scholarly journals An Audit on Gastrointestinal Perforation in a Tertiary Care Teaching Hospital Based in Northern Part of India: A Study of 100 Cases

2022 ◽  
Vol 8 (1) ◽  
pp. 106-116
Rakesh Kumar Chanania ◽  
Lakshay Goyal ◽  
Sanjeev Gupta ◽  
Gagandeep Chanania ◽  
Sahil Heer

Background: A prospective study was conducted on 100 patients of perforation peritonitis: To find out the incidence of gastro intestinal perforation in various age groups, sex, riral or urban, socio economic status, To find out the various causes and sites of gastra intestinal perforartions, To determine various types of procedures being done to treat gastro intestinal perforations.Methods:The study population consisted of 100 patients of perforation peritonitis admitted at surgical wards of Rajindra Hospital, Patiala. Patients underwent necessary investigations such as Blood counts, biochemical analysis and urine analysis. X-ray Abdomen and chest / USG Abdomen/Pelvis CT-Abdomen (as and when required). All diagnosed patients were subjected to surgery. In all cases, operative findings and postoperative course were followed up for three months. Final outcome was evaluated on the basis of clinical, operative and radiological findings. In pre-pyloric and duodenal perforation, GRAHAM’S PATCH REPAIR carried out. In Ileal and Jejunal perforations, primary closure or exteriorization done depending upon the condition of the gut and duration of the symptoms. The patient outcome was assessed by duration of hospital stay, wound infection, wound dehiscence, leakage/entero-cutaneous fistula, intra-abdominal collection/abscess, ileostomy related complications and reoperation. Wound infection was graded as per SSI grading.Results:Most common age group for perforation was 21-40 years (50%) followed by 41-60 (33%) years in present study. Mean age of the patients is 37.91 + 13.15 years with male predominance (78%) in our study. 4% of the patients were of upper socio-economic status while 32% of the patients were of middle and 64% of the patients were of lower socio-economic status.Abdominal pain was seen in 100% of the patients while abdominal distension was present in 69% of the patients. Nausea/Vomiting was seen in 61% of the patients while Fever and Constipation was seen in 53% and 86% of the patients respectively. Diarrhoea was seen in 3% of the patients. Tenderness, guarding & rigidity, distension, obliteration of liver dullness and evidence of free fluid were present in 100% of the patients. Bowel sounds were not detected in all the patients. Most common perforations were Duodena(37%), Ileal (25%), Gastric (25%) followed by Appendicular (9%), Jejunal (4%) and Colonic perforation (2%). The most common etiology of gastrointestinal perforations was Peptic ulcer followed by Typhoid, Appendicitis, Tuberculosis, Trauma, Malignancy and non-specific infection.In Gastric perforations, Peptic ulcer was the most common cause of perforation followed by Trauma. In Ileal perforations, Typhoid was the most common cause of perforation followed by Tuberculosis and non-specific infection. In Appendicular perforations, most common cause was Appendicitis. In Jejunal perforations, most common cause was Trauma. In Colonic perforations, most common cause was Malignancy.Conclusions:The incidence of gastrointestinal perforations was common in 21-40 years age group followed by 41-60 years age group with male preponderance in our study. The most common site of perforations was Gastro-duodenal followed by Ileal perforations and the most common cause for these perforations was peptic ulcer followed by typhoid. The most common procedure done to treat gastrointestinal perforations was primary closure, resection and anastomosis, appendectomy and stoma formation. However, small sample size and short follow up period were the limitations of the present study.

2017 ◽  
Vol 4 (2) ◽  
Mr. Ashok B. Patil ◽  
Dr. G. B. Chaudhari

Chakraborty T, Gupta D, Saha R (2017), Role of Psychological Predisposition on Employability of Management Students: Moderation Analysis through Soft Skills Training, International Journal of Indian Psychology, Volume 4, Issue 2,DIP: 18.01.172/20170402, DOI: 10.25215/0402.172In this era, the value and sex behaviour attitude of the Youth plays important role for the healthy society. The present study is conducted to investigate the values and sex behaviour attitude among engineering college students of Jalgaon city. Kamal Dvivedi and Shagufta Hafeez (1995) Values Scale and Dr Yashvir Singh (2004) Sex Behavior Attitude Inventory is used for the for the sample of 40 students of age group 18-22 years from engineering college of  Jalgaon City.

