scholarly journals Prospective study of 50 cases of perforative peritonitis a single centre experience

2017 ◽  
Vol 4 (8) ◽  
pp. 2782
Author(s):  
Prakash B. Patel ◽  
Suryadeep Baria
Keyword(s):  
Prospective Study ◽  
Exploratory Laparotomy ◽  
Medical College ◽  
Primary Peritonitis ◽  
Surgical Emergencies ◽  
Perforative Peritonitis ◽  
Common Etiology ◽  
Perforation Peritonitis ◽  
A Prospective Study ◽  
Surgical Treatments

Background: Perforative peritonitis are most common surgical emergencies seen worldwide. Despite improvement in diagnosis, antibiotics, surgical treatments and intensive care support, it is still an important cause of mortality in surgical patients. This study was done to know the spectrum of etiology, clinical presentation, management and treatment outcomes of patients admitted with perforation peritonitis in our hospital.Methods: A prospective study was done over a period of 3 years from January 2007 to December 2010 in NHL Medical College and V.S. hospital, Ahmedabad which included 50 patients diagnosed with perforation peritonitis. All patients admitted with perforation of gastrointestinal tract were included in this study. All cases of primary peritonitis and anastomotic leaks were excluded from this study.Results: Total 50 cases were included with 80% being males. Highest incidence of perforation peritonitis was noted in 21-30 years of age group in the present study. Most common etiology of perforative peritonitis was noted in the present study was peptic perforation 40% (20) cases, abdominal pain, tenderness were present in all of the perforative peritonitis patients.Conclusions: Perforative peritonitis is more common in male and most common pathology was peptic perforation due to acid peptic disease, in most of the cases after adequate resuscitation and stabilization of the patient Exploratory laparotomy is mainstay treatment modality

scholarly journals A prospective study to assess clinical profile and golden period for operative intervention in patients with perforation peritonitis

2018 ◽  
Vol 5 (4) ◽  
pp. 1492
Author(s):  
Sandeep Malik ◽  
Amandeep Singh ◽  
Darshan Singh Sidhu ◽  
Nitin Nagpal ◽  
Deepika Sharma
Keyword(s):  
Prospective Study ◽  
Hospital Stay ◽  
High Morbidity ◽  
Diffuse Peritonitis ◽  
Total Hospital ◽  
Icu Stay ◽  
Surgical Emergencies ◽  
Total Hospital Stay ◽  
Perforation Peritonitis ◽  
A Prospective Study

Background: Perforation peritonitis constitutes one of the most common surgical emergencies encountered by surgeons. Even with modern treatment, diffuse peritonitis carries a high morbidity and mortality rate.Methods: The prospective study was conducted at department of surgery on 50 patients of perforation peritonitis admitted in emergency department of hospital. Detailed history, clinical examination and investigations were carried out. Patients were operated upon and findings were noted. Comparisons were done for postoperative ICU stay, morbidity/ mortality, oral feed and total hospital stay between the patients who reported within 24 hours and after 24 hours of onset of symptoms to determine golden period for operative intervention.Results: Out of total 50 patients, 21(42%) patients presented within 24 hrs of onset of first symptom of perforation while 29(58%) patients presented after 24 hours. Postoperative ICU stay, morbidity/ mortality, delay in oral feed and total hospital stay was statistically more in patients presenting after 24 hours.Conclusions: It can be concluded that the golden period of 24 hrs between the onset of symptom and start of treatment is the most important factor to determine the outcome.

scholarly journals Aetiological Pattern of Gastrointestinal Perforations: A Prospective Observational Study

2021 ◽  
Vol 29 (2) ◽  
pp. 106-109
Author(s):  
Prosunto Kumar Das ◽  
Chowdhury Md Mushfiqur Rahman ◽  
AZM Mahfuzur Rahman ◽  
Md Nayeem Dewan ◽  
Md Mahmudul Islam ◽  
...  
Keyword(s):  
Enteric Fever ◽  
Early Recognition ◽  
College Hospital ◽  
Female Ratio ◽  
Ulcer Disease ◽  
Medical College ◽  
Surgical Emergencies ◽  
Perforative Peritonitis ◽  
Perforation Peritonitis ◽  
Duodenal Perforations

