<p class="abstract"><strong>Background:</strong> The purpose of this retrospective study was to evaluate the outcome of laryngotracheal stenosis in patients undergoing Montgomery T-tube insertion in our institution. This study also throws light on the indications and complications of Montgomery T-tube insertion.</p><p class="abstract"><strong>Methods:</strong> 39 patients who presented with laryngotracheal stenosis in the Department of Otorhinolaryngology at the JSS Medical College, Mysore, India during period of January 2012-December 2015.Out of which, 32 patients underwent stenting by Montgomery T-tube through an external approach. The follow-up period ranged from 6-24 months.The T-tube was removed after a minimum period of 6–12 months. </p><p class="abstract"><strong>Results:</strong> The most common cause of laryngotracheal stenosis was prolonged intubation as seen in 89.7% patients, majority of patients (41%) in this study were in the 3<sup>rd</sup> decade. In this study all the patients underwent tracheostomy prior to treatment for stenosis. Out of 32 patients, decannulation was not possible in four (12.5%). The most common complication seen was surgical emphysema in 21 patients (50%) followed by crusting in 13 patients (40.6%), granulations at the upper of end in 1 patient (3.1%), and granulations around the stoma in 4 patients (12.5%).</p><p><strong>Conclusions:</strong> Laryngotracheal stenosis (LTS) has always been and will remain a challenge to the otolaryngologist and a multidisciplinary approach is required to tackle it. Stenting remains a relatively conservative treatment, is successful in a proportion of cases. Although there are complications associated with the T tube it is always easily manageable and are not usually life threatening. </p>
Introduction Tonsillectomy is one of the most commonly performed surgical procedures worldwide, with the major drawback of significant post operative pain.There is no consensus regarding topical application or local infiltration of anesthetics post operatively to reduce pain. The present study was performed to evaluate the effect of bupivacaine infiltration in the tonsillar fossae after tonsillectomy. Materials and Methods A double-blinded clinical trial was performed on 75 patients undergoing tonsillectomy between January 2019 and January 2020. All patients underwent tonsillectomy under general anesthesia and were then randomly divided into 3 groups of 25 patients each. For Group I, a swab soaked in normal saline was applied to the tonsillar fossae for 5 minutes just before extubation. In Group II, a swab soaked in 5 ml of 0.5% bupivacaine was placed for 5 minutes, while in Group III, 5ml of 0.5% bupivacaine was infiltrated in the tonsillar fossae. The intensity of pain for each group was measured in the immediate post op period, at6 hours, 24 hours and 1 week by Wong Baker Faces Pain Rating Scale. Results There was a significant difference in the mean level of pain between groups I and III in the immediate post op period, at 6 hours and 24 hours. Although the average pain scores of group III were better than those of group II, the results were significant only in the 6 hour post op period. Conclusion To reduce post-tonsillectomy pain,0.5% bupivacaine can be infiltrated into the tonsillar fossa.
RIF pain is a hall mark of acute appendicitis until proven otherwise decision making in a case of acute appendicitis may be difficult for junior surgeons hence we aimed at analysis in RIF pain. Out of 120 cases we found 3 rare entities they are PMP, CT of appendix and perforated appendix in LIF. Pseudomyxomaperinei and carcinoid tumour are rare presentations. Despite the current standard of treatment modalities as extensive surgical resection combined with chemotherapy, PMP and CT frequently recurs with treatment options being limited at recurrence and with severe impact on quality of life. Perforated appendix in LIF is also a rare presentation which needs appendicectomy, perforation closer with omental patch.
This study aims at nding out the common organisms responsible for surgical site infections following emergency non - traumatic abdominal operations and their sensitivity patterns of the microorganisms were ascertained. Determination of factors responsible for infections to reduce the infection rate and thereby reduce the morbidity and mortality. The patients admitted to various surgical wards in KIMS General Hospital, who are operated for emergency non -traumatic abdominal operations are included in this study. A proforma for study of all consecutive patients of emergency non-traumatic abdominal operations will be used. Culture and sensitivity of the organism at the surgical site infection are documented. Various statistical and epidemiological parameters used will be are mean and standard deviation. It was revealed that, overall surgical site infection rate was17.14 per cent. It was observed that among the various host factors studied age, sex, and educational status of the patients were not statistically signicant, but presence of comorbidity played a signicant role in causing SSI. Among the perioperative / environmental factors category of operations, types of incisions, and delay to initiate operation did not play signicant role, but duration of operation and degree of wound contamination played statistically signicant role. It can be concluded from the ndings of the study that microorganisms that are normal inhabitants of our body are mainly responsible for surgical site infection (SSI). Various host factors like malnutrition, obesity, patients’ knowledge about hygiene, presence of co- morbidity etc. coupled with environmental factors such as condition of the wounds, delay to initiate operation, duration of operation, prolonged exposure of peritoneal cavity to environment, prophylactic use of antibiotics and factors associated with surgery like type of incision, type of operation greatly contribute to occurrences of SSI. So, quality of surgical care including immediate assessment of patients, resuscitative measures, adequate preparation of patients and aseptic environment are important for control of SSI.
Introduction Otorhinolaryngologic manifestations account for almost 80% of the various manifestations of Human Immunodeficiency Virus (HIV) infection, of which Human Papilloma Virus (HPV) associated laryngeal papilloma and laryngeal malignancy are the most common pertaining to larynx. Case Report A 55year old male patient on Antiretroviral treatment since 10 years who was a chronic smoker, presented with difficulty in breathing and hoarseness of voice. Flexible laryngoscopy revealed a white, horny, wide based keratotic lesion completely covering rima glottidis resulting in obstruction of airway and stridor. Tracheostomy was done followed by endoscopic excision of the lesion. Histopathologic examination showed features of hyperkeratotic papilloma and lesion was tested negative for HPV. Discussion We report this case to emphasize on the differential diagnosis of laryngeal papillomatous lesion. A hyperkeratotic papilloma, with a dual aetiology of retroviral disease and smoking, presenting with stridor, the lesion being negative for HPV infection makes it uncommon from other laryngeal lesions.
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