Pub Date : 2019-03-31DOI: 10.17511/ijoso.2019.i01.08
K. Krishnanand, Naren Kurmi
hepatic is in the Pyogenic and amoebic liver share many clinical features. Patients usually present with a constant dull in the right quadrant of the may be ABSTRACT Background: Liver abscesses, both amoebic and pyogenic, is an important cause of morbidity and mortality in tropical countries. However, liver abscess have been managed by conservative, percutaneous needle aspiration, surgical drainage and endoscopic drainage. The aim of our study was to study the etiological, predisposing factors, signs and symptoms and various modalities of treatment of liver abscess. Methods: In this study 30 cases of liver abscess, required data was collected and was compared statistically. All cases were studied upto discharge regarding presenting signs and symptoms and treatment modalities. Results: Liver abscesses were more common in males. History of alcoholism was present in 60% of cases. The common clinical features were rt hypochondriac tenderness 100%, tender hepatomegaly 90%, fever 97%, anorexia 77%, weight loss 40%, jaundice 13%. Elevated leukocytes was seen in 72%, elevated serum bilirubin in 17%, serum alkaline phosphatase in 50 % and serum transaminase in 17% of cases. Right lobe of liver was involved in 87%, left lobe in 13%, both lobes in 0%. 23% of cases were treated conservatively, 50% by aspiration, 27% by surgical open method drainage, complications were secondary infection in 8%, rupture into peritoneal cavity 13% and pleural effusion 17%. Mortality was nil. Conclusions: The modern day ultrasound and other non-invasive imaging techniques had greatly revolutionized the diagnosis and management of the liver abscess. Conservative management with IV antibiotics and USG guided percutaneous aspiration of liver abscess are most frequent treatment modalities used now, with fewer complications.
{"title":"Clinical study of liver abscess","authors":"K. Krishnanand, Naren Kurmi","doi":"10.17511/ijoso.2019.i01.08","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i01.08","url":null,"abstract":"hepatic is in the Pyogenic and amoebic liver share many clinical features. Patients usually present with a constant dull in the right quadrant of the may be ABSTRACT Background: Liver abscesses, both amoebic and pyogenic, is an important cause of morbidity and mortality in tropical countries. However, liver abscess have been managed by conservative, percutaneous needle aspiration, surgical drainage and endoscopic drainage. The aim of our study was to study the etiological, predisposing factors, signs and symptoms and various modalities of treatment of liver abscess. Methods: In this study 30 cases of liver abscess, required data was collected and was compared statistically. All cases were studied upto discharge regarding presenting signs and symptoms and treatment modalities. Results: Liver abscesses were more common in males. History of alcoholism was present in 60% of cases. The common clinical features were rt hypochondriac tenderness 100%, tender hepatomegaly 90%, fever 97%, anorexia 77%, weight loss 40%, jaundice 13%. Elevated leukocytes was seen in 72%, elevated serum bilirubin in 17%, serum alkaline phosphatase in 50 % and serum transaminase in 17% of cases. Right lobe of liver was involved in 87%, left lobe in 13%, both lobes in 0%. 23% of cases were treated conservatively, 50% by aspiration, 27% by surgical open method drainage, complications were secondary infection in 8%, rupture into peritoneal cavity 13% and pleural effusion 17%. Mortality was nil. Conclusions: The modern day ultrasound and other non-invasive imaging techniques had greatly revolutionized the diagnosis and management of the liver abscess. Conservative management with IV antibiotics and USG guided percutaneous aspiration of liver abscess are most frequent treatment modalities used now, with fewer complications.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122084700","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}
Pub Date : 2019-03-31DOI: 10.17511/ijoso.2019.i01.05
R. Turkar, V. Padmanabhan, Siddharth Jain, Cmc Vellore India Resident
Introduction: Total knee arthroplasty (TKA) is a surgical procedure that provides pain relief and restores function for patients suffering from debilitating arthritis. Despite the overall success of the procedure, periprosthetic joint infection (PJI) is a rare but devastating complication andfound to be a major cause of TKA failure.An infected implant often requires removal, prolonged immobilization and antibiotic treatment and multistage surgery. Hence, prevention of infections in intraoperative and postoperative stage is of paramount importance. Material and method: We have conducted a retrospective study in SreeSudheendra Medical Mission hospital, Ernakulum, Kerala. We collected the data from April 2014 to March 2018. In this duration we have found 89 cases of rheumatoid arthritis underwent TKA in 148 knees. We have collected and analysed demographic data and information regarding risk factors [like ESR, H/O Diabeties, steroid intake, blood transfusion, preop deformity, preop DMARDs, intraop soft tissue manipulation/finding, Albumin Globulin ratio (A/G)] associate with infection. Postoperatively we have followed our patient for the minimum period of 9 months period to 4 years. Result: We identified DMARDs (esp. methotraxate) and intraoperative manipulation like bone grafting, extra soft tissue release, Z-plasty of tendon as a risk factor for superficial periprosthetic infection (P value 0.05). Conclusion: These results guide our understanding of the relationship between infections and TKA in RA patient, and may help to prospectively identifyinghigh-risk patients, facilitating extra vigilance and implementation of preventive strategies in such patients.
