Colorectal cancer is one of the most common surgically curable malignancies worldwide, having a good prognosis even with liver metastasis. This improved patient outcome is marred by anastomotic leaks (AL) in operated patients of colorectal cancer despite a microscopically margin-negative resection (R0). Various risk factors have been attributed to causing this. Preoperative non-modifiable factors are age, male sex, cancer cachexia, and neoadjuvant chemo-radiotherapy, and modifiable factors are comorbidities, peripheral vascular disease, anemia, and malnutrition. Intraoperative risk factors include intraoperative surgical duration, blood loss and transfusions, fluid management, oxygen saturation, surgical technique (stapled, handsewn, or compression devices), and approach (open, laparoscopic, or robotic). Postoperative factors like anemia, infection, fluid management, and blood transfusions also have an effect. With the advent of enhanced recovery after surgery (ERAS) protocols, many modifiable factors can be optimized to reduce the risk. Prevention is better than cure as the morbidity and mortality of AL are very high. There is still a need for an intraoperative technique to detect the viability of anastomotic ends to predict and prevent AL. Prompt diagnosis of an AL is the key. Many surgeons have proposed using methods like air leak tests, intraoperative endoscopy, Doppler ultrasound, and near-infrared fluorescence imaging to decrease the incidence of AL. All these methods can minimize AL, resulting in significant intraoperative alterations to surgical tactics. This narrative review covers the methods of assessing of integrity of anastomosis during the surgery, which can help prevent anastomotic leakage.
Background: Diabetic foot identifies a Diabetic patient foot that has a potential risk of pathological risk effects that includes inflammation, ulceration and deep tissue destruction consistent with neurological disorders, differing degrees of Peripheral arterial disease , and lower limb with metabolic complications. An ulcer is a breach of the continuity of skin, epithelium of mucous membrane in the body which is caused by removal of necrotic tissue . Foot ulcers may be caused by numerous medical conditions. The key to treatment is daily sterile dressing till the formation of healthy granulation tissue, infection control by appropriate use of antibiotics, surgical interventions such as debridement or amputation if needed. Methods: It will be a observational study, done on the patients with Diabetic foot . It will be conducted at Dept. of General Surgery, J.N.M.C. and AVBRH, Sawangi (Meghe), Wardha of DMIMS (DU). The study will be conducted on patients of foot ulcers. Objectives: To evaluate the microbiological and clinical characteristics of diabetic foot infection To analyze the outcomes of a patient with diabetic foot with underlying risk factors HBA1c, Hypertension, Smoking, Diabetic Neuropathy, Recurrence, Obesity, Peripheral arterial diseases. To analyze the association of Risk factors in the causation of Diabetic foot. To predict outcome parameters based on Risk factors and its treatment modalities. Results: The results will be analyzed after data collection in SPSS software. Conclusion: Conclusion will be drawn on findings of study.
The management of cervical sub axial spondylolisthesis is a challenging task for all spinal care specialists because there is a lack of literature on the disease's diverse clinical presentations. Sub axial spondylolisthesis is a freak injury with a wide range of clinical manifestations. Particularly decisionmaking concerning the monitoring of such patients is difficult in a secondary trauma centre. The spinal column is a dynamic system that protects nervous innervation throughout the body while also enabling the head and neck to move freely. Spinal cord fractures are a major cause of mobility and mortality in trauma patients and a skeletal fracture is linked to 56% of cervical spinal cord traumas. Cervical spines fractures are classified based on the degree involved and are traditionally divided into three groups: C1, C2 and sub-axial spine (C3 to C7). Severe spinal cord injury and quadriparesis are commonly associated with trauma-related high-grade spondylolisthesis in the sub axial cervical spine. In rare circumstances, such pathology has resulted in minimal to no neurological deficits. We present a case of 45-year-old male presented with alleged history of fall from bike and is associated with history of injury over neck and over head with no other significant clinical complaints.
Apart from meconium ileus, amniotic fluid plug syndrome, malrotation of the gut, Hirschprung's disorder, trauma, and other rare causes, bowel atresia is one of the most common causes of bowel obstruction in newborns. Jejunal atresia can affect multiple lengths of the bowel. The higher the level of atresia, the greater the severity. The outcome of bowel atresia related to surgical repair is favorable. In general, both mortality and morbidity are affected by affiliated medical conditions such as preterm birth, cystic fibrosis, and other congenital anomalies; the sophistication of the lesion; and surgical complications. We present the case of a one-day-old baby who had two episodes of bilious vomiting with abdominal distension within 10 minutes of birth. The baby was advised to undergo ultrasonography of the abdomen and pelvis for further evaluation, and the findings were reported.
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