scholarly journals Appendicular Mass: A Conservative Approach

2016 ◽  
Vol 5 (2) ◽  
pp. 47-50 ◽  
Author(s):  
Ashok Koirala ◽  
Dipendra Thakur ◽  
Sunit Agrawal ◽  
Kamal Raj Pathak ◽  
Manoj Bhattarai ◽  
...  

Introduction Appendicular mass is one of the most common complications following acute appendicitis and seen in 2-6% of the patients. The treatment of appendicular mass is controversial with three general approaches. The aim of this study is to evaluate outcome of conservative approach.Material & Methods A retrospective analysis of the patients managed with appendicular mass from 1st January to 31st December 2014 was carried out in NMCTH, Biratnagar. A total of 173 patients with diagnosis of appendicular mass admitted in emergency and OPD of our hospital were studied. All age groups and both sex were included.Results Out of 496 patients with appendicitis, 173 patients [34.87%] were diagnosed with appendicular mass. Age range of the patient in the study varied between 4-84 years and maximum patients found in the age group of 21-30 years. Onset of symptoms was between 2-6 days and greater number of patients reporting between 5-6 days. During study period 10(5.7%) patients came with recurrence, 9 [5.2%] developed abscess, 35(20.23%) patients came for interval appendicectomy, whereas 119 [68.78%] failed to come for a follow up.Conclusion Our study concluded that the appendicular mass can be managed successfully by conservative approach, although few complications may arise which can be managed by surgical intervention.Journal of Nobel Medical College Vol.5(2) 2016; 47-50

2018 ◽  
Vol 7 (2) ◽  
pp. 39-43
Author(s):  
Ashok Koirala ◽  
Dipendra Thakur ◽  
Sunit Agrawal ◽  
Bhuwan Lal Chaudhary ◽  
Sagar Poudel

 Background: Acute appendicitis is very common surgical cause of acute abdomen and needs surgical removal either by laparoscopic or open appendicectomy. The aim of this study is to compare frequency of surgical site infection (SSI) in patients undergoing laparoscopic and open appendicectomy. Materials and Methods: The study was prospective study conducted in NMCTH, Biratnagar. Total 200 patients with diagnosis of acute appendicitis admitted through the emergency department of our hospital were included in the study. The patients were randomly allocated in two groups: Laparoscopic appendicectomy group (LA) and Open appendicectomy group (OA). Both groups underwent successful emergency appendicectomy. Wound infections in terms of surgical site infection (SSI) if present were recorded. All age groups and both sexes were included.  Results: Two hundred patients underwent appendicectomy, one hundred Laparoscopic appendicectomy (LA) and another hundred open appendicectomy (OA). The mean age of patients with acute appendicitis was 30.63±16.14 years with minimum of 6 years and maximum of 77 years. The highest number of patients were in age group of 10 to 20 years (29.5%). In LA group SSI noted in 3 patients (3%) whereas in OA group it was found in 12 patients (12%). Conclusion: Laparoscopic appendicectomy is better and offers great advantages in terms of SSI as compared to Open appendicectomy.  


Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 324
Author(s):  
Ho-Seok Oh ◽  
Sung-Kyu Kim ◽  
Hyoung-Yeon Seo

To investigate the incidence and characteristics of osteoporosis and osteoporotic fractures in Korea, we used the Health Insurance Review and Assessment Service (HIRA) database. Patients over 50 years old, who were diagnosed or treated for osteoporosis and osteoporotic fractures in all hospitals and clinics, were analyzed between 1 January 2009 and 31 December 2017 by using the HIRA database that contains prescription data and diagnostic codes. These data were retrospectively analyzed by decade and age-specific and gender-specific incidents in each year. We also evaluated other characteristics of patients including medication state of osteoporosis, primary used medical institution, regional-specific incidence of osteoporosis, and incidence of site-specific osteoporotic fractures. The number of osteoporosis patients over 50 years old, as diagnosed by a doctor, steadily increased from 2009 to 2017. The number of osteoporosis patients was notably greatest in the 60′s and 70′s age groups in every study period. Patients undergoing treatment for osteoporosis increased significantly (96%) from 2009 to 2017. Among the patients diagnosed with osteoporosis, the proportion who experienced osteoporotic fracture increased gradually (60%) from 2009 to 2017. The number of patients with osteoporotic fractures of the spine and hip was highest in the 70 to 90 age range, and the number of patients with osteoporotic fractures in the upper and lower extremities was highest in the 50 to 70 age range. Understanding the trends of osteoporosis in Korea will contribute to manage the increased number of patients with osteoporosis and osteoporotic fractures.


