ABSTRACT
Background: Acute appendicitis is one of the most common acute surgical condition of the abdomen and appendicular lump is formed if treatment is delayed. It is encountered in 2 – 6%of patients. The traditional treatment of appendicular lump is conservative followed by delayed appendectomy. During conservative treatment 10-20% are not resolved and lead to gangrene or perforation followed by localized abscess or generalized peritonitis requiring early surgical intervention. Aims & Objective: A comparison of early exploration versus conservative management of appendicular lump. Material and Methods: A total of 632 patients were admitted in emergency and OPD of this hospital with diagnosis of appendicular lump and acute appendicitis over a period of three years, all were included in the study. All age groups and both sexes were included. The patients were divided randomly into two groups. Group I, early surgical exploration and group II, conservative approach with OCHSNER SHERREN, REGIME followed by interval appendectomy. Results: Out of 632 patients, only 62 patients who presented with appendicular lump were reviewed, suggesting 9.81% incidence. Maximum patients were found in age group of 21–30 years. Average duration of symptoms was 4 days. Two methods were adopted for the management of appendicular lump. The first group included 31 patients who were operated immediately after investigations and second group of 31 patients were managed conservatively followed by delayed appendectomy. In the first group mean hospitalization time was 4 days. Residual abscess, adhesive intestinal obstruction, failure of treatment and readmission were not observed. In the II group mean hospitalization time 10 days, more chances of residual abscess, adhesive intestinal obstruction, failure of treatment and readmissions were noted. Conclusion: Based on our finding, it can be concluded that early surgical exploration confirms the diagnosis and cures the problem, reduce the cost of management, shortens the convalescence and hospital stay with reasonably satisfactory outcome.
ABSTRACT
Background: Burn trauma is the common problems seen in emergency in tertiary care centre of Rohilkhand region. So, far there is no published study regarding the magnitude of burn trauma in this area. Aims & Objective: To study the etiology of major burn trauma in Rohilkhand region of Uttar Pradesh. Material and Methods: This retrospective study was carried out on 96 patients admitted in the Department of Surgery, Rohilkhand Medical College & Hospital, Bareilly during the period of 1st January 2010 to 31st December 2012. Results: Among the total of 36 patients (37.5%) from urban area, 16 (16.6%) were males and 20 (20.8%) were females and from rural area 46 (47.9%) were male and 14 (14.6) were female. The most frequent etiological agent was hot liquid (45.8%) followed by flame burns (33.3%), chemical (13.5%) and electrical (7.2%). Out of the total patients, 47 (48.9%) had 1 and 2 degree burn, 32 (33.3%) had 3 degree burn and 17 (17.7%) had mixed burn. Out of the total of 20 patients, who had died 6 were males and 14 were females. Conclusion: The most frequent cause of burn in Rohilkhand region was hot liquid. The mortality rate was higher for females than males.