scholarly journals A study of non-traumatic gastrointestinal perforations in a tropical country

2021 ◽  
Vol 8 (9) ◽  
pp. 2656
Author(s):  
Prasan Kumar Hota ◽  
Nikitha Bung ◽  
Yeramaneni Venkat Prashanth
Keyword(s):  
Gastrointestinal Perforation ◽  
Clinical Spectrum ◽  
Active Management ◽  
Tropical Country ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Surgical Emergencies ◽  
Clinical Presentations ◽  
Management Protocol ◽  
Enteric Perforation

Background: Gastrointestinal perforations constitute one of the commonest surgical emergencies encountered by surgeons all over the world. However, non traumatic gastrointestinal perforations are more commonly seen in tropical countries. They cause considerable mortality and usually require emergency surgery. This study was designed to study the clinical spectrum of non traumatic gastrointestinal perforation in a tropical country and thereby assessing the surgical outcome.Methods: An observational study was conducted in the department of general surgery, Mamata medical college, Khammam to analyse the clinical spectrum and their management protocol with outcome of the patients presenting with non traumatic gastrointestinal perforation. A total number of 140 patients of various etiologies of non traumating gastrointestinal perforations were found to be treated over a period of six years. Detailed demographic profile, clinical presentations and etiological factors were studied along with various management protocols offered to them with the outcome.Results: Most common age of presentation was 41-60 years with 72%being males. Most common site of perforation was duodenum (28.57%) followed by stomach (25%). Peptic ulcer (53.57%) was the predominant etiology followed by appendicular perforation (15.71%), enteric perforation (12.85%), tubercular (4.28%), malignancy (1.42%) and diverticula (0.71%). Most common post-operative complication was wound infection (37.14%) followed by dyselectrolytaemia (31.42%). Mortality was 7.14%.Conclusions: Gastrointestinal perforations constitute one of the commonest surgical emergencies. Non traumatic gastrointestinal perforations are quite common in a tropical country like India. The high rates of mortality among those, who present late, prompt an early diagnosis and active management protocol in order to reduce mortality and morbidity in such patients.

scholarly journals A STUDY OF SURGICALAPPROACH TO TYPHOID ILEAL PERFORATION

2020 ◽  
pp. 1-3
Author(s):  
Sitesh Kumar Karn ◽  
Ramesh Kumar Ajai ◽  
Debarshi Jana
Keyword(s):  
Primary Closure ◽  
Loop Ileostomy ◽  
Exploratory Laparotomy ◽  
High Rate ◽  
Ileal Perforation ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Clinical Presentations ◽  
Enteric Perforation ◽  
Full Proof

Introduction: Even with variety of procedures, typhoid (enteric) perforation still has a high rate of morbidity and mortality. The aim ofthe present study is to study clinical presentations, to evaluate management pattern of typhoid ileal perforation, to determine mortality and morbidity of perforation and to study the re-exploration rate and causes of re-exploration and its effect on mortality and morbidity. Methods: This prospective observational study was conducted in the Department of Surgery at Nalanda Medical College and Hospital, Patna, Bihar during May 2019toApril 2020. A total 45 patients with typhoid ileal perforation were included in the study. Among them, 32 cases (71%) undergone the simple primary closure of the perforation and peritoneal lavage after refreshing the edge, 7 cases (16%) undergone exploratory laparotomy with proximal loop ileostomy with primary closure and 6 (13%) were operated by exploratory laparotomy with resection anastomosis. Results: Mean duration of the stay for patient undergone PC+PL was 10.20 days and for ileostomy it was 18.4 days and for RA + PL it was18.6 days. Total 37 incidences of complications were found in 45 cases. Among them wound infection was presented in 16 (43%) and burst abdomen presented in 2 (5%) cases. Fecal fistulae, post-operative collection and pneumonitis were present in 4 (11%) cases each. Conclusion: The overall mortality was found nearly 4 percent in our study. The typhoid ileal perforation should be always treatedsurgically. There are many operative techniques to deal with but no one is full proof.

