M. Anant, Mrinal Sharma, Sangam Jha, A. Paswan, Anuja Pritam, P. Raj
Introduction Gynecological surgery in adolescent girls (10–19 years) remains challenging due to remarkable differences in anatomy, physiology and need for fertility preserving conservative surgical approach. We aimed to identify the various gynecological causes, operative outcomes, and need for follow-up surgeries in adolescents. Methods A single-center hospital record-based retrospective study was conducted for gynecological surgeries performed on adolescents in a 5-year period with exclusion of obstetrical and nongynecological causes. Results Sixty-eight adolescents of mean age 16.77 ± 2.317 years underwent gynecological procedures wherein 63 (92.64%) were postmenarchal girls. Pain abdomen (75%), menstrual abnormality (47%), and abdominal swelling (47%) were their main complaints. Note that 35 (51.4%) surgeries performed were for adnexal masses and 24 (35.3%) for obstructive Mullerian anomalies or neovagina creation. Other indicated surgeries were uterine leiomyoma (4.4%), Bartholin's cyst (5.8%), and pelvic abscess (1.4%). The mean interval of symptoms to the diagnosis was 1.22 ± 1.381 years while the mean diagnosis to surgery interval was 8.71 ± 5.880 days. A statistically significant difference (243.3 vs. 783.1 days, p < 0.00001) was found in the symptoms to diagnosis interval and the length of hospital stay (difference in means 16 days, p < 0.00001) in the two major operative groups. Minimal access surgery could be completed in 37% of cases. Complications encountered were bowel injury in 5.8%, bladder injury in 2.9%, blood transfusion requirement in 5.8%, and reoperation in 2.94%. Follow-up revealed one death, adjuvant chemotherapy in 7.3%, and suppressive hormone therapy for endometriosis in 13% of operated girls. Conclusion Diagnosis of a gynecological presentation is protracted and delayed in adolescents. Both diagnosis and surgery is challenging, and minimal invasive surgery is preferable. Malignancy diagnosis or exclusion, treatment, and follow-up should be prioritized to limit delays in the decision to treat. Timely and appropriate, as far as possible conservative surgery and adherence to follow-up protocols will ensure successful outcomes.
{"title":"Adolescent Gynecological Surgeries: Cause for Concern","authors":"M. Anant, Mrinal Sharma, Sangam Jha, A. Paswan, Anuja Pritam, P. Raj","doi":"10.1055/s-0042-1751232","DOIUrl":"https://doi.org/10.1055/s-0042-1751232","url":null,"abstract":"\u0000 Introduction Gynecological surgery in adolescent girls (10–19 years) remains challenging due to remarkable differences in anatomy, physiology and need for fertility preserving conservative surgical approach. We aimed to identify the various gynecological causes, operative outcomes, and need for follow-up surgeries in adolescents.\u0000 Methods A single-center hospital record-based retrospective study was conducted for gynecological surgeries performed on adolescents in a 5-year period with exclusion of obstetrical and nongynecological causes.\u0000 Results Sixty-eight adolescents of mean age 16.77 ± 2.317 years underwent gynecological procedures wherein 63 (92.64%) were postmenarchal girls. Pain abdomen (75%), menstrual abnormality (47%), and abdominal swelling (47%) were their main complaints. Note that 35 (51.4%) surgeries performed were for adnexal masses and 24 (35.3%) for obstructive Mullerian anomalies or neovagina creation. Other indicated surgeries were uterine leiomyoma (4.4%), Bartholin's cyst (5.8%), and pelvic abscess (1.4%). The mean interval of symptoms to the diagnosis was 1.22 ± 1.381 years while the mean diagnosis to surgery interval was 8.71 ± 5.880 days. A statistically significant difference (243.3 vs. 783.1 days, p < 0.00001) was found in the symptoms to diagnosis interval and the length of hospital stay (difference in means 16 days, p < 0.00001) in the two major operative groups. Minimal access surgery could be completed in 37% of cases. Complications encountered were bowel injury in 5.8%, bladder injury in 2.9%, blood transfusion requirement in 5.8%, and reoperation in 2.94%. Follow-up revealed one death, adjuvant chemotherapy in 7.3%, and suppressive hormone therapy for endometriosis in 13% of operated girls.\u0000 Conclusion Diagnosis of a gynecological presentation is protracted and delayed in adolescents. Both diagnosis and surgery is challenging, and minimal invasive surgery is preferable. Malignancy diagnosis or exclusion, treatment, and follow-up should be prioritized to limit delays in the decision to treat. Timely and appropriate, as far as possible conservative surgery and adherence to follow-up protocols will ensure successful outcomes.