scholarly journals Gastro intestinal perforations: an audit from a tertiary care teaching hospital, Mysore, India

2018 ◽  
Vol 5 (11) ◽  
pp. 3484
Author(s):  
Shashikumar H. B. ◽  
Madhu B. S. ◽  
Shyama S.

Background: Peritonitis secondary to hollow viscus perforation is one of the most frequently encountered surgical emergencies in India. The objective of this study was to study the demographic and clinical profile of gastro intestinal perforations and surgical procedures done for the same in a tertiary care teaching hospital.Methods: This study was performed on 46 cases of hollow viscus perforation admitted in K. R. Hospital from January to June 2018. The presenting symptoms, age and sex profile, risk factors, site of perforation, the surgical procedure they underwent, post-operative complications were assessed and analyzed.Results: The most common age group affected was 21-30 years out of which 89.1 % were males. Gastric perforations were the most common type (56.5%) and jejunal perforations were the least common (6.5%). Abdominal pain was the main presenting symptom in all the cases. Fever was found to be a significant history in cases of ileal perforation (p=0.001) as was history of trauma in cases of jejunal perforation (p=0.001). Guarding, rigidity and air under the diaphragm were seen consistently in most cases. Graham’s patch repair was the most common surgical procedure performed. Ileostomy was the most common surgery done for ileal perforations. Wound infections were the most common post-operative complication observed and death occurred in 13% of cases mostly due to sepsis and cardio pulmonary complications.Conclusions: This study showed an increased incidence of perforation in younger age group which is alarming. The rise in the frequency of gastric perforations points towards an unhealthy lifestyle and dietary habits.

Author(s):  
Deepa Hatwal ◽  
Chitra Joshi ◽  
Ranjan Agrawal

Introduction: Ovarian sex cord-stromal tumours, including Granulosa Cell Tumours (GCTs), are a group of neoplasm that occurs rarely, especially in children. Only 0.1% of all ovarian tumours and 4-5% of GCTs occur in children. They commonly present as precocious puberty especially in prepubertal girls. Aim: To analyse the clinico-pathological features along with the laboratory findings of ovarian mass. Materials and Methods: A prospective study in tertiary care teaching institutions was carried out during a three year study period starting from April 2017 to March 2020. The study was carried out in tertiary care teaching institutions i.e., VCSGG Medical Sciences and Research Institute, Srinagar Garhwal, PauriGarhwal, Doon Medical College, Dehradun and Rohilkhand Medical College, Bareilly. A total of 11 cases of Juvenile Granulosa Cell Tumour (JGCT) among girls in the age group of 5-13 years who presented with precocious puberty were included in the present study. The results were analysed especially the clinico-laboratory parameters including histopathology and Immunohistochemistry (IHC) findings. All the patients underwent resection of the ovarian mass and were subjected to histopathological examination. Microscopy and IHC was compatible with the diagnosis of juvenile GCT in all the 11 cases. Results: Majority of the patients with GCTs of the ovary presented in the early stage. Of the 11 cases included, only one patient was aged 13 years; seven were in the age group of 5-8 years and three in the 9-12 years of age group. The laboratory profile in all showed an elevated Estradiol level, low Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) levels. Among the thyroid profile only the Triiodothyronine (T3) levels were raised while Thyroid Stimulating Hormone (TSH) and Thyroxine (T4) levels were within normal limits. All cases were histopathologically proved and confirmed using IHC markers. Surgery is the primary treatment modality for GCTs. Conclusion: Histopathology along with specific IHC is important in the diagnosis of JGCT. A careful search provides good insight of the tumour and its final outcome. Diagnosing JGCT especially in the early stage is important as they carry a favourable prognosis when treated in the initial phase.


2021 ◽  
Vol 8 (11) ◽  
pp. 3359
Author(s):  
Lokesh M. G. ◽  
S. Chandrashekar ◽  
Arundathi Raikar ◽  
Abhishek S. S.

