scholarly journals Acute intestinal obstruction in adults: etiology, clinical presentation, investigations and management: a longitudinal study

2020 ◽  
Vol 8 (1) ◽  
pp. 170
Author(s):  
Pankaj Bargaje ◽  
Nitin Wasnik
Keyword(s):  
Longitudinal Study ◽  
Intestinal Obstruction ◽  
Tertiary Care ◽  
Intestinal Tuberculosis ◽  
Age Distribution ◽  
Previous History ◽  
Operative Management ◽  
Standing Position ◽  
Acute Intestinal Obstruction ◽  
History Of

Background: Aim of the study was to evaluate the causes of acute intestinal obstruction, modes of presentation and outcome of conservative and operative management in acute intestinal obstruction.Methods: The study was conducted in tertiary care academic hospital from November 2017 to October 2019. 60 Patients over 18 years of age who were diagnosed with acute intestinal obstruction were included in this study.Results: The result of present study showed that mean age distribution was 46±15.4 years. Incidence in males was more compared to females. Pain in abdomen was found in 54 (90%), vomiting in 38 (63%), distension of abdomen in 37 (61%) and constipation in 42 (70%) as patient’s chief complaint. Commonest cause was adhesions followed by obstructed inguinal hernia.Conclusions: From the result of present longitudinal study it can be concluded that conservative management can be tried in patients with previous history of abdominal operation and intestinal tuberculosis. Acute intestinal obstruction was more common in male than female. X ray abdomen in standing position and USG helps in ascertaining the site of intestinal obstruction.

scholarly journals Clinical study of acute intestinal obstruction in tertiary care centre

2017 ◽  
Vol 4 (9) ◽  
pp. 2903
Author(s):  
Vikas M. Daddenavar ◽  
Pramod Mirji ◽  
Ishwar Kalburgi
Keyword(s):  
Intestinal Obstruction ◽  
Tertiary Care ◽  
Age Distribution ◽  
Age Groups ◽  
Acute Intestinal Obstruction ◽  
Postoperative Adhesions ◽  
Tertiary Care Centre ◽  
X Ray ◽  
Main Complaint ◽  
Pain Abdomen

Background: Acute intestinal obstruction is one of common abdominal emergencies and is associated with significant morbidity and mortality, especially if it progresses to bowel ischemia. The aim of this study is to analyse various modes of presentation of acute intestinal obstruction in both children and adult age group, etiopathogenesis, various therapeutic modalities of treatment and to accomplish operative management and anticipate the post-operative complication.Methods: Fifty consecutive patients of all age groups presenting with acute intestinal obstruction were admitted in SN Medical College HSK hospital were taken randomly and managed between February 2013 to February 2016. A detailed examination was done as per proforma after admission. Plain X-ray erect abdomen was done in all cases except inguinal hernias with obstruction.Results: Mean age distribution was 35.4 years. Incidence in male was more compared to female. Pain abdomen was found in 39 (78%), vomiting in 35 (70%), distension abdomen in 29 (58%) and constipation in 26 (52%) patients as main complaint. Commonest cause was postoperative adhesions. Mean duration of stay in hospital was between 1-5 weeks (average 2 weeks).Conclusions: All age groups were involved. More commonly found in males than females. Main complaint was pain abdomen followed by vomiting, distension and constipation. Plain X-ray abdomen and ultrasonography were important. Pathology ranged from simple bands to malignant obstruction. Postoperative adhesions were the commonest cause of obstruction. Earlier the presentation better the outcome was found.

scholarly journals Clinical study of bowel obstruction in relation to etiological factors

2017 ◽  
Vol 4 (2) ◽  
pp. 485 ◽  
Author(s):  
Pradeep Kumar Chitumalla ◽  
Naresh Kumar Vemulapally ◽  
Surya Narayana Reddy
Keyword(s):  
Intestinal Obstruction ◽  
Age Distribution ◽  
Age Groups ◽  
Operative Management ◽  
Acute Intestinal Obstruction ◽  
Female Population ◽  
X Ray ◽  
Adult Age ◽  
Abdominal Emergency ◽  
Therapeutic Modalities

Background: Acute intestinal obstruction is one of common abdominal emergency and is associated with significant morbidity and mortality, especially if it progresses to bowel ischemia. The aims of this study was to analyse various modes of presentation of acute intestinal obstruction in both children and adult age group, etiopathogenesis, various therapeutic modalities of treatment and to accomplish operative management and anticipate the post operative complications.Methods: 50 consecutive patients of all age groups presenting with acute intestinal obstruction were admitted were taken randomly and managed between October 2013 to September 2015.Out of these 50 cases, 36 were male, 14 were female, patients with subacute intestinal obstruction and patients with paralytic ileus were excluded in this study. Plain X-ray erect abdomen was done in all cases. Ultrasonography was done only in those patients whose X-ray finding was inconclusive. CT as a modality also included for work up.Results: Mean age distribution was 35.4years and the standard deviation measured 24.57. Incidence in male (36) was more as compared to female population (14). Pain abdomen was found in 45(90%) patients, vomiting in 35(70%) patients, distension abdomen in 34 (68%) patients and constipation in 30 (60%) patients were noted as many patients had coincidence of symptoms. Commonest cause of acute intestinal obstruction noted was postoperative adhesions.Conclusions: Postoperative adhesions were the commonest cause of obstruction. Earlier the presentation, the better the outcome was found.

scholarly journals THE PATTERN OF ACUTE INTESTINAL OBSTRUCTION: A HOSPITAL BASED. STUDY..

2019 ◽  
pp. 1-3
Author(s):  
Sunil Kumar Patanaik ◽  
Chaitali Pattanayak*
Keyword(s):  
Intestinal Obstruction ◽  
Age Groups ◽  
Operative Management ◽  
Acute Intestinal Obstruction ◽  
Common Symptom ◽  
Common Procedure ◽  
Therapeutic Modalities ◽  
Study Results ◽  
Obstructed Hernia ◽  
Subacute Intestinal Obstruction

BACKGROUND: Intestinal obstruction is a surgical emergency that causes confusion both in the diagnosis and the management. It is related by important disease and mortality. The goal of this study was to classify the etiology, to analyse the methods of performance of acute duodenal obstruction in different age groups, various therapeutic modalities of treatment, to accomplish operative management, anticipate the post-operative complications and outcomes of patients with acute intestinal obstruction. MATERIAL& METHODS: 82 patients of all age groups (except infants) presenting with acute intestinal obstruction were studied between June 2017 and December 2018 in a multispeciality hospital in Eastern India. Patients with history of subacute intestinal obstruction and paralytic ileus were excluded from this study. RESULTS: Males were found to be affected much more than females. Pain abdomen was the most common symptom found in 94% cases followed by distension and vomiting in 86.6% and 68.3% cases respectively. Most common etiology of intestinal obstruction was due to adhesion and bands (40.3%) followed by obstructed hernia (22%) and malignancy (17%). The most common procedure done in intestinal obstruction in present study was release of adhesions and bands (37.8%) followed by resection and anastomosis (26.8%). CONCLUSION: Bowel obstruction continues to be one of the most common abdominal problems faced by general surgeons. Success in the treatment of intestinal obstruction depends largely upon early diagnosis, skilful management and treating the pathological effects of the obstruction just as much as the cause itself.

6123A novel ECG parameter predicts lack of eligibility for Subcutaneous Implantable Cardioverter Defibrillator (S-ICD) in patients with Brugada Syndrome

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Mazzanti ◽  
S Marelli ◽  
T Chargeishvili ◽  
A Trancuccio ◽  
M Marino ◽  
...  
Keyword(s):  
Brugada Syndrome ◽  
Multivariable Analysis ◽  
Previous History ◽  
Standing Position ◽  
Implantable Cardioverter Defibrillators ◽  
S Wave ◽  
History Of ◽  
Automated Screening ◽  
Screening Sensitivity

