ABSTRACT
Background: Patients, operative technique and instrumental factors, all affect the intestinal anastomosis outcome. Preoperative, intraoperative and postoperative blood transfusion influences the very common surgical procedure. Blood transfusion is discriminated from other risk factors in that; its intentionally added risk factor. Aims & Objective: The effect of intra-operative and post-operative blood transfusion on elective gastrointestinal anastomosis mainly evaluated by following factors; (1) surgical site complications (2) anastomosis leak (3) faecal fistula and (4) death. Material and Methods: To evaluate the effect of blood transfusion (Intraoperative and Postoperative) in outcome of Gastrointestinal anastomosis at Government General Hospital. Data collected from fifty two patients who underwent elective gastro intestinal anastomosis at our hospital. Results: The total number of patients was 52, 28male and 24 female. Mean age was 43 years, 17.3% were underwent small bowel anastomosis, 83.7% were underwent large bowel anastomosis, and 15.38% were transfused intraoperative and 26.92% were transfused postoperatively. Regardless other risk factors the incidence of surgical site infection was significantly high in transfused patients (25%), also there was a high rate of other complications in transfused patients. Conclusion: Intraoperative and post-operative blood transfusion is a good predictor for development of complications in elective intestinal anastomosis. There were some limitations in this study, as other risk factors might change the outcome and the effect of blood amount wasn’t considered, so more precise studies have to be done to give more support to our results.
ABSTRACT
Giant Scrotal Lymphoedema is a rare disease. Such Scrotal elephantiasis presents multiple problems both to the patient as well as the treating clinician obstruction, aplasia, or hypoplasia of the lymphatic vessels. The most common cause worldwide is lymphatic Filariasis. A case where the resected scrotal tissue weighed 30kg which is one of the largest so far mentioned in literatures. The lymphedema was progressive over 15 year’s duration and the testes were not palpable with the penis deeply buried. There is no effective medical treatment for filariasis. There are different surgical methods for scrotal filariasis in the literature. In this case, the patient was treated by Modified Charles procedure. Once fibrosis sets in resectional therapy will be needed in most cases. Successful reduction scrotoplasty with acceptable cosmetic results can be obtained in giant scrotal lymphedemas weighing as large as 30kg as in this case.
ABSTRACT
Background: Interstitial lung disease accounts for more than 200 etiology. There has been worldwide increase in diagnosis of interstitial lung disease because of the help of recent advance diagnostic tools. Aims & Objective: to study age & sex distribution, to correlate symptoms & pulmonary function, role of HRCT as etiology diagnosis particular in interstitial pulmonary fibrosis, to study ECG & 2D ECHO changes and to study pulmonary function test pattern. Material and Methods: This was the study of 25 cases of interstitial lung disease in which various parameters like DLCO, PFT, 2D ECHO, ECG, identification of etiology, assessment of prognosis & role of immunosuppressant, steroids were studied. The exclusion criteria was age < 12 years. Results: The age distribution was highest in age group of 50-70 years. Occupational interstitial lung disease was more common in male while the connective tissue disorders are common in female which lead to more incidence of interstitial lung disease. Pulmonary function test is very helpful for prognosis. The patient with high pulmonary artery pressure had worst prognosis. HRCT is a useful tool for diagnosis of IPF without biopsy. Conclusion: Interstitial lung disease with moderate to severe pulmonary artery hypertension leads to poor prognosis. HRCT is very useful non-invasive diagnostic tool for interstitial lung disease.