A CLINICOPATHOLOGICAL STUDY IN PATIENTS OF ACUTE APENDICITIS AND CORRELATION OF SYMPTOMS WITH DIFFERENT POSITIONS SEEN INTRAOPERATIVELY

2021 ◽  
pp. 25-29
Author(s):  
Sandip Kumar Ghosh ◽  
Ajay Halder ◽  
Arnab Mishra ◽  
Prabir Biswas
Keyword(s):  
Acute Appendicitis ◽  
Prospective Observational Study ◽  
Signs And Symptoms ◽  
Vermiform Appendix ◽  
Female Ratio ◽  
Medical College ◽  
Study Results ◽  
Male Female Ratio ◽  
Recurrent Appendicitis ◽  
Pelvic Position

INTRODUCTION: The appendix, another named vermiform appendix (from the Latin ward-appendix means “dangling” + “vermis”+ “form” i.e.-dangling worm-shaped thing) is a diverticulum of caecum and marks the beginning of the colon in the conuence of taenias. The appendix is posteromedially attached to the caecum, about 2cm below the ileocecal junction. Taking into account that often the appendix is a mobile structure, the medical 9 importance of its relative position has been questioned by some authors. In general, however some authors describe a signicant relationship between its location and sign and symptoms of acute appendicitis. OBJECTIVES:1.To study the commonest position of appendix seen intraoperatively among the patients with acute appendicitis present in Emergency and OPD of Burdwan Medical College. 2.To identify the commonest position responsible for of gangrenous appendix and appendicular perforation. 3.To identify various signs and symptoms according to their different anatomical position and correlation with intraoperative ndings MATERIALS AND METHODS: This is a Prospective Observational Study in Burdwan Medical college and hospital ,May 2019 to July 2020 on 100 patients. All willing patients in Emergency and OPD of BMCH with acute and recurrent appendicitis who underwent surgery are included in this study. RESULTS: rd th Appendicitis is commonest during 3 decade (43%) followed by 4 decade (36%).Appendicitis is slightly commoner in females with male: female ratio 1:2.4..The most common position of appendix in our study is pelvic position.

COMPARING THE ACCURACY OF CT AND ULTRASONOGRAPHY IN THE DIAGNOSIS OF ACUTE APPENDICITIS IN TERTIARY MEDICAL CENTRE OF SOUTH BIHAR

2021 ◽  
pp. 16-19
Author(s):  
Kumar Brajbhanu Jha ◽  
Pushpkant Tiwari ◽  
Md Shamim Ahmad ◽  
Rahul Mohan
Keyword(s):  
Acute Appendicitis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Signs And Symptoms ◽  
Preoperative Imaging ◽  
Medical College ◽  
Surgical Emergencies ◽  
The Difference ◽  
The One

Introduction: Acute appendicitis is the one of the most common surgical emergencies, the incidence rate is almost 10% . Making an accurate diagnosis is of utmost importance to surgeons providing care, so preoperative imaging is now widely accepted by most surgeons and emergency medicine physicians in the workup of acute appendicitis. To calculate the Aim And Objective: sensitivity, specicity, positive predictive value and negative predictive value for both CT and USG having the histopathology ndings as gold standard. This is a prospective observational study planned to conduct at Narayan Material And Methods: medical college and Hospital, Rohtas, Bihar on the 110 patients presented with signs and symptoms suggesting Acute Appendicitis. They will be selected from Emergency Department of Narayan medical college & Hospital. On the diagnosis of AA Result: , the sensitivity, specicity, positive and negative predictive value, and accuracy of US vs. CT were 85.5 percent vs. 87.8%, 66.7 percent vs. 75.0 percent, 98.5 percent vs. 97.7%, 15.4 percent vs. 33.3 percent, and 84.8 percent vs. 86.8%, respectively (Table 2). The researchers next included a subgroup of 24 patients who had both US and CT exams prior to surgery for ROC analysis to compare the diagnostic efcacy of the two imaging procedures. The area under the ROC (AUC) of US was 0.84, which was higher than that of CT (0.66), albeit the difference was not statistically signicant , Both ultrasonography and Conclusion: CT examinations were highly effective in diagnosing acute appendicitis.

CLINICAL FEATURES, INDICATIONS AND RESULT OF TRACHEOTOMY

2017 ◽  
pp. 50-55
Author(s):  
Duc Luu Ngo ◽  
Tu The Nguyen ◽  
Manh Hung Ho ◽  
Thanh Thai Le
Keyword(s):  
Clinical Features ◽  
University Hospital ◽  
Female Ratio ◽  
Tube Obstruction ◽  
Level Ii ◽  
Study Results ◽  
Male Female Ratio ◽  
Hospital Patients ◽  
Level I

Background: This study aims to survey some clinical features, indications and results of tracheotomy at Hue Central Hospital and Hue University Hospital. Patients and method: Studying on 77 patients who underwent tracheotomy at all of departments and designed as an prospective, descriptive and interventional study. Results: Male-female ratio was 4/1. Mean age was 49 years. Career: farmer 44.2%, worker 27.2%, officials 14.3%, student 7.8%, other jobs 6.5%. Respiratory condition before tracheotomy: underwent intubation 62.3%, didn’t undergo intubation 37.7%. Period of stay of endotracheal tube: 1-5 days 29.2%, 6-14 days 52.1%, >14 days 18.7%. Levels of dyspnea before tracheotomy: level I 41.4%, level II 48.3%, level III 0%, 10.3% of cases didn’t have dyspnea. Twenty cases (26%) were performed as an emergency while fifty seven (74%) as elective produces. Classic indications (37.7%) and modern indications (62.3%). On the bases of the site, we divided tracheostomy into three groups: high (0%), mid (25.3%) and low (74.7%). During follow-up, 44 complications occurred in 29 patients (37.7%). Tracheobronchitis 14.3%, tube obstruction 13%, subcutaneous empysema 10.4%, hemorrhage 5%, diffcult decannulation 5.2%, tube displacement 3.9%, canule watery past 2.6%, wound infection 1.3%. The final result after tracheotomy 3 months: there are 33 patients (42.9%) were successfully decannulated. In the 33 patients who were successfully decannulated: the duration of tracheotomy ranged from 1 day to 90 days, beautiful scar (51.5%), medium scar (36.4%), bad scar (12.1%). Conclusions: In tracheotomy male were more than female, adult were more than children. The main indication was morden indication. Tracheobronchitis and tube obstruction were more common than other complications. Key words: Tracheotomy

scholarly journals Hospital based study of demography and clinical picture of vernal keratoconjunctivitis

2017 ◽  
Vol 6 (1) ◽  
pp. 65 ◽  
Author(s):  
Maneesha Sethi ◽  
Ridham Nanda ◽  
Amarjeet Singh Bali ◽  
P. Sadhotra
Keyword(s):  
Mixed Type ◽  
Clinical Presentation ◽  
Signs And Symptoms ◽  
Vernal Keratoconjunctivitis ◽  
Female Ratio ◽  
Northern India ◽  
Department Of Ophthalmology ◽  
Male Female Ratio ◽  
History Of ◽  
Ocular Morbidity

Background: Vernal Keratoconjunctivitis (VKC) is common cause of ocular morbidity in children living in tropical countries. Its diagnosis is based on signs and symptoms of the disease. The study was undertaken to stress upon the demography and clinical presentation of VKC.Methods: Retrospective pre-formed proforma of 155 patients of VKC, who were detected at random in the out - patient department of ophthalmology, ASCOMS, Jammu from May 2016 to April 2017, were analyzed.Results: Mean age at presentation was 10.31 years +4.05. The Male: Female ratio was 4.96:1. Majority of patients reported in the month of May. Mixed type of VKC was predominant. Personal or family history of allergy was seen in 5.8% of patients. Itching (100%) was commonest symptom and palpaberal papillae were commonest sign seen in 78.70% of patients.Conclusions: Clinical pattern of VKC seen in hot and dry climate of Northern India is like that seen in other parts of country.

scholarly journals Anaesthesia and Perioperative Care in Remote Health Camps- Patients’ Concerns

2010 ◽  
Vol 49 (179) ◽  
Author(s):  
Balkrishna Bhattarai ◽  
A Ghimire ◽  
BK Baral ◽  
A Shrestha ◽  
Y Dhungana
Keyword(s):  
Observational Study ◽  
Perioperative Care ◽  
Local Anaesthesia ◽  
Prospective Observational Study ◽  
Main Concern ◽  
Surgical Experience ◽  
Female Ratio ◽  
Male Female Ratio ◽  
The Mean ◽  
Remote Health

INTRODUCTION:Identifying patients' concerns and expectations regarding anaesthesia and perioperative care in mobile surgical camps is relevant for the camp workers. This prospective observational study was conducted to assess knowledge, concerns, and expectations about anaesthesia and perioperative care in patients undergoing surgery in mobile surgical camps in remote mountainous districts of Eastern Nepal.METHODS:A questionnaire with seven items related to anaesthesia and perioperative care was used for interviewing 80 individuals of age > or = 12 years, 20 from each camp at Solukhumbu, Sankhuwasabha, Khotang and Bhojpur districts.RESULTS:Data of two patients were lost leaving only 78 individuals for analysis. The mean age of the subjects was 30.5 (+/- 14.6) years with the male: female ratio of 43: 35. Fifty-eight (74.4%) patients had some gross idea about the modality of administration of anaesthetics. Twenty-six (33.3%) individuals preferred GA over local anaesthesia, whereas 22 (28.2%) were happy either way if there was no pain. Pain was the main concern for 73.1% of the patients. Of the 25 patients expressing fear of GA, death or not being able to wake up anymore was the main concern for 60.0%. Increasing age was associated with lower fear of GA (p < 0.05). Surgical experience was distressing for 17 (21.8%) patients. The overall experience of the anaesthesia and surgery was worse than expected for 25.6% of the patients.CONCLUSIONS:Patients presenting to these health camps have limited knowledge regarding anaesthesia and perioperative care but have valid concerns and expectations in respect of their safety, comfort and outcome.

Laparoscopic Cholecystectomy for Acute Cholecystitis: Indication, Risk, and Outcome

2021 ◽  
Vol 8 (06) ◽  
pp. 5508-5513
Author(s):  
Dr. Shiladitya Shil ◽  
Dr. Ashutosh Deb Sarma ◽  
Dr. Md. Alomgir Islam ◽  
Dr. Md. Abdullah-Hel-Baki Abdul ◽  
Dr.Monira Begum
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Prospective Observational Study ◽  
The Other ◽  
Surgical Indication ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
The Mean ◽  
Good Treatment Option

Background: A laparoscopic cholecystectomy is a fundamental approach to treating acute cholecystitis, and the timing of performing this given treatment is associated with clinical outcomes. It is unknown whether surgical indication, risk, and consequences of laparoscopic cholecystectomy for acute cholecystitis differ from those for the chronic form, making it questionable whether urgent laparoscopic cholecystectomy is the best approach even in severe acute cases. Objective: This study aimed to evaluate surgical indication, risk, and outcomes of laparoscopic cholecystectomy for acute cholecystitis. Methods: This prospective observational study was carried out at Bangladesh Medical College Hospital (Uttara Campus) from July 2006 to November 2008. A total of 103 acute cholecystitis patients were observed to evaluate the safety, risk, and outcomes (includes hospital stay, joining to routine daily works) of laparoscopic cholecystectomy. Result: Male and female ratio is 1:4, and the mean age in our series is 47 years. Acute calculas cholecystitis ultra-sonogram feature shows the highest percentage (85.4%) compare to the other four parts. The study also confirmations around 69% did not get any complications, and bleeding was the most frequently observed (16%) complication. The overall outcomes in this research were observed around 75% of total operated patients did not experience any difficulty and said they fit entirely. The other 19% who had some complications include Pain, RTI, Seroma, Jaundice, Cholangitis, Wound infection). Conclusion: Regarding bile duct injury and prolonged complications, laparoscopic surgery is not a very good treatment option for acute cholecystitis.

Study of predictive value of serum C- reactive protein in diagnosis of acute appendicitis

2021 ◽  
Vol 19 (1) ◽  
pp. 31-34
Author(s):  
Pradeep Chandra Sharma ◽  
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Common Finding ◽  
C Reactive Protein ◽  
Diagnostic Efficacy ◽  
Female Ratio ◽  
Reactive Protein ◽  
Serum Crp

Background: Acute appendicitis is a common surgical condition and the most common cause of acute surgical abdomen. Commonly used tests for diagnosis of acute appendicitis were WBC, CRP ESR and procalcitonin (PCT) levels. In present study we correlated the serum levels of CRP with the histopathology of the removed appendix, to study predictive value of serum C- reactive protein in diagnosis of acute appendicitis. Material and Methods:Present study was conducted in patients with possibility of acute appendicitis, underwent appendicectomy. The histopathology report was considered as the final diagnosis. CRP more than 6 mg/dl was considered to be positive. Results: In present study total 88 patients were included. Male to female ratio was 1.4:1, most common age group was 21-30 years (35.23%) followed by 31-40 years (27.27%). Abdominal pain (92.05%), McBurney tenderness (80.68%), vomiting (76.14%), rebound tenderness (67.05%) and fever (55.68%) were common signs and symptoms noted in present study. On histopathology examination, inflammed appendix (51.14%) was most common finding, others were gangrenous appendix (23.86%), perforated appendix (5.68%) and normal appendix (19.32%). In present study diagnostic efficacy of serum CRP was sensitivity (80%), specificity (84.62%), positive predictive value (96.77%), negative predictive value (42.31%), diagnostic accuracy (80.68%). Conclusion. Serum CRP estimation is useful adjunct in diagnosis of acute appendicitis along with clinical diagnosis. Serum CRP value should be interpreted in combination with clinical findings.

Appendicoliths: the neglected stones

2017 ◽  
Vol 4 (1) ◽  
pp. 3-6
Author(s):  
Saroj Dhital ◽  
Udaya Koirala ◽  
Birendra Dhoj Joshi ◽  
Amit Mani Upadhyaya ◽  
Arbin Joshi
Keyword(s):  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Vermiform Appendix ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Recurrent Appendicitis ◽  
Right Iliac Fossa Pain

Introductions: Cases of colic of the vermiform appendix have been rarely described or diagnosed. Appendicoliths cause acute appendicitis and appendicular perforation. It is still not clear whether appendicoliths cause appendicular colic in the absence of acute appendicitis. Methods: A cross sectional study that included appendectomy done for recurrent appendicitis or chronic right iliac fossa pain. Histology reports were reviewed. The presence of an appendicolith in the report was noted. Results: Thirty-two cases of recurrent appendicitis and chronic right iliac fossa pain were included. Twenty-four patients (75%) had fecoliths in the histology specimens. Eight patients (25%) who presented with appendicular colic without signs of appendicitis were further evaluated. Conclusions: Majority of patients with chronic or colicky right iliac fossa pain had appendicoliths.

scholarly journals Prevalence of Anti-Red Cell Antibodies in Repeatedly Transfused Patients

2019 ◽  
Vol 14 (1) ◽  
pp. 73-77
Author(s):  
Masuma Ahmed Salsabil ◽  
Ashesh Kumar Chowdhury ◽  
Debashish Saha ◽  
Arif Ahmed Khan ◽  
Sazia Sultana
Keyword(s):  
Haemolytic Anaemia ◽  
Armed Forces ◽  
Cross Sectional Study ◽  
Red Cell ◽  
Cross Sectional ◽  
Transfusion Therapy ◽  
Female Ratio ◽  
Medical College ◽  
Male Female Ratio ◽  
Immune Haemolytic Anaemia

Introduction: The development of anti-RBC antibodies (alloantibodies and/or autoantibodies) can significantly complicate transfusion therapy, particularly in patients needed repeated transfusion. Objectives: To find out the prevalence of alloantibodies and autoantibodies in repeatedly transfused patients so that serious hazards due to immune reaction may be avoided. Materials and Methods: This descriptive cross-sectional study was carried out in Department of Immunology, BIRDEM and Armed Forces Institute of Pathology (AFIP) during the period of July 2015 to June 2016. Total 370 patients who had received at least five units of transfusions were enrolled in this study but known patients of auto immune haemolytic anaemia, patients in whom antibody was previously detected and pregnant women were excluded from the study. Blood grouping and Direct Anti-globulin Test (DAT) were performed with cell suspension using a poly-specific Coombs reagent. In cases of a positive DAT, further investigation using specific monoclonal reagents to detect IgG or a complement (C3d) was carried out. Serum was used to detect red cell alloantibodies using standard blood bank methods. Antibody identification was performed in antibody screening positive samples using red cell Identicells. Results: Maximum 132 (35.7%) patients were in the age group 1-10 years. The male-female ratio was 1.2:1. Among 370 total patients 290 were HHA and 80 were non-HHA. Antibody was detected in only 17(4.59%) patients. Among the Hereditary Haemolytic Anaemia (HHA) patients it was 11 (3.79%) but among the non-HHA patients it was 6(7.5%). Out of 8 auto-antibodies, 5 were anti IgG followed by 3 were anti C3d. Out of 14 alloantibodies, 4(28.6%) were anti E, 3(21.4%) were anti K and in 3(21.4%) cases specificity of alloantibody was not detected. Conclusion: Prevalence of anti-RBC antibodies was not so uncommon in multiple transfused patients. Journal of Armed Forces Medical College Bangladesh Vol.14(1) 2018: 73-77

scholarly journals Socio-demographic Characteristics of Patients with Tuberculosis Spine in Bangladesh

