Pseudocysts of the spleen are very rare, found in <1% of the splenectomies done and usually develop secondary to trauma. Pseudocysts of spleen rarely grow to large size and most of these remain asymptomatic, they require exploration only in symptomatic cases and chances for spleen preservation in these cases are usually less. Here, we present two cases of this rare entity developing secondary to abdominal trauma in the past, both presented with complaints of pain and lump in the abdomen. After thorough investigations, laparotomy was done preserving spleen in one case and doing splenectomy in the other. On histopathological examination, diagnosis of splenic pseudocysts was confirmed by the absence of lining epithelium. We would like to report these two cases because of their rarity and as diagnostic dilemmas.
Background: The breast is a dynamic structure that undergoes cyclical changes throughout the menstrual cycle. Any aberration from normal physiological changes in breast produces different problem in breast. Many drugs are used for treatment for these disorders like Danazol, Bromocriptine, Tamoxifen and LH-RH analogue but still no consensus for any drug is present.Methods: The aim of our study was to analyze the effectiveness of drug Centchroman and its comparison with Danazol in treatment of benign breast disorders in respect to symptoms relief, decrease in nodularity and lump size, recurrence, cost and side effects of drug. This prospective study was conducted on 250 patients of benign breast disorders attending surgical OPD between May 2018 to September 2019 in SMS medical college and Hospital, Jaipur.Results: Tolerance and improvements in symptoms in centchroman group was more than danazol (100% vs 92.8%) with less recurrence in former group. While side effects varied between the two groups with menstrual irregularities more common in centchroman group.Conclusions: The study shows that centchroman is safe, more effective and less expensive to Danazol for the treatment of benign breast disorders in long term.
Background: Minimal invasive surgery has many advantages. In order to maintain and control pain, one of the most effective technique is Transversus abdominis plane (TAP) block technique. Aim of the study was to demonstrate the efficacy of laparoscopic guided transversus abdominis plane block in post-operative analgesia requirement in elective laparoscopic cholecystectomy.Methods: It was a hospital based prospective interventional study. Sample size was calculated at 0.05 α error and 80% study power assuming mean difference of VAS score between TAP block +/A group and TAP block- /B group is 1 and standard deviation of VAS score 1.3 among patients undergoing elective laparoscopic cholecystectomy.Results: A total of 60 patients were enrolled in this study. The mean age of group A was 48.56 years and for group B was 43.53 years. In group A 80% patients were females and for group B 83.3% patients were females. There was significant difference in VAS score at immediate post operation, at 1 hour, at 6 hours, at 18 hours and at 24 hours as p value was <0.0001 for all these groups. The mean VAS score was recorded less in group A at all the time duration compared to group B.Conclusions: With advantages like maximum safety, efficacy, potential for lower visceral injury risk and shorter operational time and other numerous advantages (decreased analgesic requirements, etc.) laparoscopic-guided TAP block counts as an ideal abdominal field block in the patients.
Background: Tuberculosis is a transmittable disease caused by Mycobacterium tuberculosis. Tuberculosis (TB) is a widespread and serious health issue, particularly in developing nations where ignorance, poverty, overcrowding, inadequate sanitation, and malnutrition are prominent. The goal of this study was to assess the clinical signs and outcomes after surgery for intestinal TB and to compare the clinicopathological profile and outcome of surgical therapy of abdominal tuberculosis in our environment to what has been reported in the literature. Methods: The research was carried out at the SMS hospital in Jaipur, general surgery ward. This was a hospital-based descriptive observational study that lasted until September 2021 carried out from September 2020 to September 2021 the necessary sample size was reached. The sample size was computed using a 95% confidence interval and the assumption that 76.7% of the patients had abdominal pain. The sample size of 68 patients with intestinal TB was rounded up to 70 patients. Results: Out of 70 patients, there were 30 patients in the age range 15-30 years, followed by 20 (28.57%) in the age group 46-60 years, and 16 (22.85%) in the age group 61-75 years. Females made up 55.71% of the 70 patients. Conclusions: The disease is characterised by young age at presentation, delayed manifestation, poverty, and high morbidity and mortality in this region. These issues must be addressed in order to provide the best possible treatment for these individuals. The key to an early and successful diagnosis of abdominal tuberculosis is extreme monitoring in patients with abdominal symptoms.
Introduction: Anal fissure is a common problem with widespread presence in young adults and middle age group people. After the failure of conservative method there is a need of a good surgical procedure. Aim of this study is to determine the better surgical outcome between LIS and AD. Material and methods: This is a prospective observational hospital based study which included 65 patients of CAF in each LIS and AD group. They were followed for 3 months post-op for recurrence, pain relief and ulcer healing. Study was conducted after approval from ethics committee. Result: By the end of 2nd week, 99% patients of LIS group show pain relief with median VAS score of 1 and IQR of 0-1 while 93.84% patients in AD group with median VAS score was 1 with IQR of 0-2. (p-value=0.013). At one-month post-op 100% patients in LIS group shows healing of ulcer while in 92.3% in AD group. (p-value=0.068). At 3rd month LIS group show 4.6% recurrence while it is 27.7% in AD group, which is significantly higher with p-value>0.001. Conclusion: Both the surgical procedures are good with ulcer healing and pain relief but, LIS shows significantly higher pain relief than AD. In terms of recurrence LIS is a significantly far better procedure than AD. Overall LIS is a superior procedure for CAF than AD.
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