Lactate is produced in the cells in anaerobic metabolism of glucose for the generation of adenosine triphosphate (ATP) and may be an indicator of occult or global hypoperfusion. Thus, early serum lactate measurement may be a prognostic indicator of the outcome in critically ill patients. Therefore, the present study was conducted to assess the value of serial measurements of serum lactate levels in the predicting the outcome. After obtaining approval from the Institutional Ethics Committee and written voluntary informed consent from the relatives/patients, a total of 50 cases of trauma to chest or abdomen and patients with sepsis as per quick Sequential Organ Failure Assessment (qSOFA) score or having Systemic Inammatory Response Syndrome (SIRS) were included. Serum lactate levels were measured at 24 and 48 hours and the nal outcome and duration of discharge was noted. It was observed that serum lactate levels were similar in terms of gender, presence of multiple organ dysfunction syndrome (MODS) and type of treatment. Baseline lactate levels were similar. Death was associated with signicant increase in serum lactate levels at 24 and 48 hours while a decrease in levels were associated with early discharge (at less than 7 days). It can be effectively concluded that serial measurements of serum lactate levels are of prognostic value to predict the outcome in critically ill patient with increasing levels being a harbinger of potentially fatal outcomes.
{"title":"EVALUATION OF SERUM LACTATE AS A PREDICTOR OF MORBIDITY AND MORTALITY IN SEPSIS AND TRAUMA PATIENTS","authors":"Vivek M. Kele, Lisha Suraj","doi":"10.36106/ijsr/4205470","DOIUrl":"https://doi.org/10.36106/ijsr/4205470","url":null,"abstract":"Lactate is produced in the cells in anaerobic metabolism of glucose for the generation of adenosine triphosphate (ATP) and may be an indicator of\u0000occult or global hypoperfusion. Thus, early serum lactate measurement may be a prognostic indicator of the outcome in critically ill patients.\u0000Therefore, the present study was conducted to assess the value of serial measurements of serum lactate levels in the predicting the outcome. After\u0000obtaining approval from the Institutional Ethics Committee and written voluntary informed consent from the relatives/patients, a total of 50 cases\u0000of trauma to chest or abdomen and patients with sepsis as per quick Sequential Organ Failure Assessment (qSOFA) score or having Systemic\u0000Inammatory Response Syndrome (SIRS) were included. Serum lactate levels were measured at 24 and 48 hours and the nal outcome and\u0000duration of discharge was noted. It was observed that serum lactate levels were similar in terms of gender, presence of multiple organ dysfunction\u0000syndrome (MODS) and type of treatment. Baseline lactate levels were similar. Death was associated with signicant increase in serum lactate\u0000levels at 24 and 48 hours while a decrease in levels were associated with early discharge (at less than 7 days). It can be effectively concluded that\u0000serial measurements of serum lactate levels are of prognostic value to predict the outcome in critically ill patient with increasing levels being a\u0000harbinger of potentially fatal outcomes.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141047097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Srijan Shailesh Pandey, Ananta Kulkarni, Mayur Babaurao Tayde, Namrata Ravi Amolik, Suhas G Gaykhe
Spindle cell sarcoma is a soft-tissue tumour which can start in the bone. Spindle cell sarcoma is referred to in this way due to the appearance of its tumour cells when they are looked at under a microscope. The cells which make up a spindle cell sarcoma are long and narrow, which is known as a 'spindle-cell shape'(1,7).Spindle cell carcinoma can affect any age group but mostly affects age group of over 40.It more commonly affects men than women.[2,5]Myositis ossicans is a reaction to a bruise in a muscle that has been injured. During the healing of the bruise, calcium can become deposited in the bruise causing a hard bone like structure within the muscle.The knowledge of case where both spindle cell carcinoma and myositis ossicans is present is very important for the clinical physician to diagnose and treat properly.[3,8]
