ABSTRACT
Background: Inflammation of gallbladder bed, CO2 pneumoperitoneum, and intraoperative patient posture all plays a role in the etiology of pulmonary dysfunction during laparoscopic cholecystectomy. Aims and Objectives: The goal of this study was to detect any changes in pulmonary function following laparoscopic cholecystectomy using a portable spirometry instrument, as well as to determine the degree of pulmonary function impairment and complications. Materials and Methods: The pre-operative and post-operative spirometry of 150 patients undergoing laparoscopic cholecystectomy under general anesthesia were compared in this prospective observational study conducted at JLN medical college and attached group of hospitals after obtaining due permission from the Institutional Ethics Committee. Spirometry was performed preoperatively to determine baseline values forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow rate (PEFR). Those who were unable to complete the required maneuvers were not included in the study. Pulmonary function testing was performed thrice after surgery, on days 1, 2, and 3 after surgery. To achieve a VAS score of <4, enough pain alleviation was provided. The paired t-test was used to compare spirometry values. Results: Between the preoperative and immediate post-operative periods, significant changes in FVC, FEV1, and PEFR were detected, indicating restrictive ventilator dysfunction. Conclusion: After laparoscopic cholecystectomy, light restrictive respiratory disturbances were noted with quick recovery of pulmonary function, potentially lowering post-operative pulmonary morbidity and mortality.
ABSTRACT
Background: Intestinal obstruction is a common clinical entity in surgeons practice. In a large number of patient, therapeutic options are surgery versus conservative treatment; the choice of the treatment, that is, surgical versus conservative depends mainly on the surgeon’s assessment and therefore, is a clinical challenge to decide. Aims and Objectives: The purpose of our study is early detection of strangulated bowel obstruction based on a clinical, laboratory, and radiological parameters, a severity indicator score developed by combining these parameters. Materials and Methods: It was a hospital-based prospective observational study of 100 patients between April 2019 and October 2020 who presented with intestinal obstruction. Clinical, laboratory, and radiological parameters were noted and scoring was done as per severity scores. Results: Common cause of obstruction in this study was adhesions 41%, tuberculosis 13%, malignance 8%, and mesenteric ischemia 6% followed by intussusception and volvulus. Patients who had score <3 were managed conservatively, while 90.9% of patients having a score of three or more where operated on, which was statistically significant. Conclusion: Evaluation of the patient is not only to confirm the diagnosis but also timely management of strangulation and prevention of ischemia of gut to improve morbidity and mortality. This study used a severity scoring system of clinical parameters, laboratory and radiological investigation to help in the decision-making of treatment in a case of intestinal obstruction.
ABSTRACT
Background: Low back pain with radicular symptoms is one of the most prevalent musculoskeletal disorders and leading cause of disability. Radicular back pain can be defined as a diffuse process affecting more than one underlying nerve root that causes pain and depending on the severity of symptoms may cause loss of sensation and motor function. Quality of life (QOL) is a multidimensional patient-based outcome criterion which can be used to describe the impact of health condition on the patient as well as the effects of the treatment. Low back pain interferes with QOL and work performance. Aim and Objectives: To analyze the QOL in patients of low back pain with radiculopathy. Materials and Methods: This descriptive-analytical study was carried out on 364 low back pain patients and healthy people in Government medical college, Patiala, India, from January 2021 to June 2021. We used SF-36 questionnaire to assess QOL, which allows calculating eight different scores (on a scale of 0–100), a physical component scale (PCS), and a mental component scale (MCS) summary. Mean Mental (MCS) and Physical (PCS) component summary scores were assessed and compared with healthy people involved in the study. Overall, a higher PCS and MCS score indicates better QOL. Results: Out of 364 patients enrolled, 311 patients with mean age of 49.1 ± 11.9 years were included for the study. SF-36 was administered and assessed. The result from this questionnaire showed that mean PCS and mean MCS were significantly lower in the low back pain patients compared to the normative population and were statistically significant. Conclusion: Patients of low back pain with radiculopathy have poor QOL compared to normative individuals. Lower QOL in patients necessitates getting early treatment, educating the patient, and rehabilitation. It is vital to give more attention to the QOL of the patient as it is an untouched domain.