ABSTRACT
BACKGROUND: Perforation of the bowel is the most serious complication of typhoid fever. The role of early limited surgery in managing these patients needs to be assessed. METHODS: The records of 110 cases of typhoid enteric perforation treated at JLN Hospital, Ajmer between 1990 and 1995 were reviewed. RESULTS: A total of 42.7% of the patients were in the 21-30-year age group, and 83.6% were male. All patients presented with the classic features of typhoid enteric perforation. A total of 83.6% were operated on within 36 h of perforation. Surgical management consisted of primary closure of the perforation (74.5%), closure with omental graft (14.5%), resection and anastomosis (3.6%), and only drainage (7.3%). A total of 79.1% of patients developed wound infection and 10% of patients developed faecal fistula. The overall mortality rate was 16.4%. Increasing the time interval between perforation and operation significantly increased the mortality (P < 0.05). The mortality was least with early primary closure of the perforation. Patients with postoperative faecal fistula had higher mortality rates (P < 0.001). CONCLUSIONS: Early limited surgery with thorough peritoneal lavage provides optimal results, faecal fistula is a grave complication, and the use of the McBurney incision may provide better results in terms of subsequent wound healing.
Subject(s)
Intestinal Perforation/microbiology , Intestinal Perforation/surgery , Typhoid Fever/complications , Adolescent , Adult , Age Distribution , Child , Child, Preschool , Female , Hospital Mortality , Humans , Intestinal Perforation/diagnosis , Male , Middle Aged , Rectal Fistula/etiology , Retrospective Studies , Sex Distribution , Surgical Wound Infection/etiology , Survival Analysis , Time FactorsABSTRACT
50 cases of breast malignancy constituted the study group. 26 age and sex matched formed the control group. Serum and tissue trace element viz copper, zinc, selenium and molybdenum levels were estimated by atomic absorption photometry. The study group showed significant hypercupremia and molybdenemia, hypozincaemia and hyposeleniamia. The reversal of trend was documented after therapy. The tissue level of copper and molybdenum was high and zinc and selenium was low. An association between serum and tissue level of trace element, stage, histological differentiation was observed. It was postulated that levels of trace elements may help in diagnosis and prognosis of disease.
Subject(s)
Breast Neoplasms/chemistry , Trace Elements/analysis , Breast/chemistry , Breast Neoplasms/diagnosis , Breast Neoplasms/therapy , Breast Neoplasms, Male/chemistry , Breast Neoplasms, Male/diagnosis , Breast Neoplasms, Male/therapy , Copper/analysis , Copper/blood , Female , Humans , Male , Molybdenum/analysis , Molybdenum/blood , Selenium/analysis , Selenium/blood , Trace Elements/blood , Zinc/analysis , Zinc/bloodABSTRACT
Seventy-three cases of bull horn injury from a predominantly rural population around Allahabad were admitted to our unit between 1966 and 1975. Injury to the deep viscera is uncommon and the possible explanations of this pattern of injury are discussed. The abdomen was the commonest site of injury with prolapse of loops of small intestine in 60 per cent of cases. Management differs from other penetrating abdominal wounds and simple cleansing and careful examination of the bowel is sufficient in those injuries with prolapse of the intestine.
