Clinical Study on Acute Inflammatory Inguinoscrotal Lesions

Introduction: Acute inguinoscrotal swellings are the most common swellings affecting both children and adults.Although these swellings are frequently encountered, many times correct diagnosis is not made and testes have beensacrificed. A wide variety of acute inflammatory conditions affects inguinoscrotal region and testes such as inguinalabscess, funiculitis, inguinal lymphadenitis, primary infections of scrotum, and/or secondary infection of testes such asepididymo-orchitis and scrotal abscess, pyocele, and Fournier’s gangrene. Knowledge of the risk factors, prevention,and early detection with prompt treatment of inguinoscrotal lesions, which leads to reduction in morbidity and mortalityassociated with these lesions.Materials and Methods: In this prospective study carried out in 195 patients in the Department of Surgery, Shyam ShahMedical College and associated Gandhi Memorial and Sanjay Gandhi Memorial Hospitals, Rewa, Madhya Pradesh, during theperiod of 1 June 2017 to 31 May 2018. All male patients with complaints of acute painful inguinoscrotal swelling and ulcer witha history of <2 weeks were included in the study. Presenting complaints and detailed history were recorded in a predesignedpro forma. Thorough general examination and local examination were done. Patients were investigated and final diagnosiswas established. Then, treatment was initiated according to diagnosis.Results: Acute epididymo-orchitis (42.6%) was the most common cause for acute inguinoscrotal pathology followed byFournier’s gangrene (19.5%) and scrotal abscess (17.9%). Majority patients belong to the age group of 31–40 years, 22.6%and in the age group of 41–50 years, 20.5%. The most common predisposing factor was lower urinary tract syndrome presentin 47.1% followed by poor personal hygiene (43.07%). Conservative treatment was given in 80 patients. All, except eight casesof epididymo-orchitis (83), two cases of scrotal cellulitis and four cases of inguinal lymphadenitis were treated conservatively.All 38 cases of Fournier’s gangrene and one case of scrotal cellulitis were treated by debridement and daily dressings. Incisionand drainage of pyocele was carried out in five patients. Scrotal exploration with drainage of testicular abscess was done inthree cases. Orchidectomy was required in two cases of testicular abscess.Conclusion: Acute inguinoscrotal lesions are common in younger and middle age individuals with variable symptomatology.Such conditions presenting to emergency department need careful examination, proper evaluation, and prompt treatment.Conservative treatment with rest, scrotal support, antibiotics, and analgesics is effective in case of epididymo-orchitis.Emergency surgical exploration proved to be the best in case of scrotal abscess, Fournier’s gangrene, pyocele, andhematocele. Various predisposing factors can be minimized by proper health education and developing good primary healthcare system.

Effect of Liquid Paraffin Gauze Dressing In Burn Wounds: A Prospective Study

Introduction: Burn injury causes a considerable amount of disability, prolonged hospital stay, and burden on the public healthsector. Main requirement in burn wound management is an economical, easy to apply, readily available dressing, or method ofcoverage that will provide good pain relief, protect the wound from infection, promote healing, prevent heat and fluid loss, beelastic, non-antigenic, and adhere well to the wound while waiting for spontaneous epithelialization of superficial partial thicknessburns. The sterilized paraffin gauze dressing is non-adherent and non-allergenic and helps in speedy recovery of burn wounds.Materials and Methods: A prospective study of 90 patients with partial thickness burns who were salvageable (≤40% bodysurface area), admitted to Burn unit of Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital,Rewa from June 1, 2017, to May 31, 2018. The autoclaved liquid paraffin gauze was applied over burn wound. Patients wereassessed on the basis of subsidence of pain, time of epithelialization if occurred after liquid paraffin gauze dressing. Patients’blood investigations were noted and the assessment of the effect of hemoglobin (anemia) and platelet counts in burn woundhealing in terms of mean epithelialization time were done.Results: Mean epithelialization time was 16 days. In 25% of cases epithelialization developed in 10–12 days. Post-burn painsubsided in 4–6 days in maximum in 54.44% cases. Mild and moderate anemia had no significant effect on wound healingtime (mean epithelialization time). Patient with less than normal platelet counts (<1.5 lakh/cumm) had more epithelializationtime and with normal platelet count had less epithelialization time. 15 patients developed complications and most commoncomplication was hyper granulation (11.11%).Conclusion: Burn wounds pose a great burden on health-care infrastructure and burn units. We can conclude that liquid paraffingauze dressing has good patient acceptability and less painful, it is easily available and relatively less expensive. In developingand resource-poor countries, most of the patients are from the rural background so these patients will need a dressing that isrelatively less expensive and easily available such as liquid paraffin gauze dressing.

Study of Incidence of Helicobacter pylori Infection in Patients of Peptic Ulcer Perforation

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 gastrointestinal diseases. Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs are the predominant causes of PUD overall, PU mortality and hospitalization rates have declined for the past two decades, but complications such as PU perforation and bleeding remain a substantial health-care problem. Materials and Methods: A prospective 1-year study conducted in 116 cases of peptic perforation admitted in surgical wards of Sanjay Gandhi Memorial Hospital, Rewa, M.P., during the study period June 2016–May 2017. All patients suspected of peptic perforation were admitted to surgery ward and underwent emergency exploratory laparotomy. Post-operatively, H. pylori serological test to detect IgG antibody was done with patients’ blood serum. Their findings were recorded in a pro forma and master chart. The information obtained was tabulated and analyzed. Results: The incidence of H. pylori infection in our study was found to be 31.03%, i.e., 36 cases of 116 cases. Conclusion: Tobacco chewing, smoking, alcohol, inadvertent use of analgesics, and H. pylori infection are the most common predisposing factors for PUD, and patients’ inability to get proper and complete treatment is responsible for peptic perforation. Early hospitalization and urgent surgical intervention can significantly reduce the post operative morbidity and mortality in peptic ulcer perforation patients. Post-operative H. pylori eradication therapy and follow-up endoscopic facilities in patients found positive for H. pylori can reduce recurrence rates and subsequently the burden of this disease