INTRODUCTION Peritonitis due to hollow viscous perforation is one of the common causes for emergency surgery requiring immediate surgical intervention. Scoring systems that provide objective descriptions of the patient’s conditions at specific points in the disease process aid our understanding of these problems. Hence this study is undertaken to study the effectiveness of Mannheim’s peritonitis index in predicting the outcome in peritonitis patient. MATERIAL AND METHODS This study was carried out in Department of Surgery of National Medical College and Teaching Hospital. A total of 44 patients with diagnosis of peritonitis due to hollow viscous perforation over period 2 years was included in this study. History and detailed clinical examination were performed as per the working proforma. Blood investigation was done. Data analysis was done using SPSS (Statistical Package for social sciences) version 25. RESULTS In this study 44 cases of peritonitis due to hollow viscous perforation were included. The mean age of patients was 38.16 ± 21.09 years. Abdominal pain and abdominal distension were most common presentation. MPI scoring system done in all patients depending on preoperative and intra-operative and patients were categorized into three categories, <21, 21 to 29, and >29 where 50% of patients had MPI less than 21, 25% of patient had MPI score 21-29 and 25% of patient had MPI score >29. CONCLUSION MPI scoring system is required to predict the outcome in peritonitis patients and whether the line of management taken is appro- priate or needs to be changed.
This study examines the influence of multi-axial Compression (MAC) on the wear attributes of 7075 Al alloy and optimize the dry sliding wear parameters using the response surface methodology (RSM). Optical microscopy images were used to detect microstructural changes in the 7075 Al alloy after MAC processing. The Face Centered Central Composite Design (FCCD) method was made up of three factors, each with three levels. To investigate the impact of various factors and how they interact with one another on wear, surface plots, contour plots, and mean effects plots were developed. The coefficient of regression R2 was 0.9621, demonstrating the constructed model’s acceptable accuracy. After six passes, average grain size was observed to reduce by up to 2.3 µm. The alloy processed by MAC is harder and stronger than the zero MAC pass alloy. The mechanical properties of Al alloy enhance with increased MAC pass. In this study, the Vickers micro-hardness, X-ray diffraction analysis, optical microstructural, energy dispersive X-ray spectroscopy analysis (EDS), tensile test, and scanning electron microscopy (SEM) were performed on broken tensile specimens and worn surface of the wear pin.
In pediatric age group peptic ulcer disease and duodenal perforation are usually rare condition. We report here a case of 3 years old girl who presented with upper abdominal pain, fever. On examination, she was febrile, tachycardia, with the feature of peritonitis. X-ray Abdomen reveled pneumoperitoneum. After resuscitation and investigating the child, a provisional diagnosis of peritonitis due to hollow viscus perforation was made. The child was planned for laparotomy. Intraoperative diagnosis of first portion of duodenum perforation was made and she underwent repair of perforation.
Necrotizing pancreatitis is a very rare in children and is associated with high morbidity & mortality rates. We report a case of 5yr old boy who presented with upper abdominal pain, vomiting and non-passage of stool for 1day. After resuscitation and investigating the child, a provisional diagnosis of biliary ascariasis (BA) with acute pancreatitis was made. The child developed peritonitis after 2 days of admission and exploratory laparotomy was planned. An intraoperative diagnosis of necrotizing pancreatitis was made and the child was successfully managed.
Introduction: Laparoscopic cholecystectomy is clean-contaminated surgery. Prophylactic antibiotics are used to reduce SSI but there is still controversy regarding use of antibiotics in postoperative period. The aim of this study is to compare the effect of single dose versus multiple doses of antibiotics in terms of wound infection. Methods: This prospective study was carried out in department of surgery of National Medical College and Teaching Hospital, Birgunj from March 2020 to March 2021. Patients with diagnosis of symptomatic cholelithiasis were divided alternatively in single dose (SD) group and multiple doses (MD) group. SD group were given injection ceftriaxone 1gm at the time of induction of anaesthesia and MD group received injection ceftriaxone 1gm at the time induction of anaesthesia and followed by continuation of same dose twice a day for 2 days. Results: A total of 249 patients were enrolled in the study. Among 249 patients, 127 patients were in the single dose (SD) group and 122 patients in (MD) group. The mean age of patient was 37.37±14.30 years with minimum age of 13 years and maximum 75 years. In single dose (SD) group, 5(3.9%) patients developed wound infection and 3(2.5%) patients in multiple (MD) group developed wound infection which was not statistically significant (p=0.437) Conclusion: Single dose antibiotic was found as effective as multiple doses of antibiotics in terms of wound infection in laparoscopic cholecystectomy.
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