Mirizzi syndrome is a complication of long standing cholelithiasis. In this, obstruction of the extrahepatic bile duct by stone/s in the Hartman's pouch or cystic duct (Mirrizi type I) may erode in to the bile duct forming cholecystobiliary fistula (Mirrizi type II). Altered biliary tract anatomy and the associated pathology make cholecystectomy, open or laparoscopic, a formidable undertaking. Awareness of this entity and its preoperative diagnosis is of paramount importance to avoid injury to the bile duct at surgery. Improper surgical procedures may lead to long-term stricture formation. The present article reviews the available literature on various aspect of this syndrome including its pathogenesis, diagnosis and recommended management guidelines.
Importance-Extremely preterm infants contribute disproportionately to neonatal morbidity and mortality.Objective-To review 20-year trends in maternal/neonatal care, complications, and mortality among extremely preterm infants born at Neonatal Research Network centers.Design, Setting, Participants-Prospective registry of 34,636 infants 22-28 weeks' gestational age (GA) and 401-1500 gram birthweight born at 26 Network centers, 1993-2012. Exposure-Extremely preterm birth.Main Outcomes-Maternal/neonatal care, morbidities, and survival. Major morbidities, reported for infants who survived more than 12 hours, were: severe necrotizing enterocolitis, infection, bronchopulmonary dysplasia, severe intracranial hemorrhage, cystic periventricular leukomalacia, and/or severe retinopathy of prematurity. Regression models assessed yearly changes, adjusting for study center, race/ethnicity, GA, birthweight for GA, and sex.
Objective : This is a Prospective cohort study carried out in department of Obstetrics and Gynaecology, Hi-Tech Medical College & Hospital, Bhubaneswar, a tertiary care centre, with the objective of knowing the etiology and outcome of preterm labour and formulate measures to prevent the onset of preterm labour and deal with complications arising from preterm labour. Materials and methods : A total of 112 patients with preterm labour were included in the study. The investigations required to identify the etiology and also other routine investigations were carried out . The study was conducted over a two year period i.e. from November 2018 to October 2020 at Hi-Tech Medical College & Hospital, Bhubaneswar. Results : Majority of the patients were in the age group of 20-24 years. Among them, majority of the patients belonged to the gestational age group of 28-34 weeks . Infection was the commonest cause of preterm labour. There is signicant improvement in neonatal outcome in steroid covered group if gestational age is less than 34 weeks . Conclusion: Preterm labour has major impact on neonatal mortality and morbidity. Hence identication of risk factors and etiologies of preterm labour and timely interventions in the form of investigations and management and preparedness to tackle the maternal and neonatal complications are vital for a good maternal and neonatal outcome.
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