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Background: Appendix is a vestigial organ in human body. Inflammation of appendix is termed as appendicitis. The diagnosis of appendicitis still holds dilemma amongst surgeons leading to negative appendectomies on one hand and appendicular perforation on the other hand of therapeutic spectrum. Judicial patient selection for appendectomy and follow up histopathological examination for incidental findings is the cornerstone in management of appendicitis. The current study aims to assess the demographic and histopathological findings of all the appendectomies occurring within study period at our center.Methods: It was a retrospective study over two years done in a teaching hospital of Dehradun. Hospital records were retrieved from medical records department and looked for histopathological findings, demographic details and intervention. The data was analyzed in SPSS version 23. Qualitative and quantitative data were expressed in proportions and mean respectively. T-test was applied for comparison.Results: About 2/3rd of participants were males. The peak age was 20-30 years. 100 underwent open appendectomy and 45 had lap appendectomy. Commonest histopathological exam finding was acute appendicitis (46.2%) followed by peri appendicitis (40%) and resolving appendicitis (28.9%). One specimen had tubercular appendix. There were no negative appendectomies.Conclusions: Elective appendectomy in patients satisfying clinical, lab and radiological criteria can reduce negative appendectomies. Histopathological examination of appendix still holds a valid role for any incidental findings requiring further management.
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Broad ligament ectopic pregnancy is a rare and serious form of extrauterine pregnancy with a high risk of maternal mortality. There are no specific clinical features. Ultrasonography may help in diagnosis, but definitive diagnosis is made only during surgery. Authors are reporting a case of 30 years female G3P1L1A1 seven weeks pregnancy with previous lower segment cesarean section and previous history of right sided salpingectomy with no complaints. Ultrasound was advised to know the location of sac this time, in which, she was diagnosed as a case right sided unruptured live ovarian ectopic pregnancy. On examination, signs and symptoms of ectopic pregnancy were absent. On laparoscopy, she was diagnosed as a case of right sided live unruptured broad ligament ectopic pregnancy as her right ovary was absent because of previous surgery. With advances in sonography and laparoscopic skills, more cases can be diagnosed in the first trimester and can be safely managed laparoscopically.
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Background: Swine flu is an infective disease caused by any one of the several types of Influenza viruses. The world saw its first pandemic of swine flu this century in the year 2009 when the WHO raised a world-wide pandemic alert to level 6 on June 11, 2009. In India, first few cases (index cases) of swine flu were reported from Pune, Maharashtra. The most recent outbreak of this dreaded infection was reported during late winter of 2015.Methods: The present study was retrospective study. In order to collect the data, we reviewed medical charts of patients who were hospitalized in our hospital during the study period. Diagnosis of swine flu was confirmed after sending the blood-samples to Government approved laboratories in Pune and Mumbai. Real time, Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) method was employed for serological diagnosis. Forty-five confirmed cases of swine flu were included in this retrospective study. The primary objective of this study was to highlight the differences in the clinical profile as well as outcome between the patients who survived the attack of swine flu and those who did not.Results: Forty-five of these patients tested positive for H1N1 amounting to a positivity rate of 52.94%. Cough (93.3%) was the most common symptom followed by fever (88.8%) and breathlessness (82.2%). Patients who did not survive were more likely to have associated co-morbid conditions like Hypertension, Diabetes, cardio-vascular disease, pre-existing lung disease and pregnancy though this was not statistically significant ( p=0.189). Acute Respiratory Distress Syndrome (ARDS), Multi-Organ Dysfunction (MOD) and secondary bacterial infections were among the most common conditions that lead to death.Conclusions: Early detection of swine flu through meticulous screening in the community with a high index of suspicion followed by prompt and adequate treatment can go a long way in preventing another pandemic. Creating awareness among the lay people about personal as well as public hygiene is also vital to prevent the spread of this viral illness.
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The paper assesses health of the tropical urban Robertson Lake, Jabalpur which receives domestic sewage from neighboring human inhabitation and is infested with water hyacinth. Peak density of this macrophyte was 12.5 t dw ha(-1). The water-column was anaerobic (0.6 to 1.9 mg O2 L(-1)), neutral in pH, and enriched with inorganic carbon (23.5 to 37.1 mg L(-1)), NH4-N (0.48 to 2.96 mg L(-1)), and organic nitrogen and phosphorus. Density of heterotrophic bacteria was high (6.8 to 15x10(5) cfu ml(-1)) along with that of total coliforms and fecal bacteria. Species diversity of phytoplankton and submerged macrophytes was very low. Growing stands of water hyacinth could store up to 613 g C m(-2), 23.5 g N m(-2) and 5.5 g P m(-2) and released them during decomposition. The release of nutrients was 3-4 times faster than the uptake. Water hyacinth stabilized water quality and provided substantial support to bacterial density, which in turn contributed significantly to its growth and nutrient dynamics. Turnover of water hyacinth was only 70-80%, adding approximately 175 t humus in the lake. The results denote poor health of the lake, characterized by low species diversity, fast shallowing, dominance of detritus food--webs, and the water unsuitable for human consumption.