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  • 1
    Online Resource
    Online Resource
    Ultrasound guided percutaneous catheter drainage of an appendicular perforation with large intraperitoneal abscess formation: an effective modality of management in selected cases
    Medip Academy ; 2019
    In:  International Surgery Journal Vol. 6, No. 6 ( 2019-05-28), p. 2219-
    Details
    In: International Surgery Journal, Medip Academy, Vol. 6, No. 6 ( 2019-05-28), p. 2219-
    Abstract: Appendicular pathology is a very common entity and appendicular perforation can present in various forms ranging from right lower abdominal pain, fever and anorexia to frank peritonitis with endotoxaemic shock. We present a 18 year female with fever, anorexia and a large upper and mid abdominal swelling of 2 weeks duration which after admission was treated with intravenous fluids, antibiotics, analgesics and antiemetics. Her CECT abdomen and pelvis revealed a huge fluid containing cystic lesion with a perforated appendix tip and intraluminal faecolith and calculi.  She underwent USG guided 10F pigtail catheter drainage of the walled off peritoneal collection on 3rd day of admission. About 700 ml of serous fluid with minimal flecks was drained within 2 hours and another 860 ml over next 3 days. The pigtail drain was removed on day 7 and she was discharged on day 9, with USG abdomen confirmation of complete disappearance of the abdominal collection. Ultrasound guided percutaneous catheter drainage of the appendicular abscess with IV antibiotics cures the patient in selected case scenario. 
    Type of Medium: Online Resource
    ISSN: 2349-2902 , 2349-3305
    URL: Article
    DOI: 10.18203/2349-2902.isj20192399
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2019
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  • 2
    Online Resource
    Online Resource
    Conservative management of an iliopsoas hematoma causing walking difficulty in an elderly patient on anticoagulation therapy: a case report
    Medip Academy ; 2019
    In:  International Surgery Journal Vol. 7, No. 1 ( 2019-12-26), p. 313-
    Details
    In: International Surgery Journal, Medip Academy, Vol. 7, No. 1 ( 2019-12-26), p. 313-
    Abstract: Spontaneous iliopsoas hematoma is a rare complication in patients suffering from bleeding disorders like hemophilia, Von Willebrand’s disease or those taking blood thinners like aspirin and clopidogrel or anticoagulant medications like warfarin for atrial fibrillation or post-thrombotic status. It can present as severe pain, muscle dysfunction, difficult walking or neurological dysfunction due to compression on femoral nerve or lumbar plexus. A high index of suspicion with early blood and radiological investigations like contrast enhanced computed tomography (CECT) or magnetic resonance imaging (MRI) of the part is immensely helpful in diagnosis and prompt management of such patients. A low hemoglobin or hematocrit level and a high INR is supportive while CECT or MRI of the abdomen and pelvis is confirmatory. Management in a hemodynamically and neurologically stable patient include immediate withdrawl of the anticoagulant, bed rest, infusion of I.V. fluids, vitamin K, fresh frozen plasma and packed red cell transfusion, which ensures complete recovery in most of the cases. However angio-embolization to control ongoing arterial bleeding is lifesaving when feasible or emergent open decompression and bleeding control surgery can save the life or prevent permanent neurological damage to the limb. Decompression of the hematoma by ultrasound or computed tomography guided catheter drainage is helpful alternative in few selected cases. We report an elderly patient on warfarin, who suddenly developed difficulty in walking within hours of a strained defecation, diagnosed to suffer from left iliopsoas hematoma and responded to conservative management with complete resolution of symptoms by 3 weeks.
