ABSTRACT
Background: Perforation peritonitis is a commonly encountered surgical emergency and it is defined as inflammation of theserosal membrane that lines the abdominal cavity and the visceral organs. The aim of this study is to analyze the demographicpattern and site of perforation of non-traumatic hollow viscus perforation peritonitis in Vindhya region.Materials and Methods: A total of 209 cases were studied with hollow viscus perforation peritonitis admitted in the surgicalwards in Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa (MP), India, in the period fromJune 1, 2018, to May 31, 2019. All necessary investigations were carried out. X-ray, Ultrasonography abdomen, and bloodinvestigations were done. The patient underwent emergency exploratory laparotomy and a careful record of pre-operative andpost-operative findings was made and was carefully filled in the pro forma. All the patients were advised to attend the surgicaloutpatient department for follow-up.Results: Of 10,887 patients admitted to Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa(MP), India, from June 1, 2018, to May 31, 2019, in which non-traumatic hollow viscus perforation peritonitis was diagnosedin 209 patients (1.9%), among which most of the patients were male (177) and rest were female (32). Most of the patientsbelonged to the low-socio-economic status of 21–40 years of the age group. From this study, the duodenum was found to bethe most common site of perforation, followed by stomach.Conclusion: Patients were admitted in the Department of Surgery, Shyam Shah Medical College and Sanjay Gandhi HospitalRewa, the Vindhya region in the Madhya Pradesh, patients diagnosed as a case of non-traumatic hollow viscus perforationperitonitis were included in the study. The majority of the patients of the perforation peritonitis belonged to 21–40 years ofage group. 41–60 years of age group was the second most common age group of patients who presented with perforationperitonitis with a male-to-female ratio of 5.5:1. The most common site of perforation was duodenum followed by gastric andappendicular and the least common site of perforation was colon.
ABSTRACT
Introduction: Chest trauma is one of the most serious injuries of the chest and also a common cause of significant disabilityand mortality. Chest trauma is the leading cause of death from physical trauma after head and spinal cord injury. Thoracicinjuries are primary or a contributing cause of about one-fourth of all trauma-related deaths. Traumatic chest injuries are onthe rise mainly due to increased frequency of road traffic accidents (RTAs) and rise in community disharmony. Chest injuriesare one of the common causes of major mortality and morbidity. The management of traumatic chest injuries depends on theseverity of injury, patient accessibility to nearby hospital, and availability of resources at tertiary care center.Materials and Methods: It is a prospective study of a total of 134 patients presenting to the emergency department with chest injuriesof varying severity in Sanjay Gandhi Memorial Hospital from 1 June 2018, to 31 May 2019 had been carried out. Data collectedregarding common injury modes, age and gender distribution, pre-hospitalization practices, clinical presentations, associated injuries,severity of injuries, and management options from the hospital record section and these data were analyzed with descriptive statistics.Results: Chest trauma is most common in males in their thirties with mean age of presentation 33.47 years. The most commonmode of injury was RTA 69.4%, followed by fall from height 14.9% and assault 11.1%. Pain in chest (53%) was the most commonsymptom of blunt trauma chest in the patients of our study sample followed by dyspnea (31%) and asymptomatic (9%). Clinicalsign was tenderness over chest. About 61.2% of patients found with collection in pleural cavity, in which hemothorax (23.9%)was the most common collection followed by pneumothorax (22.4%) and hemopneumothorax (15.7%).Conclusions: Chest injury is seen commonly in RTA patients. Most of the patients of chest injury had soft tissue trauma overchest in the form of abrasions and majority of these patients can be managed by symptomatic care and simple life-savingintervention, i.e. intercostal drainage. With increased RTAs, it is needed to have public awareness regarding road safetymeasures and educating them about the first aid measures for trauma patients.
ABSTRACT
Background: Perforation peritonitis is a commonly encountered surgical emergency and it is defined as inflammation of the serosal membrane that lines the abdominal cavity and the visceral organs. The objective of this study is to predict a correlation between post-operative outcomes in perforation peritonitis patients with reference to the history of nonsteroidal anti-inflammatory drugs (NSAIDs) use. Materials and Methods: A total of 209 cases were studied with hollow viscous perforation peritonitis admitted in the surgical wards in Sanjay Gandhi Memorial Hospital associated with S. S. Medical College, Rewa (M.P.), India, in the period from June 1, 2018, to May 31, 2019. All necessary investigations were carried out. X-ray, ultrasonography abdomen, and blood investigations were done. Patient underwent emergency exploratory laparotomy and a careful record of pre-operative and post-operative findings was made and was carefully filled in the pro forma. All the patients were advised to attend surgical OPD for follow-up. Results: Most of the patients (73.2%) of perforation peritonitis had a history of NSAID intake, out of which 81.6% recovered from the disease while mortality rate in perforation peritonitis associated with NSAID use was found to be 18.4%. Those patients with no history of NSAID use (26.8%) had a mortality rate of 9% while 91% of patients of perforation peritonitis were recovered from the disease. Conclusion: In this study, it is concluded that the outcome of the patients of the perforation peritonitis is not dependent on the history of NSAIDs use, but NSAIDs abuse is one of the etiological factors in the pathogenesis of the perforation peritonitis
ABSTRACT
Objective: The objective of the study was to determine the extent of vasculopathy in patients with diabetic foot using Dopplerultrasound scanning.Methodology: This descriptive study was carried out in surgical wards SS Medical College and SGMH Rewa from June 1,2017, to May 31, 2018. All patients having diabetic foot complications including abscess formation, cellulitis, ulceration, andgangrene were included in the study after taking informed consent. Peripheral pulses such as posterior tibial, dorsalis pedis,and popliteal arteries were checked. The presence of vasculopathy was checked with Doppler scanning of dorsalis pedis artery,posterior tibial artery, and popliteal artery. The data were collected on a pro forma that was especially designed for this study.Results: A total of 115 patients were included in this study. Out of total cases of the diabetic foot, 21% of cases peripheralpulses were not palpable, 30% of cases were weakly palpable, and in 50% of cases were palpable. In right affected limb outof 66 affected limb, peripheral pulses were palpable in 45% of cases, weakly palpable in 32% of cases, and absent in 23% ofcases and left affected limb out of 49 affected limb peripheral pulses were palpable in 55% of cases, weakly palpable in 26%of cases, and absent in 19% of cases, with a male preponderance.Conclusion: This study shows that vasculopathy is a strong independent risk factor in the development of diabetic foot lesions.The usual symptoms and signs of lower limb ischemia may not be present and indeed may be misleading in diabetic foot disease.