ABSTRACT
Background: The etiological pattern of obstructive jaundice varies from one region to another due to higher incidence being noticed in the Northern region of India. Very limited studies have been carried out in the western regions of Uttar Pradesh. The various etiological parameters ranges from malignant biliary stricture, stone in the CBD and even secondaries lymph node compression at porta hepatis. Due to the transition from open surgery to the minimum invasive laproscopic surgery. The etiology related to surgical jaundice also become more common in relation to procedure related complications like CBD injury that leads to surgical jaundice.Material & Methods:This present study has been conducted in the department of general surgery in TMMC and RC of a Tertiary Care hospital. In this observatory study the patients having clinical records of surgical jaundice who had attended the surgical Out Patient Department are going to be included. The time period of the study was from 1 jan 2020 to 30 sept 2021 . Overall, 44 patients were being considered. The selection of subject was done randomly and any type of special consideration regarding the gender of the patients was not being considered while selecting for the study.Results:In our study from 44 patients according to frequency distribution of etiology maximum of the subjects were having choledocholitheasis along with cholelitheasis that are 34.5 % and choledocholitheasis with obstructive jaundice was the 2ndmost common cause with 31.78%.The 3rdmost common etiology was found carcinoma of gall bladder with 11.35%.Conclusions:It can be concluded that for the cases of malignant surgical jaundice good survival benefit usually depends upon the detection of the disease early during the course period. It has also been found that in malignant cases the stage of disease with jaundice were advanced. As per our study results it has been observed that there are various etiological factors contributing to development of surgical jaundice which needs multiple modes of precise investigations and further evaluations further studies and research needed to cover various factor responsible for surgical jaundice.
ABSTRACT
Introduction: Spontaneous Bacterial Peritonitis (SBP) iscommon and serious complication of patients with livercirrhosis and ascites, without an apparent surgically treatableintra abdominal source of infection. Its prevalence rangesfrom 10% to 30%. Mortality rate was earlier reported morethan 90%, but it has now reduced to 30% -50% as a resultof rapid diagnosis and prompt initiation of antibiotics. Thepresent study was done to evaluate the various non culturemethods for the diagnosis of SBP.Material and Methods: Ascitic fluid sample were collectedaseptically from 100 cirrhotic patients with ascites. PMN(polymorphonuclear leukocyte) count was determined byNeubauer’s manual counting chamber and Leishman’s stainfor differential PMN cell counts. Granulocyte esterase activitywas detected using LER (Leukocyte esterase reagent) dipstickstrips.Results: Out of 100 samples processed, PMN cell count >250 cells/mm3 was found in 91% samples by conventionallight microscopy. Scale of > 2+ by LER strip was found in61 samples. Reading of PMN cell count of > 250 cells/mm3matched in 60 samples and < 250 cells/mm3 matched in 8 cellsby both microscopy and LER strip test. Sensitivity, specificity,positive predictive value and negative predictive value ofLER strip test was 65.9%, 88.89%, 98.36% and 20.51%respectively.Conclusion: LER strips as a screening tool for SBP haveadvantage of speed, low cost, availability at odd hours, requiresno technical expertise and can be performed everywhere.Its high specificity and PPV may help in early institution ofempirical antibiotic therapy in patients.
ABSTRACT
Background & objectives: There is a paucity of data available on genetic biodiversity of Mycobacterium tuberculosis isolates from central India. The present study was carried out on isolates of M. tuberculosis cultured from diagnostic clinical samples of patients from Bhopal, central India, using spoligotyping as a method of molecular typing. Methods: DNA was extracted from 340 isolates of M. tuberculosis from culture, confirmed as M. tuberculosis by molecular and biochemical methods and subjected to spoligotyping. The results were compared with the international SITVIT2 database. Results: Sixty five different spoligo international type (SIT) patterns were observed. A total of 239 (70.3%) isolates could be clustered into 25 SITs. The Central Asian (CAS) and East African Indian (EAI) families were found to be the two major circulating families in this region. SIT26/CAS1_DEL was identified as the most predominant type, followed by SIT11/EAI3_IND and SIT288/CAS2. Forty (11.8%) unique (non-clustered) and 61 (17.9%) orphan isolates were identified in the study. There was no significant association of clustering with clinical and demographic characteristics of patients. Interpretation & conclusions: Well established SITs were found to be predominant in our study. SIT26/CAS1_DEL was the most predominant type. However, the occurrence of a substantial number of orphan isolates may indicate the presence of active spatial and temporal evolutionary dynamics within the isolates of M. tuberculosis.