Abstract Background A conclusive estimate of the eligibility rate for the use of subcutaneous implantable cardioverter defibrillators (S-ICD) in patients with Brugada Syndrome (BrS) is lacking. Objective We aimed to: 1) evaluate the eligibility for S-ICD in patients with BrS using a novel automated tool; 2) investigate predictors of ineligibility for S-ICD, based on baseline 12-lead electrocardiogram. Methods Automated screening for S-ICD was performed in 118 consecutive BrS patients using the programmer provided by the S-ICD producer. The system automatically assessed the acceptability of each of the three sense vectors used by the S-ICD for the detection of cardiac rhythm. Eligibility was defined when at least one vector was acceptable both in supine and standing position. Results The clinical characteristics of 118 BrS patients were as follow: age 43±11 years; 89% males; 2% with aborted cardiac arrest; 14% with a history of syncope; 81% with spontaneous type 1 ECG pattern; 21% with a familial history of sudden cardiac death; 24% with an SCN5A mutation. No patients had an indication for pacing. Only 8/118 (7%) patients were ineligible for S-ICD. Of note, 5/8 (63%) patients who failed the screening exhibited a slurred S wave of ≥80 ms duration in the peripheral lead aVF on the 12-lead baseline electrocardiogram, vs. 4/110 (4%) of those who passed the screening (sensitivity of S wave in aVF for screening failure 63%, specificity 97%; p<0.001). Remarkably, the presence of a slurred S wave of ≥80 ms duration in lead aVF remained significantly associated to the failure of eligibility for S-ICD (odds ratio 50, p<0.001) in a multivariable analysis that included the previous history of symptoms, the presence of a spontaneous type 1 ECG pattern, the gender and the presence of SCN5A mutations. ECG predictor of S-ICD screening Conclusion Up to 93% of BrS patients are eligible for S-ICD when the automated screening tool is used. The presence of a slurred S wave in lead aVF on the 12-lead electrocardiogram is a powerful predictor of screening failure.

scholarly journals A study on risk factors, maternal and foetal outcome in cases of preeclampsia and eclampsia at a tertiary care hospital of South India

2017 ◽  
Vol 7 (1) ◽  
pp. 266
Author(s):  
Bandaru Sailaja ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Sailcheemala ◽  
Surayapalem Sailaja
Keyword(s):  
Risk Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Previous History ◽  
Developed Countries ◽  
Reproductive Technologies ◽  
Care Hospital ◽  
History Of ◽  
Foetal Outcome ◽  
In Pregnancy

Background: Hypertension in pregnancy remains still a major health issue for women and their descendants throughout the world but remains a major issue in developing countries rather than developed countries. Eclampsia accounts for 24% of maternal deaths during pregnancy in India according to FOGSI study in India. Changing trends in pregnancy globally with increased maternal age of conception, assisted reproductive technologies has contributed a significant impact in the risk factors for PE and eclampsia. The present study was aimed to investigate and determine the related risk factors in cases of PE and eclampsia. The maternal and foetal outcomes with major complications of the women with PE and eclampsia were also studied.Methods: A prospective cross sectional study for a period of two years was conducted at a tertiary care hospital among antenatal cases and all cases of PIH were recorded and studied. Cases were managed as per the existing obstetric protocol after clinical examination and investigations. Detailed socio demographic data and history of risk factors were collected and entered into Microsoft excel sheet and analyzed. Maternal and foetal outcome were noted in the cases of the study.Results: The incidence of PE and eclampsia in the study was 43.3% and 10.8%, 25-35 years age group being the most common. PE and eclampsia was associated with BMI>30, parous women with previous history of PE, diabetes mellitus and more in unregistered cases. PE and eclampsia were more in Illiterates and socio economic class 2 &3. The incidence of maternal complications was 32.99% with premature labour being the common and in case of foetal complications prematurity was the commonest with 16 cases. The maternal mortality was very less with only 4.64% in the study.Conclusions: Pregnancy induced hypertension with PE and eclampsia still remains a major problem in developed countries. Good antenatal care with increased awareness and increased antenatal visits may help in reducing the incidence and maternal and foetal complications. Increased incidence among illiterates and low socio economic status group provides the target group to be directed against any medical measures and national health programmes.

