ABSTRACT
Background: Geriatric patients having surgical problems are more vulnerable for devastating resulting in higher morbidity and mortality rates. Because of comorbid medical illness and low immunity power management of surgical problems in a geriatric patient at the initial stage is necessary. Materials and Methods: It was a prospective 1 year study. On admission, every patient was interrogated about name, age, sex, address, occupation, religion, and residence. They were also inquired for chief complaints with duration, past history, drug history, personal history, and family history. Their findings were recorded in a pro forma and master chart. The information obtained was tabulated and analyzed. Results: Incidence of surgical problems in the geriatric patient was 19.18% out of total surgical ward admission. The majority of patients were male (70.35%) with male:female ratio of 2.4:1. The majority of patients were in age group 60-64 years (31.89%). A number of patients in the age group 80 years and above was also significant (15.28%). The eldest patient was 102-year-old male. The majority of patients were from a rural area (83.39%) followed by urban (16.61%). The majority of elderly patients admitted were suffering from medical illness associated with surgical problems most common being anemia (28.79%) followed by diabetes mellitus (19.54%), hypertension (18.96%), and tuberculosis (9.71%). The majority of elderly patients in both sexes were suffering from gastrointestinal tract disorders (28.79%). In males, the second common system involved was genitourinary system (24.67%) followed by skin and soft tissue lesions (18.87%), central nervous system (8.98%), and hernia (8.66%). In females, the second common system involved was skin and soft tissue lesions (21.12%) followed by hepatobiliary system (17.44%), central nervous system (11.43%), and breast lesions (8.72%). Conclusion: For healthy old age life, it is advised to take balanced diet and do physical activity for prevention of functional decline, increased survival and also avoids smoking, tobacco chewing, and alcoholism to reduce cardiovascular and other diseases risks.
ABSTRACT
A rapid survey of the 253 cases of urinary lithiasis shows 57 cases with obstruction below the stone. This gives an incidence of 22.3. Since practically all of these 253 cases had infected urine, the absence of close relation between the incidence of urinary infection and urinary obstruction would seem to preclude any possibility of cause-and-effect relations between the two factors. However, the high incidence of urinary infection in the cases of lithiasis discussed above cannot be of etiologic significance, as far as infection is concerned, unless it be proven in every instance of lithiasis that there had been an antecedent urinary infectionNothing of the sort was found in my cases. One is tempted to conclude, therefore, that neither infection nor obstruction had much significance in the production of stones in these patients, although, once the stone had formed, infection and obstruction might possibly accelerate the growth of the stone, even to the extent of perpetuating the lithiasic stateSuch a superficial analysis as this of a small series cannot very well advance, except by elimination, the studies on the etiology of stone. It can only be hoped that, when a thousand of more cases are studied and more histological sections of the urinary tract are made, some more light may be shed on the problem. For when one says that the majority of the stones in this series are "primary" stones, the use of the adjective "primary" wound only reveal an ignorance of elusive etiologic factors.(Summary and Comments)