BACKGROUND Seroma formation is the commonest complication of modified radical mastectomy. Exact pathophysiology and risk factors for seroma is still a matter of debate. This prospective cross-sectional study aims to detect incidence of seroma formation in patients undergoing Modified Radical Mastectomy (MRM) in carcinoma breast and to identify risk factors for seroma in MRM patients. MATERIALS AND METHODS All patients who underwent modified radical mastectomy for carcinoma breast over a period of 1 year were enrolled and prospectively followed up. Patients were assessed for parameters including age, BMI, diabetes, hypertension, serum haemoglobin levels, neoadjuvant chemotherapy and T-stage in preoperative period. Level of lymph node dissection and type of drainage used were also assessed. Drain volumes in each postoperative day was documented and mean volumes calculated. Clinically detectable seroma, if present, was diagnosed 14 days after removal of drain. RESULTS Out of the 118 patients studied, incidence of seroma was found to be in 22.88%. Incidence of seroma was found to be higher in patients with BMI >25. It was also significantly higher in patients with first day drain volume more than 150 mL. No statistically significant difference in incidence was noted with age, diabetes, hypertension, serum haemoglobin levels, neoadjuvant chemotherapy, T-stage of disease or level of lymph node dissection. CONCLUSION Incidence of seroma is higher in patients with BMI >25. Occurrence of seroma can be predicted even on the first postoperative day, if the drain volume is more than 150 mL.
BACKGROUNDAppendicitis is the most common acute abdominal condition requiring a surgical intervention, worldwide. Conservative management of uncomplicated appendicitis and the need for an interval appendicectomy are still an area of debate. This study aims to find the recurrence rate of appendicitis in conservatively managed patients and to analyse its related factors.
BACKGROUNDMultiple fracture ribs following trauma is one of the common problems managed in a surgical casualty. Pain in rib fracture can be managed by different modes of analgesia. Superior analgesia provides superior improvement in lung compliance after rib fracture thereby reducing morbidity and mortality due to secondary pulmonary complications. METHODSPatients with evidence of rib fracture who received intercostal nerve block along with non-opioid drugs were grouped into Group A and those who received non-opioid drugs alone were grouped into Group B. The effect on pain score and lung compliance were measured by using Visual Analogue Scale and a respirometer respectively before therapy, soon after therapy, 12 hours after therapy and 24 hours later (in both groups). RESULTSIn patients who received both intercostal nerve block as well as non-opioid therapy, the pain score decreased, and respirometer score increased progressively. In patients who received non-opioid therapy alone, only a mild decrease in pain score and mild increase in respirometer score till 12 hours and even worsening of mean score 24 hours post therapy were noted. Also, the incidence of development of pulmonary complications of rib fractures was significantly low in the former group compared to the latter.
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