ABSTRACT
Background: Pancreaticoduodenectomy (PD) in the setting of preoperative post-ERCP acute pancreatitis (PAP) might pose significant challenges and leads to higher morbidity as compared to those without acute pancreatitis. The aim of the study was to study patients undergoing PD and compare intraoperative variables and postoperative outcomes in patients with and without preoperative PAP. Methods: We retrospectively analysed 20 patients who underwent PD from January 2015 to July 2017. Out of these, 2 patients had preoperative PAP following endoscopic biliary drainage for cholangitis.This group was compared with the rest 18 patients (control group) in terms of patient characteristics, operative variables and postoperative outcomes. Postoperative outcomes and overall complication rate, specifically hemorrhage, delayed gastric emptying and pancreatic fistula were noted. The postoperative complications in stented (n=9) and non-stented (n=11) patients were studied. Risk factors for pancreatic fistula were analysed in entire study population. (n=20). Results: PAP was found in 2 out of 20 patients (10%). The number of complications were higher in the PAP group (8/2) compared to control group (20/18). The ICU stay, delayed gastric emptying (DGE)and postoperative stay was higher in PAP group. There was one perioperative mortality due to grade C pancreatic fistula in the control group. Overall as well as infectious complications, were not statistically different in stented versus non-stented group. Soft pancreas(p=0.001) and non-dialted pancreatic duct (p=0.004) were significantly associated with pancreatic fistula. Conclusion: PD in the setting of PAP is feasible, albeit associated with more frequent complications, prolonged ICU and hospital stay.
ABSTRACT
Background: The objective of this study was to wether perineal tear predicted by scoring of severity of striae gravidarum. The objective of this study was to predict perineal tear by simple non-invasive method and help to prevent maternal morbidity.Methods: Three hundred ninety four patients delivered normally were included in this study. Striae gravidarum score was assessed using the Atwal numerical scoring system. The association was examined between striae and perineal tear as the outcome measure, defined by tears or laceration, and the total striae scores (TSS) was obtained.Results: In present study population mean age was 25.16 years ranging from 16-40 , mean gravidity was 2.16 ranging from 1 -8 ,average baby birth weight was 2.713 kg ranging from 1.62-4.58 The only predictors of perineal tears that were found to be statistically significant in our study were severity of striae gravidarum and episiotomy given or not. In patients with moderate to severe striae there was tear in 90 patients as compared to 29 patients with no or mild striae. 224 patients belonging to no or mild striae group delivered without any perineal tear whereas 51 patients in moderate to severe striae group delivered without tear. Out of these 51 patients 5 were given episiotomy. 2 patients who were given episiotomy had perineal tear as compared to 117 patients who were not given episiotomy. This shows that patients who had an episiotomy were less likely to have perineal tear in most cases.Conclusions: This study demonstrates a significant relation between severity of striae gravidarum and perineal tear. The findings suggest that striae gravidarum assessment may be used in the clinical setting even by paramedical staff as a simple and noninvasive tool to better define women at risk for perineal tear.
ABSTRACT
Background: India is facing nutrition transition. Period of college life is the phase was healthy and unhealthy diet habits takes place. The present study was aimed to study nutritional status among students of a medical college.Methods: A cross sectional study was conducted among the 254 students of a medical college attached with the civil hospital Gandhinagar over a period of six months. Pre-tested, semi-structured, self-administered questionnaire was used to collect socio-demographic information. Anthropometric examination like height, weight, BMI, waist-hip ratio was done according to WHO criteria. Data were analysed with Epi info 7.Results: Among 254 study participants, 159 (62.60%) were female and 99 (33.40%) were males. Obesity according to waist-hip ratio is significantly higher in females as compared to males Physical activities are significantly higher in females as compared to males in present study (p<0.05). Family history of diabetes and hypertension were also significantly higher in females as compared to males.Conclusions: Obesity according to Weight hip ratio was more in females as compared to male. Physical inactivity is also significantly higher in females. As per BMI undernutrition was also prevalent in the study participants.