Jagdish Sadasivan - Academia.edu (original) (raw)
Papers by Jagdish Sadasivan
Indian Journal of …, 2005
One of the rare complications of appendicitis is the formation of fistulous communication between... more One of the rare complications of appendicitis is the formation of fistulous communication between appendix and adjacent viscera or skin. We report three unusual cases of cutaneous fistula that developed following acute appendicitis. Symptoms at presentation and pathogenesis of ...
Journal of Emergencies, Trauma, and Shock
Background: Pediatric trauma is emerging as an epidemic worldwide; the epidemiology of pediatric ... more Background: Pediatric trauma is emerging as an epidemic worldwide; the epidemiology of pediatric trauma is different in different parts of the world. There are very few studies describing the pediatric trauma in developing countries. Objectives: The objectives of this study were to assess the type, mechanism, and extent of trauma among pediatric trauma patients and its association with clinical outcome. Methodology: This was a prospective observational study conducted in the department of emergency medicine and trauma at a tertiary care hospital in South India from September 2015 to March 2017. All children aged <12 years with a history of injuries irrespective of the cause for attending our trauma center were included in the study. Observations and Results: Of the 911 children enrolled, 63.9% sustained injuries at home. The leading modes of injury were fall at level ground (26.9%), road traffic accidents (RTAs) (25.5%), and fall from height (16.8%). Majority of RTA victims were two-wheeler pillion riders (40.5%) and pedestrians (31.9%). Nearly 49% of children had head and maxillofacial injuries. Polytrauma was found in 3.6% of children. Based on the Pediatric Trauma Score (PTS), 72.6% of children had mild trauma and 6.1% severe trauma. Totally, 18.9% of children required inpatient management, 7.5% surgical intervention, and 1.8% expired. Conclusions: Most of injuries in children occurred at home. This was followed by injuries on road. The leading cause of polytrauma was RTA. RTA victims were more likely to have severe injuries and poor outcome. They were more likely to require inpatient management compared to those who fell from height or fell at level ground. Glasgow Coma Scale and PTS may be used reliably to assess the severity of injuries sustained by children.
Indian Journal of Cancer, Apr 1, 2003
Nair A, Pai DR, Jagdish S, Krishnan R. Alveolar soft part sarcoma: A unique tumor with disputed h... more Nair A, Pai DR, Jagdish S, Krishnan R. Alveolar soft part sarcoma: A unique tumor with disputed histogenesis. Indian J Cancer [serial online] 2003 [cited 2011 Oct 20]; 40: 82-3. Available from: http://www. indianjcancer. com/text. asp? 2003/40/2/82/13050
Indian journal of pathology & microbiology, 2006
Two cases of congenital teratoma were operated upon. In view of the high degree of organoid diffe... more Two cases of congenital teratoma were operated upon. In view of the high degree of organoid differentiation of the teratomas with rudimentary limbs, intestine, brain-like and pulmonary tissues, it was difficult to distinguish it from fetus-in-fetu. In the light of the data obtained and extensive review of related literature, we consider that fetus-in-fetu and teratoma may not be unrelated entities. Our cases support the view held that fetuses in fetu are highly differentiated teratomas.
