Medpulse International Journal of Surgery

Medpulse International Journal of Surgery

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  • Publisher: MedPulse Publishing Corporation
  • Country of publisher: india
  • Date added to EuroPub: 2019/Nov/07

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  • Language of fulltext: english
  • Time from submission to publication: weeks

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  • Waiver policy for charges? No

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  • Open Access Statement: No
  • Year open access content began: 2017
  • Does the author retain unrestricted copyright? False
  • Does the author retain publishing rights? False

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This journal has '266' articles

Relation between ABO blood groups and helicobacter pylori infection

Relation between ABO blood groups and helicobacter pylori infection

Authors: S Abhijit Sudhakar Shetty, Nawaz Shariff A, M S Mossabba
Year: 2017, Volume: 1, Number: 3
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Abstract

Background: Helicobacter pylori are spiral-shaped bacteria that grow in the digestive tract and have a tendency to attack the stomach lining. Helicobacter pylori infections are usually harmless, but they are responsible for the majority of ulcers in the stomach and small intestine. Aim: To record the distribution of helicobacter pylori infection in various ABO blood groups. Methodology: After ethical committee approval and informed consent, 100 patients selected prospectively who had epigastric pain. Endoscopy Biopsy, ELISA and Urease test was conducted. Blood groups of these patients will be collected from the file. Data analysis and results will be concluded. Results: In 100 patients with epigastric pain 58 were helicobacter pylori infected patients, 23 are O positive, 4 are O negative, 8 are A positive, 5 are A negative, 8 are B positive, 4 are B negative, 5 are AB positive, 1 are AB negative. Conclusion: H. pylori infection was common amongst people of O positive blood group.

Keywords: Helicobacter pylori, ABO blood group.
Comparative study between Phenytoin and Sucralfate dressing in diabetic foot ulcers

Comparative study between Phenytoin and Sucralfate dressing in diabetic foot ulcers

Authors: Sonali Prabhakar, Natasha Mathias, Moosabba M S
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Successful diagnosis and treatment of patients with diabetic foot ulcers involves a holistic approach that includes optimal diabetes control, effective local wound care, infection control, pressure relieving strategies, restoring blood flow. Phenytoin and sucralfate are drugs which have helped in wound healing and in filling of granulation tissue faster compared to other medicated dressings. In this study, we assess the efficiency of topical phenytoin compared to topical sucralfate in conventional wound care in improving the healing process in diabetic ulcers and prove that topical phenytoin and topical sucralfate can be used as relatively low cost, and is a better alternate in management diabetic ulcers. Methodology: This study is the comparison between the two types of dressings as to which is better. A randomised control trial was performed with 33 patients undergoing phenytoin dressing, 33 patients undergoing sucralfate dressing and rest 33 saline dressing. Daily dressings were done and the changes in the depth and width of the ulcers were considered. Results: Normal saline dressings reduced the size of the ulcer by 1.2x1.5cms, Phenytoin by 2.1x2.12cms and Sucralfate by 2.12x2.3cms respectively with the p value of 0.001, within the given period of time.

Keywords: Phenytoin, Sucralfate, Diabetic foot
A study of sociodemographic study of gall bladder disease at tertiary health care center

A study of sociodemographic study of gall bladder disease at tertiary health care center

Authors: Balaji D Dhaigude, Prithviraj Vivek Patil, Aditya B Patil, Yasaswi K, Varun Chauhan, Sagar Ambre
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Gallbladder disease (GBD) is the most common disorder of the biliary system. Other than ethnicity, advancing age and female gender are risk factors for gall bladder diseases. To identify risk factors in a given population, epidemiological studies must first define the frequency of disease. Hence, this sociodemographic study of Gall bladder disease was undertaken at a tertiary care center. Material and Methods: Thisprospective study was conducted on patients with gall bladder diseases in the Department of General Surgery at a tertiary care center. A detailed history of each patient was obtained along with clinical examination. Results: Majority of the patients (28%) were in the age group of 21-30 years followed by 24% in the age group of 31-40 years. The mean age of the patients was 44.04 ± 13.89 years. There were 68 (68%) female patients with male to female ratio of 1:2.12. Abdominal pain was present in all patients. Nausea and vomiting was observed in 96 patients while fever was the presenting symptom in 56 patients. Discussion: The prevalence of gallbladder disease at any point in time has advanced with the use of ultrasonographic investigations. These studies can better define important risk factors, both unchangeable and modifiable.

Keywords: Gall bladder disease, age, females, abdominal pain.
Bacteriological spectrum and antibiogram of cholelithiasis

Bacteriological spectrum and antibiogram of cholelithiasis

Authors: Balaji D Dhaigude, Prithviraj Vivek Patil, Aditya B Patil, Yasaswi K, Parth Patel, Nagendra Yadav, Firoz Alam
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Different microbes in the bile may be cause to post-cholecystectomy infections. Systemic bacteremia may occur in severe cases. Thus, understanding the most common organisms causing them and their antibacterial susceptibility pattern would be useful in prevention of these infections. The present study aimed to find outthe microbial flora in the bile of patients with cholecystitis and cholelithiasis and also to study their antibiotic susceptibility patterns. Material and Methods: A total of 100 elective cholecystectomy patients with gall bladder stones were included.Patients underwent laparoscopic or open cholecystectomy depending on their choice. Bile from removed specimen of gall bladder was aspirated and sent for culture and sensitivity to Microbiology department. Results: On culture and sensitivity test, 58% have positive growth while 42% has no growth. The most common bacteria isolated was E. coli (23%) followed by Klebsiella spp. (18%), Salmonella spp. (12%) and Shigella spp. (5%) E. coli showed high sensitivity to cefuroxime in 18 (78.3%) cases, whereas, others showed high sensitivity to ciprofloxacin. Discussion: Cholelithiasis is one of the most common diseases of gastrointestinal tract. The biliary tract is usually sterile; however, if cholelithiasis occurs, different microbes might be identified in and/or cultured from the bile or gallbladder wall. The most common bacteria of symptomatic cholelithiasis are E. coli and Klebsiellaspp. followed by Salmonella spp. and Shigella spp. and bile infectionplays a major role in the formation of pigmented gallstones.

Keywords: Cholelithiasis, bile culture, antibiotic sensitivity, E. Coli.
Comparative study of fistula in ano in primary closure and wound kept open

Comparative study of fistula in ano in primary closure and wound kept open

Authors: Manoj N More, Syed Faiyaz Ali
Year: 2017, Volume: 1, Number: 3
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Abstract

Objective: To compare the fistula in ano repair method by primary closure and wound kept open Design: A prospective comparative study of all patients with fistula in ano. Results: The primary closure method of fistulectomy is safe and feasible and equally effective in the management of fistula in ano in our comparative study of primary closure and open fistulectomy. The post operative pain score in primary closure group 60% less than open group. The aveage post operative healing period in closure group is 30% less than open group. The average post operative hospital stay in primary closure is 50% less than open group. There is100% success rate in closure group and 96.5% success rate in open group.

Keywords: Fistula in ano, primary closure.
Study of comparison between laparascopic and open repair for ventral hernia

Study of comparison between laparascopic and open repair for ventral hernia

Authors: Syed Faiyaz Ali, Manoj N More
Year: 2017, Volume: 1, Number: 3
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Abstract

Objective: To study the comparison between Laparascopic and open repair for ventral hernia. Design: A prospective comparative study of all patients with ventral hernia. Results: Although open repair requires less operative time as compared to laparoscopic ventral hernia repair, it (LVHR) has shown promising results and a clear advantage over open repair in regard with reduced post operative pain, decreased post operative complications, reduced length of hospital stay, and less time for return to normal activity and better cosmesis rates, with comparable recurrence rates. Hence, laparoscopic ventral hernia repair is a safe and feasible alternative to open repair, where expertise is available. The drawback in the study is that the time period for the assessment of recurrence rate is short and the cost of raw materials used for LVHR is higher as compared to open repair.

