AimTo evaluate maintenance intravenous fluid-prescribing practices and the incidence of hospital-acquired hyponatremia in children admitted to a general pediatric ward.MethodsThis is a prospective observational study conducted over a 2-month period in children ages 2 months to 5 years who were admitted to a general pediatric ward and who were receiving maintenance intravenous fluids. The composition, rate, and duration of intravenous fluids were chosen at the discretion of the treating physician. Serum biochemistries were obtained at baseline and 24 h following admission. Patients who were at high risk for developing hyponatremia or hypernatremia or had underlying chronic diseases or were receiving medications associated with a disorder in sodium and water homeostasis were excluded. Intravenous fluid composition and the incidence of hyponatremia (sodium <135 mEq/L) were assessed.ResultsFifty-six children were enrolled. All received hypotonic fluids; 87.5% received 0.18% sodium chloride (NaCl) and 14.3% received 0.45% NaCl. Forty percent of patients (17/42) with a serum sodium (SNa) less than 140 mEq/L experienced a fall in SNa with 12.5% of all patients (7/56) developing hospital-acquired or aggravated hyponatremia (126–134 mEq/L) with fall in SNa between 2 and 10 mEq/L.ConclusionAdministration of hypotonic fluids was a prevalent practice in children admitted to a general pediatric ward and is associated with acute hospital-acquired hyponatremia.

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Background: Hernias of the abdominal wall constitute an important public health problem. Laparoscopic inguinal hernia repair (TEP) is a minimal access surgical procedure as compared to open hernia repair. The objective of the study was to compare open and laparoscopic hernia repair in terms of safety, complications, morbidity, recurrence, post-op pain and hospital stay.Methods: This was a prospective observational comparative study. Total 50 patients were taken in this study; out of them 25 patients subjected to group A (open repair of inguinal hernia) and 25 patients subjected to group B (laparoscopic repair of inguinal hernia). Postoperatively patients were observed for any complications and followed up one year.Results: Present study shows high incidence of inguinal hernia in males. Mean operative time for open hernia repair group was less than laparoscopic hernia repair group. Time to return to normal work, duration of hospital stay and postoperative pain were less in laparoscopic hernia repair group than open hernia repair group. Out of 25 patients in laparoscopic hernia repair (TEP) 1 patient had recurrence but in open hernia repair group there was no recurrence.Conclusions: Laparoscopic hernia repair is quite safe; it has definite advantages in bilateral and recurrent cases, postoperative pain, early return to normal activities, less postoperative hospital stay and better cosmetic results although it has its own disadvantages in terms of recurrence rate, operative time and cost effectiveness.

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.

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Background: The aim of the study was to analyze the role of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) as diagnostic and prognostic markers in patients of esophageal cancer. Various tumor markers are being investigated as non-invasive diagnostic and prognostic tools in patients of esophageal cancer.Methods: This was a prospective observational study in which we analyzed the levels of CEA and CA 19-9 in blood samples of 35 patients of esophageal cancer. All patients underwent esophagoscopy and computed tomographic (CT) scan to assess site and extent of tumor. Histological diagnosis was confirmed in all cases by endoscopy guided biopsy.Results: The sensitivity of CEA and CA 19-9 in detecting disease was found to be 34.3% and 28.6% respectively. The difference in CEA levels between squamous cell carcinoma and adenocarcinoma of esophagus was not found to be significant (p value=0.69). However, the difference in levels of CA 19-9 was found to be statistically significant (p value=0.02) between the two groups. The sensitivity and specificity of CEA to predict severity of disease was 66.7% and 70% respectively with positive and negative predictive value of 62.5% and 73.4 % respectively. In case of CA 19-9, sensitivity, specificity, positive and negative predictive values were 26.7%, 55%, 30.8% and 50% respectively.Conclusions: CEA was found to be a more sensitive diagnostic marker than CA 19-9 and better at predicting prognosis. However sensitivity and specificity of both were relatively low. CA 19-9 levels were seen to be higher in esophageal squamous cell carcinoma versus adenocarcinoma.

Background: Fibroadenoma is the second most common tumour in the breast (after carcinoma) and is the most common tumour in women younger than 30 years. Multiple fibroadenomas (more than five lesions in one breast) are very uncommon and are considered disease. Familial bilateral multiple fibroadenoma is an exceedingly rare presentation with only one such case described earlier in medical literature where three siblings had multiple bilateral breast fibroadenomas. We report a case series of familial fibroadenomas present in four siblings, along with one case presenting with bilateral multiple fibroadenoma, which is first in the medical literature.Case Presentation: Fine needle Aspiration were suggestive of bilateral multiple fibroadenoma. Upon surgery, 10 fibroadenomas were removed from the right breast and 9 fibroadenomas were removed from the left breast. Histopathological examination was consistent with fibroadenoma with myxomatous change. Conclusion: Familial fibroadenoma of the breast is an exceedingly rare presentation of a very common tumour. This was the first reported case of 4 siblings having familial fibroadenoma. Further studies are required to investigate the familial nature of this disorder.