Introduction: Peritonitis secondary to gastrointestinal perforation is one of the commonest surgical emergencies encountered all over the world. This study was done to highlight the spectrum of perforation peritonitis encountered in surgery unit of Dhaka Medical College Hospital. Method: It was observational prospective of 100 cases of perforation peritonitis treated in our hospital. All cases of perforative peritonitis whether spontaneous, infective or neoplastic pathology were included in this study. Results: The maximum numbers of patients were in age group between 31 to 40 years (39 %) with mean age 35 years. Male female ratio was 9:1. The most common aetiology of perforation peritonitis was peptic ulcer disease (73%) followed by enteric fever (12%), appendicitis (10%), tuberculosis (3%) and malignancy (2%). The most common sites of perforation were in descending order of frequency - first part of the duodenum (65%), terminal ileum (12%), appendix (10%), gastric antrum (9%), jejunum (3%) and rectum (1%). Abdominal pain (100%) and vomiting (81%) were the most common symptoms while tachycardia (96%), muscle guard and rigidity (100%) were the common signs. Approximately 15-20% presented late with features of shock. Mortality rate was 2% and was significantly high in patients coming hospital late. Conclusion: Gastrointestinal perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations secondary to enteric fever have highest morbidity. Early recognition and timely appropriate intervention is very important in reducing morbidity and mortality. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 106-109

scholarly journals Emergency Surgery during COVID-19: Lessons Learned

2020 ◽  
Vol 06 (03) ◽  
pp. e167-e170
Author(s):  
Hemanga K. Bhattacharjee ◽  
Shafneed Chaliyadan ◽  
Eshan Verma ◽  
Keerthi Kumaran ◽  
Priyank Bhargava ◽  
...  
Keyword(s):  
Stable Condition ◽  
Exploratory Laparotomy ◽  
Sigmoid Volvulus ◽  
Lessons Learned ◽  
Suspected Case ◽  
Surgical Emergencies ◽  
Viral Particles ◽  
Hospital Patients ◽  
Perforation Peritonitis ◽  
Precautionary Measures

Abstract Introduction The ongoing coronavirus disease-2019 (COVID-19) pandemic has disrupted health services throughout the world. It has brought in several new challenges to deal with surgical emergencies. Herein, we report two suspected cases of COVID-19 that were operated during this “lockdown” period and highlight the protocols we followed and lessons we learned from this situation. Result Two patients from “red zones” for COVID-19 pandemic presented with acute abdomen, one a 64-year male, who presented with perforation peritonitis and another, a 57-year male with acute intestinal obstruction due to sigmoid volvulus. They also had associated COVID-19 symptoms. COVID-19 test could not be done at the time of their presentation to the hospital. Patients underwent emergency exploratory laparotomy assuming them to be positive for the infection. Surgical team was donned with full coverall personal protective equipment. Sudden and uncontrolled egression intraperitoneal free gas was avoided, Echelon flex 60 staplers were used to resect the volvulus without allowing the gas from the volvulus to escape; mesocolon was divided using vascular reload of the stapler, no electrosurgical devices were used to avoid the aerosolization of viral particles. Colostomy was done in both the patients. Both the patients turned out to be negative for COVID-19 subsequently and discharged from hospital in stable condition. Conclusion Surgeons need to adapt to safely execute emergency surgical procedures during this period of COVID-19 pandemic. Preparedness is of paramount importance. Full precautionary measures should be taken when dealing with any suspected case.

scholarly journals Comparative study between endoscopic cartilage myringoplasty and endoscopic temporalis fascia myringoplasty

2018 ◽  
Vol 5 (1) ◽  
pp. 24 ◽  
Author(s):  
P. Chozhan ◽  
M. Sankara Subramanian ◽  
D. Kannathal ◽  
R. Malarvizhi
Keyword(s):  
Comparative Study ◽  
Prospective Study ◽  
Temporalis Fascia ◽  
Ear Surgery ◽  
Medical College ◽  
The World ◽  
Prospective Comparative Study ◽  
Patient Series ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Myringoplasty is a common ear surgery performed all over the world. This study is focused on prospective comparative study using two different graft materials.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study done in the Department of ENT Stanley Medical College, Chennai during the period from March 2013 to September 2013. Sample size was 60 patients. Follow up was done till 6 months.  </p><p class="abstract"><strong>Results:</strong> Graft acceptance was achieved in 28 patients (93%) who underwent palisade cartilage myringoplasty, whereas it was achieved in 24 patients (80%) in the temporalis fascia myringoplasty group.</p><p class="abstract"><strong>Conclusions:</strong> The outcomes in our patient series indicate that cartilage myringoplasty achieves good results. Cartilage, a very effective material for the reconstruction of the TM and grafts can provide an excellent anatomical result, perfect stability and good functional outcome.</p>

