BEZOARS are retained concretions of indigestible foreign material that accumulate and conglomerate in the gastrointestinal tract, most commonly in the stomach. Prevalence of bezoar is 0.4%. Bezoars are classified in four categories: phytobezoars; trichobezoars; pharmacobezoars; lactobezoars. A 58-year-old man admitted with complains of pain abdomen and recurrent vomiting since last 3 months. Upper GI endoscopic biopsy reported—chronic gastritis with very occasional non-caseating epitheloid granuloma in lamina propria, no evidence of neoplasia? Crohn’s disease. Keeping Crohn’s as diagnosis patient was given mesalamine 400 mg tid by gastrophyscian. But patient did not respond so the patient was advised surgical management. Repeat UGI endoscopy revealed multiple pills (mesalamine) in the stomach with gastric outlet obstruction (GOO). Around 40 pills were extracted with the help of flower basket, and then patient develope GOO and underwent Laparoscopic gastrojejunostomy and truncal vagotomy.
A 41 years old male patient, having acute respiratory distress syndrome (ARDS) due to viral pneumonia, was put on venovenous (VV) extracorporeal membrane oxygenation (ECMO). After 3 h of initiation, the ECMO pump malfunctioned. The patient was initially managed on a hand crank for 5 h. However, as another machine would be available after 12–24 h, we decided to use a roller pump with a conventional cardiopulmonary bypass (CPB) circuit. We successfully manage this crisis with this technique without any complications. This technique can be lifesaving in catastrophic situations such as ECMO console or pump failures when there are neither backup machines nor service engineers available.
Capsule endoscopy (CE) is commonly used for examining and diagnosing gastrointestinal disease, especially small bowel disease. Capsule retention is a well-known and significant complication of CE and requires surgical or endoscopic removal. Most reports described the retrieval of retained CE via laparotomy. We report a case of successful retrieval of the capsule using laparoscopic surgery.
Abstract:Purpose: This study was conducted to assess the Knowledge, Attitude, and Practice (KAP) of cardiac surgical patients towards the ongoing Coronavirus Disease (COVID-19) pandemic, as they are among the high-risk group for morbidity and mortality associated with COVID-19. Methods: This cross-sectional survey was conducted from September 2021 to November 2021 at a tertiary care hospital in western Rajasthan. A total of 88 patients were enrolled, and a questionnaire was created with 20 questions to assess KAP towards COVID-19. The KAP of enrolled patients was compared according to age, gender, place of residence, and education status. Results: A total of 88 participants completed the survey questionnaire, of whom 41 were male, and 47 were female. The mean age of the participants was 41.5 years. The mean knowledge score of our study group was 21.49±7.42, the mean attitude score was 4.08±1.84, and the mean practice score was 4.60±0.74. In the subgroup analysis, the difference in the knowledge score was statistically significant (p<0.05) in different age groups, however, the attitude and practice scores were comparable for all the age groups. There was no difference in KAP scores concerning the gender of the participants. KAP scores were significantly higher for the participants residing in urban areas than those from rural places. The KAP scores also showed a statistically significant relationship with the education status of the population (p<0.001). The knowledge score of the participants with graduation and above was 32.50±2.31, whereas the illiterate subgroup scored 13.72±3.15. Similar results were seen in the attitude and practice scores, with the mean values showing a gradual rise with the education status of the study population. Conclusion: This single-center KAP study on COVID-19 among cardiac patients who are considered high risk was able to postulate a comprehensive evaluation. The findings suggest that high-risk patients have decent knowledge scores and an overall optimistic outlook on surviving the pandemic. However, novel and far-reaching awareness programs are required for patients who are less educated and reside in rural areas as they are found to have lower KAP scores. Keywords: KAP, COVID 19, Cardiac surgery, Knowledge, Attitude, Practice
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