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83248619","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 Objectives Dyspepsia is the commonest indication for upper gastrointestinal (UGI) endoscopy. This study was done to describe the UGI endoscopic findings and the risk factors like alcohol abuse, smoking, pan chewing, and drug intake and the endoscopic findings in patients with alarm symptoms. Materials and Methods This was an institution-based (Department of General Surgery at Government T.D. Medical College, Alappuzha) observational study (descriptive) on 250 dyspeptic patients who underwent UGI endoscopy for the duration of 1 year between November 2018 and October 2019. Results Among the patients, 130 were males and 120 were females. The mean age was 51.36 years. The majority were between 36 and 65 years (65.6%) of age. Precisely, 28.8% showed alarm symptoms. The commonest alarm symptoms were vomiting (26.8%), weight loss (7.6%), and gastrointestinal bleed (6.4%). Also, 237 (94.8%) patients had abnormal findings. The commonest abnormal findings included gastric erosions/erythema in 197 (78.8%), duodenal erosions/erythema in 69 (27.6%), and esophageal erosions/erythema in 56 (22.4%) patients. Substance use included smoking (29.6%), followed by alcoholism (27.2%) and pan chewing (14%). Dyspepsia along with alarm symptoms was seen in patients with malignant endoscopic findings. The commonest malignancy was stomach cancer (4.8%). Conclusion Dyspepsia was more common among males aged 36 to 65 years. Gastric, duodenal, and esophageal erosions/erythema were the commonest abnormal findings. Smoking and alcoholism were common in patients with dyspepsia. Malignant endoscopic findings were common in patients with alarm symptoms. UGI endoscopy is an effective and appropriate initial investigation to assess patients with dyspepsia.
{"title":"Profile of Upper Gastrointestinal Endoscopy Findings in Dyspeptic Patients","authors":"Althaf Ali, R. Ramlal, P. Vinod, V. Manoj","doi":"10.1055/s-0042-1744538","DOIUrl":"https://doi.org/10.1055/s-0042-1744538","url":null,"abstract":"\u0000 Background and Objectives Dyspepsia is the commonest indication for upper gastrointestinal (UGI) endoscopy. This study was done to describe the UGI endoscopic findings and the risk factors like alcohol abuse, smoking, pan chewing, and drug intake and the endoscopic findings in patients with alarm symptoms.\u0000 Materials and Methods This was an institution-based (Department of General Surgery at Government T.D. Medical College, Alappuzha) observational study (descriptive) on 250 dyspeptic patients who underwent UGI endoscopy for the duration of 1 year between November 2018 and October 2019.\u0000 Results Among the patients, 130 were males and 120 were females. The mean age was 51.36 years. The majority were between 36 and 65 years (65.6%) of age. Precisely, 28.8% showed alarm symptoms. The commonest alarm symptoms were vomiting (26.8%), weight loss (7.6%), and gastrointestinal bleed (6.4%). Also, 237 (94.8%) patients had abnormal findings. The commonest abnormal findings included gastric erosions/erythema in 197 (78.8%), duodenal erosions/erythema in 69 (27.6%), and esophageal erosions/erythema in 56 (22.4%) patients. Substance use included smoking (29.6%), followed by alcoholism (27.2%) and pan chewing (14%). Dyspepsia along with alarm symptoms was seen in patients with malignant endoscopic findings. The commonest malignancy was stomach cancer (4.8%).\u0000 Conclusion Dyspepsia was more common among males aged 36 to 65 years. Gastric, duodenal, and esophageal erosions/erythema were the commonest abnormal findings. Smoking and alcoholism were common in patients with dyspepsia. Malignant endoscopic findings were common in patients with alarm symptoms. UGI endoscopy is an effective and appropriate initial investigation to assess patients with dyspepsia.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82916193","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}
In India two vaccines were initially recommended for vaccination; Covaxin in the 3rd phase trial and Covishield in the 4th phase for coronavirus disease 2019 (COVID-19). Covaxin was approved to be given only in tertiary care health centers and urban areas. An adverse event is any untoward medical problem in a patient after the administration of a new drug or vaccine that may or may not be related to that product. There are several case reports of stroke followingCOVID-19 vaccination. Here, we have reported five cases of ischemic stroke following COVID-19 vaccination presenting to the neuro-outpatient department or casualty. We have taken three patients who were vaccinated with Covishield and presented with acute neurological deficit within 24 hours of vaccination. All patients were