ABSTRACT
Background: Present study outlines the outcomes of laparoscopic appendicectomy compared to open conventional appendicectomy in a tertiary care set up with aim to validate advantages and shortcomings of both procedures.Methods: A series of 80 cases above 18 years of age with clinical diagnosis of appendicitis having Alvarado score of seven and above were studied prospectively under the two groups after proper written consent: Open appendectomy-40 cases, Laparoscopic appendectomy-40 cases. Both groups were compared on grounds of intra-operative complications, additional diagnostic potential, operative time, postoperative analgesia, post-operative complications, length of hospital stay, subjective cosmesis, and return to routine normal activities. Values obtained were statistically analyzed.Results: The median operative time in Laparoscopic Appendicectomy was 58.22 minutes (range 32.68-85.46 min) as compared to open procedure which took 43.65 minutes (30.36-65.48min) (P<0.05). Conversion to open procedure was done in 10% (n=4) of laparoscopic cases. Mean value of postoperative pain by visual analogue scale was low in Laparoscopic Appendicectomy (LA) compared to Open Appendicectomy (OA) (P<0.05). Mean post-operative stay (3.2±0.34 days versus 2.3±0.24 days) and surgical site infection was recorded in 10 patients (25%) in OA group and 5 (13.9%) in LA group (P<0.05).Conclusions: It can be concluded that laparoscopic surgery is safe with greater diagnostic potential for additional pathologies and better Subjective cosmesis . But all these merits were at the price of longer operating time and a specialized set up needed for laparoscopy.
ABSTRACT
Background & objectives: Vitamin D deficiency with a resurgence of rickets and tetany are increasingly being reported in young infants from temperate regions, African Americans and also from India. The data on vitamin D status of healthy term breastfed Indian infants and mothers are scant. Therefore, we undertook this study to determine the prevalence of vitamin D deficiency and insufficiency [serum 25 hydroxyvitamin D (25OHD) ≤ 15 ng/ml and 15-20 ng/ml, respectively] among healthy term breastfed 3 month old infants and their mothers, evaluate for clinical and radiological rickets in those infants having 25OHD < 10 ng/ml, and check for seasonal variation and predictors of infants’ vitamin D status. Methods: A total of 98 infants aged 2.5 to 3.5 months, born at term with appropriate weight and their mothers were enrolled; 47 in winter (November- January) and 51 in summer (April-June). Details of infants’ feeding, vitamin D supplementation, sunlight exposure and mothers’ calcium and vitamin D intake were recorded. Serum calcium, phosphate, alkaline phosphatase, 25 hydroxyvitamin D (25OHD) and parathormone were estimated. Results: Vitamin D deficiency was found in 66.7 per cent of infants and 81.1 per cent of mothers; and insufficiency in an additional 19.8 per cent of infants and 11.6 per cent of mothers. Radiological rickets was present in 30.3 per cent of infants with 25OHD < 10 ng/ml. 25OHD did not show seasonal variation in infants but maternal concentrations were higher in summer [11.3 (2.5 - 31) ng/ml] compared to winter [5.9 (2.5-25) ng/ml, P=0.003]. Intake of vitamin supplement, sunlight exposure and mother’s 25OHD were predictors of infants’ 25OHD levels. Interpretation & conclusions: Prevalence of vitamin D deficiency and insufficiency was found to be high in breastfed infants and their mothers, with radiological rickets in a third of infants with 25OHD < 10 ng/ml in this study. Studies with large sample need to be done in different parts of the country to confirm these findings.
Subject(s)
Adult , Breast Feeding , Female , Humans , India/epidemiology , Infant , Prevalence , Seasons , Vitamin D Deficiency/epidemiologyABSTRACT
Fifty patients with signs and symptoms of chronic sinusitis and refractory to medical treatment constituted this study. They were divided at random into two groups of 25 patients each. Group A (study group) patients were subjected to functional endoscopic sinus surgery (FESS) and group B (control group) patients were treated by conventional surgery. The age of the patients varied from 16-55 years (mean 29.1). Out of 25 patients in the study group, 19(76%) had complete relief of symptoms, 4(16%) had partial relief of symptoms and 2(8%) had no relief of symptoms in the follow-up period of 15-33 months (mean 19.2 months). Out of 25 patients in the control group, 15(60%) had complete relief of symptoms, 4(16%) had partial relief of symptoms and 6(24%) had no relief of symptoms in the follow-up period of 15-33 months (mean 19.2 months). The results of this series revealed that FESS had the combined advantages of precise, atraumatic removal of the disease with minimal morbidity and at the same time retaining the physiological function of the nose and paranasal sinuses.