scholarly journals A clinical study of complicated inguinal hernias

2019 ◽  
Vol 6 (5) ◽  
pp. 1608
Author(s):  
Vijaykumar Kappikeri ◽  
Nitinkumar N. N. Kalaskar

Background: Hernia is a common, treatable condition, if ignored can lead to life- threatening complications. Lack of health awareness, poverty, and lack of surgical facilities will lead to devastating complications. This study aims at illustrating the various modes of presentation, management and postoperative outcome in complicated inguinal hernias.Methods: 50 patients of complicated inguinal hernia admitted in Basaveshwar Teaching and General Hospital attached to M.R. Medical College, Kalaburagi from September 2016 to August 2018 was studied.Results: 12 cases (24%) presented within 24 hrs of onset of symptoms, while 38 cases (76%) after 24 hrs. 32 cases (64%) were right sided and 16 cases (32%) were left sided hernias. 2 cases (4%) were bilateral hernias but had complication on only 1 side. 44% cases were irreducible, 36% were obstructed and 20% were strangulated. 96% cases were indirect while only 4% were direct hernia. 82% cases were from rural and 18% cases were from urban areas. Most common age of presentation was 4th and 5th decade. Most common mode of presentation was an irreducible swelling (100%), followed by pain in 48% and vomiting in 46% cases. The content was small bowel in 54% cases, omentum in 18% cases and both in 16% cases. Herniorrhaphy was performed in 74% cases and hernioplasty in 14%. 6 cases of strangulated hernia with non-viable bowel underwent resection and anastomosis. 3 deaths (6%) were reported.Conclusions: Patients who presented within 24 hours of onset of symptoms had shorter hospital stay, lesser complications and no mortality. Whereas cases presented after (>24 hrs) had higher rate of complications and mortality. Most of the complicated cases were from rural area and were right sided indirect inguinal hernias.

Author(s):  
Dr. Sunil Kumar Mehra, Dr. Dinesh Kumar Barolia, Dr. Arun Kumar Gupta, Dr. Vinita Chaturv

Intussusception is the most common cause of intestinal obstruction in infants and children in < 1yr of age (1). Intussusception cases usually reported late therefore operative procedure was inevitable and results in significant morbidity and mortality. By this study we emphasized on timely transfer of intussusception case to a pediatric surgical center so as to decrease surgical risk. The surgical morbidity was low in those who were admitted early or directly to our center.  Methods - We retrospectively reviewed cases of intussusception in children <15 years. Children were treated from October 2015 to December 2107 at pediatric surgery department of SMS medical college Jaipur Rajasthan. Age, sex, month of admission, symptom with duration, diagnostic methods, and treatment modalities were recorded and analyzed.  Results - We studied 300 patients with intussusception.272 (90%) were treated surgically. We recently started ultrasonography guided pneumatic reduction and 24(85.7%) out of 28 treated successfully by it. Out of the patients requiring surgery 202 (67.34%) patients were reduced by per-operative manual reduction and in 60(22%) patients resection and anastomosis with 10(3.6%) treated with resection and ileostomy. 25.34% cases have delayed diagnosis and lately  transferred from peripheral hospitals requiring resection and diversion. Conclusion - In conclusion, Intussusception cases usually reported late therefore high likelihood of surgical management. The patients who underwent resection have longer duration of hospital stay.


KYAMC Journal ◽  
2018 ◽  
Vol 9 (3) ◽  
pp. 133-135
Author(s):  
Joya Debnath ◽  
Arpan Kumar Basak ◽  
Md Zubaidur Rahman ◽  
Anujit Saha

Background : Self poisoning with organophosphate pesticides is a major health problem in world wide. Organophosphorus compound poisoning is a very common toxicological emergency encountered at Mirzapur in Tangail. It is particularly common among the rural agricultural worker's which comprise a substantial group of the population of this region.Objective: The objective of this study was to find out the incidence, frequency, pattern of poisoning, outcome and aetiological aspect of Organo phosphorus poisoning patient admitted in Kumudini Women's Medical college Hospital.Methods: A total 366 cases of OPC poisoning were analysed during 1 year from January 2015 to December 2015. The emphasis was given on age, sex, socio-economic status, occupation, motive of poisoning, types of compound consumed its quality, place, distance from referral place and the ultimate outcome.Results: Young population of rural background, particularly agricultural workers were the commonest patients (51.91%). The most common motive of poisoning was with a suicidal intent, both in males (27.59%) and females (66.39%). Financial crisis was one of the most common reasons analysed as the motive behind the poisoning (54.20%). Three hundred forty four Patients recovered and 22 were expired. The major cause of death in these cases was respiratory failure followed by multi-organ failure.Conclusion : Strict of the pesticide act and involving a new policy by the government to educate the public and youth in large about the dangerous, life threatening effects of Organophosphorus compound could help amelerioating the harmful effects of such poisoning.KYAMC Journal Vol. 9, No.-3, October 2018, Page 133-135


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Hisham A. Almetaher ◽  
Mohammed Awad Mansour

Abstract Background Meckel’s diverticulum (MD) is the commonest congenital abnormality of the gastrointestinal tract that occurs in 2% of general population. It remains asymptomatic, but it may lead to life-threatening complications. These complications may be misdiagnosed with other gastrointestinal disorders like acute appendicitis, making its diagnosis challenging among pediatricians and pediatric surgeons. In this study, we reported five cases with different presentations of complicated MD in children. Results Five patients with different presentations of MD were reported during the period from January 2016 to January 2020. Patients’ demographics, clinical presentations, investigations, operative data, and postoperative outcome were recorded and analyzed. Conclusions The present study highlights different presentations of MD. Surgical interference is the main key of treatment of symptomatic MD either by wedge resection of a small base diverticulum or by resection anastomosis of the small intestine in wide base and inflamed diverticulum.


2021 ◽  
pp. 9-9
Author(s):  
Neelkamal Gupta ◽  
Mangtani Jitendra K ◽  
Khandelwal Dheeraj K

INTRODUCTION:Apeptic ulcer is a defect in the upper gastrointestinal mucosa that extends through the muscularis mucosa into deeper layers of the gut wall. Non-steroidal anti-inammatory drugs (NSAIDs) are the major risk factors for peptic ulcer disease.Long-term use of NSAIDs, however, can cause gastrointestinal (GI) ulcers and potentially life-threatening ulcer complications. MATERIALAND METHOD: The present study was conducted on 100 patients of peptic ulcer of either sex in Department of Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur. History of any other co morbid illness and any drug being taken with its time duration were recorded in detail. RESULT AND DISCUSSION: From this study, it was observed that among the 69 patients of duodenal perforation, 73.91% were taking NSAID. Similarly among the 31 patients of gastric perforation 80.64% were taking NSAID. Overall total 76% patients were taking these drugs. CONCLUSION: It is concluded from this study that a strong statistical correlation was found between use of NSAIDs and peptic ulcer perforation.


2021 ◽  
Vol 10 (9) ◽  
pp. 577-582
Author(s):  
Mani Kathapillai

BACKGROUND Hand size measurements are commonly used references when instruments are not available and still practiced in rural and even in urban areas of Tamil Nadu. Ancient literature evidences have adequate support for their usage. We wanted to correlate hand span length, hand breadth, and hand length with the stature of an individual. We also wanted to compare the level of correlation of hand span length between males and females. METHODS 214 students were recruited for this study as a convenient sample size. Male students were 122, females were 92. They were aged between 18 - 23 years of Shri Sathya Sai Medical College and Research Institute. Hand span is the distance between tips of the casually extended pollex and minimus. RESULTS The results of Pearson’s correlations were moderately significant between height and the hand breadth (0.315), between height and weight (0.340), and between height and hand length (0.387). The extent of correlation was significant between height and the hand span (0.954) in case of males. In case of females, value of the correlation was also moderately significant between height and the hand breadth (0.619), between height and weight (0.392), between height and hand length (0.515) and between height and the hand span (0.973). CONCLUSIONS The stature was reliably estimated from the hand span length, and the same could be applied for the medicolegal, and forensic purposes. KEY WORDS Hand Span, Stature, Medico Legal, Anthropometry