{"title":"DIAGNOSTIC DILEMMA: DISCREPANT PATHOLOGY REPORTS IN A CASE OF THIGH MASS","authors":"Srijan Shailesh Pandey, Ananta Kulkarni, Mayur Babaurao Tayde, Namrata Ravi Amolik, Suhas G Gaykhe","doi":"10.36106/ijsr/0900147","DOIUrl":"https://doi.org/10.36106/ijsr/0900147","url":null,"abstract":"Spindle cell sarcoma is a soft-tissue tumour which can start in the bone. Spindle cell sarcoma is referred to in this way due to the appearance of its\u0000tumour cells when they are looked at under a microscope. The cells which make up a spindle cell sarcoma are long and narrow, which is known as a\u0000'spindle-cell shape'(1,7).Spindle cell carcinoma can affect any age group but mostly affects age group of over 40.It more commonly affects men\u0000than women.[2,5]Myositis ossicans is a reaction to a bruise in a muscle that has been injured. During the healing of the bruise, calcium can become\u0000deposited in the bruise causing a hard bone like structure within the muscle.The knowledge of case where both spindle cell carcinoma and myositis\u0000ossicans is present is very important for the clinical physician to diagnose and treat properly.[3,8]","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"31 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141053186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and aims: Fetal echocardiography stands as the diagnostic pivot for serial assessment of cardiovascular anatomy and hemodynamics of fetus from rst trimester to postnatal life. It offers high sensitivity in accurate detection of cardiac development and lesions during intrauterine life. The gold standard remains as postnatal or autopsy validation of antenatal ndings. Our objective was data analysis of the factors determining referral pattern to pediatric cardiologist, conrmation of the diagnosis and appropriateness of parental counseling and pregnancy management strategies. an observational study retrospectively reviewed all pregnant women reporting for fetal e Methods and results: chocardiography to tertiary pediatric cardiac center from February 2021 to July 2023. Relevant factors for referral to pediatric cardiology were tabulated. Fetal echocardiography protocol was adapted from American Institute of Ultrasound in Medicine guidelines with Extended Cardiac Echocardiographic Examination protocol. Fetal echocardiographic results were categorized into simple, severe and functional defects. The fetuses were reviewed postnatally by neonatal echocardiography. Total of 330 pregnant ladies reported for fetal echocardiography in our department, 268 (81.2%) of them were referred cases. The most common reasons for referral were intra-cardiac echogenic foci (ICEF) in 87 (32.5%) cases followed by suspected congenital heart disease (CHD) in 80 (29.9%), maternal illness in 39(14.6%), extra-cardiac anomaly 22 (8.2%), family history of CHD 18(6.7%), fetal arrhythmia 11(4.1%), isolated valve regurgitation seven (2.6%), assisted reproduction three (1.1%) and cardiac mass in one (0.3%) case. We detected cardiac abnormality in 113 (34.2%) fetuses. Of those, 55 (48.7%) had severe CHD, 32 (28.3%) had simple defect and 26(23%) had functional heart defect. 70 (62%) were born with congenital heart disease; of which 15(21.4%) were operated at the appropriate postnatal age. Conclusions: fetal echocardiography by pediatric cardiologist delivers additive diagnostic value and facilitates appropriate parental counseling from mid gestation, helps in proper perinatal triaging and continued cardiac care from fetus- to newborn.
{"title":"AN OBSERVATIONAL STUDY ANALYZING THE TREND OF CARDIOLOGIST DRIVEN FETAL ECHOCARDIOGRAPHY IN INDIAN SCENARIO WITH A COMPARISON OF PRENATAL VERSUS POSTNATAL FINDINGS: LESSONS LEARNED DURING A LONGITUDINAL ASSESSMENT OF FETAL CARDIA.","authors":"Mandal Krishna D, Chaudhuri Maitri, Amatya Unnati, Kumar Gaurav, Tomar Munesh","doi":"10.36106/ijsr/4707583","DOIUrl":"https://doi.org/10.36106/ijsr/4707583","url":null,"abstract":"Background and aims: Fetal echocardiography stands as the diagnostic pivot for serial assessment of cardiovascular anatomy and hemodynamics\u0000of fetus from rst trimester to postnatal life. It offers high sensitivity in accurate detection of cardiac development and lesions during intrauterine\u0000life. The gold standard remains as postnatal or autopsy validation of antenatal ndings. Our objective was data analysis of the factors determining\u0000referral pattern to pediatric cardiologist, conrmation of the diagnosis and appropriateness of parental counseling and pregnancy management\u0000strategies. an observational study retrospectively reviewed all pregnant women reporting for fetal e Methods and results: chocardiography to\u0000tertiary pediatric cardiac center from February 2021 to July 2023. Relevant factors for referral to pediatric cardiology were tabulated. Fetal\u0000echocardiography protocol was adapted from American Institute of Ultrasound in Medicine guidelines with Extended Cardiac Echocardiographic\u0000Examination protocol. Fetal echocardiographic results were categorized into simple, severe and functional defects. The fetuses were reviewed\u0000postnatally by neonatal echocardiography. Total of 330 pregnant ladies reported for fetal echocardiography in our department, 268 (81.2%) of them\u0000were referred cases. The most common reasons for referral were intra-cardiac echogenic foci (ICEF) in 87 (32.5%) cases followed by suspected\u0000congenital heart disease (CHD) in 80 (29.9%), maternal illness in 39(14.6%), extra-cardiac anomaly 22 (8.2%), family history of CHD 18(6.7%),\u0000fetal arrhythmia 11(4.1%), isolated valve regurgitation seven (2.6%), assisted reproduction three (1.1%) and cardiac mass in one (0.3%) case. We\u0000detected cardiac abnormality in 113 (34.2%) fetuses. Of those, 55 (48.7%) had severe CHD, 32 (28.3%) had simple defect and 26(23%) had\u0000functional heart defect. 70 (62%) were born with congenital heart disease; of which 15(21.4%) were operated at the appropriate postnatal age.\u0000Conclusions: fetal echocardiography by pediatric cardiologist delivers additive diagnostic value and facilitates appropriate parental counseling\u0000from mid gestation, helps in proper perinatal triaging and continued cardiac care from fetus- to newborn.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"82 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141143171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Prolapse of uterus is a very common reproductive health problem in women in India. It is detrimental to emotional, physical and psychosocial well being of a woman. Factors affecting prolapse of uterus, if studied well,will help for preventive measures. Aim and Objective: To study the factors associated with uterine prolapse at SIMS,Manglore. Material and Methods: Total 60 patients diagnosed with uterine prolapse were studied. Data was collected with standard questions. Data included Detailed history,clinical examination and sociodemographic data. It was analysed with appropriate statistical tests. Results: Mean age of the patients in our study was 46 ± 3 years. Majority i.e. 41.66% of the patients were in the age group of 41-50 years .Patients from age group of 31-40 years were 10%. Majority patients were contribution with 3-4 parity. 66.66% patients were menopausal and 33.33% patients were premenopausal. 1st degree prolapse was not observed in any patients. 2nd degree and 3rd degree prolapsed was observed in 70% and 20% patients respectively.Procidentia was observed in 10% patients. Cystocele and rectocele were observed in 90% patients. “something coming out of vagina“ was the most common complaint of the patients (100%).11
{"title":"FACTORS ASSOCIATED WITH PROLAPSE OF UTERUS","authors":"Ashwini S. Hambarde, Sandeep R. Hambarde","doi":"10.36106/ijsr/3904352","DOIUrl":"https://doi.org/10.36106/ijsr/3904352","url":null,"abstract":"Background: Prolapse of uterus is a very common reproductive health problem in women in India. It is detrimental to emotional, physical and\u0000psychosocial well being of a woman. Factors affecting prolapse of uterus, if studied well,will help for preventive measures. Aim and Objective:\u0000To study the factors associated with uterine prolapse at SIMS,Manglore. Material and Methods: Total 60 patients diagnosed with uterine prolapse\u0000were studied. Data was collected with standard questions. Data included Detailed history,clinical examination and sociodemographic data. It was\u0000analysed with appropriate statistical tests. Results: Mean age of the patients in our study was 46 ± 3 years. Majority i.e. 41.66% of the patients were\u0000in the age group of 41-50 years .Patients from age group of 31-40 years were 10%. Majority patients were contribution with 3-4 parity. 66.66%\u0000patients were menopausal and 33.33% patients were premenopausal. 1st degree prolapse was not observed in any patients. 2nd degree and 3rd\u0000degree prolapsed was observed in 70% and 20% patients respectively.Procidentia was observed in 10% patients. Cystocele and rectocele were\u0000observed in 90% patients. “something coming out of vagina“ was the most common complaint of the patients (100%).11","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"86 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141034937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic Tonsillitis is one of the most common chronic inammatory conditions occurring as a result of bacterial and environmental factors with CD4+ cells predominance, which is also characteristically seen Rheumatoid Arthritis, although the exact pathogenesis remain unknown. Delayed diagnosis and prompt treatment of Rheumatoid arthritis is a signicant factor leading to morbidity in elderly population. Aim:To nd association between Rheumatoid Factor positivity in patients with Chronic Tonsillitis Materials and Methods:Atotal of 50 patients were selected who were diagnosed with Chronic Tonsillitis after fullment of inclusion and exclusion criteria, in whom Rheumatoid Factor serology was evaluated and studied. Results:Astatistically signicant Rheumatoid Factor positivity were obtained - 13 out of 50 patients (26%) with a p<0.001. No statistical signicance was obtained when Rheumatoid Factor positivity and negativity was compared with age and gender distribution of the patients. Conclusion: Early evaluation of Rheumatoid Factor helps ensure better outcome on patient's quality of life by early adequate and effective treatment.
{"title":"A STUDY OF ASSOCIATION OF RHEUMATOID FACTOR POSITIVITY IN PATEINTS WITH CHRONIC TONSILLITIS","authors":"Santosh U. P., Baneet Chadha","doi":"10.36106/ijsr/9303861","DOIUrl":"https://doi.org/10.36106/ijsr/9303861","url":null,"abstract":"Chronic Tonsillitis is one of the most common chronic inammatory conditions occurring as a result of bacterial and environmental factors with\u0000CD4+ cells predominance, which is also characteristically seen Rheumatoid Arthritis, although the exact pathogenesis remain unknown. Delayed\u0000diagnosis and prompt treatment of Rheumatoid arthritis is a signicant factor leading to morbidity in elderly population. Aim:To nd association\u0000between Rheumatoid Factor positivity in patients with Chronic Tonsillitis Materials and Methods:Atotal of 50 patients were selected who were\u0000diagnosed with Chronic Tonsillitis after fullment of inclusion and exclusion criteria, in whom Rheumatoid Factor serology was evaluated and\u0000studied. Results:Astatistically signicant Rheumatoid Factor positivity were obtained - 13 out of 50 patients (26%) with a p<0.001. No statistical\u0000signicance was obtained when Rheumatoid Factor positivity and negativity was compared with age and gender distribution of the patients.\u0000Conclusion: Early evaluation of Rheumatoid Factor helps ensure better outcome on patient's quality of life by early adequate and effective\u0000treatment.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"38 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141035657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The aim of study was to nd out the effectiveness of the Epley maneuver, Semont maneuver and Gufoni maneuver on vertigo in BPPV and to evaluate the effectiveness of Epley maneuver and Semont maneuver and gufoni maneuver by using DHI, and ABC scale (Activities- Specic Balance Condence scale). A comparative study, including google scholar, pubMed as data sources. 50 Methodology: patients were included both male and female were included with age group between 50-65 years. Duration of study was 4 weeks and method used for sampling was convenient. The treatment was done using Epley Maneuver and Semont Maneuver (Group A) and Epley and Gufoni Maneuver (Group B). Outcomes were measured using DHI and ABC scale, questionnaires at beginning and at the end of repositioning treatment. Mean result of the DHI of both Result: the groups shows that the post results of the group 2 have more effect than that of the group 1. The post of group 1 was 30.88 whereas the post of the group 2 was 6.96 And More the DHI the more functional disability is present. To become more functionally stable DHI should be lowered. Means result of the ABC of both the groups shows that the post results of the group 2 have more effect than that of the group. The post of the group 1 was 73.06 and post of the group 2 was 81.00 and the more the ABC score the more Functional stability is present. The study concludes that Conclusion: there was marked improvement in functional balance, disability and postural control following Epley maneuver and Gufoni maneuver. Both the group have positive effects and was effective for long term intervention in vertigo patients and these maneuver can be added to the regular intervention for vestibular rehabilitation to decrease the symptoms of the patients.
{"title":"EFFICACY OF SEMONT MANEUVER VS GUFONI MANEUVER IN IMPROVING THE QUALITY OF LIFE IN BPPV PATIENTS: A COMPARATIVE STUDY","authors":"Preeti Sangwan (PT), Sonia Saroha(PT), Suman Rani (PT)","doi":"10.36106/ijsr/0801949","DOIUrl":"https://doi.org/10.36106/ijsr/0801949","url":null,"abstract":"Objective: The aim of study was to nd out the effectiveness of the Epley maneuver, Semont maneuver and Gufoni maneuver on vertigo in BPPV\u0000and to evaluate the effectiveness of Epley maneuver and Semont maneuver and gufoni maneuver by using DHI, and ABC scale (Activities- Specic\u0000Balance Condence scale). A comparative study, including google scholar, pubMed as data sources. 50 Methodology: patients were included both\u0000male and female were included with age group between 50-65 years. Duration of study was 4 weeks and method used for sampling was convenient.\u0000The treatment was done using Epley Maneuver and Semont Maneuver (Group A) and Epley and Gufoni Maneuver (Group B). Outcomes were\u0000measured using DHI and ABC scale, questionnaires at beginning and at the end of repositioning treatment. Mean result of the DHI of both Result:\u0000the groups shows that the post results of the group 2 have more effect than that of the group 1. The post of group 1 was 30.88 whereas the post of the\u0000group 2 was 6.96 And More the DHI the more functional disability is present. To become more functionally stable DHI should be lowered. Means\u0000result of the ABC of both the groups shows that the post results of the group 2 have more effect than that of the group. The post of the group 1 was\u000073.06 and post of the group 2 was 81.00 and the more the ABC score the more Functional stability is present. The study concludes that Conclusion:\u0000there was marked improvement in functional balance, disability and postural control following Epley maneuver and Gufoni maneuver. Both the\u0000group have positive effects and was effective for long term intervention in vertigo patients and these maneuver can be added to the regular\u0000intervention for vestibular rehabilitation to decrease the symptoms of the patients.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"26 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hydatid disease is a parasitic infection caused by tapeworm echinococcus. The muscular localization of the hydatid cyst is extremely rare, usually secondary to hepatic or pulmonary disease and often clinically mistaken as soft tissue mass. Primary muscular hydatid cyst comprises less than 0.5 % of the cases. Preoperative diagnosis is mandatory to avoid surgical contamination or future accidents.
