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Bhamre, Sudhir D.
- Evaluation of the Mannheim’s Peritonitis Index in Predicting Mortality in Patients with Perforative Peritonitis
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1 Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik, IN
2 Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IN
1 Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik, IN
2 Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IN
Source
MVP Journal of Medical Sciences, Vol 1, No 2 (2014), Pagination: 67-70Abstract
Aim: To study the applicability of the Mannheim's peritonitis index in predicting mortality in patients with perforative peritonitis.
Methods: A total of 50 patients diagnosed as perforative peritonitis based on history, clinical examination, and plain skiagram abdomen erect antero-posterior view were studied. The Mannheim's peritonitis index was calculated at first laparotomy.
Results: Overall post-operative mortality rate was 10%. Middle age population (35-55 years) was predominantly affected (48%) with male preponderance (75%). Peptic ulcer perforation was the most common cause of peritonitis. Malignant perforation of hollow viscus accounted for only 4% of cases. Mean MPI Score of survivors was 22.04, and that of non survivors was 33.2. Mortality rate was highest in patients with high MPI Score.
Conclusion: Mannheim's peritonitis index is easy to use, with all variables easily available at first laparotomy, with reproducible results and is a reliable predictor of mortality.
Keywords
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- A Prospective Study to Observe the Results and Complications of Lateral Internal Sphincterotomy in Anal Fissure
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PDF Views:104
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MVP Journal of Medical Sciences, Vol 2, No 2 (2015), Pagination: 81-84Abstract
Aim: To observe the results and complications of lateral internal sphincterotomy in anal fissure. Materials&Methods: The study was carried out as a prospective observational study of 40 patients at surgery department of a medical college&tertiary health care center, over a period of two years that included cases of anal fissure in the age group of 16 years and above for conservative&surgical management. Results: The recovery of the patient after this marvellous operation was fast and the pain relief was dramatic. On follow-up at 2 weeks post-operatively pain and other symptoms were present only in 11 patients (27.5%). On follow-up at 8 weeks post-operatively all 40 patients (100%) were symptom-free in this study. The complications that were observed within time frame of this study were Soiling in 4 patients (10%) and incontinence to flatus in 1 patient (2.5%). There was no recurrence of anal fissure observed in this study group within the time frame of this study. Conclusion: It is very evident from the above study that 'Lateral Internal Sphincterotomy' is by far the best operation for an indolent anal fissure.Keywords
Anal Fissure, Complications, Lateral Sphincterotomy.Full Text
References
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- Keck JO, Remond J, Coller, et al. Computer generated profiles of anal canal in fissure. Dept of colon and rectal surgery, Lahey clinic, Massachusetts. Dis colon rectum 1995; 38:72-9.
- Xynos E, Chrysos E, et al. Anal manometry in patients with fissure in ano before and after internal sphincterotomy. Colorectal disease. 1993; 8(3):125-8.
- Notaras MJ. The treatment of anal fissure by lateral subcutaneous internal sphincterotomy- a technique and results. Br J Surg. 1971; 58:96-100.
- Notaras MJ. Fissure in ano- Lateral subcutaneous Sphincterotomy. 3rd ed. Todd IP (Ed). Colon rectum and anus. 354-60.
- Garcea G, Sutton C, Mansoori S, Lioyed T, Thomas M. Results following conservative lateral sphincterotomy for the treatment of chronic anal fissures. Colorectal Dis. 2003; 5:311-4.
- Howley PR. Treatment of chronic anal fissure. A trial of Methods. Br J Surg. 1969; 56:915-8.
- Anorectal Surgery- Jerome J Decosse, Ian P Todd. Clinical surgery international. 15: 1-8, 20-43, 56-93.
- Collopy B, Ryan P. Comparison of lateral sphincterotomy with anal dilatation. Med J Australia. 1979; 2:461-2.
- Jensen SL, Lund F, Neilsen OV, Tange G. Lateral subcutaneous sphincterotomy versus anal dilatation in the treatment of fissure in ano in out patients: a prospective randomized study. BMJ (Clin Res Ed). 1984; 289:528-30.
- Goligher JC. An evaluation of internal sphincterotomy and simple sphincter stretching in the treatment of anal fissure. Surg Clin North Am. 42:1299,1965.
- Hoffman DC. Lateral subcutaneous Sphincterotomy in treatment of anal fissure. Br Med J. 1970; 3:673-75.
- Abcarian HMD. Lateral internal sphincterotomy. A new technique for treatment of chronic fissure in ano SCNA. 1975; 55-143.
