All unidentified / unaccompanied & unknown TBI patients admitted in department of neurosurgery, Gandhi Medical College Bhopal from June 2016 to May 2019 were enrolled in this study. Management of unidentified and unaccompanied patients is difficult in any health care setup due to challenges in managing their day to day care. Traumatic brain injury is the most common cause of death in trauma patients. We analyzed demography, mode of injury, clinical presentation & condition at admission, treatment given, hospital stay, outcome & factors affecting outcome of the patients. Very few studies in world literature are available on this subgroup of patients. We analyzed data pertaining to 100 consecutive patients at our hospital. Aim and Objectives: The aim and objective of this study is to determine the outcome of traumatic Brain Injury in patients who were admitted in trauma unit/ Neurosurgery unit of Gandhi medical College Bhopal India from June 2016 to May 2019. As unaccompanied / unknown/ unidentified. In this study we collected the data of unknown/ unidentified patients of TBI to analyze the outcome. Material and Methods: It was a prospective study of all unaccompanied/ unknown patients who were admitted in the trauma unit/ Neurosurgery unit of surgery department of Gandhi Medical College & Associated Hamidia Hospital Bhopal India from June 2016 to May 2019 a total number of 100 unidentified /unaccompanied patients were admitted whose data were collected and analyzed Departmental staff, social workers, police and media persons help were take in for relocation of unknown patients to their home or non government organization shelter homes . Results: There were total 100 consecutive patient enrolment in this study, 87% of the patients were male. Most common age group was 40-59 years, 48% patients falls in this age group. Most common cause of trauma was road traffic accident (48%), followed by Cause Unknown (36%). Overall mortality was 39%. Others clinical characteristic and type of lesion in traumatic brain injury of unidentified and unaccompanied patients is given in detail in. Out of 100 patients, 43 (43%) patients were managed conservatively based on CT head findings and neurological status & 57 (57%) were operated. Decompressive Craniectomy was most common operative procedure depending on the clinical & neurological status. Overall complication rate during hospital stay was 26%. Keywords: TBI, Unidentified Patient & Unaccompanied & Decompressive Craniectomy, Rehabilitation.
Background: Skin infections are major cause of morbidity and mortality worldwide, affecting more than one person/1000 person/year. Sepsis has a worldwide incidence of more than 20 million cases a year, with mortality due to septic shock reaching up to 50% even in industrialized countries. Acute phase reactants like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) have been used traditionally as markers for inflammation and are readily available in most centres. Aim was to study the correlation between the values of ESR and CRP with severity of cellulitis and necrotising fasciitis (in term of hospital stay and disease outcome).Methods: This was a prospective observational study conducted at Department of Surgery, GMC and Hamidia Hospital, Bhopal from a period of March 2016 to August 2018.Results: Skin and soft tissue infections are most commonly affects male, diabetes mellitus most common co-morbid condition. Mean value of ESR and CRP in patients who could not survived was 64.44 and 145.92 respectively and value more than 54.95 and 93.41 requires longer hospital stay.Conclusions: ESR and CRP are non-specific test but they are good predictors of severity of cellulitis and necrotising fasciitis not only in planning of management of these cases but also predicting outcome of the disease.
Background: Breast carcinoma is one of the most common malignant tumor of women. Determination of estrogen receptors (ER) and progesterone receptors (PR) status, prior to therapeutic intervention has become standard practice. Survival and response to hormone therapy are most favorable among women who are receptor positive. The aim of this study is to assess the hormone receptor status in locally advanced breast carcinomas and correlate this reactivity pattern with tumor stage, clinical stage and lymph node metastasis. Objective of the study was to co-relate the locally advanced breast cancer and their hormone receptor analysis.Methods: Patients who visited Department of General Surgery, Hamidia Hospital, Bhopal were assessed clinically, radiologically and histopathologically and then ER and PR study was done, for a total of 50 cases were done.Results: In our study majority of the cases were locally advanced breast cancer (50%) which may be due to the low socio economic status, late presentation, pain tolerance, illiteracy and availability of the resources. Majority of cases were in postmenopausal, clinical stage 3 and histological grade 2. ER positivity 50% and PR positivity 44% and it was found that hormone receptor positivity was high in locally advanced breast cancers 63.5%.Conclusions: Hormone receptor analysis should be an integral part of initial workup of carcinoma breast, as the percentage of hormone receptor positivity is increasing in our population in locally advanced breast cancer. So locally advanced breast cancer can be diagnosed at an early stage by screening and conducting breast awareness programs.