COVID-19 reverse transcription-polymerase chain reaction negative. Computed tomography brain, magnetic resonance imaging brain, echocardiography, carotid Doppler study, and other routine blood investigations were done on all patients. All the three patients were male in the age group of 30 to 60 years. All were ischemic strokes. All patients had associated other risk factors for stroke. None of them had thrombocytopenia. The proposed mechanism is vaccine-induced immune thrombotic thrombocytopenia. One patient had a posterior circulation stroke. Two patients recovered and one patient was in critical condition and left against medical advice. We cannot conclude that the thrombotic events were due to the vaccine only as other risk factors were also present. Weighing the beneficial effect of vaccines these complications can be called mere associations. But since these can be serious adverse effects of vaccines, more and more studies are required to prove vaccines as the causative agent of thrombotic stroke.
{"title":"A Case Series of Stroke following COVID-19 Vaccination—Is It Just an Association?","authors":"Rajalaxmi Satapathy, Diptiranjan Satapathy","doi":"10.1055/s-0042-1751313","DOIUrl":"https://doi.org/10.1055/s-0042-1751313","url":null,"abstract":"In India two vaccines were initially recommended for vaccination; Covaxin in the 3rd phase trial and Covishield in the 4th phase for coronavirus disease 2019 (COVID-19). Covaxin was approved to be given only in tertiary care health centers and urban areas. An adverse event is any untoward medical problem in a patient after the administration of a new drug or vaccine that may or may not be related to that product. There are several case reports of stroke followingCOVID-19 vaccination. Here, we have reported five cases of ischemic stroke following COVID-19 vaccination presenting to the neuro-outpatient department or casualty. We have taken three patients who were vaccinated with Covishield and presented with acute neurological deficit within 24 hours of vaccination. All patients were COVID-19 reverse transcription-polymerase chain reaction negative. Computed tomography brain, magnetic resonance imaging brain, echocardiography, carotid Doppler study, and other routine blood investigations were done on all patients. All the three patients were male in the age group of 30 to 60 years. All were ischemic strokes. All patients had associated other risk factors for stroke. None of them had thrombocytopenia. The proposed mechanism is vaccine-induced immune thrombotic thrombocytopenia. One patient had a posterior circulation stroke. Two patients recovered and one patient was in critical condition and left against medical advice. We cannot conclude that the thrombotic events were due to the vaccine only as other risk factors were also present. Weighing the beneficial effect of vaccines these complications can be called mere associations. But since these can be serious adverse effects of vaccines, more and more studies are required to prove vaccines as the causative agent of thrombotic stroke.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90742528","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}
With a rising number of coronavirus Omicron cases reported across the whole world, starting a third wave of the pandemic in India, the chances are high that it will soon replace Delta as dominant global variant. The trend was already visible in the U.S. where Omicron has taken over Delta as the dominant strain. Omicron is nearly four to five times more infectious than Delta. That is because of mutations in the spike protein which make it easier for the cells to be attacked. Omicron is spreading with faster pace with very little consequences, except for the elderly population and those with comorbidities. Omicron will take a big toll on the vulnerable population with comorbid diseases. Meanwhile, it is a burden as it is causing devastating infections across the world, the World Health Organization has warned that Omicron should not be dismissed as “mild” variant. Increased transmission may lead to more hospitalizations which can lead to increase strain on frontline workers and health care systems and can result in more deaths. While people who recover from coronavirus disease 2019 may develop some natural immunity to the virus, how well the individual is protected from future genetic mutation of coronavirus is still a big question. The definitive evidence for increased remission and immune evasion and vaccine effectiveness is still awaited. This article will highlight few aspect of Omicron including increased transmission, immune evasion, hospitalization, mortality, vaccine effectiveness, and therapeutic drugs effective against the disease.
{"title":"Omicron Threat or Boon to Global Health Systemic Review","authors":"Bhupendra Kumar Jain, U. Maheshwarchandrakantham","doi":"10.1055/s-0042-1751312","DOIUrl":"https://doi.org/10.1055/s-0042-1751312","url":null,"abstract":"With a rising number of coronavirus Omicron cases reported across the whole world, starting a third wave of the pandemic in India, the chances are high that it will soon replace Delta as dominant global variant. The trend was already visible in the U.S. where Omicron has taken over Delta as the dominant strain. Omicron is nearly four to five times more infectious than Delta. That is because of mutations in the spike protein which make it easier for the cells to be attacked. Omicron is spreading with faster pace with very little consequences, except for the elderly population and those with comorbidities. Omicron will take a big toll on the vulnerable population with comorbid diseases. Meanwhile, it is a burden as it is causing devastating infections across the world, the World Health Organization has warned that Omicron should not be dismissed as “mild” variant. Increased transmission may lead to more hospitalizations which can lead to increase strain on frontline workers and health care systems and can result in more deaths. While people who recover from coronavirus disease 2019 may develop some natural immunity to the virus, how well the individual is protected from future genetic mutation of coronavirus is still a big question. The definitive evidence for increased remission and immune evasion and vaccine effectiveness is still awaited. This article will highlight few aspect of Omicron including increased transmission, immune evasion, hospitalization, mortality, vaccine effectiveness, and therapeutic drugs effective against the disease.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"30 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72464780","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}
Nilesh S. Sakharkar, P. Tathe, S. Mitra, Aniket N. Adewar
Introduction Classical characteristics of osteoarthrosis are reduction or loss of articular cartilage, new bone formation, accompanied by synovial proliferation resulting in pain, loss of joint function, and disability. Platelet rich plasma (PRP) has been used to provide stimulus for local regeneration and healing. The present study was conducted with the aim of evaluating the clinical outcome and efficacy of injecting PRP intra-articularly in early primary osterarthrosis knee. Objective Prospective study was conducted with the aim of evaluating the clinical outcome of efficacy of injection of PRP in early primary osteoarthrosis knee with respect to pain, stiffness, function and quality of life, in short-term follow-up. Attempt was made to standardize protocol and formulate PRP. Materials and Methods Patients were divided into two groups: one treated with two autologous PRP injections at 2 weeks interval and second received symptomatic treatment with physiotherapy. Patients were prospectively evaluated at baseline and then at 1 month, 3 months, and 6 months of follow-up using the visual analog scale (VAS) score, Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score, and range of movements. Results There was reduction in VAS score in group 1 patients compared with group 2 patients with the p-value <0.0001 which was highly significant. There was a significant improvement in WOMAC score at 1 month, 3 months, and 6 months in group 1 compared with group 2 patients. Conclusion Autologous PRP in osteoarthrosis of knee has emerged as a simple technique, sensitive procedure, and cost-effective treatment option. Administration of intra-articular PRP injections reduced the VAS score significantly and also a significant improvement in the WOMAC score was observed in patients who were treated with PRP injection. The two doses of injection of PRP were found to give adequate relief in short term of 6 months and further long-term studies are required.