    Type of Medium: Online Resource
    ISSN: 2349-2902 , 2349-3305
    URL: Article
    DOI: 10.18203/2349-2902.isj20195994
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2019
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  • 3
    Online Resource
    Online Resource
    Aspects of urinary tract infections and antimicrobial resistance in hospitalized urology patients in Asia: 10-Year results of the Global Prevalence Study of Infections in Urology (GPIU)
    Elsevier BV ; 2018
    In:  Journal of Infection and Chemotherapy Vol. 24, No. 4 ( 2018-04), p. 278-283
    Details
    In: Journal of Infection and Chemotherapy, Elsevier BV, Vol. 24, No. 4 ( 2018-04), p. 278-283
    Type of Medium: Online Resource
    ISSN: 1341-321X
    URL: Article
    DOI: 10.1016/j.jiac.2017.11.013
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
    detail.hit.zdb_id: 1481768-8
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  • 4
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    Online Resource
    Stapled hemorrhoidopexy versus Milligan-Morgan haemorrhoidectomy: a paradigm shift in the management of 3rd and 4th degree hemorrhoids
    Medip Academy ; 2017
    In:  International Surgery Journal Vol. 5, No. 1 ( 2017-12-26), p. 209-
    Details
    In: International Surgery Journal, Medip Academy, Vol. 5, No. 1 ( 2017-12-26), p. 209-
    Abstract: Background: Hemorrhoids being a common anorectal problem with its well known morbidity and complications is treated since long by conservative measures, injection sclerotherapy or rubber banding for 1st and 2nd degree and by open Miligan Morgan hemorrhoidectomy or closed Fergusson hemorrhoidectomy for 3rd and 4th degree. However, since 1998, the adoption of Stapled Hemorrhoidopexy has proved over time to be a better alternative in terms of lesser postoperative complication and an overall patient satisfaction.Methods: A prospective study conducted on 114 patients at Department of General Surgery, Kalinga institute of Medical Sciences, Bhubaneswar, Odisha from May 2014 to December 2016.Results: Our study showed stapled hemorrhoidopexy, significantly reduced the time taken for the operative procedure (p 〈 0.001), post operative pain (p 〈 0.01), hospital stay along with early return to work and a better patient satisfaction.Conclusions: Stapled hemorrhoidopexy is an effective alternative to open Miligan-Morgan procedure in treating 3rd and 4th degree hemorrhoids, in terms of lesser time taken for the operative procedure, post operative pain, use of analgesics, hospital stay and early return to work, better post operative patient’s satisfaction and reduced procedure related complication.
    Type of Medium: Online Resource
    ISSN: 2349-2902 , 2349-3305
    URL: Article
    DOI: 10.18203/2349-2902.isj20175897
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2017
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  • 5
    Online Resource
    Online Resource
    AN EMERGENT MANAGEMENT OF ACUTE SUPERIOR MESENTERIC ARTERY EMBOLISM WITH ILEAL GANGRENE
    World Wide Journals ; 2021
    In:  INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH
    Details
    In: INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, World Wide Journals
    Abstract: Acute mesenteric ischemia (AMI) occuring due to sudden, partial or complete interruption of blood ow in main visceral arteries of the abdomen eventually resulting in intestinal ischemia and/or bowel gangrene is a surgical emergency. It represents 0.1% of hospital admissions and 2% of the revascularization operations for atheromatous lesions. 50% of AMI is caused by embolic phenomenon, 25% by thrombotic episode and rest 25% by both. The most common vessel involved in AMI is superior mesenteric artery. Acute mesenteric embolic ischemia (AMEI) arises typically from a cardiac emboli in patients with atrial brillation or following MI. Patients usually presents with central abdominal pain, out of proportion to the physical ndings initially, later becoming diffuse associated with bloody diarrhoea during the episode. An early diagnosis, an aggressive resuscitation, intravascular or surgical restoration of blood ow and subsequent bowel resection based on bowel viability helps reduce morbidity and mortality.
    Type of Medium: Online Resource
    URL: Journal
    URL: Article
    DOI: 10.36106/ijsr
    DOI: 10.36106/ijsr/6403142
    Language: English
    Publisher: World Wide Journals
    Publication Date: 2021
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  • 6
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    Online Resource
    An evaluation of efficacy of Lichtenstein mesh hernioplasty in emergency settings: a study in tertiary care hospital in Odisha
    Medip Academy ; 2018
    In:  International Journal of Research in Medical Sciences Vol. 6, No. 5 ( 2018-04-25), p. 1761-
    Details
    In: International Journal of Research in Medical Sciences, Medip Academy, Vol. 6, No. 5 ( 2018-04-25), p. 1761-
    Abstract: Background: Despite the high incidence, the technical aspects of hernia repair continue to evolve making it the most common operations performed by general surgeons. Lichtenstein mesh hernioplasty repairs all hernias without distortion of the normal anatomy and with no suture line tension. This study was performed to evaluate the outcomes of Lichtenstein mesh herinioplasty in emergency inguinal hernia patients.Methods: A 84 patients were operated for complicated (obstructed irreducible) inguinal hernia. A follow-up period of 6 months using the Quantitative and Qualitative Measurement Instrument for evaluation of Lichtenstein hernioplasty outcomes was completed for 44 emergency patients.Results: The age incidence of the hernia patients in the study group was 40% (25-35 years) followed by 24% (15-25 years). The anatomical position of the hernia in the study group was to the right having a dominant percentage of 72% followed by left (24%) with none in bilateral. Early postoperative complications in mesh repair (Lichtenstein hernioplasty) comprising of factors like wound infection (10%), hematoma (5%), seroma (10%) was significantly lower compared to tissue repair with wound infection (20%), hematoma (5%) and seroma (25%). Further mesh rejection in Lichtenstein hernioplasty was 0% for the study population. Similarly, late postoperative complications in Lichtenstein hernioplasty comprising of factors like wound dehiscence (4%), neuralgia (27%) was significantly lower compared to tissue repair with wound dehiscence (27%), neuralgia (41%).Conclusions: The study revealed that the use of polypropylene prosthesis in the emergency setting (obstructed hernia) is safe and outcomes are satisfactory.