PEDIATRICS ◽  
1951 ◽  
Vol 8 (3) ◽  
pp. 349-361
Author(s):  
GERARD GROS ◽  
ARMOND GORDON ◽  
ROBERT MILLER

The ECGs of 104 normal children from a few hours old to 5 years of age were studied. These ECGs consisted of the standard limb leads, the aV limb leads and six precordial leads: V4R, V1, V2, V4, V5 and V6. While the number of cases in each group are small, the following conclusions are suggested by this study: 1. ECGs of the newborn infant present important variations from those seen in later life. This is especially true during the first week of life. Thereafter the contour evolves [SEE FIG. 2 IN SOURCE PDF] in a definite manner until the adult-like pattern is reached. 2. The vertical and semivertical "electric" positions were the most frequently encountered in this age group. 3. P-waves present a rather permanent pattern in this age range: a. is usually upright in lead 1 and 2, aVF, V4, V5 and V6. b. is usually inverted in lead 2 and aVR. c. is either upright, inverted or diphasic in lead 3, aVL, V4R, V1 and V2. 4. The P-R interval varies from 0.10 sec. minimum to 0.16 sec. maximum with the average being 0.12 sec. in this age range. It tends to become greater in the older age groups. 5. QRS duration is shorter in the younger age groups and increases slowly with age. 6. Polyphasic, M-shaped or slurred QRS complexes are not uncommon in the ECGs of normal children in this age range. 7. A Q wave is frequently absent in lead 1 and in all chest leads during the first week of life. Thereafter up to 5 years of age the pattern of the Q wave is as follows: a. Q is generally absent in lead 1, V4R, V1, V2 and V4. b. Q is generally present in lead 3, V4R, aVF, V5 and V6. 8. There is a distinct pattern of right ventricular dominance in leads from the sternum and to its right at birth. This pattern gradually undergoes involution, probably related to normal physiologic development, until the left ventricle becomes dominant. Thus the evolution of the S-wave parallels a gradual involution of the R-wave in right precordial leads and probably also in aVR. This dominance of the left ventricle over the entire precordium is usual by about 3 years, but may be delayed normally until 5 years of age. 9. The T-wave is upright or diphasic in V4R, V1, and V2 and inverted in V5 and V6 for the first 24 hours of life; it gradually alters so that by the fourth day it is inverted in V4R, V1 and V2 and upright in V5 and V6 and thereafter. 10. The transition zone of QRS varies from one age group to another and tends in some ages to be broad. In some instances no real transition zone can be determined.


Author(s):  
Sreelakshmi U. ◽  
Tushara Bindu V. ◽  
Subhashini T.

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management. 


2016 ◽  
Vol 5 (2) ◽  
pp. 26-28
Author(s):  
Zubaida Gulshan Ara ◽  
ASM Shafiqul Islam ◽  
Umme Kulsum Sharmin Zaman ◽  
Anjuman Ara ◽  
Reeva Aireen Busreea

This cross sectional descriptive study was done to see the length of the cervix in Bangladeshi cadaver to find out the anatomical variation and to compare it with other study findings. 60 post mortem specimens containing female genital organs particularly uterine cervix were collected by purposive sampling technique from cadavers of different age groups. All the collected specimens were fixed in 10% formalin solution. This study was carried out in the department of Anatomy, Mymensingh Medical College from July 2006 to June 2007. Both gross and fine dissections were performed to measure the length of the uterine cervix. We compare our study findings with that of the references. Maximum mean length of the cervix was found in the 13-45 years age group. It was 2.89 cm. CBMJ 2016 July: Vol. 05 No. 02 P: 26-28


2020 ◽  
pp. 80-82
Author(s):  
Shweta Shah ◽  
S.K. Suri ◽  
Ami Shah

Background: Most frequently performed gynaecological surgery is hysterectomy. The prevalence of hysterectomy varies within different regions. There are mainly two types of hysterectomies according to which part of uterus is removed. The main types of hysterectomy are total and subtotal or partial hysterectomy. The hysterectomy can be performed by three routes abdominal, laproscopic and vaginal hysterectomy. The main objective of our study is to know most common pathology and different age groups of the patients underwent hysterectomy. Materials and Methods: In this retrospective study was carried during period 6 months, at GCS medical college, hospital and research centre, Ahmedabad. Total 100 hysterectomy specimens were analyzed for histopathological lesions. We had taken the clinical and histopathological findings of these cases from the records of department of pathology, GCS medical college , hospital and research centre. Results: In our study of 100 cases, most common age group underwent hysterectomy was 40-49 years and least common age group was 20-29 years. Type of hysterectomy performed most commonly in this study was total abdominal hysterectomy with bilateral salpingoophorectomy. Most of lesions were seen in the myometrium 42 cases (42%), Endometrium 32 cases (32%), Cervix 16 cases (16%) and Ovary 10 cases (10%). Hysterectomy remains the widely used treatment modality.


Author(s):  
Kovalevsky A.M. ◽  
Nikitenko V.V. ◽  
Potockaya A.V.

As an outpatient appointment, 347 patients (185 men and 162 women) who first sought dental care for chronic generalized periodontitis were examined in the therapeutic department of the Dentistry clinic of the Kirov Military Medical Academy. All patients were divided into three age groups: 40-45 years, 46-50 years, 51-55 years. There were no patients younger than 40 years old and older than 55 years old among the examined ones. When analyzing the results of the examination of patients, it was revealed that the largest number of patients belongs to the age group of 40-45 years (49.3±2.7% of all examined), on the second place was the age group of 46-50 years – 127 (36.6±2.6% of all examined) people (p<0.001), the smallest the group of patients was 51-55 years, 49 (14.2±1.9% of all examined) people (p<0.001). There were no large differences in the number of patients by gender between the age groups (p>0.05). Mild chronic generalized periodontitis prevails among the examined patients (65.1±2.6%, p<0.001). The mild severity of chronic generalized periodontitis was recorded in 121 (65.4±3.5%) of the 185 men, among 162 women – in 106 (64.8±3.8%). Chronic generalized periodontitis of moderate severity was detected in 42 (22.7±3.1%) men and 38 (23.5±3.3%) women. Finally, 22 (11.9±2.4%) men and 19 (11.7±2.5%) women went to the therapeutic department of the dental clinic with severe chronic generalized periodontitis. Thus, there were no large differences between the sexes in the number of patients with different degrees of severity of chronic generalized periodontitis (p>0.05).


Author(s):  
Pankajkumar B. Nimbalkar ◽  
Jaldhara N. Patel ◽  
Nilesh Thakor

Background: Timely induction of labour could reduce maternal mortality and morbidity as well as assure a delivery of healthy baby. The objective of this study was to evaluate the efficacy of Misoprostol as a cervical ripening agent and its comparison with Dinoprostone gel in terms of success rate, safety, side effects and patient compliance.Methods: A total of 250 pregnant women requiring induction of labor were recruited. Out of 250 cases, 150 were induced with 50 microgram Misoprostol and 100 cases with 0.5 mg intracervical Dinoprostone gel during September 2014 to August 2017 at the department of Obstetrics and Gynaecology, GMERS Medical College, Dharpur-Patan. Written and informed consent was taken from the patients. Outcome measures, such as change in Bishop's score, need of augmentation, induction delivery interval; complications like hyperstimulation, fever and meconium passage were compared between two groups. Statistical analysis was performed by Epi Info 7.Results: Age range of the patients was 21 to 35 years. 74.8% of the patients were in 21-25 years age groups. 50.4% patients were multigravida. 57.6% patients had more than 37 weeks of pregnancy. 50.4% of the patients had premature rupture of membrane as indication of labour. The mean Bishop's score for induction was 3.21 in Misoprostol group. 81.3% patients in Misoprostol group and 93% of patients in Dinoprostone group were delivered by vaginal delivery. 60% patients delivered within 6 hours in Misoprostol group. (Misoprostol: 60%, Dinoprostone: 27%, p<0.001). Incidence of thin meconium was 11.3% in Misoprostol group, 9% in Dinoprostone group. In Misoprostol group 3.3 women had fever after induction.Conclusions: Vaginal misoprostol is more efficacious in cervical ripening and for induction of labor than Dinoprostone.


