Safe and Feasible Time Limit for Early Appendectomy in Appendiceal Mass.

Background Early appendectomy in appendiceal mass is gaining popularity among some surgeons. However, it is endowed with increasing operative difficulty with time, and safe and feasible timing is not yet clear. Objective To know safe and feasible time limit for early appendectomy in appendiceal mass. Method This is a retrospective study. Between May 2009 and July 2014, 114 patients of appendiceal mass who underwent early surgical intervention by a single surgeon were studied. Group I included 98 patients operated within seven days of onset of pain and group II included 16 patients operated between 8th and 15 days of pain. Type of operative procedure, difficulties and complications were analyzed. Result There were 58 men and 56 women. Their mean age was 24.27 ± 8.7 years. In group I, 98 (100%) patients had appendectomy and adhesiolysis was safe and feasible. In group II, 5(31.25%) patients had extra-peritoneal drainage of abscess without attempt for appendectomy. Remaining 11 patients had attempt for appendectomy, but only 3(18.75%) out of 4 patients operated on the 8th day could have appendectomy. Six (37.5%) patients had just drainage of abscess. Two (12.5%) patients, operated on the 12th and 15th days of pain had just open-closed due to dense adhesion and both resolved. One patient operated on the 10th day sustained ileal injury. Surgical site infection occurred in 16.6% (14 in 86) in group I and 33.3% (5 in 15) in group B (P= 0.001). Mean operative time was 34.4 ± 9.23 minutes and 43.7 ± 16.38 minutes for group I and group II respectively. Mean hospital stay after surgery was 2.9 ± 1.1 days and 5.5 ± 1.37 days in group I and group II respectively. Conclusion Early appendectomy in appendiceal mass seems safe and feasible up to 7th day since onset of pain in my experience. However, this limit may vary with surgeon's experience, and further studies are required to better clarify this issue.

Retrospective analysis of management of patients presenting with acute urinary retention due to benign prostatic hyperplasia: a hospital based study.

OBJECTIVES: To analyze current practice of management of acute urinary retention (AUR) in men above 40 years of age at B.P.Koirala Institute of Health Sciences, Nepal. MATERIALS AND METHODS: A total of 68 patients (aged 50-91 years) presenting with indwelling catheter for AUR were included in the study. Because of lack of clear guideline and limited health care facility in our setup trial without catheter (TWOC) was given selectively depending mainly on preexisting symptoms. AUR presumed to be due to urinary tract infection received only antibiotic and others diagnosed of benign prostatic hyperplasia (BPH) received alpha 1 blocker prior to TWOC. TWOC was given 3-15 days after such treatment. Those satisfied without catheter for at least a week were considered successful TWOC. RESULTS: The data was available for 68 patients (mean age 66.1 years). Of 15 patients treated with antibiotic alone, 11 (73.3 %) had successful TWOC. Of 57 with presumptive diagnosis of BPH, 68.9% (31 of 45) had successful TWOC. Mean age, symptom score and prostate volume were higher for patients with unsuccessful TWOC. CONCLUSION: Selective TWOC may be imperative to minimize unnecessary suffering from AUR in less easily accessible health care facilities like ours. It may also reduce total cost of treatment.

Effect of pregnancy on body weight and pelvic conformation in crossbred cows (Friesian x Gir and Jersey x Gir).

Studies were conducted into 80 pregnant crossbred cows belonging in equal numbers to 1/2Friesian (F) 1/2Gir (G) and 1/2Jersey (J) 1/2G genetic groups to determine the effect of pregnancy on body weight (B.W.) and pelvic conformation of the dam. Mean B.W. started to increase in 1/2F1/2G/1/2J1/2G genetic groups from 406.08 +/- 6.16/375.45 +/- 7.73 kg on the 120th day of pregnancy and reached its maximum of 470.42 +/- 7.22/428.05 +/- 8.36 kg on the day of calving. A significant increase in weight occured in both groups between the 240th and 270th days of pregnancy. Total weight gain in both groups during pregnancy was 63.34/52.60 kg. There was a steep fall (P less than 0.01) in B.W. in both groups, within 1 month after calving. Weight became stable 60 days after calving in both groups. The cows in the 1/2F1/2G group were significantly heavier (P less than 0.01) than the 1/2J1/2G group, all the time. The mean pelvic outlet area started to increase in 1/2F1/2G/1/2J1/2G groups from 278.28 +/- 4.03/249.29 +/- 5.02 cm2 by the 120th day of pregnancy. Like B.W., the pelvic area, too, increased significantly (P less than 0.01) between the 240th and 270th days of pregnancy and dropped within 1 month post partum in both groups. Total increase in pelvic area was 49.15/39.76 cm2 in both groups, between the 120th day of pregnancy and calving. The area became stable 60 days after calving in both groups. The pelvic area in the 1/2F1/2G group was always significantly larger (P less than 0.01) than that in the 1/2J1/2G group.(ABSTRACT TRUNCATED AT 250 WORDS)

A note on post partum utero vaginal prolapse in Gir cows: estimation of serum calcium, phosphorus, proteins, and cholesterol.

Reported are results obtained from determination of calcium, phosphorus, protein, and cholesterol in blood serum of 10 Gir cows with uterine prolapse. Particular reference is made to possible adverse effects of hypocalcaemia in conjunction with physiological stress resulting from pregnancy and parturition.

Prenatal mortality and its effects on subsequent fertility in purebred and crossbred Gir cows.

A study was conducted on 851 cows (Gir cows and their crossbreeds) between 1971 and 1984 at the Livestock Farm of the All India Coordinated Research Project on Cattle in Jabalpur, India. The cows were impregnated with frozen or fresh semen from 90 bulls and a total of 2699 pregnancies resulted. An overall incidence of prenatal mortality was recorded at 4.89%. A significantly higher (P / 0.01) incidence of prenatal mortality was encountered in three breed crosses in comparison with Gir cows and their first generation crossbreeds. Parity of dam had no effect on prenatal mortality. However, effects of season and individual sires on prenatal mortality were documented. It was observed that reproductive performance was improved significantly after prenatal mortality.

Effect of polyols and lipids on buffalo spermatozoal survival at 5 degrees C and -196 degrees C.

Six semen samples were obtained from each of the four healthy Murrah buffalo bulls and preserved at 5 degrees C up to 72 h in EYC diluter treated with glycerol (5, 7, 9 and 11%), mannitol (0.5, 1.5 and 3%), sorbitol (1, 2 and 4%), lecithin (1, 2 and 3%) and cholesterol (0.5, 1 and 2.5%). EYC diluter with semen (1:20) was kept as control. Individual motility of the spermatozoa was scored at 3, 24, 48, and 72 hours after dilution of the neat semen. By completion of 72 hours the efficiency of various treatments over control was in order of 1 and 2% lecithin, 5% glycerol/3% lecithin, 7% glycerol, 1% sorbitol and 0.5% mannitol. Mannitol and sorbitol improved the sperm motility at initial preservation phase, while glycerol at this phase depressed the motility. Lecithin at 1 and 2% levels revealed encouraging results for all the periods. Semen samples diluted in EYC with 5 and 7% glycerol were frozen up to -196 degrees C. Glycerol at 7% level yielded better post thawed revival. There appeared to be bull variation with respect to ultra-low temperature preservation.