{"title":"Prediction of infection after total knee arthroplasty in rheumatoid arthritis patients by evaluating various risk factor","authors":"R. Turkar, V. Padmanabhan, Siddharth Jain, Cmc Vellore India Resident","doi":"10.17511/ijoso.2019.i01.05","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i01.05","url":null,"abstract":"Introduction: Total knee arthroplasty (TKA) is a surgical procedure that provides pain relief and restores function for patients suffering from debilitating arthritis. Despite the overall success of the procedure, periprosthetic joint infection (PJI) is a rare but devastating complication andfound to be a major cause of TKA failure.An infected implant often requires removal, prolonged immobilization and antibiotic treatment and multistage surgery. Hence, prevention of infections in intraoperative and postoperative stage is of paramount importance. \u0000Material and method: We have conducted a retrospective study in SreeSudheendra Medical Mission hospital, Ernakulum, Kerala. We collected the data from April 2014 to March 2018. In this duration we have found 89 cases of rheumatoid arthritis underwent TKA in 148 knees. We have collected and analysed demographic data and information regarding risk factors [like ESR, H/O Diabeties, steroid intake, blood transfusion, preop deformity, preop DMARDs, intraop soft tissue manipulation/finding, Albumin Globulin ratio (A/G)] associate with infection. Postoperatively we have followed our patient for the minimum period of 9 months period to 4 years. \u0000Result: We identified DMARDs (esp. methotraxate) and intraoperative manipulation like bone grafting, extra soft tissue release, Z-plasty of tendon as a risk factor for superficial periprosthetic infection (P value 0.05). \u0000Conclusion: These results guide our understanding of the relationship between infections and TKA in RA patient, and may help to prospectively identifyinghigh-risk patients, facilitating extra vigilance and implementation of preventive strategies in such patients.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130879331","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}
Pub Date : 2019-03-31DOI: 10.17511/ijoso.2019.i01.03
Karpagavel Chandrabose, V. Subbiah
Background: Most common anorectal diseases seen in the community is hemorrhoids. The treatment aspect of each stage of hemorrhoids varies. Conservative treatment for first and second stages is preferred. Failure of conservative treatment and advanced diseases hasother options like sclerotherapy, ban ligation, cryosurgery and stapling. The objective of the present study is to compare treatment outcome of rubber band ligation and sclerotherapy in stage 2 hemorrhoid cases. Methods: Prospective observational study including uncomplicated stage 2 hemorrhoids cases was conducted in department of general surgery, Velammal Medical College. Madurai. The study population was divided into two groups by random allocation treatment procedure of rubber band ligation or sclerotherapy was allotted. The study was conducted during March 2018 to December 2018. Results: Total of 116 patients were included for analysis. The mean of group I was 53.2±4.63yrs and in group II was 52.7±5.37 yrs. The male and female distribution was almost similar in both groups. 41 of the group I patients and 37 of group II patients had stage 2 disease. 29% in group I and 36% in group II had stage 3 disease. In group I, 82.75% participants had complete recovery and 10.35% participants had partial recovery. In group II, 79.31% participants had complete recovery and 17.51% participants had partial recovery. The difference in the proportion of post-operative outcomes between study groups was statistically not significant. Comparison of pre and post-operative SS score between the two study groups was statistically significant. Conclusions: Stage 2 and 3 hemorrhoids warranting OPD based interventional procedures were presented with almost similar set of symptoms. The rubber band ligation and injection sclerotherapy both had similar post treatment outcome. Based on the patient’s willingness and surgeons’ decision any method can be chosen for the benefit of the patient.
{"title":"Comparison of treatment outcome following rubber band ligation vs injection scleratherapy for treatment of hemorrhoids: a prospective observational study","authors":"Karpagavel Chandrabose, V. Subbiah","doi":"10.17511/ijoso.2019.i01.03","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i01.03","url":null,"abstract":"Background: Most common anorectal diseases seen in the community is hemorrhoids. The treatment aspect of each stage of hemorrhoids varies. Conservative treatment for first and second stages is preferred. Failure of conservative treatment and advanced diseases hasother options like sclerotherapy, ban ligation, cryosurgery and stapling. The objective of the present study is to compare treatment outcome of rubber band ligation and sclerotherapy in stage 2 hemorrhoid cases. Methods: Prospective observational study including uncomplicated stage 2 hemorrhoids cases was conducted in department of general surgery, Velammal Medical College. Madurai. The study population was divided into two groups by random allocation treatment procedure of rubber band ligation or sclerotherapy was allotted. The study was conducted during March 2018 to December 2018. Results: Total of 116 patients were included for analysis. The mean of group I was 53.2±4.63yrs and in group II was 52.7±5.37 yrs. The male and female distribution was almost similar in both groups. 41 of the group I patients and 37 of group II patients had stage 2 disease. 29% in group I and 36% in group II had stage 3 disease. In group I, 82.75% participants had complete recovery and 10.35% participants had partial recovery. In group II, 79.31% participants had complete recovery and 17.51% participants had partial recovery. The difference in the proportion of post-operative outcomes between study groups was statistically not significant. Comparison of pre and post-operative SS score between the two study groups was statistically significant. Conclusions: Stage 2 and 3 hemorrhoids warranting OPD based interventional procedures were presented with almost similar set of symptoms. The rubber band ligation and injection sclerotherapy both had similar post treatment outcome. Based on the patient’s willingness and surgeons’ decision any method can be chosen for the benefit of the patient.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"04 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129199720","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}
Pub Date : 2019-03-31DOI: 10.17511/ijoso.2019.i01.09
K. Krishnanand, Narendra Singh Kurmi
Background: To identify and evaluate the predisposing factor in gall bladder disease prospectively and to study the incidence of gall bladder malignancy in gall bladder disease. Methods: The present study included 240 patients who were distributed in three groups. About 198 patients of cholelithiasis, 27 patients of carcinoma gall bladder and 15 other patients of gall bladder disease were included. Findings of the patients were tabulated to reach the possible association of the factors concerned with a particular gall bladder disease. Results: The highest incidence of carcinoma gall bladder was in 7th decade oflife in females and 6th decade in males and the highest incidence of cholelithiasis in 6 decade for males as well as females. Carcinoma gall bladder in females was 2.375 times more than males while this ratio in gallstones was 1: 2.54 in favor of females. Conclusion: Gallstone associated symptoms are non-specific and accurate diagnosis cannot be reliedonclinical assessment alone.Careful clinical evaluation can guide patient selection for diagnostic imaging andappropriate management of those found to harbor stones.
{"title":"Study of gall bladder disease with incidence of gall bladder malignancy","authors":"K. Krishnanand, Narendra Singh Kurmi","doi":"10.17511/ijoso.2019.i01.09","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i01.09","url":null,"abstract":"Background: To identify and evaluate the predisposing factor in gall bladder disease prospectively and to study the incidence of gall bladder malignancy in gall bladder disease. Methods: The present study included 240 patients who were distributed in three groups. About 198 patients of cholelithiasis, 27 patients of carcinoma gall bladder and 15 other patients of gall bladder disease were included. Findings of the patients were tabulated to reach the possible association of the factors concerned with a particular gall bladder disease. Results: The highest incidence of carcinoma gall bladder was in 7th decade oflife in females and 6th decade in males and the highest incidence of cholelithiasis in 6 decade for males as well as females. Carcinoma gall bladder in females was 2.375 times more than males while this ratio in gallstones was 1: 2.54 in favor of females. Conclusion: Gallstone associated symptoms are non-specific and accurate diagnosis cannot be reliedonclinical assessment alone.Careful clinical evaluation can guide patient selection for diagnostic imaging andappropriate management of those found to harbor stones.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131388398","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}
Pub Date : 2019-03-31DOI: 10.17511/ijoso.2019.i01.02
V. Malviya, Shivam Diwan, Tarun Kumar Sainia, Ashwin V. Apte
Background: Hemorrhoids are the most prevalent benign anorectal disorder diagnosed in clinical practice. Risk factors commonly associated with hemorrhoidal disease include low fiber diet, chronic constipation & diarrhea, straining during defecation, pregnancy, sedentary lifestyle, obesity etc. Treatment of symptomatic first-degree, second degree and early third-degree hemorrhoids includes banding and sclerotherapy. Patients with fourth-degree or large third-degree hemorrhoids should be referred for hemorrhoidectomy surgery. Methods: This retrospective study was conducted in the department of surgery in J.K. Hospital Bhopal. 430 adult patients with diagnosis of hemorrhoids, admitted in surgery ward were included in this study. All the relevant details were obtained from medical record department with all demographic details. Results: Most of the patients (46%) belongs to the younger age (20-40 years). 69% were male patients and 31% were female patients. Patients with higher socioeconomic status were most commonly affected group (37.2%) with hemorrhoids. Commonest symptoms was Bleeding per rectum. In the present study, risk factors for hemorrhoids were low fiber diet, mixed diet, poor hydration, chronic constipation or diarrhea, straining during the defecation, low physical activity and obesity. Sclerotherapy (11.1%) and rubber band ligation (4.1%) were non operative treatment. Operative procedures performed in the present study were open hemorrhoidectomy (81.4%) and stapled hemorrhoidopexy (3.2%). Conclusion: This demographic study of hemorrhoidal disease in this region can guide us to better understand the trends of this disease which is most commonly encountered in our society.This useful information may aid in the assessment and definitive care of these patients with hemorrhoids.
{"title":"Demographic study of hemorrhoid with analysis of risk factors","authors":"V. Malviya, Shivam Diwan, Tarun Kumar Sainia, Ashwin V. Apte","doi":"10.17511/ijoso.2019.i01.02","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i01.02","url":null,"abstract":"Background: Hemorrhoids are the most prevalent benign anorectal disorder diagnosed in clinical practice. Risk factors commonly associated with hemorrhoidal disease include low fiber diet, chronic constipation & diarrhea, straining during defecation, pregnancy, sedentary lifestyle, obesity etc. Treatment of symptomatic first-degree, second degree and early third-degree hemorrhoids includes banding and sclerotherapy. Patients with fourth-degree or large third-degree hemorrhoids should be referred for hemorrhoidectomy surgery. \u0000Methods: This retrospective study was conducted in the department of surgery in J.K. Hospital Bhopal. 430 adult patients with diagnosis of hemorrhoids, admitted in surgery ward were included in this study. All the relevant details were obtained from medical record department with all demographic details. \u0000Results: Most of the patients (46%) belongs to the younger age (20-40 years). 69% were male patients and 31% were female patients. Patients with higher socioeconomic status were most commonly affected group (37.2%) with hemorrhoids. Commonest symptoms was Bleeding per rectum. In the present study, risk factors for hemorrhoids were low fiber diet, mixed diet, poor hydration, chronic constipation or diarrhea, straining during the defecation, low physical activity and obesity. Sclerotherapy (11.1%) and rubber band ligation (4.1%) were non operative treatment. Operative procedures performed in the present study were open hemorrhoidectomy (81.4%) and stapled hemorrhoidopexy (3.2%). \u0000Conclusion: This demographic study of hemorrhoidal disease in this region can guide us to better understand the trends of this disease which is most commonly encountered in our society.This useful information may aid in the assessment and definitive care of these patients with hemorrhoids.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131056909","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}
Pub Date : 2019-03-31DOI: 10.17511/ijoso.2019.i01.07
Dr. Ravichandran K.S.
