scholarly journals A Prospective study on Gastrointestinal Perforation Peritonitis in Andhra Pradesh, India

Author(s):  
Dr. G. Someswara Rao ◽  
◽  
Dr. B. Visweswara Rao ◽  

Introduction: Perforation is defined as an abnormal opening in a hollow organ or viscus. All overthe world, perforation peritonitis is the most prevalent surgical emergency tackled and treated by asurgical team. The etiology leading to peritonitis in tropical countries shows a different spectrumfrom its western world. The present study was conducted to highlight the spectrum of hollow viscusperforation peritonitis in terms of etiology, clinical presentations, site of perforation, surgicaltreatment, postoperative complications, and mortality encountered. Methods: The study was aprospective observational study conducted from March 2016 to March 2019 in the Department ofGeneral Surgery, Great Eastern Medical School and Hospital, Andhra Pradesh. A total of 320 patientswith perforation peritonitis were included in the study and underwent exploratory laparotomy.Results: Out of 320 patients, there were 276 males (86.25%) and 44 females (13.75%). Duodenalperforation was the most common type (34.38%), which was mainly due to Acid peptic diseasefollowed by Jejunal and Ileal perforations. Wound infection was the most common complication. Themortality rate was 8.44% (27 patients). Conclusion: Early diagnosis, resuscitation with fluids, andtimely surgical intervention are the most important factors deciding the fate of the patient withperforation peritonitis.

2013 ◽  
Vol 25 (2) ◽  
pp. 65-70
Author(s):  
Sharmeen Mahmood ◽  
Sadia Afrin ◽  
Farhana Dewan

Objectives: The objective of the study was to find out the efficacy and safety of misoprostol in termination of missed abortion.Materials and Methods: This was a prospective study carried out during the time from August 2009 to April2010 in Dhaka Medical College Hospital.Results: A total 50 cases of missed abortion (12-28weeks) were included in the study. Tab.misoprostol(2oo?gm) was used pervaginally 4hourly for termination of pregnancy. Maximum 4tab.were used. Outcome variables were doses of misoprostol, expulsion times need for use of oxytocin and D and C and side effect of misoprostol. In the present study, 58% percent (29 out of 50 ) experienced complete expulsion (20% after 1st dose, 24% after 2nd dose 24% after 3rd dose and, 31% after 4th dose).24% cases needed oxytocin drip as an adjunct and 18% needed surgical evacuation when 4 doses of misoprostol (tab cytomis)and oxytocin fail to expel the product of conception. Mean (±SD) time required for expulsion of product of conception was 11.44 ± 4.43 hours in 29 (58%) women who were given tab misoprostol only. The results showed that 5(out of 25) has a complete expulsion after first dose, 13 after second 4 after 3rd  and Mean induction expulsion time was 6.1 hours The most common complication was temperature 6%, vomiting 4%, and diarrhoea 2%.Conclusion: Vaginal application of misoprostol can be used to women with missed abortion   for complete expulsion of the product of conception and may reduce the need for surgical   intervention. DOI: http://dx.doi.org/10.3329/bjog.v25i2.13742 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(2) : 65-70  


2014 ◽  
Vol 13 (2) ◽  
pp. 139-142 ◽  
Author(s):  
Dionei Freitas De Morais ◽  
João Simão De Melo Neto ◽  
Antonio Ronaldo Spotti ◽  
Waldir Antonio Tognola

Objective: To analyze individuals with spinal cord injury who developed secondary clinical complications, and the variables that can influence the prognosis. Methods: A prospective study of 321 patients with spinal cord injury. The variables were collected: age, sex, cause of the accident, anatomical distribution, neurological status, associated injuries, in-hospital complications, and mortality only in patients who developed complications. Results: A total of 72 patients were analyzed (85% male) with a mean age of 44.72±19.19 years. The individuals with spinal cord injury who developed clinical complications were mostly male, over 50 years of age, and the main cause was accidental falls. These patients had longer hospitalization times and a higher risk of progressing to death. Pneumonia was the main clinical complication. With regard to the variables that can influence the prognosis of these patients, it was observed that spinal cord injury to the cervical segment with syndromic quadriplegia, and neurological status ASIA-A, have a higher risk of developing pneumonia, the most common complication, as well as increased mortality. Conclusion: Clinical complications secondary to spinal cord injury are influenced by demographic factors, as well as characteristics of the injury contributing to an increase in mortality.


Author(s):  
Tripta S. Bhagat ◽  
Luv Kumar ◽  
Prakhar Garg ◽  
Apoorv Goel ◽  
Amit Aggarwal ◽  
...  

Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large proportion of hospital beds. This study was conducted for analysis of patients with cellulitis according to their demographics and clinical presentation and to examine their comorbidities, complications, and its management. This observational cross-sectional study was conducted in the Department of Surgery at Santosh Medical College and Hospitals involving a total of 60 cases having cellulitis and other soft tissue infections of lower limb. Analysis of their demographic profile, management, and complications was done. Cellulitis is seen commonly in males, 46 (76.6%). The mean age of patients affected by cellulitis in the study was 36.4 ± 1.23 years. The most common site affected is leg involving more people in field jobs. The most common risk factor was trauma in 46.6%, and other factors were diabetes mellitus and smoking, while abscess formation was the most common complication observed in 36.6% of cases. A total of 56.6% cases were managed conservatively, while 43.3% cases required surgical intervention. Mean hospital stay in this study was 5.02 ± 0.23 days. It was concluded that cellulitis is subcutaneous, spreading bacterial infection is more common in males, and its incidence is highest in working age group population. Lower limb is commonly involved. Trauma, smoking, and diabetes are significant risk factors for development of cellulitis. Abscess is the most common complication. About 50% patients with cellulitis can be managed conservatively and the rest require surgical intervention.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
G Esworthy ◽  
N Johnson ◽  
J Dias ◽  
P Divall

Abstract Background Treatment of intra-articular distal radius fractures is guided by the displacement of the articular fragments. Symptomatic post-traumatic arthritis is expected to occur if step displacement is > 2mm; this value is often used as an indication for surgery if closed reduction is not possible. Method A systematic review was performed to establish the origin and adaptations of the threshold, with papers screened and relevant citations reviewed. Orthopaedic textbooks were reviewed to ensure no earlier mention of the threshold was present. Results Knirk and Jupiter, 1986, are the first to quantify a threshold, with all their patients developing arthritis with >2mm displacement. Some papers have discussed using 1mm, although 2mm is most widely reported. Current guidance from the British Society for Surgery of the Hand supports 2mm. Although this paper is still widely cited, the authors published a re-examination of the data showing methodological flaws which is not as widely reported. They claim their conclusions are still relevant today; however, the radiological arthritis does not correlate with the clinical presentation. Conclusions Knirk and Jupiter originated the threshold value of 2mm. The lack of correlation between the radiological and clinical presentations warrants further investigation. The principle of treatment remains restoration of normal anatomical position.


2020 ◽  
Vol 13 (12) ◽  
pp. e236019
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Jeyakumar Sundaraj ◽  
Pradeep Joshua Christopher ◽  
Ramyasree Paladugu

Tuberculosis (TB) of the breast is extremely rare and is often mistaken for benign or malignant lesions of the breast. They are rare even in countries which are endemic for TB, like India. The most common type of clinical presentation is a vague lump in the breast, but there are even other types of presentations which are documented. In olden days, there was a lot of dilemma and challenge in diagnosing TB of the breast, but thanks to improved pathological knowledge and the advent of investigations such as QuantiFERON-TB gold and GeneXpert, TB can be diagnosed early nowadays and treated accordingly. In this study series, we report 10 cases of TB of the breast with variable clinical presentations as fibroadenosis, breast abscess, duct ectasia and breast lump on evaluation, and the challenges encountered in establishing the diagnosis.


2017 ◽  
Vol 34 (2) ◽  
pp. 179-188
Author(s):  
Milovan Stojanović ◽  
Marina Deljanin-Ilić ◽  
Aleksa Vuković ◽  
Dejan Petrović

Summary Tetralogy of Fallot is the most common cyanogenic congenital heart defect. The diagnosis is based on clinical signs, ECG examination, ultrasound examination of the heart, additional imaging methods and invasive testing. The therapeutic approach to the patient with tetralogy is complex and based on conservative and radical methods. Patients who have not undergone a radical surgical intervention have a poor prognosis, whereas the prognosis is much better for patients who have been operated. The most common complication of the surgical treatment is the pulmonary valve insufficiency which usually requires reintervention, as was the case with our patient.


2017 ◽  
Vol 56 (205) ◽  
pp. 137-140
Author(s):  
Anil Kumar Adhikari ◽  
Mahuya Dutta ◽  
Chittra Ranjan Das

Introduction: The study of lower genital tract trauma has become important in gynaecological practice. There is paucity of reports on this clinical entity from our settings. The main aim of this study is to document injuries in female lower genital tract in Mid-Western Nepal. Methods: Sixty female patients admitted to the hospital with genital tract injuries caused by coitus or accidents were included in the study. Details of the causes of trauma clinical presentations and management were recorded. Results: These injuries were grouped according to etiological factors. This study included 33 (55%) coital injuries and 27 (45%) non- coital injuries. Out of coital injury, 12 cases were criminal assault (rape) in age group of 4 to 18 years. Four unmarried girls had consensual sex. Non-coital injuries were due to fall from height, cattle horn injuries, straddle type of trauma, vulvar haematoma and anorectal injuries. Conclusions: Appropriate surgical intervention can avert morbidity and mortality. Keywords: accident; lower genital tract; Nepal; trauma.


2021 ◽  
Vol 8 (4) ◽  
pp. 753
Author(s):  
Priyanka Yadav ◽  
Ankit Agarwal

Meconium peritonitis is sterile chemical peritonitis that occurs after intestinal perforation resulting in meconium leakage and subsequent inflammatory cascade within the peritoneal cavity. The clinical presentations after birth can range from completely sealed-off peritonitis without any symptoms, to severe peritonitis requiring emergency surgical intervention. We describe a case of meconium peritonitis in a premature infant following intestinal perforation. In the immediate postnatal period, the patient was intubated and a peritoneal drain was placed. Laparotomy with bowel resection was performed the following day. The postoperative course was uneventful and the patient was discharged home in good clinical condition.


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