Keywords: Laparascopic, ventral hernia.
Clinicopathological pattern of benign breast diseases among female patients at a tertiary care center in India

Clinicopathological pattern of benign breast diseases among female patients at a tertiary care center in India

Authors: Anmod G L, Ganesh Swami, Aditya Deshpande
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Benign breast diseases are a heterogeneous group of lesions, that may present a wide range of symptoms. The accurate diagnosis of patients with benign breast diseases can be obtained by a combination of tests, these modalities when use together are more accurate, reliable and acceptable. This study was undertaken to evaluate the different types of benign breast lumps in females aged 15-45 years in the study area. The modes of clinical presentation, local ultrasonographic findings and pathologic findings were also studied. Material and Methods: This study was conducted on 150 female patients, aged 15-45 years, admitted with benign breast diseases. The clinical diagnosis was compared with the cytological or the histological findings and the accuracy of the clinical diagnosis was evaluated. Results: Painless lump was the commonest presentation. Fibroadenoma was the commonest in 91 (60.6%) cases and commonly seen in the 15-25years age group. The clinical diagnoses of the benign breast lumps were accurate in 81.2% cases. Discussion: A comprehensive approach to the diagnosis of benign breast diseases by using a combination of methods helps to reduce unnecessary apprehension of the feat of cancer to the patient and helps the surgeon to plan appropriate treatment of benign breast disease.

Keywords: Benign breast diseases, clinical diagnosis, Fibroadenoma, histopathology.
Bile culture and sensitivity in post cholecystectomy specimens

Bile culture and sensitivity in post cholecystectomy specimens

Authors: Abhijith Sudhakar Shetty, Sonali Prabhakar, Moosabba M S
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Without previous biliary intervention, most bile is considered sterile. However, with the presence of stones or obstruction, the likelihood of bacterial contamination increases. With nucleation of bile and gallstone formation, gallstones can provide a reservoir for bacteria, but the source of the bacteria is unclear. In that most bactobilia is caused by gram-negative aerobes, passage of bacteria upward from the duodenum into the biliary tree is a commonly held explanation for bacterial contamination. The most common types of bacteria found in biliary infections are Enterobacteriacae, such as Escherichia coli, Klebsiella, and Enterobacter, followed by Enterococcus spp. To cover the most common bacterial species, a first- or second-generation cephalosporin or fluoroquinolone should suffice. For those undergoing elective laparoscopic cholecystectomy for biliary colic, no antibiotic prophylaxis is necessary. However, antibiotics should be used for any patient with suspected or documented infection of the biliary tree, such as acute cholecystitis or ascending cholangitis, and should be chosen to cover gram-negative bacteria and anaerobes. Methodology: In this study we have collected bile aspiration samples from cholecystectomy specimens from 2 years from January 2015 to January 2017 and tabulated the organisms and culture sensitivity in Yenepoya medical College, Mangalore. Results: Among 76 patients, 52 bile culture was sterile. E.coli (6) and Klebsiella (4). The organisms were sensitive to Colistin (26.3%) and Imipenem (23.7%) accordingly. And a resistence for Amikacin and Gentamycin was noted as per the study conducted in Yenepoya University, Mangalore.

Keywords: Cholecystectomy, bile culture and sensitivity.
Role of laparoscopy in the diagnosis and management of nonspecific abdominal pain

Role of laparoscopy in the diagnosis and management of nonspecific abdominal pain

Authors: Ganesh Swami, Anmod G L, Gagan Dhal
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Patients withnonspecific abdominal pain undergo multiple, often costly, investigations. A definitive diagnosis is not always possible with non-invasive imaging tests. A delay in surgical intervention while further investigations are performed, may increase morbidity and prolong hospital stay. The diagnostic and therapeutic laparoscopy allows perfect visual examination of the peritoneal cavity and further makes histological diagnosis of target biopsy under vision possible. This study was carried out an analysis of change in the management of the patients after diagnostic laparoscopy, complications of the procedure during follow up period of 6 months after discharge. Material and Methods: A total of 50patients admitted with abdominal pain of less than 7 days duration where other clinical symptoms and investigations were not conclusive needing exploratory laparotomy were considered for diagnostic laparoscopy previous to the planned laparotomy. Results: Out of the 50 NSAP patients, 19 (38%) were male and 31 (62%) were females. Most of the patients were between 21-40 years age group. Diagnostic laparoscopy could identify pathology in 33 out of 50 patients. But, together with group B patients with no pathology identified, diagnostic laparoscopy alone could help diagnosing 41 i.e. 82% of the patients. These was no diagnostic laparoscopy related complications or morbidity. Discussion: Early diagnostic laparoscopy and treatment results in the accurate, prompt, and efficient management of acute abdominal pain. In patients with acute abdomen with no specific localization, without either perforation or intestinal obstruction on X-ray study, a median laparotomy is the classical approach to reach a diagnosis and treat the problem.