Background: Peripheral neuropathy and peripheral vascular diseases are the important causes of non-traumatic lower limb amputation. The risk of amputation among diabetic patients increases by two to four folds with the advancement of age and duration of diabetes.It has also been proven by many longitudinal epidemiological studies that among diabetic patients, the life time foot ulcer risk is about 25%, thereby accounting for two thirds of all non-traumatic amputations. Clinical guidelines recommend that all patients with diabetes should be screened annually to establish their risk of foot ulceration. Aim: To ascertain the risk factors leading to amputation for patients with diabetic foot ulcer. Materials and method: The present study was conducted in the Department of General Surgery of Melmaruvathur Adhiparasakthi institute of medical sciences. Melmaruvathur. For our study, we selected 200 patients admitted to the surgical ward with diagnosis of diabetic foot ulcer. History of diabetic status of patient, whether patient was a undetected case or a known diabetic, if known the duration of the disease, whether patient was on regular or irregular treatment (diet/oral/drugs/insulin) were recorded. Lab tests of each patient were conducted for hemoglobin, TLC, DLC, ESR, blood urea, serum creatinine and blood sugar. All the cases were managed following conservative and surgical approach. Results: A total of 200 patients were present in the study group. The mean of the subjects was 49.28 + 6.88 years. Out of 200 patients, 46 were females and 154 were males. We observed that 54 patients were undetected at the time of admission at hospital. Majority of patients (n=46) had duration of diabetes from 5-10 years. 38 patients had duration of diabetes less than 4 years, 10 patients had duration of diabetes from 11-15 years. Most of the patients present with more than one lesion. Only major lesion is considered here. Ulcer was the major lesion seen in present series being present in 144 patients. Conclusion: We conclude that Routine foot care should be available to every patient with diabetes ideally, but the reality of most of these patient slack adequate knowledge and resources resulting in the absence of such care.
{"title":"A study of risk factors for patients with Diabetic foot ulcer","authors":"Dr. Ravichandran K.S.","doi":"10.17511/ijoso.2019.i01.07","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i01.07","url":null,"abstract":"Background: Peripheral neuropathy and peripheral vascular diseases are the important causes of non-traumatic lower limb amputation. The risk of amputation among diabetic patients increases by two to four folds with the advancement of age and duration of diabetes.It has also been proven by many longitudinal epidemiological studies that among diabetic patients, the life time foot ulcer risk is about 25%, thereby accounting for two thirds of all non-traumatic amputations. Clinical guidelines recommend that all patients with diabetes should be screened annually to establish their risk of foot ulceration. Aim: To ascertain the risk factors leading to amputation for patients with diabetic foot ulcer. Materials and method: The present study was conducted in the Department of General Surgery of Melmaruvathur Adhiparasakthi institute of medical sciences. Melmaruvathur. For our study, we selected 200 patients admitted to the surgical ward with diagnosis of diabetic foot ulcer. History of diabetic status of patient, whether patient was a undetected case or a known diabetic, if known the duration of the disease, whether patient was on regular or irregular treatment (diet/oral/drugs/insulin) were recorded. Lab tests of each patient were conducted for hemoglobin, TLC, DLC, ESR, blood urea, serum creatinine and blood sugar. All the cases were managed following conservative and surgical approach. Results: A total of 200 patients were present in the study group. The mean of the subjects was 49.28 + 6.88 years. Out of 200 patients, 46 were females and 154 were males. We observed that 54 patients were undetected at the time of admission at hospital. Majority of patients (n=46) had duration of diabetes from 5-10 years. 38 patients had duration of diabetes less than 4 years, 10 patients had duration of diabetes from 11-15 years. Most of the patients present with more than one lesion. Only major lesion is considered here. Ulcer was the major lesion seen in present series being present in 144 patients. Conclusion: We conclude that Routine foot care should be available to every patient with diabetes ideally, but the reality of most of these patient slack adequate knowledge and resources resulting in the absence of such care.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117140721","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}
Pub Date : 2019-03-31DOI: 10.17511/ijoso.2019.i01.10
Anil Kumar Chintada, Anil Nathi
