ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
Background: Peptic ulcer disease (PUD) is a common disorder that affects millions of individuals each year. PUD has a major impact on our health-care system by accounting for roughly 10% of medical costs for digestive diseases. Overall, peptic ulcer mortality and hospitalization rates have declined for the past two decades, but complications such as peptic ulcer perforation and bleeding remain a substantial health-care problem. Materials and Methods: It was a prospective 1-year study conducted in all cases of peptic perforation admitted in surgical wards during the study period August 2013-July 2014. On admission, every patient was interrogated about name, age, sex, address, occupation, religion, and residence. All patients suspected of peptic perforation with symptoms of the sudden onset of epigastric pain in abdomen, distention of abdomen, constipation, and vomiting were admitted to surgery ward from the outpatient department or transferred from other wards. Their findings were recorded in a pro forma and master chart. The information obtained was tabulated and analyzed. Results: Incidence of peptic perforation was 1.65% of all surgical admissions. It was 6.63% of total case of acute abdomen and 50.17% of total case of perforation peritonitis. A maximum number of peptic perforation cases was found in age group 51-60 years (24.67%). Conclusion: Perforation of the peptic ulcer is due to the persistence of causative factors of peptic ulceration with a decrease in mucosal resistance due to injudicious use of corticosteroids, decreased immunity, malnutrition, delay in hospitalization due to initial treatment by homemade medicines and abdominal massage further complicates the perforation in this region. Peptic perforation is diagnosed on clinical grounds and abdominal X-ray easily, yet due to delayed hospitalization and time consumed in resuscitation of the patient affects the outcome of standard surgical procedure.