Background: Mediastinitis is lethal complication and a challenge in post cardiac surgery patients. We aim at evaluation of topical vancomycin by applying it at sternal edge in prevention of deep sternal wound infection.Methods: The vancomycin group had local application of vancomycin paste prepared by mixing 1gm of powder in 3 ml of normal saline and stirred until paste was formed. The control group had reinforced closure technique without vancomycin paste application. All cases were followed up for symptoms and signs of sternal wound infection during hospital stay and uptil 1 month.Results: There was increase incidence of wound infection with control group as compared to vancomycin group, there were no wound infection in patients of vancomycin group.Conclusions: Application of topical vancomycin significantly reduces post-sternotomy wound infection and prevents deep mediastinitis.
Foreign body ingestion is a problem seen frequently in the emergency department, particularly in children. In this case report, we present an uncommon example: foreign body ingestion in an elderly patient with a history of dementia. This patient’s symptoms of dysphagia, cough, and pooling secretions in the posterior oral cavity suggested food impaction, and after further investigation, coins were found in the upper and middle esophagus. Most of the coins were removed, the patient was monitored, and outpatient follow-up was organized to ensure the safe elimination of all the coins. This case illustrates the importance of having a high pretest probability for certain diagnoses based upon how specific patient populations present.
Acquired tracheo-esophageal fistulas (TEFs) are challenging. The most common causes are prolonged intubation, malignancy, and trauma whereas granulomatous infections like tuberculosis are rare. Endoscopic intervention with esophageal or tracheal stenting or clipping is of unproven benefit in the management of such lesions, where surgical repair is almost invariably required. We report a case of a 32-year-old man, with a case of multidrug-resistant pulmonary tuberculosis. He had no history of malignancy or trauma. The patient developed spontaneous TEF probably due to mediastinal lymph node necrosis. Multiple attempts were made using staplers, clips, and atrial septal defect (ASD) device closure but were unsuccessful. The nuanced complication leads to very individualized course of treatment which was optimal for this patient.
AIMS AND OBJECTIVES:The aim of our study was to see the effect of single dose regime versus multi dose regime of antibiotic in laparoscopic surgery; in terms of type of laparoscopic surgery done, type and dose of intravenous antibiotic given and the occurrence of post-operative complications like wound gape, stitch abscess, local pain and discharge from the wound in both the groups. STUDY DESIGN: The present study was prospective, observational and longitudinal. Protocol of the procedure was formed along with Performa, Patient Information Sheet and Informed Consent Form. METHODOLOGY: A total of 120 patients undergoing emergency and elective laparoscopic surgery at surgery department of C.U Shah medical college, Surendranagar; Gujarat state, India during
Intestinal malrotation is partial or complete failure of 270% counterwise rotation of midgut around the superior mesenteric vessels in embryonic
life. Malrotation can present in any age group. Most of the patients present within rst month of life. However late presentation is rare, we present a
case report of 58 yr female with tuberculosis transverse colon mass with malrotation with ladd's band with sub acute intestinal obstruction. She
presented with epigastric pain,mass and vomiting. Patient underwent laaproscopic ladd's procedure and descending colon and ileum bypass with
Ileo Descending anastomosis , She had good postoperative recovery. In this article we describe our experience in creating descending colon and
ileum bypass with Ileo Descending anastomosis.
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