Background: High mortality and morbidity is associated with peritonitis secondary to hollow viscus perforation, proving it a most common life threatening condition which needs emergency surgical care. Hence a proper evaluation was needed regarding appropriate management to have a better outcome, which was a challenge to operating surgeon.Methods: A serial study of 96 cases of peritonitis secondary to hollow viscus perforation was conducted at tertiary care centre, department of general surgery, Mysore medical college and research institute, Mysore, Karnataka from the period of August 2020 to July 2021. Data related to aetiology, surgical intervention and its peri-operative complications were noted. Appropriate statistical analyses were done to draw the inference.Results: Out of 96 cases studied, 74 were male, 22 were female with mean age of 45.53 years. Most common cause of peritonitis was GU perforation, followed by idiopathic, infective, malignancy, appendicular perforation and Trauma.Conclusions: Hollow viscus perforation being most common surgical emergencies, surgical outcomes and its related complications depends on age, general condition, site, co-morbidities and aetiologies.


2019 ◽  
Vol 04 (02) ◽  
pp. 079-084
Author(s):  
Shibba Takkar Chhabra ◽  
Gurleen Kaur ◽  
Samir Kapoor ◽  
Gagandeep Nagi ◽  
Devanshi Kajal ◽  
...  

Abstract Background Women have been thought to be protected against the perils of cardiovascular disease (CVD) till late in their lives. But the literature suggests quite the opposite with CVD being a major cause of death even in young women. In contrast, the lack of awareness among women is disheartening and needs to be addressed radically. Methods The study was designed and conducted as retrospective cohort at a tertiary care center. Data was collected from patients presenting for routine cardiac health checkup over the past 15 years. The parameters observed included age at presenting, symptoms and/or signs, plus area of residence or domicile. Results A total of 32,831 patients presented for routine cardiac health checkup, of which 9,211 (28.1%) patients were women and 23,620 (71.9%) were men. On 5 yearly cumulative assessment, the mean attendance of women was 28.1 ± 2.5% as compared with 71.9 ± 2.6% men. Trend observed over the past 15 years revealed little change in the number of women versus men presenting for cardiac health checkup annually. Statistical significance was seen at p < 0.01. Among the women presenting for the checkup, it was observed that most women were in the postmenopausal age group (42.8%), followed by perimenopausal age group (34.6%), and least in premenopausal age group (22.5%) during the timeline of the study. A similar trend was observed in the male attendance; the input of males being higher at all instances. Noteworthy were trends of urban women (69.6%) presenting for health checkup more often as compared with 30.4% visiting from rural residence. Conclusions Coronary artery disease (CAD) is not uncommon in female gender. It is accompanied by varying symptom presentation with high mortality. It is seen that cardiac health awareness is significantly lacking among women as compared with men. There are almost static trends observed over the past 15 years, especially in premenopausal age group and rural domicile. Corrective actions inclining toward campaigns and communication to distribute information on cardiac disease prevention and treatment modalities among women are needed to curb CAD. This may promote early detection of CAD leading to early interventions to promote a healthy heart among women. Recommendations and necessary actions steps for a woman oriented cardiac program are the need of the hour.


Author(s):  
Varsha Medasani ◽  
Paquirissamy Oudeacoumar ◽  
Rao Chitralekhya ◽  
Saurabh Krishna Misra

<p class="abstract"><strong>Background:</strong> Skin diseases are a major health problem in the paediatric age group and are associated with significant morbidity. Dermatoses in children are more influenced by socioeconomic status, dietary habits, climatic exposure and external environment as compared to adults. The present study was undertaken to know the prevalence of paediatric dermatoses among patients attending Dermatology outpatient department in a tertiary care hospital in Puducherry.</p><p class="abstract"><strong>Methods:</strong> All newly diagnosed, untreated male and female paediatric patients (from neonates to adolescents ≤19 years of age) attending Dermatology OPD, from October 2015 to September 2017 were evaluated to study the prevalence and patterns of paediatric dermatoses. The skin disorders were classified into groups like infections, infestations, eczemas, acne, hypersensitivity disorders, sweat gland disorders, pigmentary disorders, nevi, keratinisation disorders, hair and scalp disorders, papulosquamous disorders, bullous disorders, nail disorders, drug reactions, other dermatoses.<strong></strong></p><p class="abstract"><strong>Results:</strong> The prevalence of pediatric dermatoses in our OPD is 25.21%. Incidence of pediatric dermatoses was found to be more in males 237 (59.39%) than in females 162 (40.60%) and the majority of the patients were in adolescent age group (217; 54.38%). Present study showed that majority of cases belonged to the lower socioeconomic group 186(46.6 %). In our study, majority (58.98%) of dermatoses belonged to infections and infestations group. Of the infective dermatoses, fungal infections (27.88%) were the most common.</p><p><strong>Conclusions:</strong> Infectious dermatoses were commonly seen in this study that may be due to poverty, overcrowding, poor hygiene. There is an increasing trend of fungal infections which might be related to hygiene and environment. </p>


