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Papers by Pratik Shaparia

Medico-Legal Update, Jan 9, 2021

Background: Acute poisoning is a medical emergency as well as a major public health problem as it... more Background: Acute poisoning is a medical emergency as well as a major public health problem as it leads to significant burden on healthcare services. It is pertinent to know the nature and outcome of poisoning for effective prevention and management strategies. Method: A comparative retrospective analysis of 622 poisoning cases admitted to a tertiary care hospital during the period from 2011-12 and 2018-19 were compared to assess the age, sex, mode of poisoning and the nature of the poisonous substance. Conclusion: The study reveals a sharp increase in the acute poisoning cases and changing trends of commonly used poisons with passage of time. Although, males outnumbered females, a steep rise in female poisoning cases, with majority (60%) being young adults especially in the age group of 21-30 years is alarming. Suicide was the most common manner of poisoning, while organophosphates and medicinal drugs were the most commonly used substances.

International Journal of Health Sciences (IJHS), Jul 9, 2022

Amoebic liver abscess (ALA) is the most commonly seen extra intestinal manifestation of Entamoeba... more Amoebic liver abscess (ALA) is the most commonly seen extra intestinal manifestation of Entamoeba infection. [1] Out of which, a rare complication of amoebic liver abscess is rupture of liver abscess. We report 43 cases of ruptured amoebic liver abscess coming with acute abdomen which were operated at Department of Surgery, Dhiraj general hospital, Vadodara from January 2020 to December 2021. Surgical treatment in these cases should be carried out in a timely fashion prior to the presentation of systemic repercussions or death. result: Out of all patients, 37 patients were male and 6 were female and 37 patients were chronic alcoholic. The mean age was 47 years. At presentation, most cases had clinical signs of generalized peritonitis. Ultrasonography for collection in peritoneal cavity showed moderate free fluid with internal echoes suggestive of pyoperitoneum. Out of which 09 patients had free air under the diaphragm. All 43 patients underwent resuscitation and then shifted for surgery. All underwent exploratory laparotomy for 8288 ruptured liver abscess. Intraoperatively, 05 patients had a single abscess in the right lobe, 06 had abscess in both lobes of liver and 33 had multiple abscesses in right lobe. There was no case of exclusive left lobe abscess. Out of all, 14 patients had perforation in the cecum, 03 patients had a perforation in ascending colon. Exploratory laparotomy and peritoneal wash with wash to abscess cavity was done in 26 patients. Limited resection (Caecal resection) with double barrel ileo-colostomy was done in 08 cases. Primary closure of perforation with proximal ileostomy was done in 03 patients. Right hemicolectomy with end ileostomy and transverse colostomy as mucus fistula was done 06 cases. Liver abscess in all 43 cases were amoebic as amoebic serology of pus was positive in all cases. Postoperatively, 34 patients had pleural effusion, 02 had empyema, 30 patients had sepsis and 14 patients died. Conclusion: Perforation of proximal large bowel is very frequent condition found in patients of ruptured amoebic liver abscess presenting as acute abdomen with high mortality. Surgical intervention is mandatory in all these cases.

Journal of medical science and clinical research, Aug 2, 2018

Background: Intussusception is invagination of one segment of intestine into other one. The proxi... more Background: Intussusception is invagination of one segment of intestine into other one. The proximal part known as Intussusceptum and distal part is called as Intussuscepiens. It is one of the common cause of paediatric intestinal obstruction, incidence of which may vary according to age and is common during infancy and early childhood. The male to female ratio is 3:1. The clinical presentation and aetiology may vary from patient to patients. Diagnosis is based on clinical ground and imaging methods like X rays, Ultrasonography and CT scans. Treatment may be conservative or the surgical which depends on aetiology and pathology of the disease. Aim: The study aims to find out age and sex difference, clinical symptoms and signs, seasonal variation, and various management aspects of intussusception in paediatric patients. Materials and Methods: This was a retrospective study on paediatric patients. Patients aged below 12 years and diagnosed having intussusception by clinical or radiological ground were included in the study and patients who were above 12 years of age and having diagnosis other than intussusception were excluded. Summary: Intussusception is one of the common cause of intestinal obstruction in pediatric patients. Aetiology and presentation of intussusception may be variable. Most common age of presentation is <1 year and male child were more affected [1.5:1]. Abdominal pain was commonest symptom 100%] and tenderness of abdomen was most common elicited sign [88%]. X ray abdomen and Ultrasonography was commonly used imaging technique [100%]. Most of the patients were managed conservatively [72%]. Resection and anastomosis of intestine was commonly performed procedure in those who underwent surgical intervention [57%]. Seasonal variation was observed in the study, more number of incidence were happened in the season of monsoon [56%].