Introduction: One of the common complications of open fractures is an infection which may be dependent on the time of administration of antibiotics. The study aimed to determine the prevalence of wound infection due to the delay in the interval between the initiation of intravenous (IV) antibiotics and time of paediatrics open injury. Materials and Methods: Retrospective observational study included paediatrics patients (0 to 16 years) with open fractures. A retrospective chart review was performed to identify patients with open fracture, who were treated between May 2012 and October 2013 at the tertiary care centre. The time between the injury and the first dose of intravenous antibiotic was calculated from transfer and hospital records. Fracture groups were stratified according to the severity of soft-tissue damage as determined with use of the Gustilo- Anderson system for the classification of open fractures. Results: Sixty patients with 84 open fractures were included in this study. Majority of 31.58% of participants had type III B Gustilo - Anderson fracture type. The proportion of grade IIIA, I, III C and II fracture was 29.82%, 21.05%, 14.04% and 3.51% respectively. 43 (71.6%) received IV antibiotics within 6 hours of injury of which eight had documented wound infections. Of the 17 (28%) patients who received IV antibiotics after 6 hours, 7 (41%) were diagnosed with wound infections. The incidence of infection was high in higher grades of Gustilo- Anderson opens injuries. Conclusion: The immediate administration of appropriate antibiotics on presentation is crucial to minimise the risk of infection in children.
{"title":"Does delay in initiation of intravenous antibiotics correlate with wound infections in children with open fractures?","authors":"Anil Kumar Chintada, Anil Nathi","doi":"10.17511/ijoso.2019.i01.10","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i01.10","url":null,"abstract":"Introduction: One of the common complications of open fractures is an infection which may be dependent on the time of administration of antibiotics. The study aimed to determine the prevalence of wound infection due to the delay in the interval between the initiation of intravenous (IV) antibiotics and time of paediatrics open injury. \u0000Materials and Methods: Retrospective observational study included paediatrics patients (0 to 16 years) with open fractures. A retrospective chart review was performed to identify patients with open fracture, who were treated between May 2012 and October 2013 at the tertiary care centre. The time between the injury and the first dose of intravenous antibiotic was calculated from transfer and hospital records. Fracture groups were stratified according to the severity of soft-tissue damage as determined with use of the Gustilo- Anderson system for the classification of open fractures. \u0000Results: Sixty patients with 84 open fractures were included in this study. Majority of 31.58% of participants had type III B Gustilo - Anderson fracture type. The proportion of grade IIIA, I, III C and II fracture was 29.82%, 21.05%, 14.04% and 3.51% respectively. 43 (71.6%) received IV antibiotics within 6 hours of injury of which eight had documented wound infections. Of the 17 (28%) patients who received IV antibiotics after 6 hours, 7 (41%) were diagnosed with wound infections. The incidence of infection was high in higher grades of Gustilo- Anderson opens injuries. \u0000Conclusion: The immediate administration of appropriate antibiotics on presentation is crucial to minimise the risk of infection in children.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"31 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113976069","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}
Pub Date : 2019-03-31DOI: 10.17511/ijoso.2019.i01.06
R. Thakur, N. Samal, Vasant Gawande, Niharika Kochhal
Introduction: There have been many studies on ACL reconstruction and its outcome. In our study, we used single bundle reconstruction as the technique for Indian rural population as it is one of the most reliable technique for ACL reconstruction after the injury. Aim: To study the pattern of clinical and functional evaluation of anterior cruciate ligament injury after anterior cruciate ligament reconstruction. Objectives: (1) To assess the pattern of anterior cruciate ligament injury and instability caused by it (2) To study the clinical & functional outcome of ACL in arthroscopic ACL reconstruction in patient with ACL tear. Results: The outcome scores themselves, at the end of 12 months follow up were significantly better in operated patient. We found better knee function and patients were able to do their daily activity normal (as before the injury). Results of our study were compared with other study done worldwide and we also found better results and better life style in post operated patient of ACL. The study concludes that, Arthroscopic ACLR is a good choice for ACL reconstruction and HS grafts were a good choice for reconstruction along with endobutton and screw. This study shows that ACL is one of most important ligament in the knee joint and must be taken care of for a better knee function. Conclusion: The reconstruction of anterior cruciate ligament tears with hamstring tendon grafts gives a very good clinical and functional outcome.
{"title":"Clinical and functional evaluation of anterior cruciate ligament tears after anterior cruciate ligament reconstruction","authors":"R. Thakur, N. Samal, Vasant Gawande, Niharika Kochhal","doi":"10.17511/ijoso.2019.i01.06","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i01.06","url":null,"abstract":"Introduction: There have been many studies on ACL reconstruction and its outcome. In our study, we used single bundle reconstruction as the technique for Indian rural population as it is one of the most reliable technique for ACL reconstruction after the injury. Aim: To study the pattern of clinical and functional evaluation of anterior cruciate ligament injury after anterior cruciate ligament reconstruction. Objectives: (1) To assess the pattern of anterior cruciate ligament injury and instability caused by it (2) To study the clinical & functional outcome of ACL in arthroscopic ACL reconstruction in patient with ACL tear. Results: The outcome scores themselves, at the end of 12 months follow up were significantly better in operated patient. We found better knee function and patients were able to do their daily activity normal (as before the injury). Results of our study were compared with other study done worldwide and we also found better results and better life style in post operated patient of ACL. The study concludes that, Arthroscopic ACLR is a good choice for ACL reconstruction and HS grafts were a good choice for reconstruction along with endobutton and screw. This study shows that ACL is one of most important ligament in the knee joint and must be taken care of for a better knee function. Conclusion: The reconstruction of anterior cruciate ligament tears with hamstring tendon grafts gives a very good clinical and functional outcome.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131643489","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}
Pub Date : 2019-03-31DOI: 10.17511/ijoso.2019.i01.01
Shirish V Tumbal
Background: The humerus can be considered the most versatile bone in the human body. Plating can be performed using a classic open approach or minimally invasive methods. Many humeral fractures can be successfully managed conservatively due to the wide range of acceptability. Anterior bridge plating (ABP) which utilizes the minimally invasive approach popularly known as the minimally invasive Percutaneous plate osteosynthesis (MIPPO) technique can be said to be the latest entrant in this list. The present study was undertaken to evaluate the efficacy of anterior bridge plating. Method: The study was carried out from April 2015 to December 2015 involving 15 patients who met the selection criteria and were operated at the tertiary care centre. Informed consent was obtained from all the patients for use of their clinical and imaging data. The assessment of the patients was done based on functional and radiological outcomes periodically. Result: Majority of patients belongs to age group 18-25 years (53.3%). The average age is 27.4 years. Majority of side of injury were found right side (80%). Most of cases of extent of displacement of fractures were 2-5 cms (80%). Conclusion: In conclusion anterior bridge plating (ABP) is very good technique in treating midshaft humeral fractures with minimal soft tissue dissection, smaller scars, and early return to overhead activities.
{"title":"Study of radiological and clinical outcomes by using Anterior Bridge Plating (ABP) for humerus shaft fractures","authors":"Shirish V Tumbal","doi":"10.17511/ijoso.2019.i01.01","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i01.01","url":null,"abstract":"Background: The humerus can be considered the most versatile bone in the human body. Plating can be performed using a classic open approach or minimally invasive methods. Many humeral fractures can be successfully managed conservatively due to the wide range of acceptability. Anterior bridge plating (ABP) which utilizes the minimally invasive approach popularly known as the minimally invasive Percutaneous plate osteosynthesis (MIPPO) technique can be said to be the latest entrant in this list. The present study was undertaken to evaluate the efficacy of anterior bridge plating. Method: The study was carried out from April 2015 to December 2015 involving 15 patients who met the selection criteria and were operated at the tertiary care centre. Informed consent was obtained from all the patients for use of their clinical and imaging data. The assessment of the patients was done based on functional and radiological outcomes periodically. Result: Majority of patients belongs to age group 18-25 years (53.3%). The average age is 27.4 years. Majority of side of injury were found right side (80%). Most of cases of extent of displacement of fractures were 2-5 cms (80%). Conclusion: In conclusion anterior bridge plating (ABP) is very good technique in treating midshaft humeral fractures with minimal soft tissue dissection, smaller scars, and early return to overhead activities.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127818322","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}
Pub Date : 2019-03-31DOI: 10.17511/ijoso.2019.i01.11
R. V. Kumar, S. Dharwadkar, C. Doshi
Background: Blunt renal trauma are usually caused by high-energy collisions such as road traffic accidents (RTA), fall from a height. They occur in 5 to 10 % of all trauma. Majority of hemodynamically stable patients with blunt renal trauma are successfully managed non operatively. Aims and Objective: To review the management of blunt renal trauma in our centre. Materials and Methods: A retrospective study of 22 patients was carried out in JSS Medical College and Hospital from January 2017 to January 2019. All blunt renal injuries were graded according to American Association for the Surgery of Trauma (AAST) organ injury severity scale. The following data were collected: demographics, mechanism of injury, associated injuries, admission hemoglobin, blood transfusion, CT findings, renal injury grade, presence of other organ injuries on CT scan, type of management, indication for operative intervention, operative procedures, operative findings, any other interventions required, hospital stay, morbidity, and mortality. Results: There were 22 renal injuries. Majority of them had Road Traffic Accidents and assault. Grade 2-3 were most common in 12 cases followed by grade 1 in five cases, grade 4 in three cases and finally grade 5 renal injury was seen in three cases. Three grade 5 injuries and two Grade 4 needed exploration for hemodynamic unstability and underwent emergency nephrectomy otherwise all cases were managed successful nonoperatively. There was no mortality due to blunt renal trauma. Conclusion: Conservative management of blunt renal trauma without associated abdominal injury is feasible in patients who are hemodynamically stable at presentation. Advancements in imaging techniques and improved critical care have favoured the conservative approach for even the severe grade of injuries.
{"title":"Management of blunt renal trauma in a tertiary hospital of south India: a retrospective single centre study","authors":"R. V. Kumar, S. Dharwadkar, C. Doshi","doi":"10.17511/ijoso.2019.i01.11","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i01.11","url":null,"abstract":"Background: Blunt renal trauma are usually caused by high-energy collisions such as road traffic accidents (RTA), fall from a height. They occur in 5 to 10 % of all trauma. Majority of hemodynamically stable patients with blunt renal trauma are successfully managed non operatively. Aims and Objective: To review the management of blunt renal trauma in our centre. Materials and Methods: A retrospective study of 22 patients was carried out in JSS Medical College and Hospital from January 2017 to January 2019. All blunt renal injuries were graded according to American Association for the Surgery of Trauma (AAST) organ injury severity scale. The following data were collected: demographics, mechanism of injury, associated injuries, admission hemoglobin, blood transfusion, CT findings, renal injury grade, presence of other organ injuries on CT scan, type of management, indication for operative intervention, operative procedures, operative findings, any other interventions required, hospital stay, morbidity, and mortality. Results: There were 22 renal injuries. Majority of them had Road Traffic Accidents and assault. Grade 2-3 were most common in 12 cases followed by grade 1 in five cases, grade 4 in three cases and finally grade 5 renal injury was seen in three cases. Three grade 5 injuries and two Grade 4 needed exploration for hemodynamic unstability and underwent emergency nephrectomy otherwise all cases were managed successful nonoperatively. There was no mortality due to blunt renal trauma. Conclusion: Conservative management of blunt renal trauma without associated abdominal injury is feasible in patients who are hemodynamically stable at presentation. Advancements in imaging techniques and improved critical care have favoured the conservative approach for even the severe grade of injuries.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125115839","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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