    Type of Medium: Online Resource
    ISSN: 2320-6012 , 2320-6071
    URL: Article
    DOI: 10.18203/2320-6012.ijrms20181775
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2018
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  • 7
    Online Resource
    Online Resource
    Hemobilia: an unusual and life threatening complication of laparoscopic cholecystectomy
    Medip Academy ; 2019
    In:  International Surgery Journal Vol. 6, No. 9 ( 2019-08-28), p. 3406-
    Details
    In: International Surgery Journal, Medip Academy, Vol. 6, No. 9 ( 2019-08-28), p. 3406-
    Abstract: Hemobilia though rare, occurs due to abnormal vascular and biliary communication established as a result of trauma, gallstones, neoplasms, inflammatory process and vascular disorders. It can rarely complicate a laparoscopic cholecystectomy as a result of hepatic artery injury, clip migration, clip erosion, diathermy and subsequent arteriobiliary fistula, or pseudoaneurysm eroding into the extra hepatic bile ducts. A 34 years female underwent laparoscopic cholecystectomy for cholelithiasis, suffered bile leak that settled on by 13th postoperative day, met with sudden right upper abdominal pain and hypovolemic shock on 15th postoperative day due to massive hemobilia arising out of rupture of pseudoaneurysm of the right hepatic artery into the biliary system. Urgent CT Angiography showed a large pseudoaneurysm of right hepatic artery branch with adjacent small collection, IHBR and CBD dilatation suggestive of hemobilia. Emergency CT guided trans-arterial hepatic artery embolization done to control hemobilia and save the patient. An immediate CT angiography for early diagnosis, in all postoperative laparoscopic cholecystectomy cases with suspicion of hemobilia due to an underlying hepatic artery pseudoaneurysm, followed by CT guided trans-arterial hepatic artery embolization forms the gold standard management in such patients.
    Type of Medium: Online Resource
    ISSN: 2349-2902 , 2349-3305
    URL: Article
    DOI: 10.18203/2349-2902.isj20194087
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2019
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  • 8
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    Online Resource
    A stress ulcer duodenal perforation complicating diaphragmatic rupture with multiple bone fracture in a polytrauma patient due to fall from a tree
    Medip Academy ; 2018
    In:  International Surgery Journal Vol. 5, No. 5 ( 2018-04-21), p. 1952-
    Details
    In: International Surgery Journal, Medip Academy, Vol. 5, No. 5 ( 2018-04-21), p. 1952-
    Abstract: Polytrauma in a 55 years male due to blunt trauma like fall from a height involving fracture of long bones, undisplaced fracture pelvis, fracture multiple ribs with a preliminary diagnosis of eventration of the hemidiaphragm in a apparently hemodynamically stable patient with a normal CT scan of brain, though poses a major physiological challenge, however runs a better prognosis. But with the passing of hours as patient develops respiratory distress and chest and abdomen CECT confirms a large lacerated hemidiaphragm with herniation of abdominal visceras occupying the hemithorax with lung collapse, alarms the gravity of the injury. An uncommon stress ulcer duodenal perforation on the 2nd day of admission with ensuing pyoperitoneum further threatens the hemodynamics and enhances the morbidity and mortality. This warrants an active and prompt action by multispecialty involvement. Emergency laparotomy to address the pyoperitoneum, closure of the duodenal perforation, reduction of the herniated abdominal visceras from the hemithorax, thorough saline lavage of the abdominal and involved chest cavity, placement of intrathoracic chest tube drain, repair of the lacerated diaphragm, placement of peritoneal cavity drains and closure of the abdomen settles the issue of damage control surgery in this case. Postoperative care in the ICU with ventilator support, higher antibiotics and supportive medications, repeated laboratory and radiological tests helps in overcoming the hemodynamic crisis in such critically ill patients. Our patient subsequently developed pneumonitis and had a postoperative protracted course in the ICU and finally shifted to the general ward on 7th day of his admission.  