International Journal of Health Sciences (IJHS), Aug 11, 2022

Splenic abscess is an unusual but potentially lifethreatening illness, with a 0.7% incidence. The... more Splenic abscess is an unusual but potentially lifethreatening illness, with a 0.7% incidence. The mortality rate for splenic abscess ranges from 15-20% in previously healthy patients with single unilocular leisons to 80% for multiple abscess in immunocompromised patients. An early diagnosis can be made by combining abdominal CT and/or US and clinical features. In this retrospective study of three years, there were a total 47 patients out of which 32 were males and 15 were females and the mean age was 38 years old. The most common symptoms at presentation were left upper quadrant or abdominal pain in all patients (100%), fever in 42 patients (89.36%) and nausea and vomiting in 26 patients (55.31%), breathlessness and tachypnea in 20 patients (42.5%) and 4 patients (8.5%) presented with palpable splenomegaly. A total of eight patients had pancreatitis, there were three patients with liver cirrhosis, two patients with history of splenic trauma, two patients with hiv , one patient with hbsag, two patients with tuberculosis and one patient 7976 with gastric neoplasm i.e. GIST. The majority of 41 patients i.e. 87.23% in our study had leukocytosis while other 19 patients i.e. 40.42% had anemia and 5 patient had blood culture positive. Chest xray was abnormal in 23 patients (49%) and the most frequent finding was a left pleural effusion in 36%. All 47 patients underwent ultrasonography out of which most common finding was single unilocular splenic abscess in 33 patients (70%) while 14 patients (29.78%) had multiloculated abscess and no patient had ruptured abscess. Out of all 47 patients, 10 patients (21.27%) underwent CT scan.A total of 32 of 47 patients had received only intravenous antibiotics, seven patients underwent Percutaneous needle aspiration while four patients underwent percutaneous catheter drainage and four patients(8.51%) underwent splenectomy. In a total of 4 out of 47 patients i.e. 8.51%, mortality was seen in multilocular splenic abscess and none in unilocular splenic abscess. Thus, the treatment of the patient of all splenic abscesses should be individualised based on clinical condition of patient, laboratory investigations and imaging features. The triad of clinical examination, laboratory investigations and radiological reports should be used to finalise the treatment.

Minnesota medicine, 1949

Background : Intestinal obstruction is one of the common abdominal emergencies and if not treated... more Background : Intestinal obstruction is one of the common abdominal emergencies and if not treated and delayed it may lead to bowel ischemia. Hence diagnosis and management of the patient with intestinal obstruction is one of the most important and challenging step to decrease its morbidity and mortality. This mortality due to acute intestinal obstruction can be decreased with better understanding of pathophysiology, improvement in diagnostic techniques, fluid and electrolyte correction, much potent antimicrobial hence our study focuses on early diagnosis of obstruction, skill full operative management, proper technique during surgery and intensive postoperative treatment and carries grateful results. Aim and Objectives : 1. To study the various causes of intestinalobstruction. 2. To study the symptomatology of intestinalobstruction. 3. To study the various Modalities of treatment(surgical) and also the role of imaging studies in determining the etiology and intervention in intestinal obstruction. Conclusion : Through our study we came to the conclusion that men are more commonly involved than females. Plain X-ray abdomen and ultrasonography were important for diagnosing out of which Plain X-ray erect abdomen was almost conclusive in all cases. Where diagnosis was inconclusive an ultrasonography was carried out. Amongst the causes, Postoperative adhesions are the common cause to produce intestinal obstruction. Intestinal obstruction with tuberculosis intestine are more likely to develop postoperative complications, proper anti-tubercular management is necessary to prevent mortality and morbidity. Early operations depending upon the etiology of obstruction are mandatory to avoid perforation, the development of peritonitis and systemic sepsis associated with multisystem organ failure. Through our study, Adhesiolysis followed by resection and anastomosis were the two procedures which were commonly performed. In Postoperative period, few patients had wound infection followed by would dehiscence, chest infection, septicemia and fecal fistula. Morbidity increased in old age patients and those whose presentation was late.

International journal of health sciences

Splenic abscess is an unusual but potentially life-threatening illness, with a 0.7% incidence. