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1.
Artículo | IMSEAR | ID: sea-218965

RESUMEN

Background: The acute abdomen is a condi?on that demands urgent a?en?on and treatment, ranging from trivial to life threatening condi?ons. The aim of this study was to know in detail the epidemiology and outcome in nontrauma?c acute abdomen. Methods: An ins?tu?on based, cross-sec?onal study was conducted from December 2019 to April 2020, at Department of General Surgery Govt. Medical College Kota Rajasthan. The study included 100 cases of non-trauma?c abdomen. Results: Non- trauma?c acute abdominal pain was more common in 2ndto 6thdecade of life. The males to female ra?o is 2.85:1. Hollow viscus perfora?on (30%) forms the commonest cause of acute abdomen followed by acute appendici?s, Sub acute intes?nal obstruc?on, renal/ureteric colic, cholelithiasis, pancrea??s, non-specific pain abdomen, OBG related pathology, liver abscess, Meckel’s diver?culi?s and splenic abscess in 24%, 23%, 8%, 4%, 3%, 3%, 2%, 1%, 1% and 1% respec?vely. Sixteen pa?ents managed conserva?vely. Most common surgical procedures done were exploratory laparotomy with needful for hollow viscus perfora?on and open/laparoscopic appendicectomy for acute appendici?s. Conclusions: Proper history taking, clinical examina?on with suppor?ve imaging findings are most important to narrow the differen?al diagnosis and for immediate interven?on to limit morbidity and mortality.

2.
Artículo | IMSEAR | ID: sea-213305

RESUMEN

Background: Acute pancreatitis is the most terrible of all the calamities that occur in connection with the abdominal viscera. Prediction of severity is an essential step in the management of acute pancreatitis. 50% of mortality can be reduced to 8% by its early recognition. PANC-3 score is widely available test that can be performed quickly, easy to measure with high accuracy in predicting acute pancreatitis.Methods: This cross-sectional study was conducted in the department of general surgery, VMMC and Safdarjung Hospital over 50 patients admitted with acute pancreatitis. After making the clinical diagnosis, PANC -3 score, modified ATLANTA score, APACHE II were done. CRP and CTSI (computed tomography sensitivity index) were calculated and correlated.Results: Mean age was 44.74 years and most common cause was biliary tract pathology. Mortality observed in 5 patients, 11 patients had severe disease. Sensitivity of PANC- 3 was 81.82%, specificity -92.31% with 75% PPV and 94.7% NPV.Conclusions: PANC-3 can be used to predict the severity of pancreatitis as efficiently as Modified ATLANTA classification/APACHE II. It uses only three criteria which are easily done, and available in the basic health care setup. Its interpretation does not need expertise and can be applied at the time of admission which is an advantage when compared to classical scoring systems.

3.
Artículo | IMSEAR | ID: sea-201467

RESUMEN

Background: HIV/AIDS remains a significant global public health problem. With approximately 56% HIV patients in India receiving treatment, adherence to drugs is a crucial element for successful management. Sustainable development goals, National Strategic plan for HIV/AIDS and STI (2017-24) and 90-90-90 target pushing towards ending of AIDS epidemic require adequate adherence and this research estimates the adherence, associated factors and reasons for non-compliance.Methods: This analytical cross sectional study was undertaken on 160 HIV patients from an ART Centre. A pre-structured, pilot tested, face validated questionnaire was used and data collected by face to face interviews, through random selection of participants from outpatient department register. Data was analysed using Epi Info software and chi squared test applied.Results: Of the 160 study subjects, 86.8% remained adherent to the treatment with forgetfulness (71.4%) being the most common cause for non-adherence. Statistically significant treatment adherence was observed to be associated with socio-economic status (p=0.021) and period elapsed since diagnosis (p=0.041).Conclusions: Improving adherence to drug therapy through intensive counselling, streamlined drug supply and increased family participation would go a long way in reducing the menace of HIV.

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