Background: Appendicitis remains one of the most common diseases encountered by the surgeon in practice. Appendicectomy is the most common urgent or emergency general surgical operation performed. Emergency appendicectomy is believed to be the standard treatment protocol for patients with acute appendicitis. This study was conducted to verify whether acute non-perforated appendicitis requires immediate surgery or can be delayed to be taken up on elective basis.Methods: This is a retrospective study of all the cases undergoing appendicectomy for acute appendicitis over the period of January 2016 to December 2016 in K. R. hospital, Mysuru, Karnataka, India. The cases were divided into two comparison groups: emergency group (operated within 12 hours of admission) and delayed group (operated between 12-72 hours). Parameters like age, sex, duration of symptoms, total leucocytes count, temperature, haemoglobin, radiological investigations, operative procedure, operative time, length of hospital stay, length of post-operative stay were collected and the end points for comparison were: Operative time, perforation rate, post-operative complication, length of hospital stay, readmission rate. Cases of perforated appendicitis in preoperative diagnosis, interval appendicectomy and appendicectomy done in association with other abdominal conditions were excluded from the study.Results: During this one-year period 283 patients have undergone appendicectomy. Out of this 189 (66.8%) patients have undergone surgery within 12 hours of admission and 94 (33.2%) have undergone surgery between 12 to 72 hours of admission. There was no significant difference between the two groups in operative time, per operative perforation rate, post-operative complication rate, readmission rate. Length of the hospital stay was greater in delayed group as compared to emergency group. But there was no significant difference between the post-operative length of hospital stay.Conclusions: Acute appendicitis can be treated surgically in a delayed elective basis without increasing morbidity.
Background: Clavicle fractures are common, with an overall incidence of 36.5 -64 per 100,000 people every year. Traditionally, midshaft clavicle fractures have been treated nonoperatively. Recently, there has been increasing interest in the operative treatment and plate fixation or intramedullary nailing is often the treatment modality of choice. Numerous clinical studies have been published to compare surgical and conservative treatments. The best treatment for displaced midshaft clavicle fractures remains a topic of debate. So We sought to compare patient-oriented outcome and complication rates following nonoperative treatment and those after operative treatment of displaced midshaft clavicular fractures. Objectives: To compare functional outcome and complication rates following nonoperative treatment and those after operative treatment of displaced midshaft clavicular fractures. Materials and Methods: 60 patients with a displaced midshaft fracture of the clavicle who were presented to RL Jalappa Hospital from June 2015 to October 2016 and either treated by conservative or operative methods of treatment and who were in regular follow up are selected. Functional assessment was done at 6 weeks, 3 months and 6 months with use of the Disabilities of the Arm, Shoulder and Hand (DASH) and Constant scores Complications, if any will be recorded. Results: DASH Scores and Constant scores were significantly better in the operative group compared to the conservative group at all time points. Conclusion: Operative treatment resulted in early return to function compared to conservative treatment but at the cost if complications like infection and other hardware related problems.
Background: Trauma remains the most common cause of death for all individuals between the ages of 1 and 44 years. 10% of these fatalities are attributable to abdominal injury. The Indian fatality rates for trauma are 20 times that for developed countries. The management of patients with blunt abdominal injury has evolved greatly over the last few decades from complete surgical management historically to present non operative management in most of the cases. In view of increasing number of road traffic accidents, rampant increase in construction work, accidental fall from height, this study is conducted to look into the causes of such incidents and also to strengthen the already established rules of non operative management in cases of blunt trauma abdomen.Methods: This is a prospective study of 53 patients who presented to K. R. Hospital, Mysuru, Karnataka, for management of blunt trauma abdomen over the period of January 2016 to June 2017. Unstable patients with initial resuscitation underwent Focused Assessment Sonography for Trauma. Failed resuscitation with free fluid in abdomen confirmed by FAST immediately shifted to operation theatre for laparotomy and proceed. Hemodynamically stable patients underwent computerized tomography of abdomen. Organ injuries were scaled according to the American Association for the Surgery of Trauma and these patients were managed conservatively after ruling out hollow viscus perforation.Results: Majority of the patients belonged to male sex (85%) and of the age group 21-40 years constituting 58.3% of patients. Road traffic accident was the most common mode of injury which included 35 patients (66%). A total of 19 cases had splenic injury out of which 13 (68.5%) underwent non operative management and 6 (31%) underwent emergency Splenectomy. liver injury was present in 15 patients and all were managed conservatively. In total non operative management was done in 73.5% of cases and surgical management was done in 26.5% of cases.Conclusions: The presence of free fluid with organ injury always does not mandate laparotomy. Patient selection, early diagnosis and repeated clinical examination and use of appropriate investigations forms the key in non operative management of blunt trauma abdomen. RTA being the most common mode of injury, adequate measures should be taken to prevent road traffic accidents by strict action and traffic norms and citizen education.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.