2013 ◽  
Vol 1 (2) ◽  
pp. 20
Anil Ojha ◽  
Pawan Shrestha ◽  
David A. Green

Peptic ulcer disease is uncommon in childhood, with non-specific clinical features. A tendency to late diagnosis makes it more likely for a patient to present with complications. Here we discuss a child with low socio-economic status from a developing country who presented with severe anemia secondary to a bleeding duodenal ulcer. The case highlights the importance of the patient’s background in the formulation of a management approach. In some cases this may be intuitive to an experienced physician. However, we demonstrate this with a simple mathematical diagnostic model using disease prevalences which are tied to our individual patient’s circumstances. The model shows how the negative predictive value of a test can change according to the patient’s background. We also suggest that the best treatment option will be influenced by the patient’s circumstances. Our patient comes from Nepal, but the principles involved are universally applicable.

2014 ◽  
Vol 146 (5) ◽  
pp. S-183
Steve Serrao ◽  
Christian S. Jackson ◽  
David Juma ◽  
Diana Ibrahim ◽  
Sam Soret ◽  

2018 ◽  
Vol 2 (1) ◽  
pp. 3-6
Kalanghot Padmanabhan Skandhan ◽  
Spandana Reddy ◽  
Amita Pandya ◽  
Sumangala Balakrishnan ◽  
Dayani Osuki ◽  

Menarche is a developmental milestone. Age at which menarche is attained is highly variable and highly sensitive to a variety of internal and external forces like climatic conditions, physical and mental factors, nutrition and socio-economic status. Exposure to light and other visual cues may influence the pubertal changes. Menarcheal age (MA) of 110 blind girls was compared to that of 102 normal girls of same age group and of same area of residence. An advancement of 9 months in MA was seen in blind girls. Influence of light and other factors on menarche is discussed.

Taufiq Ahmad ◽  
Rifat Haneef

This study investigated the Socio-economic and Socio-personal characteristics of agripreneurs. The study was conducted in Uttarakhand and Punjab states. Data for the investigation were collected from 120 respondent trainees, 60 each from the selected state. The study discovered that the majority of respondents (65.83) belonged to middle age group of 29-40 years, were married (75.83%) and had a low level of experience (0-5 years) in the agri enterprises. It was found that the majority of the respondents (50.83%) were engaged in agriculture belonged to the General caste and had education up to graduation (57.50%). A maximum number of the respondents were involved in social and political institutions holding more than one position (35.83%), belonged to medium family size (49.17%), possessed 5-10 animal (biogas plant, pump set, two-wheeler (36.67%). The majority of the respondents (81.17%) had a medium level of socio-economic status (SES).

2018 ◽  
Vol 5 (2) ◽  
pp. 445 ◽  
Khalilur Rahman A. ◽  
Jawahar Krishnaswamy ◽  
Muthukumaran G. ◽  
Sanjay Prakash J.

Background: Ileal perforations are a common occurrence in our hospital setup with a majority of cases having an etiology of typhoid. The presentation and management of ileal perforation with special reference to typhoid, nonspecific and traumatic perforations and the outcomes in these patients and the factors affecting prognosis are important. Aims and objectives of the study were to study the management of Ileal perforation. To compare the outcome of two different types of treatment for Ileal perforation i.e. Primary Closure (vs) Resection and Ileostomy.Methods: This is a randomized comparative observational study conducted in general surgery department of Saveetha Medical College and Hospital, Chennai between February 2016 to October 2017. A Minimum of 28 patients was included in the study. Diagnosis was made on the basis of the X-ray erect abdomen, ultrasound abdomen, Widal test and intra-operative findings.Results: The common age groups affected was 41-50 years age group (5 patients) and 61-70 years age groups (5 patients). The least affected were 1-10years age group (one patient). The incidence in males was slightly greater than females. Male to female ratio was 2.5:1. Typhoid perforation is the most common case of ileal perforation followed by non-specific perforation. Post-operative complications are more in the primary closure group with 32.14% (9 patients) which is lower when compared to ileostomy group 17.85% (5 patients). Complications of primary closure were wound infection (2 patients), burst abdomen (3 patients), faecal fistula (1 patient), respiratory complications (3 patients). Complications in ileostomy group were wound infection (4 patients) and respiratory complications (one patient).Conclusions: Mortality was more in primary closure group with 21.42% (6 patients) and mortality was less in ileostomy group with 7.14% (2 patients). This study proposes that ileostomy may be given priority over other surgical options in moribund patients.

