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Introduction: Following injury to the extremities and head,abdomen is the third most commonly injured part of the body.Blunt abdominal trauma (BAT) is particularly deceptivebecause of the delay in clinical manifestations for hours oreven days, even though the damage to the internal organsmight be serious and lethal. Road traffic accident (RTA) isthe most common mode of injury to cause BAT. Diagnosticmodalities like FAST and CT scans have caused a significantchange in the trends regarding management from surgical to amore conservative approach. Current research aimed to studythe blunt trauma abdomen with respect to management andoutcome in a tertiary care hospital.Material and methods: This observational study is basedon 50 cases of BAT who presented in Rohilkhand MedicalCollege & Hospital with respect to clinical presentation,investigations, management and outcome. Results andoutcomes will be depicted in various tables.Results: In the present study, demographic data like age andsex, the mode of injury, presenting Hb (in gm%), commonlyinjured organs, the management done and the associatedmortality was observed and compared. It was found that BATcommonly involves young males in the age group of 30-40years. RTA is found to be the most common mode of injury.Spleen was the most commonly injured solid organ followedby liver. Hollow viscus injury was seen in 10 out of 50 patientsin our study. Conservative management was done in 37 out of50 patients. Mortality was observed in 3 out of 50 cases.Conclusion: The study was conclusive of the fact that youngmales who sustained BAT due to RTA were the most commonlyaffected group. It also was conclusive that spleen and liver arethe most commonly injured organs in BAT and conservativemanagement should be followed wherever possible. Mortalitywas significantly higher in patient presenting with decreasedhemoglobin.
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Background : In recent past researches have shown genetic inheritance is an important predisposing factorfor future development of hypertension in normotensive offspring of hypertensive parents (NOHP). Heightenedcardiacautonomic reactivity to mental and physical stress has been reported in these population in recentpast. Exercise is a physiological stressor commonly used to elicit occult cardiovascular abnormalities thatare not detected at rest. Compare to maximal, supramaximal and high intensity chronic exercise, singlebout of submaximal aerobic exercise that can also potentially evoke cardiac autonomic response even atdelayed phase of recovery state has been given little attention till date. There is also paucity of dataregarding effect of aerobic exercise test particularly on young female NOHP at recovery period.Objective: The aim of this study was to evaluate the reliability and effect of single bout of submaximalaerobic exercise test to assess the cardiac autonomic response in young female NOHP.Materials And Method: An observation and cross-sectional study was conducted at autonomic functionresearch laboratory of Physiology department at R G Kar Medical College, Kolkata between March 2016 andFebruary 2017 on 50 young healthy female subjects aged 18-25 years and divided them in two groups:normotensive offspring of hypertensive (NOHP) and normotensive offspring of normotensive parents (NONP)in 1:1 ratio. Resting blood pressure (BP) was recorded first manually. After that short-term heart rate variability (HRV) test for five minutes conducted by a multiple-channel Polyrite-D instrument for five minutesin supine position at rest and last five minutes of 15 minutes recovery phase after a single bout of submaximal(50% VO2max) aerobic exercise using treadmill machine and following modified Black-Bruce protocol as wellas Astrand-Rhyming nomogram. Data was analysed in frequency domains of HRV using spectral componentslike heart rate [HR], low frequency at normalised unit [LFnu], high frequency at normalised unit [HFnu], LF/HF ratio and total power [TP].Results: Spectral components of HRV had shown exaggerated sympathetic excitation (mean LFnubasal:57.14±12.313, mean LFnurecovery: 66.403±12.471, p value: 0.0012, t value: 3.686), attenuated parasympatheticmodulation (mean HFnubasal: 42.839±12.217, mean HFnurecovery: 32.224±12.335, p value: <0.0001, t value:5.585) and overall sympathovagal imbalance (SVI) (mean LF/HFbasal: 1.559±0.858, mean LF/HFrecovery:2.378±0.925, p value: <0.0001, t value: 5.788) in NOHP only at recovery phase but not in NONP. Moreover,post exercise frequency domain HRV analysis had shown significant difference between the two groups,higher mean values of LFnu, LF/HF ratio and lower HFnu as well as attenuated TP were observed amongNOHP compared to NONP.Conclusion: Study indicated that exercise at 50% of VO2max was reliable to implement a sub-maximal loadto evoke substantial cardiac autonomic response and apparently healthy young female NOHP exhibit impairedautonomic modulation which could lead to develop hypertension in future.
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Background: Surgical site infection and wound dehiscence are the most common postoperative complications of emergency abdominal surgery in class 3 contaminated /class4 dirty of wound classification. Greatly increasing the mortality as well as morbidity of patients, in addition to prolonging hospital stay. Factors affecting the SSI are emergency surgery, age, sex, anaemia, nutrition, co-morbidities. Methods: This is a 6 months prospective study carried on 60 patients of more than 18 years age operated in department of surgery, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh after permission with institutional ethical committee. Results: Incidence rates of SSI were 53.3% and of wound dehiscence 43.3% with male to female ratio 4:1 and most common age group being 41-50 years followed by 31-40 years. Most common associated illness was respiratory diseases, anaemia and malnutrition. SSI and wound dehiscence were mainly occurred 5th to 7thpost-operative day presented as erythema, pain and pus discharge. Wound swab for culture & sensitivity were sent and debridement done. Staphylococcus and Klebsiella were commonly causative bacteria and SSI best controlled by injection gentamycin, meropenem, piperacillin+tazobactam and colistin. After control of infection wound were allowed to heal (1) conservatively with dressing and abdominal binder or (2) with delayed suturing. Conclusion: Although incidence of postoperative wound dehiscence in emergency exploratory laparotomy was high as 43.3% but this can be decreased by proper planned preoperative patient preparation,adequate antibiotic prophylaxis and better surgical expertise.
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Aim: The study was conducted with an aim to suspect and diagnose “breast tuberculosis (TB)” cases early to avoid unnecessary delay in their treatment. Materials and Methods: For this purpose, the cases of breast complaints presenting in the Department of Surgery were clinically examined, investigated with fine-needle aspiration cytology (FNAC) or biopsy along with other relevant investigations. FNAC or biopsy positive for breast TB cases were further investigated by chest X-ray and/or sputum acid-fast bacilli for any evidence of pulmonary TB. Results: A total of 9 cases of breast TB were collected. Out of these 9 cases, 7 cases were adult females in the age group of 24-40 years. Cases 1, 2, 5, 6, and 9 were non-lactating, while Cases 3 and 7 were lactating. Case 4 was a 12-year-old girl and Case 8 was 25-year-old male. All the cases were involving the right breast except Case 5, which was involving both breasts, and Case 6, which was involving left breast. Case 5 was also having active pulmonary TB. Case 7 was showing Ziehl-Neelsen staining positive for AFB in breast tissue sample. We treated all cases with first-line four drugs (HRZE) for initial 2 months and two drugs (HR) for another 4 months except in Cases 1 and 5 where the continuation phase was extended to 6 months. Conclusion: Histopathological diagnosis is a more reliable and accurate as compared to the bacteriological diagnosis of tubercular mastitis. Four drugs therapy for 6 months is adequate. The majority of the cases will heal without major surgery, and mastectomy should be reserved for extensive breast destruction and unresponsive cases.
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Necrotizing fasciitis, NF, is also known as the flesh eating disease. The incidence is rare. Infection. Mortality is a high as 40%. Very few cases have been reported in English literature and also very few cases of necrotizing fasciitis of female perineum in India have been reported. Here we report a case in India who recovered well with repeated debridement and dressing.
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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.