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Background: Post-operative respiratory complications are a major threat following emergency abdominal surgeries. It significantlyincreases post-operative morbidity and mortality. The aim of this study was to determine the incidence and factors affectingpost-operative pulmonary complications (PPCs).Materials and Methods: This is a prospective observational study conducted in 270 patients who got admitted through SOPD,casualty or transferred from other department, and undergoing emergency laparotomy over a period of 1 year (June 1, 2018–May 31, 2019). Patients were included in the study irrespective of age, sex, and occupation. Pre- and post-operative datawere collected through interview and postoperatively patients were monitored clinically and various investigations were doneto record post-operative respiratory complications. Then, their association was analyzed.Results: Two hundred seventy patients were included in the present study and 55 (20.4%) developed PPCs. Pneumonia (20)was the most common PPC followed by atelectasis (15). Elderly patients had more risk. PPCs were more in current smokers(30.98%), patients with pre-existing respiratory diseases (47.1%), duration of surgery more than 3 h. PPCs significantly increasethe duration of hospital stay and mortality.Conclusion: Pulmonary complications are significant among patients undergoing emergency laparotomy that leads to increasedmorbidity and mortality. Predictors of PPCs are smoking, pre-existing respiratory diseases, prolonged duration of surgery, andprolonged intubation.
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Background: Aging is a continuous process which begins with conception and ends with death. It is said that nobody grows oldmerely by living a certain number of years, while aging merely stands for growing. The health problems to be considered shouldinclude – physical, mental, emotional, and socioeconomical. Old age is not a disease but the aged people are often vulnerableto long-term diseases such as cardiovascular, cerebrovascular, respiratory, gastrointestinal, cancers, mental derangement,hearing and visual loss, and conditions affecting the locomotor system. Aim of this study is to analyze the common surgicalproblems in geriatric patient with special reference to gastrointestinal tract (GIT) diseases in Vindhya region.Materials and Methods: A total of 1585 cases were studied with common surgical geriatrics problems admitted in the surgicalwards in Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa (MP), India, in the periodfrom 1 June 2018 to 31 May 2019. The proposed study includes patients with age 60 years and above who will be admittedthrough surgical outpatient department, casualty and/or will be transferred from other departments. After admission of patients,particular will be recorded and they will be also inquired for chief complaints with duration, history, drug history, personal history,and family history. Their findings will be recorded in a pro forma.Results: Of 10,887 patients admitted in Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa(MP), India, during the period of 1 June 2018–31 May 2019, in which common surgical problems were diagnosed in 1585 patients(14.55%), among which most of the patients were males (1137) and rest were females (448). Most of the patients belonged to 60–64years of age group. From this study, intestinal obstruction among GIT diseases was found to be the most common surgical problem.Conclusion: Majority of elderly patients admitted with GIT disorders were having intestinal obstruction (22.17%), followedby PUD (21.47%), peritonitis (17.09%), malignant lesions and hemorrhoids (9.23%), and colitis (6.92%). Of sex-wise totaladmission. The incidence of intestinal obstruction (26.11% vs. 20.40%) and colitis (14.92% vs. 3.34%) was more common infemale than male. Whereas PUD (23.41% vs. 17.16%) and perforation peritonitis (19.06% vs.12.68%), hemorrhoids were morecommon in male than female.
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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.
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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.
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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
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Introduction: The aim of the study was to study the change in mortality pattern of surgical patients in government tertiary care hospital over a decade. Background: By analyzing the mortality pattern, we can identify the major reason for death in surgical wards. That will help to install our preventive strategies and allocate appropriate resources in terms of manpower and equipment where they are most critically needed. Materials and Methods: For our retrospective study, necessary data were obtained from the registration department due to permission from hospital authority. Out of all the admissions, data of the expired patients during the year 2008 and 2018 in detail using the proforma sheet have extracted. Then, a retrospective and descriptive observational study was done on all patients who have died in the surgery department during the year 2008 and 2018 of Sanjay Gandhi Memorial Hospital (S.G.M.H), associated with Shyam Shah Medical College, Rewa (Madhya Pradesh), during the year 2008 and 2018. Results: In 2008, there were 6286 admissions, of which 453 deaths were occurred, in contrast to 2018 there were 10,887 admissions, of which 702 deaths were noted and observed mortality rate (7.20%) in 2008 and (6.44%) in 2018. During our study, we observed that burn (26.04%) was the leading cause of the death in 2008 and (26.64%) in 2018, next was the road traffic accidents (RTA) specific to head injury (13%) in 2008 and (23.38%) in 2018 and, at third position, viscus perforation (16.78%) was the cause of death in 2008 and (16.39%) in 2018. The case fatality rate is overall decreased over a decade in all diseases. Conclusion: In our institute (S.G.M.H), surgical mortality has reduced from 7.20% (2008) to 6.44% (2018) almost by 1% over a decade. Burn and RTA were the leading causes of the deaths to reduce the incidence in this both groups, we need to work in both directions as one side we need to improve in our infrastructure and services, and on the other side, we need to focus in preventive strategy as these causes can be preventable by educating the preventive strategies to the people at ground level.
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Introduction: Computed tomography (CT) scan is an accurate tool for the detection of injuries in a trauma setting and is able to find the injuries that were occult in chest X-ray (CXR). In past years, the utility of CT scan was limited to severe trauma injuries but now is used in less severely injured trauma patients. The study aimed to compare the efficacy of CXR and chest CT scans in patients with chest trauma. Materials and Methods: The present study was conducted in the Department of Surgery of Medical Institute. For the study, we prospectively view the previous medical records of the patients who were admitted in our surgical ward for blunt chest trauma and received both CXR and high resolution CT chest scans. A total of 95 patients were included in the study. Data regarding the study were collected. Results: Out of 95 patients, 79 were males and 16 females. The mean age of the patients was 32.42 years ranging from 2 to 90 years. The most common cause for blunt trauma to the chest according to our results was a road traffic accident. We observed that CT scan is more accurate as compared to CXR in the detection of certain cases such as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax. Conclusion: Chest CT scan is highly sensitive in the detection of thoracic injuries following blunt chest trauma. In day-to-day practice, CT scan is better in visualizing as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax