Background: Trauma is recognized as a serious public health problem. In fact, it is the leading cause of death and disability in the first four decades of life and is the third most common cause of death overall. Trauma may lead to short or long-term disability. Objective was to study the pattern of chest injuries with resultant underlying damage, in rural set up.Methods: The present study was carried out among 500 cases of age group 15 to 75 years, all religions and both sexes. All patients received in the Emergency Room (ER/Casualty) were immediately attended and history, primary survey and resuscitation were done simultaneously. X ray chest-erect position was taken and subsequent management either operative or non-operative was done according to clinic-radiological findings. After discharge, patients were followed on OPD basis till the time they return to the normal activity.Results: Majority of patients (31%) were from 55 to 65 years of age group and were male (64.2%). Vehicular accident was the commonest (56.8 %) cause of injury. Vehicular accidents were the most common cause of chest injuries. In vehicular accidents two-wheeler riders were the common victims (55.28%). Assault was 2nd most common mode of injury. Among those patients who sustained chest trauma had average VAS 6 (49.2%) followed by 4 (45%). Majority of patient were treated conservatively (93.6%).Conclusions: The most active age group and males were affected with commonly vehicular accidents. They mainly suffered chest injuries.
Background: Despite the ease of diagnosis, establishing a cure is problematic as many patients tend to let their disease nag them rather than treatment. Also, due to site of this disease many patients delay the treatment. Objectives was to study the various etiologies of fistula in ano, to study the different modes of clinical presentations of these fistulae-in-ano, efficacy of different modalities of surgical approach with reference to recurrence of fistulae.Methods: Hospital based cross sectional descriptive study was carried out among 81 eligible patients of fistula in ano. Local Examination, Per Rectal Examination, Proctoscopy was done to assess the external opening, internal opening and fistula tract. Patients were advised Fistulogram and sent to Department of radiology on outpatient basis for the same. Patients with fistulography report were admitted and surgical treatment was planned according to the fistulography report. Appropriate surgery was planned. Specimens were sent to histopathology.Results: Commonest age of presentation was between 30-40 years. Males were more commonly affected. Swelling in perineal region was commonest mode of presentation. Fistula with only one opening was around 85.18%. Anteriorly situated fistula was around 14.81%. Low level fistula was more common. Majority of patients i.e. 74.07% underwent fistulectomy. 9.87% patients underwent fistulotomy. 16.04% patients underwent setonthresd placement. Three Patients developed recurrence.Conclusions: Fistulotomy is associated with slightly high recurrence but low chances of anal incontinence as compared to fistulectomy.
Background: The lip has functional and aesthetic importance. Lip defects occur due to the variety of etiology and the choice of their reconstruction has profound effect on functions and cosmesis. There are multiple options available for reconstruction according to defect size, but superiority of one method over another is still debated and hence the methods and their outcome were analyzed prospectively. Material and method: Twenty-one patients with all sizes and locations of defects in upper and lower lip with acquired etiology were included in the evaluation. Reconstruction was performed according to defect size, availability of local/regional and distant donor tissue, defect location, patients’ comorbid conditions and patients’ preference. Patients were assessed at 1 month and 6 months postoperatively. Observers’ and patients’ input were also taken into account for outcome. Results: Out of 21 patients, 5 free radial artery forearm flap reconstructions, 4 nasolabial flap reconstructions, 5 primary closures of defect, 4 Estlander flap reconstructions, 2 lip advancements, and one Karapandzic flap reconstruction were done. Free flap and nasolabial flap had hypoesthesia and incompetence if commissure is reconstructed and problem of bulk, restricted mobility and vermilion mismatch. Local and lip flaps were associated with decreased stoma size and some form of local scarring and asymmetry. However, all patients were satisfied with the functional and aesthetic outcome. Conclusion: Local flaps are better in terms of functional and aesthetic outcome but with some degree of microstomia which was well tolerated by most patients. Regional and distant flaps provide reconstruction where no other option is available and provide good functional support and acceptable cosmesis.
Cleft lip and palate are commonly observed congenital anomaly. But congenital palatal stula is very uncommon. Only few cases have been reported in literature globally. Irrespective of the doubts in etiology and pathogenesis, due to its rarity it is important to report these rare cases in the literature as and when it comes to the notice of the clinicians. Herein,we present a case of two-year-old child presented to us with isolated congenital palatal stula. Apart from nasal regurgitation on feeding and URTI, all other things were normal. Midline, rectangular stula of 2 cm x 1.5 cm extending from incisive foramen and involving posterior edge of hard palate was seen. Patient responded well to the surgery and postoperative period was uneventful.
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