Author(s):  
Sara Hayee ◽  
Amna Rehman

Caner a dreadful disease is actually one large group of diseases which dates back to times of “Hippocrates”, The Father of Medicine, (460-370BC) who used this name for the first time to talk about non-ulcer and ulcer forming tumors. Theevidence of its presence from the very past history comes from fossilized “Egyptian Mummies” having tumors on bones. Then Galen (130-200 AD) used the term “Oncos” to explain tumors. So it's a disease involving growth of abnormal cells, their proliferation and metastasizing the other tissues and organs. Now we know that biology has a branch namedOncology to deal with the scientific study of cancer and oncogenes. It took centuries to get knowledge and use modern technologies against this malady. Now we know cancer is a group disease which has hundreds of types. 19th Century saw much advancement towards its cure. Along with surgery, radiotherapy and chemotherapy were the main methods to cure cancer patients. Day by day, scientists are looking for new methods to control and cure of this curse. Hundreds of natural medicinal compounds are being tested to use clinically for its cure in order to replace the radiotherapy andchemotherapy and lower their side effects. But humanity is still fighting against this disease as the numbers of cases throughout the world are increasing day by day. If we look on the reports p r e s e n t e d b y W H O ( W o r l d H e a l t hOrganization), Cancer is the second leading cause of deaths globally which means one person in every six deaths, dies due to cancer. In 2018, the most common types of cancers reported in men were of liver, prostate, stomach, lung andcolorectal. Whereas in females the most common forms were breast, thyroid, cervical and colorectal. Cancer has become a global disasterfamily of the patient. It imparts physical, emotional and financial crisis. Unfortunately, the condition is bitterer in under developing countries. Cancer has become a lifestyle disease these days. We are living in the world withsuperficial comfort but we are breathing with urbanizations, ozone depletion, exposure to microwave and ultraviolet radiations, hazardous chemicals etc. Moreover, It is becoming a lifestyle disease due to lack of exercise, Obesity, consumptions of drugs, tobacco and alcohols. The cases of cancers are reported more in urban areas than in rural areasmore likely due to above mentioned factors. The ratio of cancer patients is expected to raise up-to 27.5 million by 2040 globally. So the battle is never ending, Humans need to figure out the factors and cutting these from their lives in orderto live a healthy life which is a blessing indeed. which is not only crunching the cancer patient but it also has damaging effects on the whole


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Dr Sanjay Bhat ◽  
Anupma Kaul ◽  
Priyanka Rai ◽  
Rohit Srivastav

Abstract Background and Aims Emphysematous pyelonephritis (EPN) is a rare but life-threatening acute suppurative infection of the kidney among diabetics. There is no current consensus on management of EPN. Method A prospective observational study was conducted at Department of General Surgery at RML institute of Medical sciences , Lucknow as well as at Eras Lucknow medical college, Lucknow from 2015-2018 to look for clinical, microbial profile and treatment outcome of diabetic patients with emphysematous pyelonephritis. Results A total of 76 Diabetic patients diagnosed with pyelonephritis were identified, of which 15 patients were diagnosed with EPN (26.3%). The mean age of the patients was 58.4±6.5 years. Mean duration of diabetes was 5.3 ± 3.3 years. 12 (82%) of the 15 patients with DM had a glycosylated hemoglobin A1C level higher than 7.5. Renal dysfunction at presentation was seen in 11 (73.3%) patients. Among the unilateral involvement, left kidney was more affected. Escherichia coli in 11 (73.3%), Klebsiella sp. in 1 (6.6%), Pseudomonas in 1 (6.6%), and 1 each with polymicrobial and fungal UTI respectively. Of 15 EPN patients, 13 (86.6 %) survived and 1 (6.6 %) expired. 2 of them underwent nephrectomy both survived. All patients with Stage I, II and IIIa EPN (n = 12) were managed with antibiotics with or without PCD. In EPN Stage IIIb/IV (n = 3), all the 3 (20 %) patients were managed with antibiotics and PCD and later 2 (13.3%) needed nephrectomy. Only time to diagnosis, altered sensorium, shock at presentation and thrombocytopenia were associated with poor outcome in EPN patients (P &lt; 0.05) Multiple logistic regression tests showed shock (P = .04) and and disturbance of consciousness (P = .05) on hospital admission as being the independent factors for poor outcome. Conclusion EPN in diabetics needs high index of suspicion, timely diagnosis and good multidisciplinary approach with adequate antibiotics and surgical management for better patient outcomes.