Author(s):  
Bhagyashri D. Gawari ◽  
Sujata R. Lavangare ◽  
Gajanan D. Velhal

Background: Health care professionals (including class IV employees) are the most ignorant as far as their own health is concerned. Problems encountered at the workplace affect not only a worker’s health but also adversely affects the workplace environment. Today is an era of women who have diverse role to play in the society and often they handle multiple tasks simultaneously. They are therefore prone to suffer from work related diseases, which are further complicated by various social (responsibilities at home), psychological and physiological (e.g., pregnancy) issues.Methods: A cross-sectional study was carried out amongst 287 female class IV employees of municipal tertiary care teaching hospital in Mumbai during the period of April 2017 to December 2018. A semi-structured interview schedule was prepared comprising of socio-demographic determinants and BMI. Data was entered in MS Excel sheet and were analyzed in the form of percentage and proportions whenever necessary.Results: Out of total 287 participants, 101 (35.2%) belonged to age group of 41-50 years, more than half 168 (58.5%) were widows and majority 231 (80.5%) were Hindu by religion, 124 (43.2%) belonged to upper middle class, 158 (55.0%) belonged to a nuclear family and 44 (15.3%) had to travel more than 60 kms daily to reach at workplace.Conclusions: Study concluded that 35.2% participants were 41-50 years age group and 80.5% were Hindu by religion and 43.2% belonged to the upper middle class. Only 2.1% respondents had completed their graduation. More than half i.e. 55.1% of the participants were having normal body mass index and 10.5% were obese.


Author(s):  
Ramaning Loni ◽  
Pruthvi Ranganath ◽  
Manisha Juvekar ◽  
Nitin Tikare ◽  
L. H. Bidari ◽  
...  

Background: Congenital heart diseases are the predominant causes of paediatric morbidity and mortality. This study was done to know the clinical profile, various acute presentations, and risk factors for repeated hospitalizations and their outcome in children with congenital heart diseases.Methods: This prospective observational study of children in the age group of 0 hour-12 years, who were previously diagnosed and or newly diagnosed with congenital heart diseases.Results: A total of 102 children were present during the study period. The most common age group for congenital heart disease was infancy with 46.1% (47 cases) of children. Acyanotic heart diseases were observed in 73.5% (75 cases) of the total, followed by cyanotic CHD with 14.7% (15 cases), complex CHD with 9.8% (10 cases), and the least, valvular diseases with 2% (2 cases). The most usual presenting symptoms in children with CHDs were breathlessness with 66.7% (67 cases), followed by fever with 54.9% (56 cases) and cough with 48% (49 cases. In this study, 23.5% (24 cases) of the children were completely immunized. The protein-energy malnutrition was present in 51% of cases (52 cases). The 16.7% of them (17 cases) have got the motor developmental delay predominantly. The dysmorphic features were present in 19 cases (18.6%) of total cases. The chest X-ray findings were abnormal in 58.8% (60 cases). The most common risk factor(co-morbidity) in children with CHD was noticed to be anaemia in 43 cases (42.2%).Conclusions: The infancy and early childhood are the most common age group for the presentation of CHDs. Most of them had the associated risk factors (co-morbid) like nutritional anaemia, pneumonia, and failure to thrive.


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