Background: Acute Pancreatitis is one of the most common disease in all parts of INDIA. The morbidity and mortality of the disease can be reduced by early detection of complications. In rural health centres, authors need a simple and easily accessible and reproducible scoring system to access the severity. The main aim of the study is, using BISAP score authors can easily identify the severity and complications of acute pancreatitis as early as possible even in rural health centres. Methods: This is a prospective study conducted at Koppal District Hospital, Karnataka. Authors included 80 acute pancreatitis patients admitted in present hospital from July 2015 to July 2017. BISAP score is used within 24 hours of admission to access the severity and complications of the pancreatitis. Complications are accessed with respect to duration of hospital stay, organ failure and necrotising pancreatitis against BISAP score less than 3 and more than 3. Results: In present study male (83.75%) patients are more affected than females (16.25%). Alcohol (52.5%) being the main culprit then biliary (32.5%) and idiopathic (15%) as causes of acute pancreatitis. Middle age group between 30 to 50 years (66.25%) are more affected. Severe pancreatitis features like organ failure (66.67%) and necrotising pancreatitis (71.4%) are seen in patients with score more than 3. And also, the duration of inpatient hospital stay is longer (more than 5 day) in same patients. Conclusions: Acute pancreatitis is one of the most common causes for acute abdomen and alcohol consumption being the main culprit in rural areas of south India. Of the many scoring systems, BISAP score can be easily done at rural health centres to early detection of severity and complication of acute pancreatitis.
In sublingual glands 85% are malignant and only 15% are benign. The incidence of malignancy in submandibular gland is higher than parotid gland and the prognosis is poorer than parotid malignancies. Risk factors linked to the development of salivary gland neoplasia include: radiation exposure; familial or genetic predisposition; tobacco use: strong association between tobacco use and the development of Warthin's tumor; microorganisms: Epstein Barr virus linked lymphoepithelial carcinoma; exposure to industrial chemicals. Total 20 cases clinically presenting as salivary gland tumours during the study period were taken for study. Each case was examined clinically and properly in a systematic manner. The cases were treated on their individual merits. All patients presented with swelling. Features of rapid growth, pain, and associated facial paralysis were considered as signs of malignancy. One out of 20 patients presented with pain in swelling, that was malignant. Features of fixity, facial paralysis and nodal involvement were considered as signs of malignancy. Hard in consistency suggests malignancy. All patients in this study had only swelling and no other signs.
Endogenous hormones have been reported in normal and neoplastic salivary glands, but some of the results have been conflicting. Estrogen receptors were found in nearly 80% of normal glands in males and females and four out of eight salivary tumours in women had estrogen receptor levels similar to those of "hormonally dependent" breast carcinomas. However, more recent studies have not confirmed this finding and questioned the methodology. Estrogen receptors have been reported in a minority of cases of acinic cell carcinoma, mucoepidermoid carcinoma and salivary duct carcinoma, but were not detected in adenoid cystic carcinoma. Estrogen or estrogen receptors have been reported in pleomorphic adenomas in some studies, but in others, estrogen receptors were absent. Progesterone receptors have been reported in normal salivary gland. After evaluation of the tumor by clinical examination and specific investigations, a surgical plan was formulated. The final decision was taken per operatively by the surgeon. The specimen was sent for HPE. Overall pleomorphic adenoma, constitute 80% of all salivary gland tumours. In parotid it constitutes 77.77% of all tumours occurring in parotid gland. Among malignant tumours sqamous cell carcinoma constitute 5% and myoepithelial tumour constitutes 5% of all tumours occuring in salivary glands. One HPR was normal accounting for 5% and one was haemangioma.
Background: Diabetic foot ulcer is a one of the major challenging problem to every surgeon in day to day practice. Superoxidised solution is an effective concept in the wound management. The present study was aimed to compare the efficacy of dressings with superoxidised solution versus povidine iodine in the management of infected diabetic ulcers.Methods: This is a randomized controlled study conducted over a period of one year. In our study, total of 60 patients presenting with infected diabetic ulcers are included. Patients were randomly divided into two groups of 30 each, group A (Topical superoxidised solution dressing) and group B (Topical povidine iodine dressing). Wound was observed for decrease in size of the ulcer, granulation, tissue quality and discharge from the wound at the end of each week for two weeks.Results: In the present study, 76.67% of patients in group A and B were males and the male to female ratio was 3.2:1. The mean age in group A was 55.90±14.27 years compared to 51.50±13.18 years in group B. The mean initial ulcer area in group A was 3882±1890 mm2 compared to 3992±2000 mm2 in group B. The mean post treatment final area in group A was significantly low (1607±862 mm2) compared to group B (2351±1240 mm2; p=0.009) and the comparison of mean change in ulcer area was significantly high in group A compared to group B (2215±1060 mm2 vs 1641±856 mm2; p=0.024). The mean percentage reduction in ulcer area among patients with group A was significantly high (58.90±5.21 percent vs. 40.90±8.76 percent; p=0.024). The commonest organism isolated in group A was Escherichia coli (26.67%) and in group B, it was staphylococcus. The culture was positive in 26% of the patients in group A compared to 50% in group B (p=0.063).Conclusions: Overall, topical superoxidised solution dressing for diabetic foot ulcer accelerated the healing process resulting in faster recovery through reduction in ulcer area compared to topical povidine iodine dressing.
Background: Solitary nodule of thyroid has increased in incidence in the present day as compared to two decades before. Because of possibility of malignancy, some clinicians especially those in surgical subspecialties recommended that all nodules have to be removed. Objectives: Clinical study of solitary nodule of thyroid and role of FNAC in the management of solitary nodule of thyroid. Method: This prospective study includes 70 patients, presenting in KIMS, Koppal who were clinically diagnosed as solitary nodule of thyroid. All patients were admitted and were subjected to thyroid profile, USG and FNAC. All patients were operated appropriately depending on the FNAC report. Histopathological examination of the operated specimen was done for all the patients. Depending on the histo-pathological report appropriate postoperative therapies were administered to all the patients and all the patients were followed up appropriately. Result: The peak incidence of solitary nodule was observed in 3 rd to 5 th decade, constituting 60% of the cases studied. Females predominated in number over males in occurrence of solitary nodule in ratio of 1:8.16. 33% of all clinically solitary nodule turned out to be multi-nodular goiter. Incidence of malignancy in solitary thyroid nodule was 10.9%. Male to female ratio in case of malignant nodule was1:5. Incidence of carcinoma in males presenting as solitary nodule was higher (16.67%) compared to that of females (10.20%). The most common cause of malignancy was papillary carcinoma (67%) followed by follicular carcinoma (33%). Conclusion:USG can be accurately used to detect patients with multinodulary goiter who clinically present as solitary nodule of thyroid. Common causes of solitary nodule of thyroid are MNG, follicular adenoma and adenomatous goiter.
Background: Globally, inguinal hernia is the most common type of hernia, comprising of approximately 75% of all abdominal wall hernias.Aim of the study was to compare the heavyweight composite polypropylene mesh versus the prolene soft mesh for the reduction of post-operative pain in patients undergoing lichensteins mesh repair for inguinal hernia.Methods: This study was conducted in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum attached to KLE University’s J.N.M.C Belgaum.Results: Male preponderance was seen with 96.67% of patients in group SP and all (100%) patients in group RP were males. The mean age in group SP was 51.93±18.73 years compared to 49.50±14.03 years in group RP (p=0.571). The mean duration of the disease was 12.67±9.85 months in group SP whereas in group RP it was 15.10±8.98 months (p=0.321). The mean pulse rate in group SP and RP (79.60±5.64 vs 82.37±5.46 /min; p=0.059), systolic blood pressure (120.33±9.99 vs 124.33±11.94 mmHg; p=0.165) and diastolic blood pressure (73.73±6.76 vs 75.80±8.59 mmHg; p=0.305) were comparable. Right position was noted in 56.67% of patients in group SP compared to 50% of patients in group RP (p=0.673).Conclusions: Prolene soft mesh (lightweight macro-porous polypropylene mesh) significantly reduced the post-operative pain in patients undergoing lichensteins mesh repair for inguinal hernia as compared to heavyweight composite polypropylene mesh.
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