{"title":"Efficacy of Autologous Intra-articular Platelet Rich Plasma Injection as a Biological Adjuvant in Early Primary Osteoarthrosis Knee—A Prospective Study","authors":"Nilesh S. Sakharkar, P. Tathe, S. Mitra, Aniket N. Adewar","doi":"10.1055/s-0042-1751245","DOIUrl":"https://doi.org/10.1055/s-0042-1751245","url":null,"abstract":"\u0000 Introduction Classical characteristics of osteoarthrosis are reduction or loss of articular cartilage, new bone formation, accompanied by synovial proliferation resulting in pain, loss of joint function, and disability. Platelet rich plasma (PRP) has been used to provide stimulus for local regeneration and healing. The present study was conducted with the aim of evaluating the clinical outcome and efficacy of injecting PRP intra-articularly in early primary osterarthrosis knee. \u0000 Objective Prospective study was conducted with the aim of evaluating the clinical outcome of efficacy of injection of PRP in early primary osteoarthrosis knee with respect to pain, stiffness, function and quality of life, in short-term follow-up. Attempt was made to standardize protocol and formulate PRP.\u0000 Materials and Methods Patients were divided into two groups: one treated with two autologous PRP injections at 2 weeks interval and second received symptomatic treatment with physiotherapy. Patients were prospectively evaluated at baseline and then at 1 month, 3 months, and 6 months of follow-up using the visual analog scale (VAS) score, Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score, and range of movements.\u0000 Results There was reduction in VAS score in group 1 patients compared with group 2 patients with the p-value <0.0001 which was highly significant. There was a significant improvement in WOMAC score at 1 month, 3 months, and 6 months in group 1 compared with group 2 patients.\u0000 Conclusion Autologous PRP in osteoarthrosis of knee has emerged as a simple technique, sensitive procedure, and cost-effective treatment option. Administration of intra-articular PRP injections reduced the VAS score significantly and also a significant improvement in the WOMAC score was observed in patients who were treated with PRP injection. The two doses of injection of PRP were found to give adequate relief in short term of 6 months and further long-term studies are required.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91325065","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 Historically, internal fixation in pelvic ring fractures has been proven to be better in outcome than both external fixation and conservative management. In an attempt to overcome the morbidity of extensile surgical approaches, percutaneous fixation of the pelvis has been receiving increasing attention. The aim of the study was to assess the functional outcome in patients with pelvic ring fractures treated with percutaneous screw fixation. Methods The study included 12 patients of pelvic ring fracture admitted at NSCB medical college, Jabalpur (Madhya Pradesh) from December 2019 to October 2021, all treated percutaneously with cannulated cancellous screw fixation. Four patients had Tiles type C1 injury, 4 patients with type C2, 2 with type B1 and 2 with type A2 injury. Functional assessment was done using the Majeed Scoring system at preoperative, at 3 weeks, 6 weeks, and 3 months postoperatively. Results Functional outcome score at 3-month follow-up was poor in 8% patients, fair in 8% patients, good in 33.3% patients, and excellent in 50% patients. Pain was the most frequent complaint on follow-up. Conclusion Fixation of acute pelvic ring injuries with 6.5 mm cc screws using percutaneous technique offers favorable functional outcome and can be performed in hemodynamically unstable patients.