The Turkish Journal of Gastroenterology, 2020
Background/Aims: Management of Haemorrhoids is suboptimal and is largely based on traditional pra... more Background/Aims: Management of Haemorrhoids is suboptimal and is largely based on traditional practices in the Indian population. Though injection sclerotherapy is a well-accepted treatment modality in early grade haemorrhoids, there is no consensus on the effectiveness of the drugs used for sclerotherapy. The study was done to compare the safety and efficacy of a standard sclerosant (polidocanol) and the conventionally used phenol in oil in bleeding grade-1 and 2 internal haemorrhoids. Materials and Methods: All patients with grade-1 and 2 hemorrhoids, were selected and randomised into two groups, 3% polidocanol and 5% phenol group. All patients were followed-up for three months and observed for "free of bleeding" or "persistent bleeding." Pain, pruritus and patient satisfaction following the procedure was also assessed. Results: A total of 150 patients were enrolled, 75 in each group. At the end of the first sclerotherapy session with polidocanol, 60.6% of patients versus 38.1% in phenol group had stopped per rectal bleeding (p=0.009). After the second sclerotherapy session, 94.7% of patients in the polidocanol group and 84% of patients in the phenol group were treated successfully. Polidocanol group required significantly fewer treatment sessions than the phenol group (1.39±0.49 vs. 1.62±0.49; p=0.035), and the total volume of injected sclerosant was also less (3.30±0.96 mL vs. 4.86±1.46 mL; p=0.001). The patient satisfaction was 87% in polidocanol group versus 73% in phenol group (p=0.040). Conclusion: 3% polidocanol is safe and more effective than 5% phenol in oil when used as injection sclerotherapy in the treatment of first and second-degree internal hemorrhoids.
Cureus, 2020
Ileal perforation is one of the most dreaded complications of abdominal tuberculosis. It is more ... more Ileal perforation is one of the most dreaded complications of abdominal tuberculosis. It is more common in immunodeficient patients, where ulcerative type of intestinal tuberculosis predominates. Various factors play role in the outcome of these patients, such as age and comorbid illness, though the lag period (advent of symptoms to time of admission to hospital) correlated directly to the mortality in these patients. Herein we present a 28-year-old male who had a coinfection of typhoid fever along with intestinal tuberculosis. The patient presented with abdominal pain and fever for one-week duration. On examination, he had diffuse tenderness of his abdomen with guarding. X-ray revealed free air under diaphragm. The patient underwent limited resection of terminal ileum and cecum with end ileostomy for ileal perforation. The patient’s serum Widal test was positive and blood culture grew Salmonella Typhi, and the patient was started on intravenous (IV) antibiotics based on culture and...
Journal of Clinical and Diagnostic Research, 2012
Case: A 50-year-old-female patient presented with a slow growing swelling, in the left parotid re... more Case: A 50-year-old-female patient presented with a slow growing swelling, in the left parotid region which was clinically interpreted as a soft tissue tumor, with a differential of neurofibroma/lipoma. Based on fine needle aspiration cytology (FNAC), a diagnosis of oncocytoma with a remote possibility of an “acinic cell carcinoma with oncocytic features” was suggested. Histopathologic examination showed it to be an encapsulated tumor with an intimate admixture of mature fat cells and oncocytes. The latter was present in glandular or microacinar pattern. The cells were positive for pancytokeratin and epithelial membrane antigen and negative for smooth muscle actin.
Journal of Indian Association of Pediatric Surgeons, 2017
Tropical gastroenterology: official journal of the Digestive Diseases Foundation
African Journal of Trauma, 2014
Impalement injury occurs due to penetration by sharp objects during road traffic accident, fall o... more Impalement injury occurs due to penetration by sharp objects during road traffic accident, fall or workplace mishaps. They usually involve the trunk, cranium, or isolated extremities. Involvement of upper and lower extremity in the same injury is rare. We report the case of a 48-year-old man who sustained a fall from 25 feet under the influence of alcohol onto a wooden fencing pole. The pole went penetrating posteriorly through the right axilla and anteriorly through the right thigh without involving the trunk.
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
Partial cholecystectomy was performed in this Institute in fifteen patients in the last 8 years. ... more Partial cholecystectomy was performed in this Institute in fifteen patients in the last 8 years. Three were performed in cirrhotic patients with bleeding diathesis. The other indications were obscure anatomy, intraperitoneal adhesions, Mirizzi syndrome and poor general condition of the patient. None of these had any major morbidity in the immediate postoperative period. Partial cholecystectomy is a safe and viable option in a difficult situation.