    Type of Medium: Online Resource
    ISSN: 2349-2902 , 2349-3305
    URL: Article
    DOI: 10.18203/2349-2902.isj20181617
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2018
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  • 9
    Online Resource
    Online Resource
    Post COVID sequelae among COVID-19 survivors: insights from the Indian National Clinical Registry for COVID-19
    BMJ ; 2023
    In:  BMJ Global Health Vol. 8, No. 10 ( 2023-10), p. e012245-
    Details
    In: BMJ Global Health, BMJ, Vol. 8, No. 10 ( 2023-10), p. e012245-
    Abstract: The effects of COVID-19 infection persist beyond the active phase. Comprehensive description and analysis of the post COVID sequelae in various population groups are critical to minimise the long-term morbidity and mortality associated with COVID-19. This analysis was conducted with an objective to estimate the frequency of post COVID sequelae and subsequently, design a framework for holistic management of post COVID morbidities. Methods Follow-up data collected as part of a registry-based observational study in 31 hospitals across India since September 2020–October 2022 were used for analysis. All consenting hospitalised patients with COVID-19 are telephonically followed up for up to 1 year post-discharge, using a prestructured form focused on symptom reporting. Results Dyspnoea, fatigue and mental health issues were reported among 18.6%, 10.5% and 9.3% of the 8042 participants at first follow-up of 30–60 days post-discharge, respectively, which reduced to 11.9%, 6.6% and 9%, respectively, at 1-year follow-up in 2192 participants. Patients who died within 90 days post-discharge were significantly older (adjusted OR (aOR): 1.02, 95% CI: 1.01, 1.03), with at least one comorbidity (aOR: 1.76, 95% CI: 1.31, 2.35), and a higher proportion had required intensive care unit admission during the initial hospitalisation due to COVID-19 (aOR: 1.49, 95% CI: 1.08, 2.06) and were discharged at WHO ordinal scale 6–7 (aOR: 49.13 95% CI: 25.43, 94.92). Anti-SARS-CoV-2 vaccination (at least one dose) was protective against such post-discharge mortality (aOR: 0.19, 95% CI: 0.01, 0.03). Conclusion Hospitalised patients with COVID-19 experience a variety of long-term sequelae after discharge from hospitals which persists although in reduced proportions until 12 months post-discharge. Developing a holistic management framework with engagement of care outreach workers as well as teleconsultation is a way forward in effective management of post COVID morbidities as well as reducing mortality.
    Type of Medium: Online Resource
    ISSN: 2059-7908
    URL: Article
    DOI: 10.1136/bmjgh-2023-012245
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2851843-3
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  • 10
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    Online Resource
    EFFICACY OF LIGATION OF INTERSPHINCTERIC FISTULA TRACT (LIFT) PROCEDURE IN MANAGEMENT OF FISTULA-IN-ANO – A PROSPECTIVE OBSERVATIONAL STUDY
    World Wide Journals ; 2023
    In:  INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH
    Details
    In: INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, World Wide Journals
    Abstract: An anal stula is a common benign anal condition and its surgical treatment runs the risk of anal incontinence and recurrence rates. However, the Ligation of the intersphincteric Fistula Tract (LIFT) devised in 2007 results in zero sphincter damage and shorter hospital stay compared to conventional stulotomy. The study aimed to nd the efcacy of the LIFT procedure in patients suffering from trans-sphincteric stula-in-ano in terms of wound infection, anal incontinence, and recurrence rate. A prospective, observational study was carried out among 40 patients of either sex diagnosed with anal stula in the Department of Surgery, Kalinga Institute of Medical Sciences, Bhubaneswar over a period of about 2 years. Statistical analysis was done by student t-test. The mean age group was 42.48 ± 10.33 years and 90% were male. Out of all the trans sphincteric stula-in-ano, 82.5% were posterior & 60.6% were posterior left side while the rest were anterior. The mean duration was 54.88 ± 10.17 mins. On average, hospital stay was 4.65 ± 1.37 days and the mean time to wound healing was 2.80 ± 1.02 weeks. Anal continence was 100% preserved in all patients. Only 3 (7.5%) patients had recurrence as observed at 6 months of follow-up. The LIFT procedure is an effective surgical procedure in terms of preventing wound infection and anal incontinence. The hospital stay was less, with early wound healing and a low pain score.
    Type of Medium: Online Resource
    URL: Journal
    URL: Article
    DOI: 10.36106/ijsr
    DOI: 10.36106/ijsr/5422672
    Language: English
    Publisher: World Wide Journals
    Publication Date: 2023
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