Background: Aim of study is to prospectively evaluate the ability of the Bedside Index for Severity in Acute Pancreatitis (BISAP) score to predict mortality as well as intermediate markers of severity.Methods: 50 patients admitted from December 2015 to November 2017 with acute pancreatitis were included in the study. BISAP score is calculated in all such patients based on data obtained within 24hrs of hospitalization. Patients were assessed for organ failure according to Marshall scoring system and followed throughout hospitalization for assessment of complications. Statistical analyses were made using Fischer’s exact probability test. The difference was assumed statistically significant when p<0.05.Results: There was a statistically highly significant trend for increasing mortality (p < 0.05) and intermediate markers of severity (p<0.05) that is transient organ failure, persistent organ failure and pancreatic necrosis with BISAP score ≥3.Conclusions: The BISAP score represents a simple way to identify patients at risk of increased mortality and the development of intermediate markers of severity within 24 hours of presentation.
Background: This study was undertaken to know whether clip usage or ultrasonic energy application, obtains better haemostasis of cystic artery during laparoscopic cholecystectomy.Methods: About 80 patients undergoing laparoscopic cholecystectomy were selected on a prospective basis and divided into two equal groups- A and B. a comparative study was done between the two group. Clips were used to control cystic artery in group A patients and ultrasonic energy device was used for the same in group B.Results: In group A, 2 patients had clip slippage intraoperatively which was dealt by reapplication of clips.in group B,1 patient had intraoperative bleeding from cystic artery few minutes after application of ultrasonic energy which was dealt by bipolar cauterization. In both the groups no, postoperative bleeding was encountered.Conclusions: During laparoscopic cholecystectomy, clip usage and ultrasonic energy application are equally competent in achieving haemostasis of cystic artery.
Acute appendicitis is a surgical emergency causing significant mortality and morbidity. 1 In other words it is referred as an acute inflammatory condition of the appendix. Most cases require immediate action to avoid unnecessary complications through surgical procedures like open or laparoscopic appendectomy. 2 Appendicitis is one of the leading cause for abdominal surgical emergencies. Worldwide statistics reveal its incidence is more than 8%. 3 The majority of the patients suffering with this mainly present with abdominal pain followed by vomiting, fever and migration of the pain to the right iliac fossa. 4 Recent studies also demonstrated that the patients up to 50% will present with features of classical presentation related to pain in the right iliac fossa. 5 Moreover rupture of appendix leads to inflammation and infection in the intestinal lining, which paves a way to sepsis, clinically called as peritonitis, which further directs to circulatory shock. 1 Hence, early diagnosis and intervention strategies were necessitated to overcome mortality and morbidity. 5
BACKGROUND: Infection with microbes in burns patients is a leading cause of morbidity and mortality. The present study was aimed to study the fungal pathogens from infected burns patients periodically during their stay in the hospital from wound surface, blood and intravascular devices and to identify and differentiate candida species. METHODS: This hospital based study was conducted during June 2011 to May 2013. Patients with greater than 25-30% burns of total body surface area (TBSA) and hospitalized in burns unit for a minimal duration of hospitalization of 7 days were included in the study. Specimens such as wound swabs, blood and intra vascular devices were collected at the end of 1 st ,2 nd , 3 rd and 4 th week, processing, isolation, identification and antibiogram of the isolates were done as per standard procedures. RESULTS: To analyze the systemic fungal infection in burn patient's Seven hundred and eight (708) blood cultures were collected and processed at regular intervals with isolation of 54 (7.6%) pathogens. Findings clearly indicates C.albicans as the most common pathogen 32 (59.26%) isolated followed by non-albicans group. In non-albicans group C.tropicalis was the most common followed by C.parapsoliasis and rest is C. krusei, C. kefyr, C. glabrata and C. guillermondii. Intravascular devices also act as sources for the systemic invasion of pathogens, Eight hundred and eighty four (884) IVD's were processed with isolation of 42(4.8%) pathogens. We found that C.albicans was the most common isolate 71.43% (30) followed by non-albicans group. In nonalbicans group C.tropicalis (6) was the common followed in the order of C. parapsoliasis (4), C.krusei (1) and C. guillermondii. CONCLUSION: We highlighted the incidence of fungal wound infection is increasing due to wide spectrum antibiotic administration. Candida albicans was the common pathogen isolated from all the specimens followed by C.tropicalis and C.parapsoliasis. Next common fungus isolated was Aspergillus spp which was further confirmed by histopathological correlation. Patients with fungal wound infection had long duration of hospital stay and systemic invasion had more mortality. Continuous surveillance of microorganisms and their antibiotic resistance can improve the efficacy of infection control programs in a burn unit.
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