Objective: To find out the effective diagnostic algorithm (clinical features and investigations) for intestinal tuberculosis. Design: A retrospective study. Place and Duration of Study: B.V. Hospital Bahawalpur, June 2007 -2009. Patients and Methods: 100 cases of diagnosed abdominal tuberculosis were included in the study. Demographic variables, symptomology, investigations and management detail were recorded from the hospital record of surgical department of B.V. Hospital Bahawalpur. Results: Out of 100 diagnosed cases of intestinal T.B, 55 patients were male. 62 patients were bellow 30 years. Most Common presentation was obstruction (29 %), peritonitis (18%) Abdominal distention (20%) and Abdominal Mass (15%), Histopathology (97%) and laparoscopy (82%) were most sensitive. Operative procedure were right Hemicolectomy (26%), resection Anastomosis (23%), stricturoplasty (13%0, Ileostomy (9%), adhesiolysis (17%). Conservativelymanaged patients on anti-tuberculous therapy (ATT) were (12%). Wound infection and dehiscence (12%) were the common complications. Four patients died. Conclusions: All patients with prolonged history of weight loss, vague health and non specific abdominal symptoms and those who are under consideration for intestinal tuberculosis should follow the protocol comprising histopathology (laparoscopic/ USG guided /open), complemented by the diagnostic laparoscopy and radiological studies.
Gastrointestinal perforation is a common complication arising due to homicidal injuries, trauma or intake of medications like aspirin. Intestinal perforation caused by chronic intake of mud, clay or soil is a rare phenomenon and very few cases have been reported in the literature. We hereby present the first case of rectosigmoid perforation from Pakistan which was caused by chronic mud intake in a female patient. Diagnosis of this condition in its early stage is important because it can be fatal if not addressed urgently.
Background: In Western countries, middle-aged women are more vulnerable to breast cancer. Globally, almost a million new cases were identified in 1998. One in 12 women in England and Wales will get the disease at some point.1 Even 5,000 years after it was first reported, the etiology of breast cancer is still unclear, and effective preventative measures are even further off. Aim: To characterize the varied ways in which breast cancer has presented itself among patients at Bahawal Victoria Hospital in Bahawalpur. Methods: This investigation employed a descriptive case series research design. This research was conducted at Bahawal Victoria Hospital's Surgery Department in Bahawalpur (Pakistan). From March 13th, 2020 through March 12th, 2021, the study was conducted (12 months). With their assent, 100 women with definite cases of breast cancer were enrolled in the study. Results: Cancer of the breast most commonly affected women between the ages of 31 and 50 (59%). Seventy-six patients arrived from the outlying rural areas of Bahawalpur and the neighboring districts. Only 18 patients had completed high school after 10 years and 5 patients were discovered to be college graduates. The single rate was 12%, with 12 patients. Eighty-one percent of patients reported having a breast lump. 56% of breast cancers involve the left breast, while 43% involve the right. One patient alone had breast cancer that had spread to both of her breasts. Illness duration varied from 1 month to 5 years. Stage III was the most prevalent presentation, with 46 instances, and Stage IV was the least common, with 16 patients. Practical implication Community based effective awareness and prompt screening programme will improve better outcomes in breast cancer management. Conclusion: Breast cancer is very common cancer in the females, and most commonly it presented as a lump in the breast, because of some social aspects, lack of awareness, poverty, no proper screening programs and above all the fear of diagnosis, females try to hide this problem and often it presented at late and more advance stage. Keywords: Breast, Nipple, Cancer, Lump, Surgery, Tumor
Scoring systems are essential to calibrate the severity of abdominal sepsis for adequate management. Disease specific scoring system based on easy to handle clinical parameters can help the cause. Objective: To study the role of Manheim peritonitis index scoring in predicting outcome and prognosis in patients with perforation peritonitis. Methods: This prospective study was carried out in Surgical Unit 1, Nishtar Hospital, Multan from 20th of August 2019 to 31st of December, 2019. It includes both sexes aged 20 years and above diagnosed at laparotomy after confirmation of peritonitis due to perforated viscus regardless of the etiology. Data were analyzed using SPSS version 19.0 Software. The outcome (death vs discharge) was compared separately to different predictors using Chi-square test. Fischer Exact test was used where assumptions of Chi-square were not met. Results: Advance age, female gender, colonic perforation, organ failure and fecal contamination were associated with high mortality. The mean MPI Score was 25.06 ± 4.96. The lowest score was 16 and the highest was 37. Overall, the in-hospital mortality rate was 14.3% in patients with MPI ≥26 compared to 6.4% in patients with MPI <26, implying over a twofold higher risk in the former group. For a score of 26 or greater as a predictor of mortality, the sensitivity was 75.0%, specificity was 38.2% at an accuracy of 94%. Conclusion: MPI enables us to categorize patients into different groups so as to tailor management according to individual needs
Background: In Western countries, middle-aged women are more vulnerable to breast cancer. Globally, almost a million new cases were identified in 1998. One in 12 women in England and Wales will get the disease at some point.1 Even 5,000 years after it was first reported, the etiology of breast cancer is still unclear, and effective preventative measures are even further off. Aim: To characterize the varied ways in which breast cancer has presented itself among patients at Bahawal Victoria Hospital in Bahawalpur. Methods: This investigation employed a descriptive case series research design. This research was conducted at Bahawal Victoria Hospital's Surgery Department in Bahawalpur (Pakistan). From March 13th, 2020 through March 12th, 2021, the study was conducted (12 months). With their assent, 100 women with definite cases of breast cancer were enrolled in the study. Results: Cancer of the breast most commonly affected women between the ages of 31 and 50 (59%). Seventy-six patients arrived from the outlying rural areas of Bahawalpur and the neighboring districts. Only 18 patients had completed high school after 10 years and 5 patients were discovered to be college graduates. The single rate was 12%, with 12 patients. Eighty-one percent of patients reported having a breast lump. 56% of breast cancers involve the left breast, while 43% involve the right. One patient alone had breast cancer that had spread to both of her breasts. Illness duration varied from 1 month to 5 years. Stage III was the most prevalent presentation, with 46 instances, and Stage IV was the least common, with 16 patients. The histological hallmark most frequently attested by examination of slides was infiltrating ductal carcinoma, and this was the case in 87% of the cases. Conclusion: Breast cancer is very common cancer in the females, and most commonly it presented as a lump in the breast, because of some social aspects, lack of awareness, poverty, no proper screening programs and above all the fear of diagnosis, females try to hide this problem and often it presented at late and more advance stage. Keywords: Breast, Nipple, Cancer, Lump, Surgery, Tumor
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