The Journal of Dermatology, 1994
An uncommon situation of primary actinomycosis of the breast is reported in a 40-year-old woman w... more An uncommon situation of primary actinomycosis of the breast is reported in a 40-year-old woman who presented with a lump, clinically simulating malignancy, in the right breast. Diagnosis of actinomycosis was established by incision biopsy. Resolution of infection, while conserving the breast, was achieved by timely diagnosis, limited surgery, and effective antibiotic therapy. Diagnostic failures leading to avoidable mastectomies have not been uncommon in cases previously reported in the literature. It is, therefore, imperative that this condition be considered in the differential diagnosis of intractable breast abscess and malignancy.
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
to malrotation with partial volvulus during pregnancy with successful outcome. This is the first ... more to malrotation with partial volvulus during pregnancy with successful outcome. This is the first case in published literature where pregnancy with malrotation and a volvulus was treated successfully non-surgically using a nasoenteric tube for feeding cum stenting. Early establishment of definitive diagnosis even if it involves radiation exposure is key in organizing management of such problems during pregnancy. Risk of maternal and fetal mortality associated with intestinal obstruction outweighs the potential risk of fetal radiation exposure. Fetal risk is considered to be negligible at exposures of 5 rad or less when compared to the risks of intestinal obstruction during pregnancy. The radiation exposure with plain X-ray is only 0.1 rad and with CT scan it is 2.6 rad both of which are within the safe limits of radiation exposure during pregnancy.
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
Truncal vagotomy with gastrojejunostomy (GJ) is the standard treatment for chronic cicatrizing du... more Truncal vagotomy with gastrojejunostomy (GJ) is the standard treatment for chronic cicatrizing duodenal ulcer with gastric outlet obstruction. We tried to determine if a significant functional difference exists in the early and late outcomes following anterior and posterior types of GJ to treat this condition. The case records of 106 patients who underwent truncal vagotomy and GJ at our institute from 1 January 1995 to 31 December 1999 were studied retrospectively. Patients were followed up with a personal interview. Perioperative and long-term parameters were compared in the anterior and posterior G.I. groups. Sixty-five patients (61.32%) were followed up; 31 in the anterior group and 34 in the posterior group. The median follow-up was 5 years (range 2.5-7.5 years). Except for a significant difference in length of afferent loop (p < 0.0001), there were no significant differences in the duration of hospital stay, nasogastric aspirates on postoperative days 1, 2, 3 and 4 and the d...
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
Two hundred and twelve cases of ileal perforation due to different causes (excluding typhoid) wer... more Two hundred and twelve cases of ileal perforation due to different causes (excluding typhoid) were treated in 3 phases in the Department of Surgery, JIPMER Hospital, Pondicherry, during the periods 1966-78 (phase I), 1981-88 (phase II) and 1990-1998 (Phase III). Forty per cent of the patients were in the second and third decades of life. Male-to-female ratio was 2.2:1. The majority of the perforations (52.8%) were due to non-specific causes. Trauma (19.3%) and mechanical factors (12.7%) were the other principal aetiologies. Pain abdomen (92.3%), constipation (63.6%) and fever (44.3%) were the principal presenting features. Abdominal guarding and rigidity (89%) were the main physical signs. Pneumoperitoneum was present in 66.8% of cases on plain X-ray abdomen. Widal and blood culture for Salmonella typhi were negative in all. Laparotomy was done in most of the cases after adequate resuscitation. Simple closure of the perforation, wedge resection and resection anastomosis were the dif...
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
Perforated duodenal ulcer is one of the common surgical emergencies. Releak after duodenal ulcer ... more Perforated duodenal ulcer is one of the common surgical emergencies. Releak after duodenal ulcer perforation closure is an important cause of mortality. This study was planned to analyse risk factors if any, which could predict releak following duodenal ulcer perforation closure and to ascertain the contribution of releak towards ultimate outcome. A prospective study was undertaken between September 1997 and August 1999 including all patients undergoing surgery for perforated duodenal ulcer. All patients (119) underwent a Graham's patch closure and were put on parenteral H2 antagonists and antibiotics postoperatively. Patients with releak were included in case group (9), and those without releak were included in control group (110). Factors considered for comparison among the two groups were age, pulse rate, systolic blood pressure at presentation, anthropometeric parameters, haemoglobin, serum total protein/albumin, total lymphocyte count and operative findings including size o...