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- Clinical Profile of Patients with Renal Calculi in a Tertiary Care Centre
Abstract Views :215 |
PDF Views:90
Authors
Affiliations
1 Department of General Surgery, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik - 422003, Maharashtra, IN
1 Department of General Surgery, Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Nashik - 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 4, No 2 (2017), Pagination: 126-134Abstract
Aims: To study the clinical profile of patient diagnosed with renal calculi. To study various Ultrasonographic findings of renal calculi. To study early complications associated with various management techniques. Materials and method: Total of 73 subjects will be included in present study after they satisfy inclusion and exclusion criteria. Intra and post operative complication if any was noted. Results: Ureter is the most common site of renal calculi followed by renal pelvis. complications with minimal invasive procedures is less as compare to open surgical procedure group with shorter hospital stay as early return to work. Conclusions: Ureter being the most common site, URSL was the most common intervention performed followed by PCNL. As compared to open techniques; in minimal invasive procedures rate of post interventional complications, duration of analgesics and days of hospital stay are low, improving the patient acceptance of the procedures.Keywords
Profile, Renal Calculi, Tertiary Care Centre.Full Text
References
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- A Clinical Study of Cholelithiasis at a Tertiary Health Care Centre
Abstract Views :372 |
PDF Views:103
Authors
Affiliations
1 Professor and Head, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
1 Professor and Head, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 6, No 2 (2019), Pagination: 109-113Abstract
Introduction: Cholelithiasis is the most common disease state involving the gallbladder and biliary tree. Gallstones become symptomatic only when they obstruct a visceral structure. In developing countries, there exists a trend toward an increasing prevalence of the risk factors for gallstone disease. Materials and Methods: Cases were selected after applying inclusion and exclusion criteria. Thereafter data collection was done by meticulous history taking, clinical examination, appropriate laboratory and radiological investigations, operative findings, and post operative evaluation of cases. Results: This study comprised of 52 cases. Female to male ratio was 15:11. The most common presenting complaint was pain in abdomen in 49 (94.23%) patients. On clinical examination most common sign was tenderness in 48 (92.31%) patients. Abdominal ultrasonography showed gallstones in all cases. Either laparoscopic or open cholecystectomy was performed. Complications included wound infection, haemorrhage, and bile duct injury. On histo-pathological examination the most common finding was chronic Cholecystitis seen in 39 (75.00%) cases. Conclusion: The incidence of disease was more in females. The most common complaint was pain and the most common sign was tenderness. Abdominal ultrasonography should be imaging study of choice for suspected cases of cholelithiasis. Laparoscopic cholecystectomy is the procedure of choice.Keywords
Cholecystectomy, Cholelithiasis.Full Text
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- A Study of Microbial Profile and Drug Resistance Pattern in the Patients with Diabetic Foot at a Tertiary Health Care Center
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Authors
Affiliations
1 Department of General Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
1 Department of General Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
Source
MVP Journal of Medical Sciences, Vol 7, No 1 (2020), Pagination: 9-15Abstract
Introduction: Diabetic Foot Ulcer (DFU) is a serious and common complication of Diabetes Mellitus (DM). India has been called “the diabetes capital of the world.” The most common cause of morbidity and mortality in DFU is infections. Diabetic foot wounds are commonly infected, and infection leads to the formation of microthrombi causing further ischemia, necrosis, and progressive gangrene. These types of situations necessitate limb amputation. Thus, accurate diagnosis of the causative organism is essential for the management of these cases. Aims and Objectives: To Study microbial profile as well as drug resistance pattern in the patients having diabetic foot at a tertiary care center. Methodology: Approval from institutional ethical committee was obtained. 62 patients of diabetic foot were selected for the present study over 1 year. Wound discharge culture and antibiotic sensitivity testing were carried out using standard microbiological procedures. Result: In the study carried out it was observed that the majority of the patients fell under the age group consisting of those >60. The most common organism was Staphylococcus followed by Streptococci, Enterococcus. Gram positive organisms were most commonly sensitive to Vancomycin. Gram negative organisms were susceptible to Piperacillin-Tazobactum. Maximum resistance was found to be for Gentamycin. Conclusion: From the study it can be conclusively noticed that majority patients belonged to the age group consisting of >60 Yrs. Gram positive organisms showed highest sensitivity to Vancomycin. In case of Gram negative organism’s antibiotic with highest sensitivity was Piperacillin-Tazobactam. Gentamicin was the drug with highest resistance. This resistance pattern to various pathogens in our study will be helpful in treatment of Diabetic foot in future.Keywords
Diabetic Foot, Diabetic Foot Ulcer (DFU), Drug Resistance PatternFull Text
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