{"title":"PRIMARY MUSCULAR HYDATID CYST: A RARE OCCURRENCE.","authors":"P R Kshirsagar, U S Kanade, S Y Swami.","doi":"10.36106/ijsr/8204667","DOIUrl":"https://doi.org/10.36106/ijsr/8204667","url":null,"abstract":"Hydatid disease is a parasitic infection caused by tapeworm echinococcus. The muscular localization of the hydatid cyst is extremely rare, usually\u0000secondary to hepatic or pulmonary disease and often clinically mistaken as soft tissue mass. Primary muscular hydatid cyst comprises less than 0.5\u0000% of the cases. Preoperative diagnosis is mandatory to avoid surgical contamination or future accidents.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"5 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Injuries to sectoral bile ducts are less common than their major bile duct counterparts and present diagnostic and therapeutic challenges because of their rarity. Records of 17 patients (5 men and 12 women) with right posterior sectoral bile duct injuries managed in a single institution from year 2000 to 2020 were analysed. Seven patients were managed non - operatively, and 9 patients underwent denitive surgery with a sectoral bile duct Roux – en – Y hepaticojejunostomy. Follow up ranged between 1 to 11 years. One patient had minor post-operative leak; 2 patients had anastomotic narrowing managed by percutaneous balloon dilatation. Persistence of bile leak despite a “normal” biliary anatomy on Endoscopic Retrograde Cholangiography ± Magnetic Resonance Cholangio Pancreatography should lead to a suspicion of a right sectoral bile duct injury. Awareness of the condition, Magnetic Resonance Cholangio Pancreatography ± Percutaneous Transhepatic Cholangiography, and expert interpretation of the ndings of imaging, are the keys to diagnosis of a Right Posterior Sectoral Bile Duct Injury.
扇形胆管损伤与大胆管损伤相比并不常见，由于其罕见性，给诊断和治疗带来了挑战。本文分析了 2000 年至 2020 年期间在一家医疗机构接受治疗的 17 例右后方扇形胆管损伤患者（5 男 12 女）的记录。其中 7 名患者接受了非手术治疗，9 名患者接受了扇形胆管鲁氏肝空肠吻合术（denitive surgery with a sectoral bile ductRoux - en - Y hepaticojejunostomy）。随访时间从 1 年到 11 年不等。一名患者术后出现轻微渗漏；两名患者通过经皮球囊扩张术处理了吻合口狭窄。尽管内镜逆行胰胆管造影术和磁共振胆胰造影术显示胆道解剖结构 "正常"，但胆漏仍持续存在，这应导致怀疑右段胆管损伤。对病情的认识、磁共振胆胰造影术±经皮经肝胆管造影术以及专家对造影ndings 的解读是诊断右后段胆管损伤的关键。
{"title":"POST-CHOLECYSTECTOMY RIGHT POSTERIOR SECTORAL BILE DUCT INJURY--A SINGLE INSTITUTION SERIES.","authors":"P. J. Halder, Swapnil Sharma","doi":"10.36106/ijsr/3505234","DOIUrl":"https://doi.org/10.36106/ijsr/3505234","url":null,"abstract":"Injuries to sectoral bile ducts are less common than their major bile duct counterparts and present diagnostic and therapeutic challenges because of\u0000their rarity. Records of 17 patients (5 men and 12 women) with right posterior sectoral bile duct injuries managed in a single institution from year\u00002000 to 2020 were analysed. Seven patients were managed non - operatively, and 9 patients underwent denitive surgery with a sectoral bile duct\u0000Roux – en – Y hepaticojejunostomy. Follow up ranged between 1 to 11 years. One patient had minor post-operative leak; 2 patients had anastomotic\u0000narrowing managed by percutaneous balloon dilatation. Persistence of bile leak despite a “normal” biliary anatomy on Endoscopic Retrograde\u0000Cholangiography ± Magnetic Resonance Cholangio Pancreatography should lead to a suspicion of a right sectoral bile duct injury. Awareness of\u0000the condition, Magnetic Resonance Cholangio Pancreatography ± Percutaneous Transhepatic Cholangiography, and expert interpretation of the\u0000ndings of imaging, are the keys to diagnosis of a Right Posterior Sectoral Bile Duct Injury.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"130 S210","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141040679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The appendix, which is a vestigial organ in humans, is attached to caecum. The disease appendicitis is one of the commonest causes of acute abdomen. It is also the commonest reason of the emergency surgery that can lead to signicant morbidity and mortality. Usually when (1) appendectomy is done early, it relieves all the symptoms. The misdiagnosis related to the disease often leads to removal of uninamed appendix. The précised aetiology of appendicitis is uncertain, although the most common hypothesis is the obstruction of appendiceal lumen with secondary infection. The luminal and intraluminal pressure and due to the constant pressure, the thrombosis of appendicular vasculature and venous obstruction occurs resulting in ischemia. The bacteria enter the damaged mucosa and the pus forms inside the appendix eventually causing the (2) infarction and perforation. Aim: We aimed at determining the spectrum, histopathology and prevalence of lesions in appendix in our tertiary care hospital. Material And Methods: This is a retrospective study conducted in the department of pathology in tertiary care hospital, Mumbai over a period of 18 months. 300 specimens of appendicular lesions received during the study period. The specimens were xed in 10% formalin and stained with Haematoxylin and Eosin stain. The lesions were classied based on their histomorphological ndings. Results: This study included total of 300 specimens of resected appendix. In the present study, the total sample number received during study period was 7840, Out of which total number of appendicectomy specimens were 300 (3.82%). present study, the age group from the paediatric to geriatric age group were considered. Majority of patients 99(33%) belong to 21-30 years age group. During the study period, a total number of 300 patients had appendectomy out of which, the number of males was higher than females, with 60% of the cases being male, 40 % being female. In the present study, the non-neoplastic lesions were found in majority. Out of 300 cases, he non- neoplastic lesions accounted for 295 cases (98.4%) and neoplastic lesions contributes 5 cases (1.66%). Conclusions: According to the current study, men are slightly more likely than women to develop appendicitis with predominancy in second and third decades of life. In all cases of acute appendicitis, a histopathological examination of the appendix should be done since it provides crucial clinical information in addition to the operational results. The importance of histological investigation of every resected appendix is demonstrated by uncommon discoveries such as low grade appendiceal mucinous neoplasia and adenocarcinoma in clinically suspected acute appendicitis, the presence of which alters the subsequent therapy. Thus, we draw the conclusion that the histological analysis is still the best method for identifying appendiceal lesions.
{"title":"HISTOMORPHOLOGICAL SPECTRUM OF APPENDICULAR LESIONS","authors":"Mitali Priya Netam, Rachana S. Binayke","doi":"10.36106/ijsr/9802942","DOIUrl":"https://doi.org/10.36106/ijsr/9802942","url":null,"abstract":"Introduction: The appendix, which is a vestigial organ in humans, is attached to caecum. The disease appendicitis is one of the commonest causes\u0000of acute abdomen. It is also the commonest reason of the emergency surgery that can lead to signicant morbidity and mortality. Usually when\u0000(1) appendectomy is done early, it relieves all the symptoms. The misdiagnosis related to the disease often leads to removal of uninamed appendix.\u0000The précised aetiology of appendicitis is uncertain, although the most common hypothesis is the obstruction of appendiceal lumen with secondary\u0000infection. The luminal and intraluminal pressure and due to the constant pressure, the thrombosis of appendicular vasculature and venous\u0000obstruction occurs resulting in ischemia. The bacteria enter the damaged mucosa and the pus forms inside the appendix eventually causing the\u0000(2) infarction and perforation. Aim: We aimed at determining the spectrum, histopathology and prevalence of lesions in appendix in our tertiary care\u0000hospital. Material And Methods: This is a retrospective study conducted in the department of pathology in tertiary care hospital, Mumbai over a\u0000period of 18 months. 