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
Two hundred and forty eight cases of proved typhoid ileal perforation were admitted and treated i... more Two hundred and forty eight cases of proved typhoid ileal perforation were admitted and treated in three phases in the department of surgery during 1966-1998. Of these, 71% patients belonged to second and third decades of life. Male female ratio was 4:1. Abdominal pain (100%) fever (95%) and constipation (87%) were the main presenting symptoms. Abdominal guarding and rigidity (84%) were the principal physical signs. Plain radiograph of abdomen showed evidence of pneumoperitoneum in 57% of cases. The Widal test was positive for S. typhi in 74% of cases. Blood and bone marrow culture were positive for S. typhi in 9% and 30% respectively. Histology of the excised edges of perforation confirmed typhoid pathology in 62% of specimens. Many of the patients were treated conservatively in the first phase. In phase two and three vigorous resuscitation and early surgery was resorted to. Simple closure in two layers and wedge resection were the treatment of choice in most of the cases. Bypass, ...
Indian journal of pathology & microbiology, 2000
Journal of the Indian Medical Association, 1999
A prospective study was conducted at JIPMER, Pondicherry from September 1993 to June 1995. Fifty ... more A prospective study was conducted at JIPMER, Pondicherry from September 1993 to June 1995. Fifty cases of inguinal herniorrhaphy were done under local anaesthesia (LA) and 60 cases under spinal anaesthesia (SA). The aim was to assess the safety and efficacy of inguinal herniorrhaphy under LA. The parameters studied were: (i) Efficacy of the anaesthesia, (ii) safety and postoperative course, and (iii) patient satisfaction. The LA group patients had better postoperative analgesia and earlier return to ambulation. They did not suffer the postspinal complications of headache and urinary retention. However, intra-operative discomfort was significantly more in this group compared to the SA group.
Indian Journal of …, 2005
One of the rare complications of appendicitis is the formation of fistulous communication between... more One of the rare complications of appendicitis is the formation of fistulous communication between appendix and adjacent viscera or skin. We report three unusual cases of cutaneous fistula that developed following acute appendicitis. Symptoms at presentation and pathogenesis of ...
Journal of Emergencies, Trauma, and Shock
Background: Pediatric trauma is emerging as an epidemic worldwide; the epidemiology of pediatric ... more Background: Pediatric trauma is emerging as an epidemic worldwide; the epidemiology of pediatric trauma is different in different parts of the world. There are very few studies describing the pediatric trauma in developing countries. Objectives: The objectives of this study were to assess the type, mechanism, and extent of trauma among pediatric trauma patients and its association with clinical outcome. Methodology: This was a prospective observational study conducted in the department of emergency medicine and trauma at a tertiary care hospital in South India from September 2015 to March 2017. All children aged <12 years with a history of injuries irrespective of the cause for attending our trauma center were included in the study. Observations and Results: Of the 911 children enrolled, 63.9% sustained injuries at home. The leading modes of injury were fall at level ground (26.9%), road traffic accidents (RTAs) (25.5%), and fall from height (16.8%). Majority of RTA victims were two-wheeler pillion riders (40.5%) and pedestrians (31.9%). Nearly 49% of children had head and maxillofacial injuries. Polytrauma was found in 3.6% of children. Based on the Pediatric Trauma Score (PTS), 72.6% of children had mild trauma and 6.1% severe trauma. Totally, 18.9% of children required inpatient management, 7.5% surgical intervention, and 1.8% expired. Conclusions: Most of injuries in children occurred at home. This was followed by injuries on road. The leading cause of polytrauma was RTA. RTA victims were more likely to have severe injuries and poor outcome. They were more likely to require inpatient management compared to those who fell from height or fell at level ground. Glasgow Coma Scale and PTS may be used reliably to assess the severity of injuries sustained by children.
