Introduction: Stoma could be a surgically created opening within the abdominal wall. The main purpose of the stoma is to divert the excreta off from the distal intestinal loops to relieve an obstruction or protect anastomosis. The indications for stoma creation are intestinal obstruction due to benign or malignant tumors, perforation peritonitis, inflammatory bowel disease, colorectal malignancies, and anorectal malformations. Aim of the study: The study aimed to identify the patterns, indications, and complications that occur following the creation of enteric stomas. Materials and Methods: It is a prospective observational study conducted from May 2012 to October 2015 on a hundred patients, who were admitted in the department of general surgery, surgical gastroenterology, and pediatric surgery, Government Stanley Medical College and Hospital. The sampling method followed here is the non-probability convenience sampling technique. The data is collected from all the patients who come under the inclusion criteria. Results: Of 100 patients, the majority of the patients belonged to 26–35 years and 46–55 years ( n = 25). Based on the study, loop colostomy is more common with age less than one year and loop ileostomy is more common in 26–55 years. The foremost common indication of an enteric stoma is a gastrointestinal malignancy (25%) followed by abdominal trauma (22%). In our study, an ileostomy (80%) is the most common type of stoma created followed by colostomy. Within the ileostomy, loop ileostomy is the more common (60%) followed by end ileostomy (20%). Among the complications related to an enteric stoma, skin excoriation (54.4%) is most common followed by surgical site infections (8.5%). Conclusion: Our study shows stoma creation is higher in the adult and old age group, mostly done as an emergency procedure compared to an elective procedure. So, better preoperative planning in both emergency and elective settings can reduce the number of stoma and its related complications. The duration of hospital stay is higher in stoma patients. So, the reduction in stoma creation leads to a reduction in complication, duration of hospital stays and indirectly reduces expenditure related to it. In our study, most of the stoma is created for obstruction in malignancy and perforation in trauma patients. From our study, we can observe early diagnosis of intestinal malignancy with a well-planned elective procedure or bride procedure like colonic stenting in malignant obstruction can reduce the number of stoma creation. Skin excoriation is the most complication followed by surgical site infections. These complications can be reduced by better postoperative stoma care and early reversal of stoma.
BACKGROUND Detecting the breast pathologies, at its earliest possible stage is the ultimate goal in imaging the breast. Diagnosis chiefly includes radiological investigations like mammography and ultrasonography followed by biopsy. The incidence of breast cancer deaths can be reduced by 30% by the routine screening of healthy women with mammography. USG plays a key role in differentiating solid and cystic masses. It is useful in the evaluation of palpable masses not visible radiographically.The purpose of this study was to compare the role of mammography and ultrasonography in the evaluation of breast diseases and to compare the diagnostic accuracy of ultrasonography and mammography for diagnosing breast diseases when doing individually and its combination on same patients. MATERIALS AND METHODSData for this descriptive study were sourced from all female patients above 15 years of age who presented with symptoms of breast diseases like breast lump, pain in the breast and nipple discharge to outpatient and inpatient surgery department in SRM Medical College Hospital and Research Centre, Kattankulathur during the period from June 2013 to May 2016. Data collection methods include direct interview, clinical examination, mammography and ultrasonogram of symptomatic breast followed by FNAC (Fine Needle Aspiration Cytology) in all patients and excision biopsy in selected cases. Then the reports of FNAC/histopathological examinations were compared with the results of mammography and ultrasonogram of breast. RESULTSAccording to this study, MG showed a sensitivity of 82.6% compared to 73.9% for USG in detecting fibroadenoma. However, their combined approach resulted in 95.7%. In case of fibrocystic disease MG showed 27.6% and USG only 75.9% and the combination resulted in 75.9%. For diagnosing carcinomas MG had a sensitivity of 83.3% and USG 73.3%, but the combination had an efficiency of 100%. Overall, the histopathological results when correlated with each modality finding showed that MG had an efficiency of only 61.3% and USG only 77.4% when used alone in detecting these lesions of the breast compared to an efficiency of 91.2% obtained by their combined approach. Positive predictive value of ultrasonogram and mammogram was 98.6% and 100% respectively. Negative predictive value for USG and MG was 22.2% and 15.2% respectively with the accuracy rate of 78% for USG and 61% for MG. CONCLUSION Mammogram and ultrasonogram are two important non-invasive investigations available for evaluating breast diseases.Mammogram is more efficient in diagnosing malignant diseases of the breast, while ultrasonogram is more efficient in diagnosing benign breast diseases. The combinations of ultrasonogram and mammogram will diagnose almost all diseases of the breast. By using these non-invasive diagnostic modality, unnecessary invasive procedures like FNAC biopsy can be avoided. KEYWORDSMammography, Ultrasonography, FNAC, Breast Cancer, Breast Evaluation. HOW TO CITE THIS ARTICLE: Chakkarapani R, Durairaj B. Diagnostic accuracy of m...
BACKGROUND There is rapid increase in the number of blunt abdomen injury patients, mainly due to road traffic accidents. The physical signs are often masked in these patients and usually there is delay in the diagnosis of these patients. The computerised tomographic scan is the investigation of choice in such patients. Focused abdominal sonography in trauma (FAST) also has been proved to be accurate, non-invasive and less time consuming in assessing the critically traumatised patient in the emergency room. So, this study was undertaken to evaluate the role of FAST/ CECT Abdomen in detecting organ injury in Blunt Abdomen Trauma patients. MATERIALS AND METHODS This descriptive study was done among blunt injury abdomen patients who needed laparotomy in SRM Medical College and Research Institute, Potheri. In all patients, FAST and CECT Abdomen was done and compared with preoperative findings. RESULTS A total of 50 cases of blunt injury abdomen were included in this study. Of these cases, 44 cases (88%) were males and 06 cases (12%) were females. The range of age of the patients studied was from 16 years to 72 years and the mean age of the study group was 37.22 years. In our study, Road traffic accidents were the predominant cause of blunt injury. FAST and CECT findings were correlated with per-operative findings. Per-operative findings were positive in 50 patients. 49 patients were correctly identified by FAST (sensitivity 98%) and CECT correctly identified all 50 patients (sensitivity 100%). CONCLUSION CECT Abdomen is found to be highly reliable in detecting blunt abdomen injuries.
BACKGROUND Breast pathologies being benign and malignant with varying treatment options remain a challenge for the surgeons. Also, the prognosis of the breast disease varies from one condition to the other. With this varying treatment options and prognosis, breast diseases especially breast carcinomas add burden not only to the health care sector but also to the patient in economic terms also. Hence, this study was planned to know the clinical profile of breast diseases among females more than 15 years of age. MATERIALS AND METHODSData was a descriptive study collected from hundred female patients above 15 yrs. of age who presented with breast lump, pain in the breast and nipple discharge and willing to undergo histopathology examination/ FNAC and treatment for their breast disease in outpatient and inpatient surgery department in
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