2017 ◽  
Vol 3 (1) ◽  
pp. 3-5 ◽  
Author(s):  
Md Shafiul Alam ◽  
Md Abdus Salam ◽  
Tayseer Farzana ◽  
ASM Raushan Newaz ◽  
Md Saiful Islam
Keyword(s):  
Spinal Tuberculosis ◽  
Demographic Characteristics ◽  
Age Group ◽  
College Hospital ◽  
Female Ratio ◽  
High Class ◽  
Medical College ◽  
Class Society ◽  
Male Female Ratio ◽  
The Mean

Background: Spinal tuberculosis is more frequently reported in developing countries.Objective: The purpose of the present study was to see the socio-demographic characteristics of spinal tuberculosis patients.Methodology: This study was carried out in the Department of Neurosurgery, Dhaka Medical College Hospital during the period of January 2002 to December 2004 to elucidate the effectiveness of surgical and conservative treatment of the tuberculosis of the spine. For this purpose, a total number of 50 consecutive cases admitted during the study period with tuberculosis of the spine supported by investigations were included in this study.Result: The mean age of the patients was 25.4 years and ranged from 7 years to 68 years. The highest incidence of tuberculosis of the spine was found in age group between 11 to 20 years and 70% of the patients were under 30 years of age. Incidence of tuberculosis of this spine was more in male (62%) in comparison to female (3 8%) with a male female ratio of 1.63:1. In this study most of the patients came from low class society (66%) followed by middle class (28%) and high class (6%) respectively.Conclusion: Spinal TB more frequently occurs among the young age group with a male predominance.Bangladesh Journal of Infectious Diseases 2016;3(1):3-5

scholarly journals Outcome of Injection Sclerotherapy for First Degree and Second Degree Haemorrhoids– A Study of 50 Cases

2016 ◽  
Vol 12 (2) ◽  
pp. 98-101
Author(s):  
Md Ershad Ul Quadir ◽  
Md Mahbubur Rahman ◽  
Md Tanvirul Islam ◽  
SM Shakhawat Hosssain
Keyword(s):  
Symptomatic Relief ◽  
Digital Rectal Examination ◽  
Cost Effective ◽  
Armed Forces ◽  
Injection Sclerotherapy ◽  
Female Ratio ◽  
Medical College ◽  
Number Of Patients ◽  
Male Female Ratio ◽  
Second Degree

Introduction: Haemorrhoid is the frequent problem in clinical practice of general surgery. Haemorrhoids are dilatation and tortuosity of rectal veins affecting almost 4.5% of the population. Various operative and non operative therapeutic options are in practice to treat haemorrhoids, yet none has been proven cent percent effective. Sclerotherapy is a simple, safe and cost effective procedure that is widely practiced globally to treat haemorrhoids. Many sclerosants are being used with variable efficacies. Objective: To evaluate the outcome of injection Sclerotherapy in first degree and second degree haemorrhoids. Materials and Methods: Fifty patients of both gender having haemorrhoids who attended Outpatient Department (OPD) at BNS Patenga from September 2013 to August 2014 were included in this study. On the basis of history, patients were selected for Digital Rectal Examination (DRE) and proctoscopic examination to confirm the diagnosis. Sclerotherapy was repeated at interval of 6 weeks till symptomatic relief was achieved. Maximum 3 sittings of sclerotherapy were given. Patients were followed up at 3 months interval for 1 year. Results: This prospective study was conducted on 50 cases of first degree and second degree Haemorrhoids. The highest number of patients 21(42%) were in the age group of 21-30 years with majority 38(76%) being male. Male female ratio was 3.16: 1. All the patients presented with painless per-rectal bleeding. Satisfactory results were observed in 29(58%) patients of whom 20(40%) patients were having first degree haemorrhoids and 9(18%) patients were having second degree haemorrhoids. Sclerotherapy was more effective in first degree compared to second degree haemorrhoids patients. Conclusion: Injecting Sclerotherapy is a suitable office procedure for treatment of haemorrhoids. The method is easy, convenient, cheap, well accepted and comfortable for patient. More or less there are no complications and the result is also satisfactory. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 98-101

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