Indian Journal of Cancer, Apr 1, 2003
Nair A, Pai DR, Jagdish S, Krishnan R. Alveolar soft part sarcoma: A unique tumor with disputed h... more Nair A, Pai DR, Jagdish S, Krishnan R. Alveolar soft part sarcoma: A unique tumor with disputed histogenesis. Indian J Cancer [serial online] 2003 [cited 2011 Oct 20]; 40: 82-3. Available from: http://www. indianjcancer. com/text. asp? 2003/40/2/82/13050
Indian journal of pathology & microbiology, 2006
Two cases of congenital teratoma were operated upon. In view of the high degree of organoid diffe... more Two cases of congenital teratoma were operated upon. In view of the high degree of organoid differentiation of the teratomas with rudimentary limbs, intestine, brain-like and pulmonary tissues, it was difficult to distinguish it from fetus-in-fetu. In the light of the data obtained and extensive review of related literature, we consider that fetus-in-fetu and teratoma may not be unrelated entities. Our cases support the view held that fetuses in fetu are highly differentiated teratomas.
The Turkish Journal of Gastroenterology, 2020
Background/Aims: Management of Haemorrhoids is suboptimal and is largely based on traditional pra... more Background/Aims: Management of Haemorrhoids is suboptimal and is largely based on traditional practices in the Indian population. Though injection sclerotherapy is a well-accepted treatment modality in early grade haemorrhoids, there is no consensus on the effectiveness of the drugs used for sclerotherapy. The study was done to compare the safety and efficacy of a standard sclerosant (polidocanol) and the conventionally used phenol in oil in bleeding grade-1 and 2 internal haemorrhoids. Materials and Methods: All patients with grade-1 and 2 hemorrhoids, were selected and randomised into two groups, 3% polidocanol and 5% phenol group. All patients were followed-up for three months and observed for "free of bleeding" or "persistent bleeding." Pain, pruritus and patient satisfaction following the procedure was also assessed. Results: A total of 150 patients were enrolled, 75 in each group. At the end of the first sclerotherapy session with polidocanol, 60.6% of patients versus 38.1% in phenol group had stopped per rectal bleeding (p=0.009). After the second sclerotherapy session, 94.7% of patients in the polidocanol group and 84% of patients in the phenol group were treated successfully. Polidocanol group required significantly fewer treatment sessions than the phenol group (1.39±0.49 vs. 1.62±0.49; p=0.035), and the total volume of injected sclerosant was also less (3.30±0.96 mL vs. 4.86±1.46 mL; p=0.001). The patient satisfaction was 87% in polidocanol group versus 73% in phenol group (p=0.040). Conclusion: 3% polidocanol is safe and more effective than 5% phenol in oil when used as injection sclerotherapy in the treatment of first and second-degree internal hemorrhoids.
Cureus, 2020
Ileal perforation is one of the most dreaded complications of abdominal tuberculosis. It is more ... more Ileal perforation is one of the most dreaded complications of abdominal tuberculosis. It is more common in immunodeficient patients, where ulcerative type of intestinal tuberculosis predominates. Various factors play role in the outcome of these patients, such as age and comorbid illness, though the lag period (advent of symptoms to time of admission to hospital) correlated directly to the mortality in these patients. Herein we present a 28-year-old male who had a coinfection of typhoid fever along with intestinal tuberculosis. The patient presented with abdominal pain and fever for one-week duration. On examination, he had diffuse tenderness of his abdomen with guarding. X-ray revealed free air under diaphragm. The patient underwent limited resection of terminal ileum and cecum with end ileostomy for ileal perforation. The patient’s serum Widal test was positive and blood culture grew Salmonella Typhi, and the patient was started on intravenous (IV) antibiotics based on culture and...
Journal of Clinical and Diagnostic Research, 2012
Case: A 50-year-old-female patient presented with a slow growing swelling, in the left parotid re... more Case: A 50-year-old-female patient presented with a slow growing swelling, in the left parotid region which was clinically interpreted as a soft tissue tumor, with a differential of neurofibroma/lipoma. Based on fine needle aspiration cytology (FNAC), a diagnosis of oncocytoma with a remote possibility of an “acinic cell carcinoma with oncocytic features” was suggested. Histopathologic examination showed it to be an encapsulated tumor with an intimate admixture of mature fat cells and oncocytes. The latter was present in glandular or microacinar pattern. The cells were positive for pancytokeratin and epithelial membrane antigen and negative for smooth muscle actin.
Journal of Indian Association of Pediatric Surgeons, 2017
Tropical gastroenterology: official journal of the Digestive Diseases Foundation
African Journal of Trauma, 2014
Impalement injury occurs due to penetration by sharp objects during road traffic accident, fall o... more Impalement injury occurs due to penetration by sharp objects during road traffic accident, fall or workplace mishaps. They usually involve the trunk, cranium, or isolated extremities. Involvement of upper and lower extremity in the same injury is rare. We report the case of a 48-year-old man who sustained a fall from 25 feet under the influence of alcohol onto a wooden fencing pole. The pole went penetrating posteriorly through the right axilla and anteriorly through the right thigh without involving the trunk.
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
Partial cholecystectomy was performed in this Institute in fifteen patients in the last 8 years. ... more Partial cholecystectomy was performed in this Institute in fifteen patients in the last 8 years. Three were performed in cirrhotic patients with bleeding diathesis. The other indications were obscure anatomy, intraperitoneal adhesions, Mirizzi syndrome and poor general condition of the patient. None of these had any major morbidity in the immediate postoperative period. Partial cholecystectomy is a safe and viable option in a difficult situation.
The Journal of Dermatology, 1994
An uncommon situation of primary actinomycosis of the breast is reported in a 40-year-old woman w... more An uncommon situation of primary actinomycosis of the breast is reported in a 40-year-old woman who presented with a lump, clinically simulating malignancy, in the right breast. Diagnosis of actinomycosis was established by incision biopsy. Resolution of infection, while conserving the breast, was achieved by timely diagnosis, limited surgery, and effective antibiotic therapy. Diagnostic failures leading to avoidable mastectomies have not been uncommon in cases previously reported in the literature. It is, therefore, imperative that this condition be considered in the differential diagnosis of intractable breast abscess and malignancy.
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
to malrotation with partial volvulus during pregnancy with successful outcome. This is the first ... more to malrotation with partial volvulus during pregnancy with successful outcome. This is the first case in published literature where pregnancy with malrotation and a volvulus was treated successfully non-surgically using a nasoenteric tube for feeding cum stenting. Early establishment of definitive diagnosis even if it involves radiation exposure is key in organizing management of such problems during pregnancy. Risk of maternal and fetal mortality associated with intestinal obstruction outweighs the potential risk of fetal radiation exposure. Fetal risk is considered to be negligible at exposures of 5 rad or less when compared to the risks of intestinal obstruction during pregnancy. The radiation exposure with plain X-ray is only 0.1 rad and with CT scan it is 2.6 rad both of which are within the safe limits of radiation exposure during pregnancy.
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
Truncal vagotomy with gastrojejunostomy (GJ) is the standard treatment for chronic cicatrizing du... more Truncal vagotomy with gastrojejunostomy (GJ) is the standard treatment for chronic cicatrizing duodenal ulcer with gastric outlet obstruction. We tried to determine if a significant functional difference exists in the early and late outcomes following anterior and posterior types of GJ to treat this condition. The case records of 106 patients who underwent truncal vagotomy and GJ at our institute from 1 January 1995 to 31 December 1999 were studied retrospectively. Patients were followed up with a personal interview. Perioperative and long-term parameters were compared in the anterior and posterior G.I. groups. Sixty-five patients (61.32%) were followed up; 31 in the anterior group and 34 in the posterior group. The median follow-up was 5 years (range 2.5-7.5 years). Except for a significant difference in length of afferent loop (p < 0.0001), there were no significant differences in the duration of hospital stay, nasogastric aspirates on postoperative days 1, 2, 3 and 4 and the d...