Keywords: Nonspecific abdominal pain, diagnostic laparoscopy, management, complications
Incidence of benign breast disorders presenting to surgery outpatient department in western Rajasthan – A prospective study of 100 cases

Incidence of benign breast disorders presenting to surgery outpatient department in western Rajasthan – A prospective study of 100 cases

Authors: Richa Purohit, Anuj Singh, Madan K, Abhijit Kumar, Chetan Sharma
Year: 2017, Volume: 3, Number: 1
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Abstract

Breast disorders are the most common disorders in females, with worldwide distribution, sparing no race or country. Benign breast conditions have further been compounded because of confusing terminology, inadequate classifications and poor correlation between clinical, radiological and pathological features. There is now an increasing interest in benign breast disorders, as the patient has become more aware of their problems, the investigations required and the treatment available for their symptoms. This has led to a more precise understanding of the clinical pictures associated with individual elements and the histological changes of cyclical nodularity are increasingly recognised as lying within the range of histological appearance in the normal breast. Spectrum of breast problems in India is different from that in the western world. Lactational breast mastitis abscesses and granulomatous lesions are more frequent in India. The purpose of present work is to study the profile of benign breast disorders in Indian patients.

Keywords: Benign Breast Disorders, Triple Assessment, Fibroadenoma.
Comparative assessment of outcomes following laparoscopic verses open splenectomy for paediatric haematological disorders

Comparative assessment of outcomes following laparoscopic verses open splenectomy for paediatric haematological disorders

Authors: Nitin Dnyaneshwar Sherkar, Nilesh Nagdeve, Vishal Tarale
Year: 2017, Volume: 3, Number: 1
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Abstract

Objectives: To compare the outcomes and to evaluate the safety and feasibility of laparoscopic splenectomy in children with haematological disorders as compared to open splenectomy. Methods: 65 patients underwent either laparoscopic(n=32) or conventional open splenectomy (n=33) during period of May 2010 to May 2015. The records of patients were evaluated for age, gender, hospital stay, time to start oral feed, conversion rate, operation time and post-operative course. Results: LS was performed in 32 patients with a mean age of 9.09±2.51years and OS was performed in 33 patients with a mean age of 9.24±2.62 years. The two groups were similar in terms of sex, age, diagnosis, duration of disease, preoperative platelet count, and spleen size. LS was associated with significantly longer operating time 127.65±29.75 vs. 67.05±9.30 minutes, LS was associated with significantly lower intra-operative blood loss 48.75±29.12 vs. 58.78±12.75 ml, less time of post-op mobilization 28.75±11.21 vs. 38.75±6.93 Hrs, lower total dose of analgesics requirement 5.28±1.83 vs. 6.10±1.39 days, more rapid resumption of oral diet 29.65±16.01 vs. 37.51±13.55 hours; and a shorter postoperative hospital stay 6.32±1.49 vs. 7.45±0.86 days. Conclusion: The laparoscopic approach to splenectomy is feasible and safe. Despite a longer operating time, the postoperative recovery following laparoscopic splenectomy is smoother, with lower morbidity and shorter postoperative hospital stay compared with open splenectomy.

Keywords: laparoscopic, open splenectomy.
Comparative study of management of pyogenic abscesses by primary closures versus incision and drainage

Comparative study of management of pyogenic abscesses by primary closures versus incision and drainage

Authors: Arun Dhankhar, Sunil Kumar Agrawal
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Pyogenic abscesses are one of the most common acute conditions in Surgical department, the standard treatment is incision and drainage. The aim of this study was to compare the conventional method of incision and drainage with an alternative method of primary closure with closed suction drain verus Incision and Drainage. Materials and Methods: A total of 40 patients admitted to the NIMS hospital were randomly divided into two groups: Closed group with 20 patients treated with primary closure with closed suction drain and open group with the conventional method of incision and drainage. Results: Closed group patients had lesser time to heal, lesser duration of hospital stay, lesser number of dressing changes, lesser pain during dressing change, and better scar than the open group. Conclusion: The method of incision, curettage, and primary closure with closed suction drain is more effective than conventional incision and drainage.

