Background: Thyroid diseases are common and comprise a spectrum of entities. After diabetes mellitus, the thyroid gland is the most common gland to cause endocrine disorder. Lesions of thyroid are predominantly confined to female in the ratio 5:1 to male. Thyroid enlargement is the most common sign, it may be diffuse or generalized or localized. Both benign and malignant lesions of thyroid commonly present with a nodule. Prevalence of thyroid nodule ranges from 0.2% to 1.2% in children and from 4-10% in general adult population. Presently due to common use of ultra-sonography in the clinical practice the incidence of thyroid nodule has risen to 14-50%.Methods: A prospective, observational, single hospital base study done during the period from 2018 to 2020 in the Department of Surgery, Gandhi medical college Bhopal. Sample size was taken 60 patients.Results: In this study as patients present with thyroid enlargement and ulrasonography scoring according to TIRAD score, as TIRAD score is increased possibility of malignancy increased. On the basis of ultrasonography of thyroid to detect the malignancy sensitivity is 88.9% and specificity is 98%.Conclusions: Commonest clinical presentation is multinodular goitre is about 53% and ultrasonography scoring is TIRAD-2 and TIRAD-3 which was consistent with nodular hyperplasia. Second commonest clinical presentation is colloid goitre (31%) and ultrasonography score is TIRAD-2 and TIRAD-3. On the basis of ultrasonography TIRAD-4 and TIRAD-5 are about 13.4% and these findings consistent with Neoplastic thyroid swelling in histopathology.
Background: Perforation is a common complication of peptic ulcer disease and presents as Perforation peritonitis. It has the highest number of mortality among all complications (≈15%). In spite of modern progress in the management, it is still a life-threatening catastrophe. Emergency surgery for complicated cases required in 7% of hospitalized peptic ulcer disease patients. Factors such as >24 hours of history, concomitant disease, shock, post operated wound infections, all are associated with increase in mortality and morbidity.Methods: A Prospective, observational, single hospital base study done during the period from 2016 to 2020 in the Department of Surgery, Gandhi medical college Bhopal. Sample size was taken 63Results: 52 out 63 cases presented with perforation peritonitis included under study period, 11 cases were excluded due to death and absconding of cases. In rest 52 cases, 15 of them went through laparoscopic repair, 28.85% of the cases were shifted directly to ORG.Conclusions: Laparoscopic repair of peptic ulcer perforation is feasible if patient presents early to the hospital. All perforation peritonitis should give fair chance to repair laparoscopically if patient’s general condition and anesthetic permits. This is a good alternative for conventional open surgery with less post-operative pain, early return to normal activities, less hospital stays and few postoperative wound infections. Thus it can significantly decrease the economic burden.
Background: Mesenteric artery thrombosis (MAT) is a condition involving occlusion of the arterial vascular supply of the intestinal system. It is a severe and potentially fatal illness typically of the superior mesenteric artery (SMA), which provides the primary arterial supply to the small intestine and ascending colon. The occlusion may occur due to underlying atherosclerotic disease or embolic occlusion from a distant source, as atrial fibrillation. The condition possesses a high mortality rate and prompt recognition and treatment are of utmost importance.Methods: A retrospective, observational, single hospital base study done during the period from 2015 to 2020 in the department of surgery, Gandhi Medical College, Bhopal. Sample size was taken 50 patients.Results: In our study, out of 50 patients, 34% patients were in the age group between 55-65 years, history of smoking was present in 44%, hypertension in 36%, past history of atrial fibrillation in 10%, signs of peritonitis were present in 62% patients. Out of 50 patients, 42% was operated while 58% were managed conservatively. Amongst operated patients, in 72% partial bowel resection was done while in 28% extensive bowel resection was done, 66% were discharged while 28% patients died, amongst 21 operated patients, 57% were discharged while 43% died.Conclusions: In this study, SMA thrombosis is more common in patients with smoking, cardiac diseases (hypertension, atrial fibrillation, ischemic heart disease, CVA), dyslipidaemia. Early intervention as thrombolysis or bypass surgery is needed to prevent complications like extensive bowel ischemia.