ESTIMATION OF FETAL WEIGHT BY CLINICAL METHODS AND ULTRASOUND AND CORRELATING ITS ACCURACY WITH ACTUAL BIRTH WEIGHT IN TERM PREGNANCIES AT ANMMCH, GAYA, BIHAR

2021 ◽  
pp. 17-19
Author(s):  
Kumari Ragini ◽  
Amit Kumar ◽  
Reena Kumari ◽  
Debarshi Jana
Keyword(s):  
Birth Weight ◽  
Prospective Study ◽  
Fetal Weight ◽  
Term Pregnancy ◽  
Abdominal Girth ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Clinical Methods ◽  
Fetal Birth Weight ◽  
A Prospective Study

Objective:This study was to estimate the fetal weight in term pregnancy by clinical methods and ultrasound and to compare the results with actual birth weight (ABW). Material and Methods:This study was conducted at Department of Obstetrics and Gynaecology, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar from December 2019 to May 2020. It was a prospective study covering 200 pregnant women at term gestation. Results: Estimated birth weight by abdominal girth × symphysis fundal height (AG × SFH) formula was closest to the ABW (P = 0.060), as compared to the estimated birth weight by Johnson's formula (P = 0.000) and Hadlock's formula (P = 0.000). Therefore, of the three formulae studied, AG × SFH formula had better predictive value as compared to Johnson's and Hadlock's formulae. The accuracy of AG × SFH (Insler's formula) for estimating the fetal weight at term was found to be comparable to Hadlock's formula (P= 0.104). Conclusion: Clinical estimation of birth weight denitely has a role in the management of labor and delivery. AG × SFH is a simple, easy, costeffective, and universally applicable method to predict fetal birth weight which can be used even by paramedics like midwives and also in centers where ultrasound is not available.

Outcomes of surgical treatments of spinal metastases: a prospective study

2019 ◽  
Vol 28 (5) ◽  
pp. 2127-2135
Author(s):  
C. Bouthors ◽  
◽  
S. Prost ◽  
C. Court ◽  
B. Blondel ◽  
...  
Keyword(s):  
Prospective Study ◽  
Spinal Metastases ◽  
A Prospective Study ◽  
Surgical Treatments

scholarly journals Diagnostic accuracy of presepsin in predicting bacteraemia in elderly patients admitted to the emergency department: prospective study in Japan

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e030421
Author(s):  
Yoshiro Imai ◽  
Kohei Taniguchi ◽  
Ryo Iida ◽  
Masahiko Nitta ◽  
Kazuhisa Uchiyma ◽  
...  
Keyword(s):  
Emergency Department ◽  
Elderly Patients ◽  
Prospective Study ◽  
Characteristic Curve ◽  
Ethics Committee ◽  
Blood Sampling ◽  
Medical College ◽  
Reactive Protein ◽  
Evaluation Scores ◽  
A Prospective Study

ObjectiveEarly prediction of bacteraemia in the elederly is needed in the emergency department (ED).Design, setting and participantsA prospective study in Japan; single-centre trial in patients who satisfied the sepsis criteria was conducted between September 2014 and March 2016. Forty-six elderly patients aged ≥70 years were included. The study protocol was approved by the ethics committee of Osaka Medical College. Ethics Committee approval number was 1585.InterventionsBlood sampling to evaluate C-reactive protein (CRP), procalcitonin (PCT) and presepsin plasma levels; two sets of blood sampling for bacterial cultures; and evaluations of the Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation scores were performed on arrival at the ED. The results were compared between patients with bacteraemia and those without bacteraemia.Main outcome measureThe accuracy of detecting bacteraemia.ResultsThe presepsin value was significantly higher in the bacteraemia group than in the non-bacteraemia group (866.6±184.6 vs 639.9±137.1 pg/mL, p=0.03). The PCT and CRP did not significantly differ between the groups. The area under the receiver operating characteristic curve values were not significantly different among presepsin (0.69), PCT (0.61) and CRP (0.53). Multivariate analysis showed that presepsin was independently associated with bacteraemia (OR 8.84; 95% CI 0.95 to 81.79; p=0.02).ConclusionPresepsin could be a good biomarker to predict bacteraemia in elderly patients with sepsis criteria admitted to the ED.

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