scholarly journals A study of surgical approach to typhoid ileal perforation at a tertiary care hospital of South Gujarat, India

2018 ◽  
Vol 5 (5) ◽  
pp. 1758
Author(s):  
Archana A. Nema ◽  
Jitendra R. Darshan
Keyword(s):  
Primary Closure ◽  
Loop Ileostomy ◽  
Tertiary Care ◽  
Exploratory Laparotomy ◽  
High Rate ◽  
Care Hospital ◽  
Ileal Perforation ◽  
Mortality And Morbidity ◽  
Clinical Presentations ◽  
Enteric Perforation

Background: Even with variety of procedures, typhoid (enteric) perforation still has a high rate of morbidity and mortality. The aim of the present study is to study clinical presentations, to evaluate management pattern of typhoid ileal perforation, to determine mortality and morbidity of perforation and to study the re-exploration rate and causes of re-exploration and its effect on mortality and morbidityMethods: This prospective observational study was conducted in the Departments of Surgery at Surat Municipal Institute of Medical Education and Research, Surat during June 2008 till October 2010. A total 45 patients with typhoid ileal perforation were included in the study. Among them, 32 cases (71%) undergone the simple primary closure of the perforation and peritoneal lavage after refreshing the edge, 7 cases (16%) undergone exploratory laparotomy with proximal loop ileostomy with primary closure and 6 (13%) were operated by exploratory laparotomy with resection anastomosis.Results: Mean duration of the stay for patient undergone PC+PL was 10.20 days and for ileostomy it was 18.4 days and for RA + PL it was 18.6 days. Total 37 incidence of complications were found in 45 cases. Among them wound infection was presented in 16 (43%) and burst abdomen presented in 2 (5%) cases. Fecal fistulae, post-operative collection and pneumonitis were present in 4 (11%) cases each.Conclusion: The overall mortality was found nearly 4 percent in our study. The typhoid ileal perforation should be always treated surgically. There are many operative techniques to deal with, but no one is full proof.

scholarly journals A CLINICAL STUDY AND OUTCOME OF PERFORATIVE PERITONITIS IN A RURAL BASED TEACHING HOSPITAL

2020 ◽  
pp. 1-2
Author(s):  
Kaushik Mandal ◽  
Mohan Kumar Das ◽  
Santanu Dutta ◽  
Anirban Bhunia
Keyword(s):  
Wound Infection ◽  
Early Recognition ◽  
Wound Dehiscence ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Post Operative Period ◽  
Surgical Emergencies ◽  
Study Results ◽  
Perforative Peritonitis ◽  
Gastro Intestinal Tract

Background Peritonitis due to perforation of gastro intestinal tract one of the commonest surgical emergencies all over the world and the most common surgical emergency in India. Aims and objectives to evaluate role of clinical assessment and usefulness of basic investigations in diagnosis and follow-up, to evaluate incidence of wound infection, wound dehiscence in post-operative period, to assess mortality upto1 month of post-operative period. Methods All consenting patients above 18 years treated with symptoms and signs of perforative peritonitis in Burdwan Medical College and Hospital from March 2018 to August 2019 were included in this institution based, interventional, prospective, non-randomised, analytical study. Results We found that 40(80.0%) patients had gas under diaphragm in Chest X-ray report. It was found that 9(18.0%) patients had acute appendicitis, 1(2.0%) patient had appendicular perforation and 40(80.0%) patients had perforative peritonitis. We found that 30(60.0%) patients had chest infection. 10(20.0%) patients had wound infection.6 (12.0%) patients had wound dehiscence. Conclusion Early recognition of symptoms and referral is very important in reducing mortality and morbidity.

scholarly journals Causes and management of secondary postpartum haemorrhage in a tertiary medical college hospital in Bangladesh

2017 ◽  
Vol 6 (7) ◽  
pp. 2694
Author(s):  
Kamrun Nessa ◽  
Sumia Bari ◽  
Sanjida Khan ◽  
Ferdowsi Sultana ◽  
Tania Akbar
Keyword(s):  
Maternal Morbidity ◽  
Postpartum Haemorrhage ◽  
Mode Of Delivery ◽  
Wound Dehiscence ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Maternal Mortality And Morbidity ◽  
Postnatal Women ◽  
Low Incidence

Background: Globally postpartum haemorrhage remains a leading cause of maternal death. It affects only 1-2% of postnatal women. This low incidence of secondary PPH and linkage to maternal morbidity rather than mortality was the reason for the little attention among obstetricians, but it is recently gaining importance and interest with the increase morbidity and mortality related to secondary PPH.Methods: A retrospective study was conducted on the diagnosed patients of secondary PPH admitted in Enam Medical College and Hospital, Dhaka, Bangladesh, from January 2015 to December 2016. Among 33 cases of secondary PPH age of the patients, parity, mode of delivery, causes and management were noted from medical records. All data was analyzed by SPSS16.Results: Among 33 patients 14 (42.4%) were primi and 19 (57.6%) were multipara, age between 18 to 38 years, majority admitted 2nd and 3rd week after delivery. Among 33 patients 12% delivered vaginally at home and 30% vaginally at hospital and 58% undergone LUCS. We found 34% retained bits of placenta, 27% uterine wound dehiscence, 24% retained clots and 15% endometritis as causes. Less than 3 units blood needed in 22 (66.7%) patients and 11 (33.3%) needed more than 3 units. About 6 (18%) patients were treated conservatively, MVA were needed in 18 (55%) patients, repair of wound in 4 (12%) and TAH was in 5 (15%).Conclusions: Secondary PPH is increasing may result in significant maternal morbidity as well as mortality. More study needed to identify the risk factors and causes to reduce maternal mortality and morbidity.

scholarly journals Patients Characteristics in a General Intensive Care Unit (GICU): Facts and Outcomes

KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 678-680
Author(s):  
Kamrunnahar Alo ◽  
Md Mahfuzar Rahman ◽  
Rahena Khatun
Keyword(s):  
Tertiary Care ◽  
Support Service ◽  
Admission Diagnosis ◽  
Technological Advancement ◽  
Management Skills ◽  
College Hospital ◽  
Team Members ◽  
Medical College ◽  
Diagnosis And Prognosis ◽  
Management Protocol

Background: Patient's management during emergency differs significantly between countries. However, technological advancement and requirement of quality support service as well as survivality is a great concern towards reduced hospital mortality.Aim and Objectives: The aim of this study is to find out patient's characteristics admitted at GICU of Khwaja Yunus Ali Medical College Hospital (KYAMCH) in order to investigate selected variables like; the duration of stay at GICU, their health problems on admission, diagnosis and prognosis including certain demographic characteristics in particular.Methods and Materials: This was an exploratory study on patient's characteristics during the period from January to June 2015 at GICU of KYAMCH. The data were collected through record review according to variables available on GICU admission register.Results: Total 163 cases were studied in 6 months. Among them 98 (60.12%. were male & 65 (39.88%) were female. The mean age of admitted male patients were 47 & in female it was 40 years with mean ± 16 and 17 years respectively. In addition GICU stays were found up to 5 days among 76.58% patients. The study revealed septic shock, cancer, injury and CVD as the common emergencies that needed skillful attention. Moreover, death and Discharge on Risk Bond (DORB) were found unwanted outcomes (52.23%) that also need to be addressed through developing skilled management protocol at GICU of concern tertiary care hospital.Conclusions: The findings will help hospital managers to identify necessary support needed as well. It will also help to identify emergency management skills needed for the GICU personnel team members in particular. Thus it can be a basis for the hospital administrators to take appropriate measures in towards reducing hospital mortality rate as well.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 678-680

scholarly journals Risk factor Analysis and Angiographic Profiles in First 228 Cases Undergone Coronary Angiography in Cardiac Cath Lab of Dhaka Medical College Hospital