2020 ◽  
Vol 17 (3) ◽  
pp. 81-89 ◽  
Author(s):  
Nazafatul Ain ◽  
Saira Khan ◽  
Muhammad Marwat ◽  
Nisar Khan ◽  
Iftikhar Ahmad ◽  
...  

Background: Global Health Estimates 2015 has shown the stroke as second leading global cause of death and 3rd leading global cause for DALYs for year 2015. The objectives of this study were to determine the frequency, distribution and determinants of hypertension in adult stroke population of D.I.Khan Division, Pakistan. Materials & Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan from February 1, 2017 to April 30, 2017. A sample 217 was selected with margin of error 5.59%, 90%CL and 50% prevalence of hypertension in 200,000 adults at risk of stroke population through consecutive sampling. All indoor adult patients of stroke were eligible. Sex, age groups, and residence and presence of hypertension were variables. Frequency and distribution of hypertension were analyzed by count and percentage. Hypotheses for distribution were substantiated by chi-square goodness-of-fit and of association by chi-square test of association. Results: Out of 217 patients with stroke, 123 (56.7%) were men and 94 (43.3%) were women, 86 (39.6%) were≤60 years and 131 (60.4%) were>60 years, and 105 (48.4%) were urban and 112 (51.6%) were rural. Frequency of hypertension was 132/217 (60.83%). Out of 132 patients with hypertension, men were 74 (34.10%), women 58 (26.73%), age group≤60 years 46 (21.20%), >60 years 86 (39.63%), urban 72 (33.18%) and rural 60 (27.65%). Presence of hypertension was associated to residence (p=.023) but not to sex (p=.817) and age groups (p=.072). Conclusion: Frequency of hypertension in adult stroke population of D.I.Khan Division, Pakistan was found to be similar as expected. Frequency was more in men, in older age group (of>60years) and in urban population. The presence of hypertension in adult stroke population of D.I.Khan Division was associated to residence but not to sex and age groups.


2018 ◽  
Vol 14 (2) ◽  
pp. 15-17
Author(s):  
A Sharma ◽  
RK Saxena ◽  
L R Verma

Background: Nasal polyposis is an unpleasant disease in the developing countries which severely interferes with quality of life but still there is a lack of data on nasal polyposis in Mid and Far Western Region of Nepal.Aim of study: The aim of this hospital based study was to find out the distribution, patterns, presentations and management of nasal polyposis in Mid and Far Western Region of Nepal with a view to improve our understanding of its clinical and epidemiological characteristics.Methods: This prospective descriptive study was conducted from January 2015 to June 2016 in 80 patients diagnosed clinically as nasal polyposis, in the department of otorhinoloryngology, Nepalgunj Medical College Teaching Hospital, Kohalpur. Results: The most common age group affected in the study was comparatively younger ranging from 10-20 yrs. Ethmoidal Polyp were more frequent than antrochoanal polyp (56.25% vs 43.75%). Antrochoanal polyp were more common among the younger age groups 10-20 yrs (30%) where as the ethmoidal polyp were more common among higher age group. All antrochonal polyps (100%) were unilateral while majority of the ethmoidal polyps (89%) were bilateral. The main presenting clinical features were nasal obstruction (100%), nasal discharge (93.75%), sneezing (72.5%) and headache (40%).Conclusion: Nasal polyposis is common in Mid and Far western region of Nepal. Ethmoidal polyps are more common than antrochoanal polyps and are usually bilateral. Antrochoanal polyps are unilateral and mostly present in 10-20 yrs age group patients. Patients usually present late when the polyps are large. NGMC, Vol. 14 No. 2 December 2016, Page: 15-17


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