Author(s):  
Vinaya Goudar ◽  
Rashmi Naganagoudaru

Background: An acute and life-threatening complication of pregnancy is characterized by the appearance of tonic clonic seizures, in a patient with pre-eclampsia. Objective of the study was to study the efficacy and safety of a ‘single dose’ of magnesium sulphate in treatment of eclamptic convulsions.Methods: The present prospective study was undertaken among women aged between 18-35 years outpatient’s Department of gynecology in Karnataka Institute of Medical Sciences (KIMS) Hubli, Karnataka, India. The study was undertaken during December 2009 to November 2010.Results: The incidence of eclampsia in our study was 2.12%. Eclapmsia is more common in patients from rural (89%) as compared to urban areas (11%) in our study. In our study eclampsia is more common in unbooked cases (80%). Majority of patients (72%) in our study group were illiterates. 61%, 28% of patients had antepartum and intrapartum eclampsia respectively in our study. We had only 11 post-partum convulsions Table 2. 80% of patients in our study were more than 28 weeks of gestations. 65% of the patients had <5 episodes of convulsions. The number of convulsions did not affect the recurrence, and 35% had >5 episodes. In present study 5 Patients had Systolic Blood Pressure less than 140 mmHg. Majority (52) had more than 160 mmHg 42 had in between 140 and 160 mmHg. Diastolic arterial pressure was >110 in 81% of cases. The convulsions were controlled in 75% of women. Recurrence of convulsions occurred in 25% of women after receiving the single dose magnesium sulphate regime. In our study 75% of cases, there was no recurrence of convulsions and in 25% of cases, there was recurrence of convulsions, out of which 20 cases received low dose magnesium sulphate regime and the other 5 cases received Phenytoin regime as 2nd line of treatment.Conclusions: Hence the single dose Magnesium sulphate is safe and effective in controlling convulsions.


2021 ◽  
Vol 6 (2) ◽  
pp. 104-115
Author(s):  
Hosni Mubarak Khan ◽  
◽  
Tirumal Rao Patwari

Objective. This is a prospective study of 50 cases of inguinal hernias which were treated through open inguinal hernia repair techniques. The study was conducted with the objective of comparing the effectiveness of these procedures and complications. Materials and Methods. A number of 50 cases of inguinal hernias admitted to Dr. BR Ambedkar Medical College and Hospital were selected on the basis of the non-probability (purposive) sampling method. All the patients with direct and indirect uncomplicated hernias treated by means of an open approach were included. After the preoperative preparation, they were randomly chosen either for Desarda’s or Modified Bassini’s repair techniques. Results. In the postoperative period, moderate pain was experienced by 19 patients included in the Desarda group and 17 patients included in the Modified Bassini’s repair group on day 1. The postoperative wound infection developed in 2 cases of Desarda and 3 cases of Modified Bassini’s, erythema was observed in 2 cases of Desarda and 3 cases of Modified Bassini’s, 3 cases reported the occurrence of seroma in the Desarda group and 4 cases of seroma were recorded in the Modified Bassini’s group. Conclusions. The patients who underwent Desarda repair complained of a higher intensity of pain, which could probably be attributed to the extensive dissection involved. The duration of Desarda repair was longer due to the learning curve of the surgeons in our hospital. The return to normal gait and normal activities was significantly lower in the Desarda group. The duration of hospital stays and the postoperative complications was not significantly different in the two groups. There were no recurrences in either of the groups until the current study.


Author(s):  
Vidya V. Patil ◽  
Rekha Udgiri

Background: Aging is a universal process. In India, the elderly account for 7.7% of the total population and the United Nations defines a country as “ageing” where the proportion of people over 60 years reaches 7.7%. Morbidity among elderly has an important influence on their physical functioning and psychological well-being. The objectives of the study were to assess the psychosocial problems associated with the elderly and to describe the chronic illness and utilization of welfare services among elderly.Methods: A cross sectional study was conducted in the urban field practice area of Shri B M Patil Medical College, Vijayapur. House to house survey was conducted for a period of 3 months from September to November 2014.Results: Total of 372 elders were interviewed, 54.5% were males, 45.4% were females. Majority were Hindus 78.8%. 46% were illiterate. Majority 79% were financially dependent. 53% were working. Around 32% were feeling lonely Most common chronic illness is joint pain (66.66%), visual problem (50%), dental and chewing problem (48%).Conclusions: Financial dependence was high among the participants and majorities were suffering from one or the other chronic illness which needs attention and knowledge about geriatric welfare services should be given. 


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