历史上，骨盆环骨折的内固定已被证明比外固定和保守治疗的效果更好。为了克服可伸展手术入路的发病率，骨盆经皮内固定已受到越来越多的关注。本研究的目的是评估经皮螺钉固定骨盆环骨折患者的功能结局。方法选取2019年12月至2021年10月在印度中央邦贾巴尔普尔市NSCB医学院收治的12例骨盆环骨折患者，均采用空心松质螺钉经皮固定。tile C1型损伤4例，C2型4例，B1型2例，A2型2例。术前、术后3周、6周和3个月采用Majeed评分系统进行功能评估。结果随访3个月功能结局评分差的占8%，一般的占8%，良好的占33.3%，优异的占50%。疼痛是随访中最常见的主诉。结论经皮应用6.5 mm cc螺钉固定急性骨盆环损伤具有良好的功能效果，可用于血流动力学不稳定的患者。
{"title":"Is Percutaneous Screw Fixation with 6.5 mm Cannulated Cancellous Screws a Viable Option in Pelvic Ring Fractures?","authors":"A. Vidyarthi, Y. Gulati","doi":"10.1055/s-0042-1751065","DOIUrl":"https://doi.org/10.1055/s-0042-1751065","url":null,"abstract":"\u0000 Background Historically, internal fixation in pelvic ring fractures has been proven to be better in outcome than both external fixation and conservative management. In an attempt to overcome the morbidity of extensile surgical approaches, percutaneous fixation of the pelvis has been receiving increasing attention. The aim of the study was to assess the functional outcome in patients with pelvic ring fractures treated with percutaneous screw fixation.\u0000 Methods The study included 12 patients of pelvic ring fracture admitted at NSCB medical college, Jabalpur (Madhya Pradesh) from December 2019 to October 2021, all treated percutaneously with cannulated cancellous screw fixation. Four patients had Tiles type C1 injury, 4 patients with type C2, 2 with type B1 and 2 with type A2 injury. Functional assessment was done using the Majeed Scoring system at preoperative, at 3 weeks, 6 weeks, and 3 months postoperatively.\u0000 Results Functional outcome score at 3-month follow-up was poor in 8% patients, fair in 8% patients, good in 33.3% patients, and excellent in 50% patients. Pain was the most frequent complaint on follow-up.\u0000 Conclusion Fixation of acute pelvic ring injuries with 6.5 mm cc screws using percutaneous technique offers favorable functional outcome and can be performed in hemodynamically unstable patients.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86718835","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}
Pradeep K. Jain, M. Lazarus, A. Tiwari, V. Athwani
Abstract Introduction Prevalence of congenital heart disease (CHD) is variable depending on the region and setting of study ranging from 0.8 to 6/1,000. Age of presentation depends on types of CHD and its severity. Burden of CHD is not known in this tribal belt of Central India. Main objective of this study was to find out prevalence of CHD in children. We have also studied the pattern and age of presentation of various types of CHDs. Methods This retrospective observational study was conducted at tertiary care teaching institute in tribal belt of Central India. Children aged 0 to 15 years reported to pediatric outpatient department (OPD) were included. CHD was confirmed by echocardiography in suspected cases. Prevalence rate was calculated as number of CHDs per 1,000 OPD patients. Pattern of CHD was categorized as per standard guidelines and age-wise presentations of various types of CHD were studied. Results The prevalence rate of CHD in our study population was 27.7/1,000, which is high when compared with most of the other hospital-based studies. Most of the patients, 60.36 and 83.26% were detected before the age of 1 year and 5 years, respectively. All critical CHD cases were detected in early infancy. Conclusion There is a high burden of CHD seen in this study. Possible cause of this may be lack of specialized facility in this reason and study period included first and second wave of COVID. Further, large sample size studies and/or nationwide registry/database are needed to know the exact burden of CHD.
{"title":"Prevalence and Pattern of Congenital Heart Disease in Pediatric Population—A Study from Central India","authors":"Pradeep K. Jain, M. Lazarus, A. Tiwari, V. Athwani","doi":"10.1055/s-0042-1751085","DOIUrl":"https://doi.org/10.1055/s-0042-1751085","url":null,"abstract":"Abstract Introduction Prevalence of congenital heart disease (CHD) is variable depending on the region and setting of study ranging from 0.8 to 6/1,000. Age of presentation depends on types of CHD and its severity. Burden of CHD is not known in this tribal belt of Central India. Main objective of this study was to find out prevalence of CHD in children. We have also studied the pattern and age of presentation of various types of CHDs. Methods This retrospective observational study was conducted at tertiary care teaching institute in tribal belt of Central India. Children aged 0 to 15 years reported to pediatric outpatient department (OPD) were included. CHD was confirmed by echocardiography in suspected cases. Prevalence rate was calculated as number of CHDs per 1,000 OPD patients. Pattern of CHD was categorized as per standard guidelines and age-wise presentations of various types of CHD were studied. Results The prevalence rate of CHD in our study population was 27.7/1,000, which is high when compared with most of the other hospital-based studies. Most of the patients, 60.36 and 83.26% were detected before the age of 1 year and 5 years, respectively. All critical CHD cases were detected in early infancy. Conclusion There is a high burden of CHD seen in this study. Possible cause of this may be lack of specialized facility in this reason and study period included first and second wave of COVID. Further, large sample size studies and/or nationwide registry/database are needed to know the exact burden of CHD.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"203 ","pages":"039 - 044"},"PeriodicalIF":0.0,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72435541","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}
Narendra D. Kulkarni, Geeta D. Adhikari, Gauri Jadhav
Littre's hernia (LH) is a very rare presentation in patients presenting with hernias. It is the presence of Meckel's diverticulum (MD) in a hernia sac. However, it usually presents with obstruction or strangulation. We are reporting here a case of Littre's hernia in a 42-year-old male patient who presented with an irreducible swelling in the left inguinal region. The diagnosis of an incarcerated indirect inguinal hernia was made preoperatively. Intraoperative finding was however an obstructed Littre's hernia with Meckel's diverticulum in a very uniquely appearing hernia sac. The patient was successfully managed by resection of the MD along with ileal segment, primary anastomosis, and mesh hernioplasty on the inguinal floor.