300 specimens of appendicular lesions received during the study period. The specimens were xed in 10% formalin and\u0000stained with Haematoxylin and Eosin stain. The lesions were classied based on their histomorphological ndings. Results: This study included\u0000total of 300 specimens of resected appendix. In the present study, the total sample number received during study period was 7840, Out of which\u0000total number of appendicectomy specimens were 300 (3.82%). present study, the age group from the paediatric to geriatric age group were\u0000considered. Majority of patients 99(33%) belong to 21-30 years age group. During the study period, a total number of 300 patients had\u0000appendectomy out of which, the number of males was higher than females, with 60% of the cases being male, 40 % being female. In the present\u0000study, the non-neoplastic lesions were found in majority. Out of 300 cases, he non- neoplastic lesions accounted for 295 cases (98.4%) and\u0000neoplastic lesions contributes 5 cases (1.66%). Conclusions: According to the current study, men are slightly more likely than women to develop\u0000appendicitis with predominancy in second and third decades of life. In all cases of acute appendicitis, a histopathological examination of the\u0000appendix should be done since it provides crucial clinical information in addition to the operational results. The importance of histological\u0000investigation of every resected appendix is demonstrated by uncommon discoveries such as low grade appendiceal mucinous neoplasia and\u0000adenocarcinoma in clinically suspected acute appendicitis, the presence of which alters the subsequent therapy. Thus, we draw the conclusion that\u0000the histological analysis is still the best method for identifying appendiceal lesions.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"24 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sudhanshu Sharma, Amal Mariyadas K. Boobily, Arbab Zaman
Background- Peptic ulcer perforation is an emergency and requires urgent surgical treatment. Due to in aberrant use of NSAID and high smoking habits among the Indian population, frequency of peptic perforation is on the rise. Objective- This study is aimed at comparing success rate between Graham's omentopexy (GO) and modied - Graham's omentopexy (MGO) as an emergency management technique for duodenal perforation. Patients and methods- A prospective study was carried out for 1 year with 90 patients. GO was done in 50 patients and 40 patients underwent MGO between January 2023 and January 2024 in the Department of Surgery, Rajkiya Medical college Orai, Jalaun UP. Data regarding age, sex, time elapsed between onset of symptoms and hospital admission, comorbid diseases, morbidity, and mortality were recorded. ResultsMGO was associated with longer operative time. Mean hospital stay in GO group is higher than MGO group. Conclusion- Graham's patch repair is as effective as modied- Graham's patch repair in terms of morbidity and mortality. There is no statistically signicant difference in undergoing either procedure for repair.
{"title":"COMPARATIVE STUDY BETWEEN GRAHAM'S OMENTOPEXY AND MODIFIEDGRAHAM'S OMENTOPEXY IN TREATMENT OF PERFORATED DUODENAL ULCERS","authors":"Sudhanshu Sharma, Amal Mariyadas K. Boobily, Arbab Zaman","doi":"10.36106/ijsr/8601354","DOIUrl":"https://doi.org/10.36106/ijsr/8601354","url":null,"abstract":"Background- Peptic ulcer perforation is an emergency and requires urgent surgical treatment. Due to in aberrant use of NSAID and high smoking\u0000habits among the Indian population, frequency of peptic perforation is on the rise. Objective- This study is aimed at comparing success rate\u0000between Graham's omentopexy (GO) and modied - Graham's omentopexy (MGO) as an emergency management technique for duodenal\u0000perforation. Patients and methods- A prospective study was carried out for 1 year with 90 patients. GO was done in 50 patients and 40 patients\u0000underwent MGO between January 2023 and January 2024 in the Department of Surgery, Rajkiya Medical college Orai, Jalaun UP. Data regarding\u0000age, sex, time elapsed between onset of symptoms and hospital admission, comorbid diseases, morbidity, and mortality were recorded. ResultsMGO was associated with longer operative time. Mean hospital stay in GO group is higher than MGO group. Conclusion- Graham's patch repair is\u0000as effective as modied- Graham's patch repair in terms of morbidity and mortality. There is no statistically signicant difference in undergoing\u0000either procedure for repair.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"4 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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