ABSTRACT
An attempt was made to compare the analysis of investigative parameters to distinguish Amoebic Liver Abscess (ALA) from Pyogenic Liver Abscess (PLA). This study was carried out at Calcutta National Medical College & Hospital, Kolkata 700014. Patients were included with signs and symptoms suggestive of Liver Abscesses. The investigations of Serological, Hematological, Biochemical, Radiological and CT scan were done. Antimicrobial Therapy, Image Guided Percutaneous Aspirations/Drainage or Open surgical Drainage was performed and checked in follow-up visits up to 3 months. The highest incidences of Liver Abscess (53.3%) were encountered in alcoholic male. Fever and Abdominal Pain were common in both ALA and PLA. Hepatomegaly was significantly high (p<0.05) in PLA (64.2%) than ALA (37.5%), but jaundice was only noted in PLA (22.2%). E coli, K pneumonia and S aureus were confirmed in PLA. Alkaline Phosphatase was significantly high (p<0.05) in PLA. Right sided pleural effusion was noted in Chest X-ray of 50% case . USG studies measured 70% Solitary Abscesses with 5-10 cm in the Right Lobe. Partial resolution occurred in 28.6% of PLA and 31.2% of ALA. USG and Serological Tests are recommended and Conservative Management should be followed for ALA and invasive treatment for PLA patients
ABSTRACT
Background: Bowel stoma namely ileostomy and colostomy are frequently performed procedure and often associated with complications. Aim of this study was to assess early local complications and association with any risk factors.Methods: A total of 99 patients undergoing ileostomy or colostomy were analysed prospectively over a period 18 months. Comorbidity, preoperative clinical data, operative time, local complications within 12 weeks and hospital stay were documented. Univariate and multivariate analysis were used to find out any association.Results: Sixty-four ileostomies and 35 colostomies were analysed in our study. Median age was 55 years in both groups. Nontraumatic bowel perforation (42%) and colorectal malignancy (48.6%) were most common etiology for ileostomy and colostomy formation respectively. 64% of ileostomy and 68% of colostomy had one or more complications. Skin excoriation (31%) was most common complication in ileostomy group and it was stomal prolapse (17%) in colostomy group. Poor stoma care was prevalent in both groups. We found diabetes to have significant association with skin excoriation (p=0.002).Conclusions: Diabetes was identified as significant risk factor for skin excoriation in ileostomy group. Further long term data and larger population are needed for better evaluation of stomal complication and their risk factors.