Background: Gallbladder cancer is a highly aggressive malignancy of the biliary system having the shortest median survival rate. Being aggressive biological nature and lack of sensitive screening test for early detection it has a poor prognosis. Aim: The purpose is to study the relative frequency of gallbladder cancer in reference to age, sex, etiological factors, clinical signs and symptoms in relation to the stages and the outcomes of different treatment modalities. Methods: This study is observational and conducted in the
Study includes hundred patients admitted to surgical emergency with acute abdomen were selected for the study. There was not any preoperative selection criteria; the cases which were proven to be cases of perforation peritonitis on the basis of investigations and clinical examination were taken for study and considered for comparative study if laparotomy diagnosed to be case of caecal perforation. Inflammatory cause 22 cases (22%) which include caecal perforation secondary to ruptured liver abscess 14 cases, appendicular base with caecal wall perforation 4 cases. Obstructive cause 06 cases (06 %) include obstructed inguinal hernia 02 case, obstructive band 02 case and caecal volvulus 03 case. 04 cases (04%) of caecal perforation secondary to neoplastic etiology were studied. The common etiologies in descending order were Traumatic 68 cases (68%) which include multiple stab injury 40 cases (40%), blunt trauma abdomen 12 cases (12%), iatrogenic 10 cases (10%), caecal perforation secondary to arrow injury 1 case (2%), and blast injury 2 case (4%). Chi Square Test of statistical significance was applied between group A (right hemicolectomy with ileo transverse anastomosis) and group B (primary repair with omental patch, primary repair with proximal ileostomy and right hemicolectomy with ileo transverse colostomy) for testing association between between group A and group B. From total Nine parameters chi square test was found to be significant in seven parameters with p value <0.05. There was no statistical significance found in two parameters with p value>0.05. Reducing mortality in patients undergoing surgery for caecal perforations. Ileostomy-specific complications, however, increase the postoperative stay of the patient. These complications can be reduced, if not outright eliminated, by proper fashioning of the stoma and provision of adequate nursing care of the stoma. It should be recommended that ileostomy in these cases is only temporary and the extra cost and cost of management are burden to life of poor community.
Background: Patients who have signs of malnutrition have a higher risk of complications and an increased risk of death in comparison with patients who have adequate nutritional reserves. It is common and occurs in about 30% of surgical patients with gastrointestinal diseases and in up to 60% of those in whom hospital stay has been prolonged because of postoperative complications. The serum albumin level is the most readily available and clinically useful parameter. A serum albumin level greater than 3.5 g% suggests adequate protein stores and it confers a protective effect through several biological mechanisms. It predicts perioperative morbidity and mortality.Methods: Our study was conducted on a cohort of 100 Patients admitted in Department of General surgery Hamidia Hospital for major elective surgery between October 2016 and September 2017. Sample size taken was 100.Results: The present study shows that patients with serum albumin less than 3 g/dl has more postoperative complications and patients with serum albumin >3.5 g/dl has less postoperative complications which was statistically significant. The study concludes that as the serum albumin level increases the complication rate decreases.Conclusions: Our study shows that sr. albumin is a good indicator of postoperative complications. The patients with sr. albumin <3.0 g/dl had a higher complication rate which was statistically significant (p<0.05). Patients with sr. albumin >3.5 g/dl had less complications which was statistically significant (p<0.05). The correlation between the serum albumin and complication rate was statistically significant in the malignant diseases when considered separately.
Background: Fibroadenoma is the second most common tumour in the breast (after carcinoma) and is the most common tumour in women younger than 30 years. Multiple fibroadenomas (more than five lesions in one breast) are very uncommon and are considered disease. Familial bilateral multiple fibroadenoma is an exceedingly rare presentation with only one such case described earlier in medical literature where three siblings had multiple bilateral breast fibroadenomas. We report a case series of familial fibroadenomas present in four siblings, along with one case presenting with bilateral multiple fibroadenoma, which is first in the medical literature.Case Presentation: Fine needle Aspiration were suggestive of bilateral multiple fibroadenoma. Upon surgery, 10 fibroadenomas were removed from the right breast and 9 fibroadenomas were removed from the left breast. Histopathological examination was consistent with fibroadenoma with myxomatous change. Conclusion: Familial fibroadenoma of the breast is an exceedingly rare presentation of a very common tumour. This was the first reported case of 4 siblings having familial fibroadenoma. Further studies are required to investigate the familial nature of this disorder.
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