2021 ◽  
pp. 1-2
Akash KR. Gupta ◽  
Manoj KR Das ◽  
Marshal D Kerketta

INTRODUCTION: Acute abdomen can be defined as “syndrome included by wide variety of pathological conditions that require emergent medical or more often surgical management.” Acute abdomen is caused due to gastrointestinal diseases such as intestinal obstruction and perforation peritonitis. AIM: The aim of our study was to observe the common cause in paediatric age group undergoing emergency laprotomy in our institutions. MATERIAL AND METHODS:This prospective study included 77children aged below or equal to 15years, underwent emergency laprotomy for acute intestinal conditions between January 2019 to December 2019 in RIMS,RANCHI. We excluded neonates ,patients of jejunoileal colonic atresia and stenosis, anorectal malformation(ARM), congenital pouch colon, neonatal necrotizing enterocolitis(NEC), hirschprung’s disease, gastrointestinal tumor. RESULTS: Total of 77 laprotomies were performed in emergency in children below or equal to 15 years age,59(76.62% ) were boys and 18(23.37% )were girls with male:female ratio of 3.2:1. 36(46.75%) cases were done for acute intestinal obstruction and 41(53.24%) cases were done for perforation peritonitis.20(25.97%)emergency laprotomy was performed in the age group 1-5 years and 57(74.02% ) were performed in the age group 5-15 years. Causes in order of frequency for intestinal obstruction were intussusceptions, post operative band/adhesion, abdominal tb obstruction, meckel’s diverticulum and worm obstruction. Causes in order of frequency for perforation peritonitis were typhoid, abdominal tb, appendicular perforation and abdominal trauma. CONCLUSION: In our study maximum emergency laprotomy was performed in male patients with male:female ratio of 3.2:1. Perforation peritonitis was more common than acute intestinal obstruction. 5-15 year age group were more commonly affected. Typhoid ileal perforation was the most common cause for emergency laprotomy followed by intussusception.

2012 ◽  
Vol 36 (0E) ◽  
pp. 293-298
Suha A. Kadhum

The aim of this study was to identify the main risk factors with Trichomonas vaginalis infection in married women that have vaginal discharge. The study include (250) female who attended Al-Yarmouk Teaching Hospital (Gynecological Clinics), through the period from February 2010 to July 2010.Patients female were subjected for a special questionnaire sheet. The study has found that (65) females were infected with this parasite from total (250), who were complaining from vaginal discharge with infection rate 26%.Higher infection rate was recorded between pregnant female was 17.2% while non-pregnant women 8.8% .The main age group of infected women concentrated in (20-29 years) in which rate were 12.83% and 11.76% in pregnant and non-pregnant women respectively.According to educational level and socio-economic status, the study recorded higher percentage 50.76% between illiterate women and with low socio-economic status 63.07%.The highest infection with Trichomonas vaginalis obtained from women with white to gray discharge 58.46% and with bad odor 81.53%.Depending on residency, in rural residence the high percentage of infection were recorded 63.07% while comparing with urban 36.93%.Considering to contraceptive types which used by women 47.69% for IUDs, followed by 32.31% for contraceptive pills and low percentage for condom 20%.

Lydia Pinirou

In the Fall of 2017, while a rising high school junior, the author founded a school club at the American Community Schools of Athens named ΚΟΙΝΩΝΟΣ (pronounced Kinonos), derived from the Greek word “Κοινωνία” which means “Community.” ΚΟΙΝΩΝΟΣ refers to the community of people that come together for a common cause. It connotes the importance of participation in community affairs that as citizens we must all participate in community affairs in order to improve social conditions, problem solve, and better plan so as to have a healthy, thriving community. On a larger scale, ΚΟΙΝΩΝΟΣ denotes that we are all members of a community, and while we have many differences we also have commonalities, the main commonality being that we are all human beings regardless of socio-economic status, gender, opportunity, or education. Revering this simple fact is a necessary mindset in order to develop the highest form of social interest and become conscious citizens who ‘see' society's plaguing issues and address them.

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