{"title":"Obstructed Inguinal Littre's Hernia: A Vague Presentation","authors":"Narendra D. Kulkarni, Geeta D. Adhikari, Gauri Jadhav","doi":"10.1055/s-0042-1755179","DOIUrl":"https://doi.org/10.1055/s-0042-1755179","url":null,"abstract":"Littre's hernia (LH) is a very rare presentation in patients presenting with hernias. It is the presence of Meckel's diverticulum (MD) in a hernia sac. However, it usually presents with obstruction or strangulation. We are reporting here a case of Littre's hernia in a 42-year-old male patient who presented with an irreducible swelling in the left inguinal region. The diagnosis of an incarcerated indirect inguinal hernia was made preoperatively. Intraoperative finding was however an obstructed Littre's hernia with Meckel's diverticulum in a very uniquely appearing hernia sac. The patient was successfully managed by resection of the MD along with ileal segment, primary anastomosis, and mesh hernioplasty on the inguinal floor.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74221170","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}
Shiekh Sarwar, Kafeel Khan, Tariq A Bhat, Isbha Nazir
Introduction Pediatric femoral neck fractures remain an enigma for orthopaedics, especially with regard to the development of avascular necrosis (AVN). These rare fractures are fraught with complications including non-union, coxa vara, premature physeal closure, and AVN. Aggressive urgent management is required to limit the development of complications. We aim to share our institutional experience of 10 such cases, spanning over a period of 5 years by analyzing the radiological and clinical outcomes after anatomical reduction and internal fixation. Materials and Methods Ten children, aged < 16 years with fractured neck of the femur, treated in our hospital with a minimum follow-up of 1 year, were retrospectively reviewed and radiological and clinical outcomes following anatomical reduction and internal fixation were analyzed. Written informed consent was taken from the parents of the children included in the study. Results The mean age was 9.6 years. In total, 60% of the cases were boys and 50% cases were due to road traffic accidents (RTA). Furthermore, 50% cases were of Delbet type II pattern, 30% Delbet type III, and 20% Delbet type IV. All patients were treated with anatomical reduction and internal fixation. The final outcome was good in 80% of cases and fair in 20% of cases. We encountered only one case of AVN in our series. Conclusion Aggressive, urgent anatomical reduction and stable internal fixation is the modality of treatment. The outcome in patients is influenced by the development of complications including AVN, limb length discrepancy, and coxa vara, and every attempt should be made to prevent them.
