Background: In this era of staplers and advanced techniques in surgery Milligan Morgan technique of open haemorrhoidectomy is still considered as gold standard procedure for symptomatic haemorrhoids. Stapler haemorrhoidectomy, even though it is practiced in many centres has not become common due to various factors. The present study was done to compare the efficacy, safety and advantages, if any, of the stapled haemorrhoidectomy to open procedure.Methods: This prospective study was performed in the department of general surgery, Government medical college, Thiruvananthapuram, Kerala over a period of 12 months from March 2015 to March 2016. Symptomatic patients with grade 3 and4 haemorrhoids were selected for the study. The patients were randomized into two equal groups of 20 each. Group A underwent conventional open haemorrhoidectomy and group B, stapled haemorrhoidectomy.Results: Mean operative time period for group A was 39.25 ±5.5 minutes and group B was 26.75±4.7 minutes. There was significant difference in the pain score between these procedures on first 3 post-operative days. There was also significant difference in group A and group B which was 6.55±1.099 and 3.55±0.759 days respectively for mean hospital stay and 9.90±1.651 and 5.70±0.865 days respectively for return to normal work.Conclusions: Stapler haemorrhoidectomy is associated with lower pain scores postoperatively and shorter duration of hospital stay with early return to work when compared to conventional open haemorrhoidectomy.
Introduction Goiter is one of the most common endocrine neoplasms found globally and its incidence varies in each country. Evaluation includes clinical, laboratory, radiological, and pathological tests to rule out malignancy. Surgery may be indicated in cases when the patient develops compressive symptoms, risks of malignancy, or cosmetic deformity. Thyroid malignancies account for only 1 to 2% of all malignancies. Irrespective of size, 9 to 13% of preoperative pathological evaluations revealed malignancy. Objective To study the prevalence of thyroid malignancy in patients presenting with multinodular goiter (MNG) undergoing thyroidectomy in the Department of General Surgery, Government Medical College, Thiruvananthapuram, India. Material and Methods This prevalence study was conducted in the Department of General Surgery, Government Medical College, Thiruvananthapuram, India, for a year, between March 2017 and February 2018. All patients with MNG undergoing thyroidectomy in the Department of General Surgery during this period were selected. A total of 651 patients were included in the study after obtaining informed consent. Results A total of 651 patients were studied, out of which 91 patients (13.9%) had malignancy. Among the total, 529 were females and 122 were males. Total malignancies reported were 91 and in those, males were around 31.9% and females around 68.1%. But when comparing incidence of malignancy in MNG, it was found to be higher in males (23.8%) than females (11.7%). Out of 91 patients with malignancy, 77 patients were found to have papillary carcinoma thyroid. Most of the papillary carcinoma thyroid occurred between 41 and 50 years of age, although it can occur in younger patients too. Palpable cervical lymphadenopathy is seen in 34 cases (37.4%) of thyroid malignancies. Conclusion Proportion of thyroid malignancy in MNG at Government Medical College, Thiruvananthapuram, is 13.9%. Females are more commonly affected than males. Papillary carcinoma is the most common differentiated malignancy associated. Cervical lymph nodal metastasis is seen in 37.4% of thyroid malignancies. The risk of malignancy in MNG should not be underestimated as significant numbers of patients with thyroid malignancies present with MNG.
Background: Burns can affect the population of all age groups and regions. There has been a reduction in the mortality and morbidity of burn patients due to improvements in standards of medical care. Several laboratory values were proposed to indicate the prognosis of burns patients. Of these, the oldest is abbreviated burn severity index (ABSI), which includes variables such as sex, age, total burned body surface area (BSA), full-thickness injuries, and burns attributable to inhalation. Later the acute physiology and chronic health evaluation (APACHE) II and APACHE III scales which incorporates biochemical markers to improve predictive power evolved.Methods: In this study, in a tertiary care government institution, we attempt to assess platelet count and serum albumin independently in the prognosis of burns patient, in a background of sepsis.Results: For analysis, patients were divided into two groups- survivors and non-survivors as sepsis development and mortality was observed. There was a progressive decline in the platelet count in non-survivors, while the initial fall improved in those who survived. There was only a marginal difference between the two groups in serum albumin levels.Conclusions: A serial fall in platelet count is a predictor of sepsis and mortality in burn patients. It is an indicator of bone marrow depression and correlation with leucocyte count needs to be evaluated. In those patients where the initial fall in platelet count improved, survival rates were high. As a biochemical marker, serum albumin was not a reliable marker in predicting sepsis and mortality.
Introduction: Gallstones are one among the common gastrointestinal illness requiring hospitalisation and frequently occur in middle- aged otherwise healthy people with a prevalence of 10 to 15%. Women are more frequently affected than men. Most patients remain asymptomatic from their gallstones and remain silent throughout life. One major factor contributing to cholesterol stone formation is high concentration of cholesterol and lipids in bile secretion from liver. Changes in human behaviour and lifestyle over the last few decades have resulted in a dramatic increase in the incidence of dyslipidaemia and gallstone disease worldwide. Aim: To estimate the prevalence of dyslipidaemia in patients with gallstones. Materials and Methods: A cross-sectional study was done on 82 patients who were admitted in a tertiary care centre with gall stone confirmed by ultrasound abdomen, during the period between November 2016 to October 2017. Patients with dyslipidaemia taking medicine were excluded. Data were entered in structured data sheet which includes all the variables and results were expressed in frequency and percentage. Results: Forty-two patients were found to have dyslipidaemia and the prevalence was found to be 51.2%. Maximum prevalence of cholelithiasis was found in the 41-50 years age group (58.5%). Fifty-six were females (68.3%). Twenty-four patients had very high Serum Low Density Lipoprotiens (LDL) levels. Twenty-three had high levels of Triglycerides (TG) (28%). Six had very low High Density Lipoprotein (HDL) level (7.3%). Conclusion: The prevalence of dyslipidaemia estimated was 51.2%. Of the fractions of serum lipids, the LDL and triglycerides level elevations was more commonly detected in patients with gall stone.
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