Keywords: Abscess, closures, healing.
Laparoscopic management of scar ectopic an unusual and interesting case report

Laparoscopic management of scar ectopic an unusual and interesting case report

Authors: Yogesh Shirgupe, Manisha Laddad
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Its an unusual and very interesting case of previous uterine scar ectopic pregnancy. Caesarean scar pregnancy is an ectopic pregnancy embedded in the myometrium at the site of a previous caesarean section. Reported incidence has increased over the last decade because of an increased rate of caesarean sections and increased levels of suspicion, ranging between 1:1800 and 1:2216 of all pregnancies. Ultrasonography and hysteroscopy provide useful information for diagnosis. Implantation of gestational sac at a site other than endometrial cavity is known as ectopic pregnancy. Now a days incidence of ectopic is increasing due to various reasons as IVF, infections but ectopic at a scar of previous LSCS is not very common. Suturing of edges at LSCS in monolayer or double layer, hemostasis, type of suture material used and most importantly stretching of scar subsequently either in pregnancy or MTP plays a important role in scar ectopic. I came across such a case of scar ectopic following 2 LSCS and 3 second trimester abortions.

Keywords: Pervious LSCS, Scar ectopic, Inj. Vasopressin.
Surgical management of carcinoma urinary bladder at tertiary care teaching hospital in central India

Surgical management of carcinoma urinary bladder at tertiary care teaching hospital in central India

Authors: Jayant Parwate, Brajesh Gupta, Vidhey Tirpude, Sanjay Dakhore, Pravin Bhingare
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Surgery a very important part of the management of invasive urinary bladder cancer, used mostly in the more classical approach (i.e. radical cystectomy with or without bladder reconstruction) or as a component of a combined-modality bladder-sparing approach (i.e. aggressive TURBT followed by chemotherapy or immunotherapy. In central India the scientific information on bladder cancer is limited, Hence this study was designed with objectives to focus on the various demographic parameter, clinical presentation, and surgical approaches according to stage mainly TURBT and Radical cystectomy with or without bladder reconstruction with early and late complications for carcinoma urinary bladder. Material and methods: Study design was a descriptive longitudinal study. A total 43 patients underwent the surgical management in the study period of 28 months. Out of which 18 cases underwent purely TURBT and 25 cases underwent other modality of management after TURBT procedure. Final data was tabulated and statistics (mean, t-test-values etc.) were used to compare outcome of various modalities. Summary and conclusion: Carcinoma urinary bladder mostly presents with haematuria in males smokers of 7th decade of age. Cyto-histopathological diagnosis and CT Abdomen and pelvis plays the most important role in staging and management of carcinoma urinary bladder. The use of TURBT for the management of carcinoma urinary bladder has shown fewer early and late complications in post operative period, while open radical approach with or without reconstruction shows more early and late post operative complications. Hospital stay was less with TURBT as compare to open radical cystectomy with or without reconstruction. With Cystoscopic TURBT and Radical cystectomy with or without bladder reconstruction carcinoma urinary bladder can be managed surgically depending on stage of presentation. Chemotherapy may be added as and when required.

Keywords: carcinoma urinary bladder.
Post endoscopic retrograde cholangiopancreatography optimal timing for laparoscopic cholecystectomy

Post endoscopic retrograde cholangiopancreatography optimal timing for laparoscopic cholecystectomy

Authors: Mirza Faraz Beg, Sunil Kumar Agrawal, Arun Dhankhar
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) makes up the current way of treating disease in patients with common bile duct (CBD) stones. The best period of time between ERCP and LC is atopic of debate. Methods: A total of 50 patients went through LC following ERCP from January 2016 to December 2017. Out of these, 28 patients had surgery within 3 days post ERCP (early) and 22 patients had surgery beyond3 days following ERCP (delayed). A prospective observational study of different technical problems encountered (conversion rate, operative duration, need for drain, bile duct injuries, frozen Calot’s, and adhesions) was done and compared. Results: The incidence of cystic duct injury, adhesions, need for drain placement, frozen Calot’s and the mean operative duration and postoperative stay were much higher in the delayed group. The conversion rate though higher is not statistically significant. Conclusion: The longer the interval between ERCP and LC, the higher are the chances of meeting difficulties and the riskof conversion to open technique as well as the need for increasedhospital stay following surgery. Early LC following ERCP is feasible and safe with short hospital stay.

Keywords: Endoscopic retrograde, cholangiopancreatography; Laparoscopic cholecystectomy; Choledocholithiasis; Common bile duct stones.

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