ABSTRACT
Despite significant advancements in the field of medicine, management of complex obstetric perineal injuries remains a challenge. Although several surgical techniques have been described, no techniques have provided satisfactory long-term results. Recently, a perineal transposed antropyloric valve has been used for anorectal reconstruction in patients with damaged or excised anal sphincters. We describe this technique in the case of complex obstetric perineal trauma with extensive tissue loss, presenting with end stage fecal incontinence. The functional outcome after this procedure was evaluated. The patient tolerated the surgery well, and there were no procedure-related upper gastrointestinal disturbances. Short-term functional outcomes were encouraging. At the 36-month follow-up, the patient’s neoanal resting and squeeze pressures were 50 and 70 mmHg, respectively. The postoperative St. Mark’s incontinence score was 7. Perineal antropyloric valve transposition is feasible and can be successfully applied in the management of end-stage fecal incontinence associated with complex obstetric perineal injury.
ABSTRACT
Background:To study the occurrence of Anemia in Patients of Type 2 Diabetes Mellitus and to promote awareness about early detection of Anemia in such subjects. Method: Out of numerous patients who came to a tertiary care hospital in Ghaziabad With high blood sugar level, Type2 Diabetes was diagnosed after basic investigations and occurrence of Anemia was studied in such patients by cross-sectional study. Type of Anemia was also studied in such subjects. Results:Among those 100 patients enrolled for study 68 were found to have Anemia. Normocytic normochromic Anemia was the most common type of Anemia in our subjects enrolled for study and Macrocytic Anemia was least common type in them. Conclusion: Anemia remains hidden in majority of Diabetic Patients and even in Diabetic with normal renal function. It is very simple to detect it at earlier stage and create awareness among patients to minimize complications.
ABSTRACT
Background:To study and analyze the serum calcium, serum uric acid, age, sex, geographical distribution and compare the results with available literature. To study the incidence, prevalence and selected risk factor of kidney stone disease and estimate the effect of relationship between risk factor distributions and compare the results with available literature from around the world. Methods: All renal colic individual were scrutinized who came to a tertiary care hospital and 187 patients met the inclusion criteria made after basic investigation and ultrasonography. Results: Over a period of one year, all renal colic patients were scrutinized and 187 patients met the inclusion criteria. The most common age group was 31-60 years and males predominated over females 67% of males versus 33% of females. The major risk factors for developing stones are hot and humid climate in this region of Kerala associated with lack of adequate fluid intake and high intake of animal protein in diet. In this study of 187 renal calculi patients, 56% had high serum calcium and those who had raised serum calcium 58% had larger calculi. Out of 187 patients, 63% had high serum uric acid level. Out of 118 patients with raised serum uric acid, 74% were male and 26% were female.Conclusion: There is an increase in the prevalence of kidney stones in India and other parts of world. Many aspects of the mechanisms of kidney stone formation remain unclear at present. Diet and life style factor likely play an important role in the changing epidemiology of kidney stones. It appears that changes in two of most important environmental factors, diet and climate have the most significant impact on these trends; kidney stones are higher in warm or hot climates with poor fluid intake. The peak age group of recurrence of stones was 31-60 years. Males are more prone to develop kidney stones than females. Patients who had raised serum calcium and serum uric acid level had larger and multiple calculi bilaterally.