1970 ◽  
Vol 3 (2) ◽  
pp. 122-125 ◽  
Author(s):  
AEMM Islam ◽  
M Faruque ◽  
AW Chowdhury ◽  
HIR Khan ◽  
MS Haque ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Coronary Angiography ◽  
Medical Therapy ◽  
Stable Angina ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Single Vessel

Background: Coronary artery diseases are one of the major challenges faced by cardiologists. Control of certain risk factors for CAD is associated with decrease in mortality and morbidity from myocardial infarction and unstable angina. So, identification and taking appropriate measures for primary and secondary prevention of such risk factors is, therefore, of great importance. This retrospective study was carried at the newly set up cath lab in Dhaka Medical college. Materials and Methods: Total 228 consecutive case undergone diagnostic coronary angiogram from 10th January 2007 to31st January 2009 out of which 194(80%) were male and 34 (20%) were female. In both sexes most of the patients were between 41 to 60 years of age. Risk factors of the patients were evaluated. Results: In females commonest risk factor was Diabetes (58.8%) followed by dyslipidaemia (35.3%). In males commonest risk factor was hypertension (30.9%) followed by smoking (29.9%) and diabetes (28.3%). In males 44.3% patients presented with acute myocardial infarction followed by stable angina (43.3%); but in females stable angina was the commonest presentation (50.0%) followed by myocardial infarction (38.2%).CAG findings revealed that in males 33.5% had double vessel disease 26.8% followed by single vessel 26.8% and multivessel disease 25.3%. In females normal CAG was found in 35.5% followed by double vessel 23.5%, multivessel 20.6% and single vessel 20.6%. On the basis of CAG findings; in males 41.8% patients were recommended for CABG, followed by PTCA & stenting 26.3% and medical therapy 30.0%; where as in females 55.9% were recommended for medical therapy , followed by CABG 32.4% and PTCA & stenting11.8%. Conclusion: The commonest presentation of CAD was 4th and 5th decades in both sexes. Diabetes and dyslipidaemia were more common in females whereas hypertension and smoking were more common in males. Myocardial infarction and stable angina were most common presentation in both sexes though in males myocardial infarction was more common. In males the angiographic severity of CAD was more and they were more subjected for CABG in comparison to females. Key words: Risk factors; Coronary angiography. DOI: http://dx.doi.org/10.3329/cardio.v3i2.9179 Cardiovasc. J. 2011; 3(2): 122-125

scholarly journals Study of aetiology and clinical spectrum of patients with acute undifferentiated fever, in a tertiary care setting: a descriptive cross-sectional study

2021 ◽  
Vol 8 (10) ◽  
pp. 1566
Author(s):  
Vinay Jishtu ◽  
Pramod K. Jaret ◽  
Prem Chand Machhan ◽  
Nidhi Chauhan
Keyword(s):  
Tertiary Care ◽  
Febrile Illness ◽  
Cross Sectional Study ◽  
Clinical Spectrum ◽  
Sectional Study ◽  
Hospital Data ◽  
Cross Sectional ◽  
Medical College ◽  
Gandhi Medical College ◽  
Study Participants

Background: Acute undifferentiated fever illness (AUFI) is a common cause of morbidity and mortality in developing countries, owing to its non-specific features. The aim of the study was to delineate the causes and clinical parameters associated with AUFI.Methods: A cross-sectional study was done among 156 patients of AUFI, admitted in the Department of Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from November 2018 to October 2019.Results: The mean age of the study participants was 37.37±14.2 years. The study participants admitted for acute undifferentiated febrile illness had fever with mean duration of 8.38±3.7 days before hospitalization. The most common aetiology of AUFI was found to be enteric fever (44%), followed by scrub typhus (35%). The majority of the cases presented from the month of September to December.Conclusions: The aetiology and clinical spectrum of AUFI is wide and variable. To outline a proper algorithm to contain it, meticulous analysis of the hospital data at each level is necessary.