The majority of the patients who were diagnosed with the glioblastoma at GMC, Bhopal. The only exceptions are the patients that have died or were not fit enough for referral. Among these patients, we have searched for those, which were older than 70 years at the time of diagnosis Result: When comparing the groups of the patients younger than 70 with those older, the difference in median survival between groups was statistically significant at p < 0.001. Conclusion: Microsurgery is safe and effective in order to improve or preserve short-term quality of life in glioblastoma patients. Total tumor resection is not associated with a significantly greater risk for neurological deterioration, either in patients with preoperative functional impairment, or in functionally independent patients. For glioblastoma the survival also depends on person's age, type of tumor, and overall health play a role as treatments improve people newly diagnosed with these aggressive brain tumors may have a better outcome. Glioblastoma is linked to age, with better rates for those below 65 years of age, but also to aggressive and complete surgical excision, a good Karnofsky index score before surgery and the application of radiotherapy after surgery Study Design: Observational Study
The study was conducted in the Department of General Surgery, Gandhi Medical College, Bhopal over the period of one & half year. Evaluation started with History and clinical examination including range of movement of joints. Scar was scored as per Clinical Assessment Score. Range of movement was measured using goniometer. Although most patients came for follow up and were compliant with the rehabilitation protocol, their compliance needs to be re-evaluated at every follow up and they should be encouraged to follow the advices strictly. Also they must be counseled that contracture may not be corrected to the full extent despite best of treatment and compliance with rehabilitation protocol but a good level of improvement can be achieved. Keywords: Burn, Surgery, Rehabilitation & Recurrence.
Study includes hundred patients admitted to surgical emergency with acute abdomen were selected for the study. There was not any preoperative selection criteria; the cases which were proven to be cases of perforation peritonitis on the basis of investigations and clinical examination were taken for study and considered for comparative study if laparotomy diagnosed to be case of caecal perforation. Inflammatory cause 22 cases (22%) which include caecal perforation secondary to ruptured liver abscess 14 cases, appendicular base with caecal wall perforation 4 cases. Obstructive cause 06 cases (06 %) include obstructed inguinal hernia 02 case, obstructive band 02 case and caecal volvulus 03 case. 04 cases (04%) of caecal perforation secondary to neoplastic etiology were studied. The common etiologies in descending order were Traumatic 68 cases (68%) which include multiple stab injury 40 cases (40%), blunt trauma abdomen 12 cases (12%), iatrogenic 10 cases (10%), caecal perforation secondary to arrow injury 1 case (2%), and blast injury 2 case (4%). Chi Square Test of statistical significance was applied between group A (right hemicolectomy with ileo transverse anastomosis) and group B (primary repair with omental patch, primary repair with proximal ileostomy and right hemicolectomy with ileo transverse colostomy) for testing association between between group A and group B. From total Nine parameters chi square test was found to be significant in seven parameters with p value <0.05. There was no statistical significance found in two parameters with p value>0.05. Reducing mortality in patients undergoing surgery for caecal perforations. Ileostomy-specific complications, however, increase the postoperative stay of the patient. These complications can be reduced, if not outright eliminated, by proper fashioning of the stoma and provision of adequate nursing care of the stoma. It should be recommended that ileostomy in these cases is only temporary and the extra cost and cost of management are burden to life of poor community.
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