ABSTRACT
Background: Emergency Laparotomy is one of the most common surgical procedures performed in Surgical Emergencies, which leads to significant mortality and morbidity. The aim of this study was to evaluate the patients undergoing emergency midline laparotomy, utilizing POSSUM scoring system to help to predict morbidity and mortality in patients, and assuring improved management in present setup. Methods: Total 104 consecutive patients underwent emergency midline laparotomy over a period of two years were included in this prospective study. Surgical outcome was assessed and compared with POSSUM scoring system. The relevant data was recorded on predesigned proforma and analysed. Results: We studied 104 emergency midline laparotomy patients, which resulted in 15 deaths (14.4% Mortality rate). On applying POSSUM, we found that the expected number of deaths for our study group was 24 (O: E= 0.63), relationship was statistically significant. Observed morbidity was 61 (58.65%). On applying POSSUM we found that the expected number of morbidity for our study group was 65 (O: E= 0.93), relationship was statistically significant. Conclusion: The present study validates that the POSSUM is an accurate scoring system for predicting postoperativeadverse outcome among patients undergoing major general surgeries in present setup.
ABSTRACT
Background: The aim and objectives of the study is to validate the role of Alvarado score in diagnosis of acute appendicitis. Methods: A total of 310 patients with clinical diagnosis of acute appendicitis were included in this study. Patients were examined thoroughly, investigated and managed accordingly. The relevant data collected and analysed. Results: Out of 310 patients, surgical procedures were performed in 22.90% of the patients. The overall negative appendicectomy rate was 9.86%, and the percentage of Positive Predictive Value (PPV) for Alvarado score was 90.14%. Conclusion: Our study validates the Alvarado score as fast, simple and reliable diagnostic tool for acute appendicitis.
ABSTRACT
Background: To compare the effectiveness of the two different methods of inguinal hernia repairs viz. The Lichtenstein hernioplasty and Rutkow-Robbins method of hernioplasty. To compare the results of these two techniques and complications if any, and to arrive at a conclusion as to the better modality of treatment in the present setup. Methods: Total 50 patients of uncomplicated direct and indirect inguinal hernia were included in the study, they were randomly chosen for two different surgeries–The Lichtenstein hernioplasty and Rutkow-Robbins method of hernioplasty, 25 cases each. The relevant data regarding age/sex incidence, mode of presentation, surgical treatment and postoperative complications were recorded on predesigned proforma and analysed. The patients were followed up after 7 days, 15 days, 1 month, 3 months and 6 months thereafter. Results: The mean operative time for Lichtenstein hernioplasty group was 57 minutes, and 47 minutes for the Rutkow-Robbins hernioplasty group. Rest of the observational findings were comparable without any significant difference. Conclusion: The Rutkow-Robbins method of hernioplasty can be completed easily and more quickly with significant reduction in the operative time than Lichtenstein hernioplasty. Incidences of Intra operative and post operative complications as well as overall results of procedures were all comparable without any significant difference.