scholarly journals Surgical management and perioperative complications of peritonitis secondary to hollow viscus perforation in a tertiary care centre

2021 ◽  
Vol 8 (11) ◽  
pp. 3359
Author(s):  
Lokesh M. G. ◽  
S. Chandrashekar ◽  
Arundathi Raikar ◽  
Abhishek S. S.
Keyword(s):  
Perioperative Complications ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Threatening Condition ◽  
Hollow Viscus Perforation

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.

scholarly journals Cornu cutaneum of Pinna

2019 ◽  
Vol 27 (2) ◽  
pp. 176-178
Author(s):  
Satish Kumar C ◽  
Bharathi K V ◽  
Kumaran Ramesh Colbert ◽  
Sophia A
Keyword(s):  
Case Report ◽  
Early Intervention ◽  
Clinical Condition ◽  
Histopathological Examination ◽  
Elderly Men ◽  
Tropical Country ◽  
Mortality And Morbidity ◽  
Cornu Cutaneum ◽  
Associated Conditions ◽  
Malignant Condition

Introduction Cornu cutaneum is a nodule of dense keratin, resembling the horn of animals, an uncommon clinical condition predominantly seen in elderly men, and even rare to be seen on the pinna.   Case Report A 70 year old man, presented with a horn like swelling on the left pinna for 2 years. The lesion was excised and histopathological examination did not show any underlying or associated conditions.  Discussion The cause of worry here is not the disfigurement, but the probability of underlying premalignant or malignant condition. Exposure to sunlight is considered as the etiology. Ours being a tropical country where exposure to sunlight could not be avoided, a high clinical vigil and early intervention is recommended to reduce the mortality and morbidity from the spectrum of diseases resembling this condition.

scholarly journals Neonatal candidiasis: clinical spectrum and epidemiology in a tertiary care centre

2017 ◽  
Vol 4 (2) ◽  
pp. 438
Author(s):  
Bhavana Koppad ◽  
Kulkarni Poornima Prakash
Keyword(s):  
Candida Albicans ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Candida Guilliermondii ◽  
Clinical Spectrum ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Neonatal Candidiasis

Background: Candidial infections are a serious problem in neonatal intensive care units (NICU) which increases the mortality and morbidity in addition to increasing health care costs. Confirming the diagnosis by laboratory tests is difficult and a high index of suspicion is required. The objective of this study was to identify the clinical spectrum and epidemiology of neonatal candidiasis in a tertiary care NICU.Methods: The present study was carried out in the NICU of SDM medical college and hospital, Dharwad. All babies who were admitted to NICU and who had positive blood culture for Candida were included in the study. One year Data (1st December 2015 to 31st November 2016) was collected retrospectively from NICU case records. Statistical test used was chi square test.Results: Total admissions to the NICU during the study period were 2591. Blood cultures were positive in 132 babies. Among these, Candidial sepsis was noted in 39.39% (52) babies. Out of the 52 positive fungal cultures, 15 were Candida albicans, 35 were Candida non albicans and 2 were mixed cultures (Candida albicans and non albicans) showing an increasing incidence of non-albicans Candida infections. Among the non albicans Candida, Candida tropicalis and Candida guilliermondii were the predominant species (11 each) followed by Candida famata (6), Candida krusei (6) and Candida parapsilosis (3). Candidial sepsis was seen to be more common among preterm and low birth weight babies. Usage of antibiotics, Total parenteral nutrition (TPN) and mechanical ventilation were common risk factors noted in our study.Conclusions: Systemic Candidiasis is a disease of modern neonatal intensive care. It deserves urgent attention for its prevention as well as effective treatment in order to minimize neonatal morbidity and mortality.

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