Rare as hen抯 teeth: laparoscopic management of primary pelvic hydatid cyst

Hydatid disease is a zoonotic parasitic disease most frequently caused by echinococcus granulose Primary peritoneal hydatidosisis very rare. We report a case of primary hydatid disease of the intraperitoneal pelvic space.A 22-year-old male patient presented with a history of abdominal pain since 5 months. Abdominal examination revealed a smooth, firm, mildly tender, non-mobile lump in suprapubic region, on digital rectal examination, a smooth spherical mass was felt anteriorly and laterally outside the rectal wall, rectal mucosa was normal. All routine investigations including liver function tests were within normal limits Computed tomography scan of the whole abdomen showed giant cyst of 10� cm with multiple well-defined cysts in rectovesical pouch.Diagnostic laparoscopy was performed. The liver, spleen, mesentery, omentum was found to be normal. A large tense hydatid cyst was noted in the pelvic cavity.Partial peri-cystectomy with endo-cystectomy was performed. Postoperative period was uneventful and patient was discharged on 4th postoperative day.Primary intra-abdominal but extra-peritoneal localization has been reported in only 0.2-2% cases making it a very rare entity.The treatment of choice for pelvic hydatid cyst is principally a careful surgical excision. Here with minimum invasive technique this case was operated and results were excellent

A comparative study to assess efficacy of Tzanakis score and Alvarado score for effective diagnosis of patients with acute appendicitis at a tertiary care centre in North Karnataka: a one-year prospective analytical study

Background: Acute appendicitis standout amongst the most widely recognized reasons for intense stomach torment. There is no ideal symptomatic assessment apparatus to distinguish acute appendix if indications are ambiguous, bringing about longer analytic procedure and it might prompt deferring of medical procedure and related increment in morbidity and fatality. In the meantime, speedy management may prompt negative appendectomy with expanded morbidity and consumption of healthcare resources.Methods: A Hospital based one year prospective study was conducted at KLEs Dr Prabhakar Kore Hospital Belagavi, Karnataka from 1st January 2018 to 31st December 2018 and required data was collected from 100 patient who were clinically diagnosed to have acute appendicitis and all patients were assessed using Alvarado score and Tzanakis score and HPR for all patients were used as gold standard to evaluate the efficacy of both scoring systems.Results: The sensitivity and specificity of Tzanakis score was 80.6% (at score >8) and 100% (at score >8) respectively.  positive predictive value in present study being 100% and negative predictive value being 41.3%. The sensitivity and specificity of Alvarado score was 11.3% (at score >8) and 100% (at score >8) respectively.Conclusions: Tzanakis Score outperformed Alvarado score displaying higher sensitivity with similar specificity.

One year randomized controlled trial to compare the effectiveness of honey dressing versus povidone iodine dressing for diabetic foot ulcer at Dr. Prabhakar Kore Hospital and MRC, Belagavi

Background: The objective of the study is to find out the effect of honey dressing versus povidone iodine dressing for reduction of wound size in diabetic foot ulcer.Methods: This randomized controlled trial was done in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital, Belagavi from January 2017 to December 2017. 64 patients were randomized into 32 group each undergoing unprocessed honey dressing and other group undergoing povidone iodine dressing.Results: The mean wound size in honey dressing was 23.16 cm2 and 23.03 cm2 in povidone dressings  at baseline, 23.16 cm2 and 22.94 cm2 at 1st day follow up, 23.16 cm2 and 22.94 cm2 at 3rd day follow up, 19.38 cm2 and  20.28 cm2 at 5th day follow up, 16.13 cm2 and 17.06 cm2 at 7th day follow up, 12.44 cm2 and  16.13 cm2 at 10th day follow up and the end of 15th day, it was 10.69 cm2 and 15.06 cm2 respectively in honey dressing group and povidone dressing group. The difference in the wound size in honey dressing group and povidone dressing group at 1st day, 3rd day, 5th day, 7th day, 10th day follow up period were statistically not significant (p>0.05). The difference in the wound size in honey dressing group at 15th day follow up period were statistically significant (p<0.05).Conclusions: This study shows more favorable results with honey dressing for reduction of wound size in diabetic foot ulcers.