{"title":"Pediatric Femoral Neck Fractures: Our Institutional Experience of 5 Years","authors":"Shiekh Sarwar, Kafeel Khan, Tariq A Bhat, Isbha Nazir","doi":"10.1055/s-0042-1751064","DOIUrl":"https://doi.org/10.1055/s-0042-1751064","url":null,"abstract":"\u0000 Introduction Pediatric femoral neck fractures remain an enigma for orthopaedics, especially with regard to the development of avascular necrosis (AVN). These rare fractures are fraught with complications including non-union, coxa vara, premature physeal closure, and AVN. Aggressive urgent management is required to limit the development of complications. We aim to share our institutional experience of 10 such cases, spanning over a period of 5 years by analyzing the radiological and clinical outcomes after anatomical reduction and internal fixation.\u0000 Materials and Methods Ten children, aged < 16 years with fractured neck of the femur, treated in our hospital with a minimum follow-up of 1 year, were retrospectively reviewed and radiological and clinical outcomes following anatomical reduction and internal fixation were analyzed. Written informed consent was taken from the parents of the children included in the study.\u0000 Results The mean age was 9.6 years. In total, 60% of the cases were boys and 50% cases were due to road traffic accidents (RTA). Furthermore, 50% cases were of Delbet type II pattern, 30% Delbet type III, and 20% Delbet type IV. All patients were treated with anatomical reduction and internal fixation. The final outcome was good in 80% of cases and fair in 20% of cases. We encountered only one case of AVN in our series.\u0000 Conclusion Aggressive, urgent anatomical reduction and stable internal fixation is the modality of treatment. The outcome in patients is influenced by the development of complications including AVN, limb length discrepancy, and coxa vara, and every attempt should be made to prevent them.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90319523","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}
Jagdeesh Nagaraju, D. Thakur, U. Somashekar, A. Verma, R. Kothari, D. Sharma
Background Hemorrhoids are one of the frequent presenting complaints in the surgical outpatient department of any hospital. Multiple options are available for the treatment of these based on the grade. Recently, there are many varieties of energy devices being tried for hemorrhoidectomy to decrease the postoperative pain and achieve better hemostasis intraoperatively. This study represented an effort to compare open versus closed method of harmonic scalpel hemorrhoidectomy to determine the differences in terms of operative time, hospital stay, postoperative bleeding, pain, and other complications. Method A total of 40 patients, 20 each in open and closed method harmonic scalpel hemorrhoidectomy, were followed up for 6 weeks postoperatively. Early and late outcomes were compared. Incontinence if any was measured with Vaizey incontinence score. Result There was significant prolonging of operative time in closed method (30.25 ± 5.49 vs. 22.0 ± 4.70). Postoperative pain was significantly more in open method group compared with closed on days 1, 3, 7, and 21. There was no significant difference between groups in terms of hospital stay, postoperative bleeding, and complications. Conclusion Leaving mucosa open after hemorrhoidal tissue excision is comparable to closed in terms of safety complication and is cost effective in terms of operative times and utility of suture materials at the expense of need for analgesics.
{"title":"Harmonic Scalpel Hemorrhoidectomy—Open versus Closed: A Comparative Study","authors":"Jagdeesh Nagaraju, D. Thakur, U. Somashekar, A. Verma, R. Kothari, D. Sharma","doi":"10.1055/s-0042-1743441","DOIUrl":"https://doi.org/10.1055/s-0042-1743441","url":null,"abstract":"\u0000 Background Hemorrhoids are one of the frequent presenting complaints in the surgical outpatient department of any hospital. Multiple options are available for the treatment of these based on the grade. Recently, there are many varieties of energy devices being tried for hemorrhoidectomy to decrease the postoperative pain and achieve better hemostasis intraoperatively. This study represented an effort to compare open versus closed method of harmonic scalpel hemorrhoidectomy to determine the differences in terms of operative time, hospital stay, postoperative bleeding, pain, and other complications.\u0000 Method A total of 40 patients, 20 each in open and closed method harmonic scalpel hemorrhoidectomy, were followed up for 6 weeks postoperatively. Early and late outcomes were compared. Incontinence if any was measured with Vaizey incontinence score.\u0000 Result There was significant prolonging of operative time in closed method (30.25 ± 5.49 vs. 22.0 ± 4.70). Postoperative pain was significantly more in open method group compared with closed on days 1, 3, 7, and 21. There was no significant difference between groups in terms of hospital stay, postoperative bleeding, and complications.\u0000 Conclusion Leaving mucosa open after hemorrhoidal tissue excision is comparable to closed in terms of safety complication and is cost effective in terms of operative times and utility of suture materials at the expense of need for analgesics.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76191243","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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