A Study Of Portsmouth-Possum Scoring In Predicting Mortality And Morbidity In Patients Undergoing Major Abdominal Surgery

Background: There is a need for an accurate risk scoring system to predict surgical outcomes. POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) and its modification P-POSSUM use a physiological score and an operative severity score to calculate risks of mortality and morbidity. In present study we have tried to assess the accuracy of P-POSSUM in predicting mortality and morbidity in general surgical patients.Methods:Total 50 Patients, undergoing major general surgical procedures were scored according to their physiological parameters and the intra-operative findings and a final expected mortality rate was calculated using P-POSSUM equation and compared with actual outcomes.Result: The mean P-POSSUM score of the patients, in whom actual morbidity was observed, was found to be 61.82, compared tomean P-POSSUM score in the remaining cases where there was no observed morbidity was 39.51, significantly lower than the previous group (36%).Similarly the mean P-POSSUM score of the patients, in whom actual mortality was observed, was foundto be 76.01. Whereas mean P-POSSUM score in the remaining cases where there was no observed mortality was 33.16, significantly lower than the previous group (56%).Conclusion:This study validates the Portsmouth possum scoring system in our setup as a valid means ofpredicting mortality and morbidity following major surgery. It is a scoring system tailored to assess patients undergoingmajor surgeries and help in risk assessmentof the patients with respect to both mortality and morbidity.

A Study On Effectiveness Of Single Dose Antibiotic Therapy In Laparoscopic Cholecystectomy To Prevent Surgical

The prophylactic use of antimicrobial agents to reduce the postoperative infection is widely practiced1. The objective of preoperative antibioticprophylaxis is to prevent postoperative infections. Rational use of antibiotic is extremely important as injudicious use can adversely affect the patient, cause emergence of antibiotic resistance and increase the cost of health care2,3.Antibiotic resistance has become a global menace, and WHO in 2012 had given a clear call to reduce the antibiotic use and prevent resistance to antibiotics4. Several evidences have shown that strict aseptic technique alone could decrease but not eliminate the contamination of the surgical field completely. Therefore, the need for antibiotics to complement aseptic technique is now being widely recognized and accepted5.In spite of wide knowledge about the effectiveness of antibiotic prophylaxis, administrative regimens are often inappropriately practiced. Main concern is the duration of prophylaxis, which is often longer than recommended6,7. Antibiotic prophylaxis is a preventive method in which antimicrobial agents are used prophylactically to combat the infectious complications in a therapeutic procedure. In conventional practice, antimicrobials are used for a predetermined period after therapeutic procedure to combat the infection8.

A Beginner Surgeon’s Experience Of Minimal Access Surgery At Tertiary Care Hospital

Introduction: Minimal access surgery is the need of the hour for departments of surgery running throughout the country. Laparoscopic surgeries are being performed routinely in surgical departments with increasing frequency. Basic laparoscopy surgeries are nowadays incorporated in training programs for post graduate students. Therefore it is important for a surgeon to achieve enough experience in basic laparoscopy and move on to advanced laparoscopic procedure for benefit of the continuing field of surgical educationMaterial & Methods: in this prospective observational study, 120 cases of laparoscopic surgery performed at department of general surgery, AMC MET MMC were reviewed in terms of age & sex distribution, mean operative time & post op complications.