Cymbopogon caesius grass is an aromatic tall grass species which grows in waste field and along the edges of crop fields in Karnataka. From this grass fungal endophytes were isolated on PDA medium and identified as Curvularia lunata. The fungus was cultured on Potato Dextrose broth for production of fungal metabolites. Ethyl acetate extract of the C. lunata was obtained by liquid-liquid partition of broth of endophyte and evaporation. Dried crude extract was tested for antimicrobial activity by agar well diffusion method. The extract showed antimicrobial nature against all the test pathogens. Crude extract of C. lunata is highly active against Staphylococcus aureus with the inhibition percentage of 92 and Candida albicans with 81 percent inhibition.
Pre-operative factors with Parkland grading system in assessing difficult Laparoscopic Cholecystectomy and expectant operative and post-operative complications. Materials and Methods: A prospective study done in hospitals attached to BMC&RI, Department of General Surgery, Bengaluru from Dec 2017-Dec 2018. A total of 110 cases were evaluated & underwent laparoscopic procedure. Gallbladder status was assessed intraoperatively with the application of Parkland grading system.Results: Out of 110 cases-majority were Grade1 (30%), shortest (64.09 mins) & longest surgery duration (152.85 mins) for Grade 1&5 respectively & more complications for Grade 4&5. The length of hospital stay was higher (12.85 days for Grade 5). Conclusion: Parkland grading system is a highly reliable, simple, intra operative based scale that can accurately predict difficult Laparoscopic Cholecystectomy and its outcomes. As the grade increases severity of the disease and difficulty in surgery and its outcomes.
INTRODUCTIONBowel gangrene is a major abdominal catastrophe associated with high mortality rate. This increased mortality is attributed to difficulty in diagnosing the condition early, the late presentation of the patient to the hospital and non availability of precised diagnostic tool for assessing bowel gangrene. 1 Intestinal obstruction accounts for 20% of all surgical emergencies around the world. Intestinal obstruction can result from variety of causes. When strangulation superimposes and blood supply to the bowel is compromised, it may lead to bowel gangrene. The most common cause of bowel gangrene secondary to mechanical obstruction is strangulated hernia in India and post operative adhesions in developed countries. The other causes being Volvulus, Intussusceptions, Hollow viscus perforation, Mesenteric Ischaemia. 2 The diagnostic evaluation should focus on the following goals: (a) distinguish mechanical obstruction from ileus (b) determine the etiology of the ABSTRACT Background: To study the role of serum LDH and D-Dimers in predicting intestinal necrosis, to correlate with bowel viability preoperatively and to determine the aetiology for intestinal necrosis due to Mesenteric Ischaemia or any other causes. Medical College for a period of one year. Results: In our study out of 100 patients 44 patients had elevated serum LDH which is 44% and among those 44 patients, 39 patients found to have bowel gangrene which is about 88%. Out of 100 patients 9 patients had elevated Ddimer levels which are 9% and among those 9 patients, 6 were suspected of mesenteric ischaemia and all patients had bowel gangrene which 100%. Conclusions: The pre operative estimation of serum LDH levels in patients presenting with features of acute abdomen helps in identifying the patients with risk of intestinal ischemia and gangrene at the earliest, facilitating early intervention and helping in reduction of morbidity and mortality due to bowel gangrene. Detection of serum D-dimer could not help to differentiate patient with mesenteric ischaemia from those with other causes of bowel necrosis but certainly all cases of mesenteric ischaemia had elevated D-dimer levels. The application of serum LDH and D-dimers in acute abdomen or suspected cases of bowel necrosis will give an important clue regarding the pathology and severity of the disease.
Background: Severe complicated intra-abdominal sepsis (SCIAS) is a worldwide challenge with increasing incidence. The sequential organ failure assessment (SOFA) score numerically quantifies the number and severity of failed organs. We examined the utility of the SOFA score for assessing outcome of patients with severe peritoneal sepsis.Methods: This is a prospective observational study. A total of 100 patients who presented to emergency department of Victoria hospital with features suggestive of peritoneal sepsis from January 2018 to August 2018 were included in the study. The presence of organ dysfunction was assessed using a sequential organ failure assessment (SOFA). Clinical, microbiologic, and laboratory factors were considered for assessing the outcome.Results: Forty-two patients had two or more sites of infection on admission. Bacteraemia was confirmed in 20 patients. 88 patients were surgical. The median age of patients was 69 years. Males being more commonly affected than females. Twenty-eight days survival rate was 41%. The incidence of organ dysfunction on day 1 was noted more frequently for renal, cardiovascular, and neurological systems. SOFA score on day 1 and day 3 were significantly higher in non-survivors than those in survivors. Patients with three and higher number of organ systems with dysfunction had a lower survival rate than the subgroups of patients with one or two organ systems with dysfunction.Conclusions: The SOFA score provides potentially valuable prognostic information on in hospital survival when applied to patients with severe peritoneal sepsis.
Background: Acute pancreatitis is an inflammatory process of the pancreas with possible peripancreatic tissue and multiorgan involvement inducing multiorgan dysfunction syndrome (MODS) with a high mortality rateand hence early identification of patients at risk for severe disease is of vital importance.Methods: Data were collected from 50 patients who presented to the emergency department of hospitals attached to BMCRI, Bangalore, having acute pancreatitis.Results: The study included 50 patients- 40 males and 10 females and median patient age was 54.5years.Out of the 50 patients, 40% had gall stones, 56% were alcoholic and 4% had idiopathic pancreatitis.56% were found to have a Ransons score of >3 and 44% had score < 3; 52%had a modified CTSI score of 0-2, 52%had a score of 4-6 and 22% had a score of 8-10. The incidence of severe acute pancreatitis in patients with Ransons score >3 has a p value <0.002. Also, the incidence of severe acute pancreatitis in patients with modified CTSI score >4 has a p value of <0.001.With respect to mortality, all 4 patients who died had a modified CTSI score of >4 (p=0.002) and 3 patients had Ransons score >3 (p=0.03) which is statistically significant.Conclusions: In our country where facility for CECT is not available to a major proportion of population, early assessment of severe pancreatitis can be performed by Ransons scoring, which is found to be comparable to modified CTSI scoring.
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