ABSTRACT
Albumin is associated with hyperinflammatory states which renders the delayed wound healing is a known fact1. In cases of a pathological state there might be a low formation of the albumin in liver or high degradation of the albumin. In either of the ways the serum albumin will be lowered. Stress and strain is also known to cause hypoalbuminemia i.e low serum level of albumin. Since albumin is a protein it has to be transcribed rom the genes and studies have shown that TNF - alpha supresses this transcription process. The TNF – alpha is known to increase in any inflammation and thus forms a cascade. In case of hospitalised patients the stress and strain in pre surgical patients and chronically hospitalised patients the serum albumin levels are known to be less than normal. In chronically hospitalised patients the nutritional cause can also be taken into consideration for lower serum albumin levels. Early detection of these low levels of serum albumin levels helps the surgeons and the physicians to intervene and thus cut off the progression of the disease. A sincere effort has been made in this study to understand the relations of the serum albumin level and its effects on the prognosis of the disease and outcome of the surgery if the patient is undergoing any. This study is intended to help the physician, surgeon and general practitioners to understand and intervene in the event and thus help the patient to recover earlier and in a better way. The study has been done in the Department of Pathology, Kanachur Institute of Medical Sciences, Deralakatte, Mangalore. The patients were mainly observed in the Department of Surgery, Emergency Medicine and Casualty. The study was done from January 2017 To December 2017 . In the present study there is a significant difference in the prognosis of the patients when the serum albumin level increases in the serum. The mean serum levels in the three groups were found to be 1.95 gm / Dl, 2.85 gm / Dl and 5.1 gm / Dl. In the third group the complications were not present at all, showing the significance of serum albumin levels in the prognosis and outcome of the disease. The disease prognosis was significantly altered when the low serum albumin was altered.
ABSTRACT
Aim: To compare the result of graft materials i.e. temporalis fascia, tragal perichondrium and ear lobule fat in various aspects but the prime interest would be the closure of tympanic membrane perforation and postoperative hearing improvement. Materials and methods: The study was carried out on 60 patients admitted for myringoplasty as per selection criteria in the Department of Ear Nose and Throat for a period of 1 year in patients autogenous graft materials was used and they were divided into three groups. In Group A 20 patients in which termporalis fascia was used as graft, Group B 20 patients in which tragal perichondrium was used as graft and Group C 20 patients in which ear lobule fat was used as graft. Results: Maximum number of patients (41.7%) was in the age group of 21-30 years. Female patients outnumber the male patients. The male female ratio was 1: 2. Rural population was more as compared to urban in study groups. Left ear was more involved in all the groups. Maximum number of patients i.e. in group A (50%), in group B (45%) and in group C (55%) was having duration of ear discharge of 1-5 years. Dry ear of <3 months of duration in group A, group B and group C was 50%, 80%, and 70% of patients respectively. In group A, 50% of patients had more than 30dB AB gap while 45% of group B and 50% of group C had less than 20dB AB gap. Overall total AB gap was 10.33 ± 9.62 dB. Mean improvement in hearing was 12.32 ± 8.42 dB, 10.38 ± 5.73 dB and 12.62 ± 8.06 dB in group A B and C respectively. Conclusion: Temporalis fascia graft has good improvement of hearing when compared to other grafts in study. Ear lobule fat when used in small perforations has encouraging results.
ABSTRACT
Injection abscess is an iatrogenic infection occurring as an isolated case or as cluster outbreak. These infections occur due to contaminated injectables or lapse in sterilisation protocol. While pathogens such as Pseudomonas, Klebsiella, E. coli, and S. aureus are the usual causative agents, unusual organisms such as mycobacteria, particularly the rapidly growing non-tuberculous mycobacteria (NTM) may cause the abscess. The chances of overlooking these organisms is high unless an acid fast bacilli (AFB) smear and culture is done on all aspirated pus specimens. We report a case of a three year old child who presented with a gluteal abscess following an intramuscular infection with an unknown preparation.