Background: The word stoma is derived from the Greek word stoma meaning mouth or opening. Intestinal stoma are surgically created opening that connect part of gastro-intestinal tract with the anterior abdominal wall. The use of various types of colostomies can be lifesaving. Since at our centre we regularly perform colostomies in treatment of various conditions in paediatric age group, this clinical study was undertaken.Methods: This clinical study was conducted in the Department of General Surgery at College of Medicine and JNM Hospital, Nadia. The study was conducted during the period from August 2018 to July 2019. The patients aged day 1 to 12 years were admitted.Results: In the one year study period, 33 cases of paediatric colostomies were performed. 17 (51.5%) were male and 16 (48.5%) were females. Majority of the patients at the time of colostomy were in the early neonatal period. A total of 22 (66.6%) cases underwent colostomy at our hospital and 11 (33.4%) patients had undergone colostomy elsewhere. Majority of the cases who had undergone colostomy were of sigmoid loop variety and 9 patients (27.3%) had transverse loop colostomy. A total of 12 patients (36.36%) suffered post colostomy major complications needing attention.Conclusions: The child is a socio-psycho-biological unit and colostomy leads to substantial psychological trauma for the child and parents. Careful examination is the key to diagnosis and initial management. An appropriately indicated, properly constructed temporary stoma is frequently unavoidable and lifesaving.
Background: Lichtenstein mesh repair technique is widely used throughout the world in inguinal hernia repair. Hernioplasty done under local anaesthesia certainly has some benefits but it is yet to be proven as standard procedure. The aims of this study are to provide the data of a comparative study between Lichtenstein hernioplasties done under local versus spinal anaesthesia as well as add more data in this scenario.Methods: In this non randomized clinical study, 84 patients were selected by calculation of sample size. 42 patients were operated under spinal anaesthesia and another 42 were operated under local anaesthesia.Results: Mean duration of operation was slightly was slightly more in local anaesthesia i.e. 62.5 minutes (SD=17.8) versus 51.1 minutes (SD=21.5) in spinal anaesthesia. At 6 hours, 12 hours and 24 hours postoperative pain was significantly less in local anaesthesia group in comparison to spinal anaesthesia group with p=0.04, p=0.042, p=0.041 respectively. Postoperative complications like urinary retention, hypotension, and headache were more in spinal anaesthesia than in local anaesthesia. Duration of hospital stay was significantly less in local anaesthesia group i.e. 24.5 hours (SD=12.8) in comparison to spinal group 57.1 hours (SD=16.7).Conclusions:The study concludes that in local anaesthesia group, postoperative pain was significantly less and postoperative complications like urinary retention, headache, and hypotension were less evident compared to spinal anaesthesia. Hence the study concludes that local anaesthesia can be used as an alternative of spinal anaesthesia as a standard mode of anaesthesia for Lichtenstein hernioplasty operation.
Background: Leg ulcers are debilitating and painful, greatly reducing patient's quality of life. These ulcers are often difficult to treat and the successful treatment of leg ulcers depends upon the accurate diagnosis and treatment of the underlying cause. Methods: This prospective cross sectional study was conducted by Department of General Surgery at College of Medicine and JNM Hospital, Nadia. The study was conducted during the period from September 2017 to August 2019 which included 193 patients presenting with ulcers of the lower limb and admitted in surgical wards of our hospital. Results: Most of the patients were engaged in agriculture (23.8%) followed by business (22.8%) and service (14.5%). 52.03% of the patients had habit of smoking, chewing tobacco and drinking of alcohol. Most of the ulcers were diabetic (36.3%) followed by venous (22.3%) (Z=2.17; p=0.01). Only 4.7% and 3.1% were malignant and trophic ulcers. Peripheral neuropathy (23.3%) was the most common type of ulcer followed by venous hypertension (22.3%). At the end of study period, 180 ulcers were healed, 3 had recurrence, 5 were disease free and 5 patients died. Conclusions: Thus, the study of various cases of leg ulcers arouses lot of interest and is mind boggling as far as the treatment of these cases are concerned. With the availability of arsenal of investigation wide range of antibiotics and with ever improving dressing material, there is certainly a great improvement in treatment of chronic leg ulcers.
Background: Since the declaration of the lockdown due to COVID-19, the usage of digital devices has gone up across the globe, resulting in a challenge for the visual systems of all ages. The aim of this study was to determine frequency, symptoms frequency and associated risk factors of Computer Vision Syndrome (CVS) among children attending online classes during COVID-19 pandemic. Materials and methods: The online electronic survey form was prepared on the Google app. Children/parents were asked to indicate the total duration of digital device use before and during COVID era. The symptoms of CVS, its severity and frequency were recorded and measured with the Computer Vision Syndrome Questionnaire. Results: One hundred and sixty four parents responded to the questionnaire, of these 124 were complete. Mean age of children was 14±3.01 years. Mean duration of digital device used during COVID era was 34.11±2.08 hours which was more than pre COVID era (0.98±0.24 hours). 36.29% used digital devices >5 hours in COVID era as compared to 0% before COVID era. The most common digital device used was smartphones (62.1%). Sixty seven children (54.03%) were attending online classes for >2 hours per day. 50% of the children had CVS. Of these 25% were mild, 12.9% moderate and 12.1% of severe grade. Most common symptoms were itching and headache. Multivariate analysis revealed age >14 years, male gender, smartphone use, use of device >5 hours and mobile games >1 h/day as independent risk factors for CVS in children. Conclusion: There is an increased prevalence of CVS among children in COVID era. Awareness about prevention of CVS should be stressed and going forward, measures to bring these adverse effects to a minimum should be explored. JCMCTA 2021 ; 32 (1) : 48-52
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