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
Two hundred and twelve cases of ileal perforation due to different causes (excluding typhoid) wer... more Two hundred and twelve cases of ileal perforation due to different causes (excluding typhoid) were treated in 3 phases in the Department of Surgery, JIPMER Hospital, Pondicherry, during the periods 1966-78 (phase I), 1981-88 (phase II) and 1990-1998 (Phase III). Forty per cent of the patients were in the second and third decades of life. Male-to-female ratio was 2.2:1. The majority of the perforations (52.8%) were due to non-specific causes. Trauma (19.3%) and mechanical factors (12.7%) were the other principal aetiologies. Pain abdomen (92.3%), constipation (63.6%) and fever (44.3%) were the principal presenting features. Abdominal guarding and rigidity (89%) were the main physical signs. Pneumoperitoneum was present in 66.8% of cases on plain X-ray abdomen. Widal and blood culture for Salmonella typhi were negative in all. Laparotomy was done in most of the cases after adequate resuscitation. Simple closure of the perforation, wedge resection and resection anastomosis were the dif...
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
Perforated duodenal ulcer is one of the common surgical emergencies. Releak after duodenal ulcer ... more Perforated duodenal ulcer is one of the common surgical emergencies. Releak after duodenal ulcer perforation closure is an important cause of mortality. This study was planned to analyse risk factors if any, which could predict releak following duodenal ulcer perforation closure and to ascertain the contribution of releak towards ultimate outcome. A prospective study was undertaken between September 1997 and August 1999 including all patients undergoing surgery for perforated duodenal ulcer. All patients (119) underwent a Graham's patch closure and were put on parenteral H2 antagonists and antibiotics postoperatively. Patients with releak were included in case group (9), and those without releak were included in control group (110). Factors considered for comparison among the two groups were age, pulse rate, systolic blood pressure at presentation, anthropometeric parameters, haemoglobin, serum total protein/albumin, total lymphocyte count and operative findings including size o...
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
Two hundred and forty eight cases of proved typhoid ileal perforation were admitted and treated i... more Two hundred and forty eight cases of proved typhoid ileal perforation were admitted and treated in three phases in the department of surgery during 1966-1998. Of these, 71% patients belonged to second and third decades of life. Male female ratio was 4:1. Abdominal pain (100%) fever (95%) and constipation (87%) were the main presenting symptoms. Abdominal guarding and rigidity (84%) were the principal physical signs. Plain radiograph of abdomen showed evidence of pneumoperitoneum in 57% of cases. The Widal test was positive for S. typhi in 74% of cases. Blood and bone marrow culture were positive for S. typhi in 9% and 30% respectively. Histology of the excised edges of perforation confirmed typhoid pathology in 62% of specimens. Many of the patients were treated conservatively in the first phase. In phase two and three vigorous resuscitation and early surgery was resorted to. Simple closure in two layers and wedge resection were the treatment of choice in most of the cases. Bypass, ...
Indian journal of pathology & microbiology, 2000
Journal of the Indian Medical Association, 1999
A prospective study was conducted at JIPMER, Pondicherry from September 1993 to June 1995. Fifty ... more A prospective study was conducted at JIPMER, Pondicherry from September 1993 to June 1995. Fifty cases of inguinal herniorrhaphy were done under local anaesthesia (LA) and 60 cases under spinal anaesthesia (SA). The aim was to assess the safety and efficacy of inguinal herniorrhaphy under LA. The parameters studied were: (i) Efficacy of the anaesthesia, (ii) safety and postoperative course, and (iii) patient satisfaction. The LA group patients had better postoperative analgesia and earlier return to ambulation. They did not suffer the postspinal complications of headache and urinary retention. However, intra-operative discomfort was significantly more in this group compared to the SA group.