and four patients (22.22%) were found perforated appendix per-operatively. In group I, the mean recovery period was less and they had minimum complications. In group II, the mean recovery period was more and they had more complications.Conclusions: Based on these findings, it can be concluded that early exploration in appendicular lump patients confirm the diagnosis, cures the problem, reduces the cost of management, and shortens the convalescence period and hospital stay with reasonably satisfactory outcomes.

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