Correlation of Clinical Findings with Radiological and Intraoperative Findings in Cases of Intestinal Obstruction

Intestinal obstruction accounts for 15% of all patients presenting to emergency department with complaints of acute abdominal pain. Recognising obstruction early, aggressive preoperative treatment, skilled surgical techniques and intensive postoperative management improves outcome. We wanted to correlate the clinical findings with radiological and intra-operative findings in cases of intestinal obstruction.METHODS50 cases of intestinal obstruction chosen by simple random technique, were studied in the department of general surgery at MMIMSR, Mullana, Ambala. Intraoperative findings were compared with x-ray, USG abdomen and CT abdomen findings.RESULTSAdhesions and bands (26%) were found to be the most common cause of intestinal obstruction. Most common finding on plain x-ray abdomen was the presence of dilated gut loops (82%). USG abdomen has limited diagnostic value in cases of intestinal obstruction with most common finding reported in USG abdomen being that of small bowel obstruction (62%). Out of 49 patients who underwent CT scan abdomen and surgery, CT findings matched with intraoperative in 45 patients (91.84%) and the most common finding was adhesions and bands (22.4%).CONCLUSIONSX-ray abdomen and USG abdomen have limitations and are diagnostic only in a handful of cases. CT abdomen provides much more elaborate information and helps the surgeon to understand the pathology. Preoperative CT also helps prevent laparotomies in scenarios where surgeon with preoperative knowledge can opt for laparoscopic approach, thereby reducing postoperative stay in the hospital and complication. So, understanding of the imaging modalities and knowing when to use them and what to look for can save precious time of the patient and also that of the surgeon allowing for early diagnosis and better plan of treatment.

Serum lipids and lipoproteins: a brief review of the composition, transport and physiological functions

The dietary fats are composed primarily of triacylglycerols and some amount of phospholipids and cholesterol. Being hydrophobic in nature, these are insoluble in water, and hence cannot be transported in the blood plasma per se; to enable these lipids to be transported by the blood stream to various peripheral tissues, nature has devised the technique of making these soluble by binding them to proteins. These proteins involved in lipid transport are known as apolipoproteins, and the protein-lipid particle is known as lipoprotein. Thus, lipoproteins can be considered to be the primary transportmechanism to carry lipids from the alimentary tract to various parts of the body. Lipoproteins have gained prominence in medical field over the past few decades because of their role in the aetio-pathogenesis of cardiovascular diseases, principally atherosclerosis which is the cause of coronary artery disease and myocardial infarction. The various types and sub-types of lipoproteins have been found to have differing and even opposing roles in the development of arterial diseases. An understanding of the differing populations of lipoproteins, the associated proteins and other enzymes, and the myriad variety of inter-actions among themselves and with body cells is vital to our understanding the pathways involved in the development of cardio-vascular disordersand in determining the precise steps where pharmacological interventions can be introduced

Incompatible foods: an important concept to understand to prevent auto-immune disorders

The emerging field of trophologydeals primarily with suitable food combinations and also a few unsuitable food combinations. The science is still in its nascent state and a few things have emerged in terms of which foods should, or should not, be eaten together. But the ancient texts ofIndian Medicine are replete with such examples. What’s interesting is that there is a huge theoretical basis behind the concept of Incompatible foods. The science is rooted in the Ayurvedic concept of six tastes and the physiological basis of homeostasis-the doshas, which roughly correspond to the humours as propounded by the Greek philosopher Hippocrates. Inter cultural exchange in modern times of rapid transit has resulted in mixing up of foods and dishes in a haphazard manner, led by gustatory and aesthetic factors rather than immunological ones. This has led to explosion of so-called auto immune and metabolic diseases, because the immunological basis of incompatible food combinations has hardly begun to be researched