scholarly journals Incidence of and Factors Associated with New-Onset Insomnia Among Lebanese Hospitalised Patients

2021 ◽  
Vol 21 (2) ◽  
pp. e210-220
Author(s):  
Nour Sakr ◽  
Souheil Hallit ◽  
Hanna Mattar
Keyword(s):  
Tertiary Care ◽  
Previous History ◽  
Severity Index ◽  
Cardiac Monitoring ◽  
Sleep Wake Disorders ◽  
Tertiary Care Centre ◽  
Post Discharge ◽  
Hospitalised Patients ◽  
History Of ◽  
New Onset

Objectives: This study aimed to determine the incidence and post-discharge resolution of new-onset insomnia in hospitalised patients with no previous history of insomnia, as well as to define major correlates of in-hospital insomnia. Methods: This prospective observational study was conducted between November 2019 and January 2020 at a tertiary care centre in Lebanon. All hospitalised patients >18 years of age with no history of insomnia were screened for new-onset insomnia using the Insomnia Severity Index (ISI) scale. Subsequently, patients were re-assessed two weeks after discharge to determine insomnia resolution. Results: A total of 75 patients were included in the study. Of these, nine (12%) had no insomnia, 34 (45.3%) had subthreshold insomnia, 22 (29.3%) had moderate insomnia and 10 (13.3%) had severe insomnia. The mean ISI score was 14.95 ± 6.05, with 88% of patients having ISI scores of >7 (95% confidence interval: 0.822–0.965). The frequency of new-onset insomnia was significantly higher among patients who shared a room compared to those in single-bed rooms (95.7% versus 75%; P = 0.011). Other factors were not found to be associated with new-onset insomnia, including the administration of medications known to cause insomnia, in-hospital sedative use, overnight oxygen, cardiac monitoring and self-reported nocturnal toilet use. Overall, insomnia resolution occurred in 78.7% of patients two weeks after discharge. Conclusion: There was a high incidence of acute new-onset insomnia among hospitalised patients at a tertiary centre in Lebanon. Additional research is recommended to further examine inhospital sleep disturbance factors and to seek convenient solutions to limit insomnia. Keywords: Sleep Wake Disorders; Insomnia; Hospitalization; Incidence; Risk Factors; Lebanon.

scholarly journals Spectrum of Gestational Trophoblastic Disease Secondary to Dilation and Evacuation - Our Experience at a Tertiary Care Centre in Mullana, Ambala

2021 ◽  
Vol 10 (16) ◽  
pp. 1106-1113
Author(s):  
Akshat Kuchhal ◽  
Harneet Narula ◽  
Amit Jain ◽  
Shivangi Jain
Keyword(s):  
Wide Spectrum ◽  
Venous Malformation ◽  
Tertiary Care ◽  
Previous History ◽  
Gestational Trophoblastic Disease ◽  
Reproductive Age ◽  
Trophoblastic Disease ◽  
Trophoblastic Diseases ◽  
Gestational Trophoblastic Diseases ◽  
History Of

BACKGROUND Gestational trophoblastic diseases have varying clinical presentations with certain diagnostic signs and symptoms. A strong correlation between gestational trophoblastic diseases (GTD) and a previous history of dilation & evacuation (D & E) has been documented in the limited available literature. We wanted to study the spectrum of gestational trophoblastic disease secondary to dilation & evacuation. METHODS A two-year study including all the females who were admitted to MMIMSR Hospital in view of suspicion of gestational trophoblastic disease was conducted with all having a common history of dilatation and evacuation in the recent past. RESULTS Through the analysis we saw the spectrum of GTD including partial mole, complete mole, invasive mole and choriocarcinoma, as well as its complications in the form of arterio-venous malformation (AVM). CONCLUSIONS The two-year experience suggests that dilatation and curettage may predispose a female of reproductive age group to develop gestational trophoblastic disease in the future. Hence, a high index of suspicion is necessary for timely diagnosis and intervention. The study further helped us understand the wide spectrum of the disease and its associated complications. KEY WORDS Abortion, AVM, Dilatation and Evacuation, GTD, GTN

scholarly journals Current Spectrum of Intestinal Obstruction in a Teaching Hospital

2019 ◽  
Vol 32 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Tamanna Tasnim ◽  
Md Mizanur Rahman ◽  
Ariful Alam ◽  
Rupsha Nura Laila ◽  
Abdul Matin ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Tertiary Care ◽  
Intestinal Tuberculosis ◽  
Large Bowel Obstruction ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Current Spectrum ◽  
Previous Laparotomy

Intestinal Obstruction is a common surgical emergency and constitutes a major cause of morbidity and financial expenditure in hospitals around the world. This study aimed to provide the current spectrum of intestinal obstruction in a tertiary care hospital with a special view to identify any change in the aetiologic pattern. This prospective observational study was carried out in all four surgical units of Rajshahi Medical College Hospital from September 2010 to August 2011. The study included 250 adult patients with clinical and radiological evidence of complete intestinal obstruction. Out of 250 consecutive patients ranging between (13-90) years with a male to female ratio of 2.1:1, the maximum cases were within (31-40) years and (51-60) years of age group. In this study 175 cases (70%) were presented with small bowel and 75 cases (30%) with large bowel obstruction. The main causes of obstructions were bands and adhesions (44%) followed by volvulus (18%), external hernias (16%), neoplasm (12%), intussusceptions (3.2%), intestinal tuberculosis (2.8%) and miscellaneous (4%). Approximately, 86% patient with adhesive obstructions had previous laparotomy while 42% needed surgical exploration for failed conservative management. The overall mortality was 8%; mainly owing to strangulating obstruction and old age. Varying degrees of wound infections were the common post-operative complications. There was a significant change in the aetiologic pattern of intestinal obstruction. Post operative adhesions were the commonest cause of obstruction and appendicectomy was the most common previous operation causing adhesion. TAJ 2019; 32(1): 62-69

scholarly journals Clinical study of adhesion obstruction at a tertiary care hospital: a prospective observational study

2021 ◽  
Vol 8 (4) ◽  
pp. 1201
Author(s):  
Iqbal Saleem Mir ◽  
Younis Bashir ◽  
Yaser Hussain Wani ◽  
Younis Dar ◽  
Shiwani Thakur ◽  
...  
Keyword(s):  
Observational Study ◽  
Intestinal Obstruction ◽  
Surgical Procedure ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Abdominal Distension ◽  
Acute Intestinal Obstruction ◽  
Predisposing Factors ◽  
Clinical Feature ◽  
Care Hospital

Background: Adhesion obstruction is one of the most common presentations of acute abdomen and an important cause of general surgical consultation. This study aimed to analyse demographic features, clinical features, predisposing factors, and management of this surgical problem.Methods: The present study was a prospective observational study and was conducted in the Department of General Surgery of SMHS hospital entitling 267 patients who were diagnosed and treated over 5 years from May 2014 to April 2019.Results: The most common age group diagnosed with acute intestinal obstruction was between 31 to 40 years, with the incidence more in males (65.5%) as compared to females (34.4%). The most common clinical feature was abdominal pain (98.1%) followed by vomiting (93.6%), constipation (86.1%) abdominal distension (82.3%). Postoperative adhesions (40.07%) followed by obstructed hernias (23.3%) and malignancies (14.6%) were the most common predisposing factors. Ischemia was the most common complication in 11.2% of patients followed by necrosis at 6.7% and perforation at 2.9%. Adhesiolysis was the most common surgical procedure performed 43.8% followed by anatomical repair 21.7% and resection and end to end anastomosis 15.3%, enterotomy 10.86%, and Hartman’s procedure 8.2%.Conclusions: Adhesive intestinal obstruction is an important surgical emergency. Post-operative adhesions remain the most common cause of acute intestinal obstruction, with patients most commonly presenting with pain abdomen, all necessary steps must be taken to lessen the chances of adhesions after any surgical procedure.

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