Abdominal trauma, both blunt and sharp, is a major public problem and constitutes one of the serious and major surgical emergencies for surgeons worldwide. Frequently, more obvious multiple injuries to head, thorax and extremities may mask the blunt abdominal trauma. A better understanding of the etiology and pattern of such injuries can help to improve the management and outcome of these patients. Blunt trauma abdomen is more common in males in age group of 21-30 years and majority of injuries are due to road traffic accidents. Solid organs of upper abdomen such as spleen and liver are primarily injuried in blunt trauma abdomen. In penetrating injuries small intestine is most frequently injuried. About 15% of all pelvic fractures are associated with concomitant bladder and urethral injuries. A direct blow to lower abdomen may result in bladder disruption; mainly intra peritoneal. This study was done to determine the incidence of trauma abdomen and its various parameters like age, sex, mode of injury, its radiological findings and detail of visceral injuries and patients' outcome.
Introduction. Chest is one of the main sites of injuries in trauma being a part of the torso. Many important organs lie in rib cage. However, data on chest injuries are scarce. Methods. A retrospective study was carried out for chest trauma patients including polytrauma (n = 184) from hospital records for five years (2016–2020). Various parameters including demographic profile, mode of injury, management, and outcomes were studied. Results. Mean age of patients was 37 ± 16 years with a male to female ratio of 2.4 : 1. Road traffic injuries remained the most common cause of trauma followed by assaults. Most of the patients were managed conservatively (55.43%). Mortality was seen in only 1.63% patients. Conclusion. Young male patients are usually affected by trauma. Road traffic injuries are the commonest cause. However, most patients can be managed by conservative treatment and mortality is seen only in polytrauma patients in the present study.
Small bowel diverticulosis represents an uncommon pathology that is often misdiagnosed, since it causes non-specific gastrointestinal symptoms. It is defined by the existence of multiple diverticula, which are located most frequently in the jejunum. Acquired and congenital diverticula of the jejunum in the adult are unusual entity. These lesions are usually asymptomatic and may produce chronic symptoms. It is because of the rarity of the entity that they often produce a diagnostic as well as therapeutic dilemma resulting in unnecessary morbidity and mortality. This is a report on a case presented to emergency with features suggestive of perforation peritonitis with incidental finding of multiple small gut diverticula.
Objective: The objective of the study is to compare the effect of superoxide solution (SOD) and chlorhexidine gluconate on wound healing. Methods: Hundred patients with different types of wounds were recruited in this study and randomized to two groups: Group A- SOD group and Group B- Chlorhexidine group. Observations were made regarding type of wounds, reduction of edema, culture of wounds, improvement, cure rates, and hospital stay. Results: Although there were no significant difference in the reduction of edema and swelling of wound in both groups, the cure rates were statistically better with SOD (p=0.001) and hospital stay was also less with the use of SOD (p=0.006). Conclusion: SOD treated case showed less morbidity, with more improvement, and more cure rate compared to chlorhexidine solution with statistically significant p-value. However, further research into the use of SOD and the cytotoxic nature of chlorhexidine in the treatment of various wounds is required.
Introduction: Trauma has been the leading cause of mortality and morbidity. However, there are changes in pattern of trauma and their outcomes with time. Aim: To study the mode and nature of injury and mortality associated with trauma of head, chest and abdomen. Materials and Methods: A prospective cohort study was conducted on 1000 individuals that presented to emergency surgery ward from 2014 to 2019. Patients presented to emergency surgery of Government Medical College, Amritsar, Punjab, India were observed for various characteristics i.e., age group, mode of injury, site of injury, outcomes and management. Results: The mean age of patients was 33.91±16.29 years with significant male predominance (n=794, 79.4%) (p-value 0.00001). Road Traffic Injuries (RTIs) were the most common mode of trauma affecting 490 patients (49%). Head injury was the most common of all injuries (n=834). Overall mortality was 3.6% (n=36). Mortality was higher in males (p-value 0.00933) and mortality rate of 25% was seen in age group of 61-70 years. Conclusion: RTIs followed by assaults are the most common cause of trauma and it significantly affects young male population. However, mortality rate increases with increase in age group with higher rates in older age groups.
Background/Aim Acute pancreatitis is encountered in both medical and surgical specialty. Assessment of severity and grading is done using radiological investigations mostly like ultrasonography or CECT. We present a study to assess the severity of Acute Pancreatitis based on Bedside Index for Severity in Acute Pancreatitis (BISAP) scoring system. Material & Methods The study was conducted on 50 patients presenting with acute pancreatitis who were included as per inclusion criteria and a detailed history, clinical examination and blood investigation performed. Data like serum amylase, serum lipase, serum calcium, blood urea nitrogen (BUN), pleural effusion and systemic inflammatory response syndrome (SIRS) was collected from the patients. Based on data collected in 24 hours of hospitalization, BISAP score was calculated. Results Results showed that no significant temperature rise, pancreatic necrosis, SIRS or impaired mental status in patients with BISAP severity of <=3. However, patients having BISAP score >3, factors like BUN, age, pleural effusion, and organ failure show significant correlation. Also on comparative analysis of patients showed that the hospital stay, respiratory rate, pulse and laboratory markers (blood urea, serum creatinine, serum amylase, serum lipase) were significantly higher in patients with BISAP score ≥3. Conclusion BISAP score is an easy, quick and bedside method to assess the severity of acute pancreatitis and predict its mortality. It is easy bedside procedure that can be done in every setup.
Background: Evaluation of the emergency department(ED) patient with acute abdomen is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. The term acute abdomen is constantly applied to such cases that signify the urgent need for prompt diagnosis and active treatment. Objective: This study is designed to examine the present state of diagnosis and management of acute abdomen and to develop evidence based guidelines for the diagnostic pathway and management of acute abdomen. Result: Our study showed that acute cholecystitis was the most common cause (29%) in patients presenting with acute abdomen followed by perforation peritonitis (25%). Pain and vomiting (49%) was the most common complaint followed by distension (44%). Ultrasound is the most sensitive and most commonly used diagnostic aid in acute abdomen. Majority of patients(73%) required surgical intervention. Conclusion: Abdominal pain is a common presenting complaint in the ED and clinicians must consider multiple diagnoses, especially in those cases that require immediate intervention in order to limit morbidity and mortality.
The involvement of prolactin is well established in mammary carcinoma in rodents.However the exact role of hormones such as oestrogen, prolactin and progesterone in human breast cancer still remains elusive.The present study was undertaken to compare the preoperative and postoperative serum prolactin levels in patients of carcinoma breast coming to the department of Surgery, Guru Nanak Dev Hospital attached to Govt. Medical College, Amritsar.. Serum prolactin levels showed a statistically significant elevation in premenopausal as well as in postmenopausal patients of carcinoma breast as compared to control group. The prolactin levels were raised two days after and one month after surgery upon breast. The elevation was more marked in premenopausal patients as compared to postmenopausal patients of carcinoma breast.
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