Causes and management out come of peritonitis

This retrospective study was conducted to study the different causes of peritonitis and to determine the surgical outcome. Retrospective study. This study was carried out at the Department of Surgery Peoples Medical College Hospital Nawabshah from 1[st] January 2001 to 31[st] December 2001. In this study of 51 patients of peritonitis admitted, out of them, 16 cases of typhoid ileal perforation, 8 cases of perforated duodenal Ulcer, 7 cases of tuberculosis of those 2 cases were of jujenal perforation and 5 cases of ileal perforation, 4 cases of perforated appendix, 4 cases of ruptured liver abscess, 2 cases of perforated neoplasms of those 1 case each with multiple ileal/ jujenal perforation due to lymphoma ,malignant caecal perforation, gastric perforation, jujenal perforation obstructive/strangulated, infective caecal perforation each, 2 cases of post operative peritonitis, 3 cases trauma, 2 cases of blunt abdominal trauma each developed peritonitis due to ileal and jejunal perforation, 1 case of gunshot injury causing peritonitis due to colon perforation, 2 cases of ruptured ovarian cyst associated with appendicitis. In our study, male to female ratio is 4:1. Maximum frequency was observed in 20-30 years age, whereas most of the patients ranged between 13 to 40 years. Surgical outcome of the peritonitis resulted poor in those cases who came late with hugely contaminated peritoneal cavity when operated. They developed post operative complications i.e. wound infection, septicemia, fecal fistula and longer hospital stays. 22 patient's outcome was poor and out of them 8 patients expired. The mean hospital stay was 23.0 +/- 17.7 days and the range was 67[3-110 days]

Hiccup: an extremely rare presentation of thyrotoxicosis of Graves' disease

Persistent hiccup is a rare but potentially severe condition that can be symptomatic of a variety of diseases or idiopathic. Most episodes last only a few minutes and are self-limited, but hiccup can get persistent and become a real problem for physician and patient alike. The center of hiccup may be activated by a great variety of stimuli traveling along different nerve pathways and bring different effecter responses. We report a case of persistent hiccup as a presentation of impending thyroid storm of Graves' disease. Though the condition is rare, clinicians should remain alert to the possibility of this diagnosis