BackgroundPsoas abscess (PA) is an uncommon disease involving infection of the psoas muscle with abscess formation. The evidence concerning clinical and diagnostic characteristics of PA and its outcomes is limited. The literature is heterogenous, with varying presentations and outcomes in different regions worldwide. We present a retrospective analysis of the clinical, radiological, and laboratory characteristics of PA, its management, and outcomes from a tertiary care center in North India. MethodologyWe reviewed the clinical records of confirmed cases of PA treated in our institute from January 2016 to December 2020 with a minimum follow-up of one year. Further, we performed a descriptive analysis of demographic characteristics, clinical features, laboratory parameters, radiological investigations, the basis of diagnosis confirmation, causative microorganisms, definitive management, treatment outcomes, and complications. ResultsWe reviewed 33 cases with a mean age of 29.9 ± 16.8 years. Overall, 48.4% of PAs were right-sided, and 24.2% were bilateral. Abdominal discomfort was the most common presenting symptom. Blood laboratory parameters were mostly within the near-normal range except for the elevated erythrocyte sedimentation rate, C-reactive protein, and neutrophil-to-lymphocyte ratio. Ultrasonography was the most commonly performed radiological investigation and was the basis of diagnosis confirmation. Mycobacterium tuberculosis was the most common causative microorganism. Most patients required percutaneous drainage, and around one-fourth required open drainage. All patients had symptomatic as well as radiological improvement and no major complications. ConclusionsTuberculosis is the most prevalent cause of PA in the North Indian population. Most patients respond well to the less invasive treatment with percutaneous therapeutic drainage and antitubercular drugs, with few patients requiring open drainage. However, tissue diagnosis may remain inconclusive in a few patients, and antitubercular treatment may need to be initiated based on the clinicoradiological evaluation. Nevertheless, the rate of complications is low, with nil mortality probably related to the mild-to-moderate disease course of tuberculosis.
Background: It is generally accepted that open book examinations create an enriched environment, offering the student an opportunity to better understand and respond to a particular question. The purpose of the pre Aim Of The Study: sent research was to examine the testing effect with two types of tests commonly found in education: closed-book tests, the traditional method of testing students, and open-book tests, a method gaining popularity. A total of n=109 stude Material & Methods: nts of nal year MBBS participated in the study. A comparative analysis was made for a terminal examination between two papers of general surgery and allied specialties, one paper conducted through conventional method and other one through Open Book Examination. Results were assessed in terms of analysis of feedback form submitted by students and marks obtained. There was st Results: atistically signicant difference in terms of pass percentage between two groups as open book examination clearly surpassed conventional system by having a pass percentage of nearly 70% as compared to closed book examination with ~53%. Marks scored were also better in open book examination. Majority of the students were of the opinion that cheating was less common in open book examination and stress level was lesser, ascertaining open book examination to be a good practical tool for implementation of knowledge. An important consideration was time management which needs to be addressed. Majority of the students were of the opinion to have more open book examinations in future. Open book exami Conclusion: nation is an important tool for practical assessment of knowledge of students & it needs to be explored more for inducting it in our conventional system of examinations.
BACKGROUND Breast abscess is a disease more of a lactating mother. Traditionally breast abscess was treated with incision and drainage which was more invasive and really painful for lactating mother. With the availability of antibiotics more conservative approach came into practice. Aspiration of deep-seated breast abscess, a less invasive procedure, has shown promising results in many studies. The aim of this study was to compare cosmetic results, recovery times, milk discharge, pain relief and recurrence rates in the management of deep-seated breast abscess with aspiration and Incision & Drainage. MATERIALS AND METHODS This non-randomised controlled trial study was performed at department of surgery, HIMSR, Jamia Hamdard, New Delhi from September 2016 to September 2018. Patients were divided into two groups. In group A, aspiration was done under sonographic guidance. In group B Incision and drainage was done. 68 patients were treated, out of which 42 patients were treated in group A and 26 patients was treated in group B. Follow up of patients was done on regular basis for 6 months (Twice a week for one month, twice a month for 2 months than every month for 3 months). RESULTS A total of 68 patients were included in the study. 88.2% patients were lactating mothers and 11.2% patients were non-lactating. Out of 68 patients 42 were treated in group A and 26 were treated in group B. In group A none had suffered from mammary fistula. In group B 7.6% patients had mammary fistula. In group A 11.9% patients had scar marks that too because of conversion to incision and drainage procedure. In group B 100% patients had scar mark. In group A 28 patients were almost pain free after 2 wks. In group B 26 patients were almost pain free after 4 weeks. CONCLUSION Aspiration under sonographic guidance is better mode of management than incision and drainage in deep seated breast abscess.
With advances in medical care there is a significant increase in life expectancy of patients with hydrocephalus. Many patients survive and live a meaningful life even after a decade of ventriculoperitoneal (VP) shunt placement. In this scenario, there are all the chances that these patients may need abdominal surgeries for pathologies unrelated to VP shunt. Laparoscopic cholecystectomy is one of the most common abdominal surgeries being performed. In patients with VP shunt in situ, before performing laparoscopic cholecystectomy factors such as type of shunt, shunt function, presence of shunt infection and possibility of shunt malfunction needs to be assessed. Laparoscopic cholecystectomy in a patient with previous VP shunt is not a well answered question. Some authors favor this while the others disagree. With proper anesthetic management and monitoring it is safe to perform laparoscopic cholecystectomy in these patients, even though literature gives little information about it. So, this case report is our sincere effort to strengthen the available data and stabilize a ground that can we can safely perform laparoscopic cholecystectomy in patient with VP shunt.
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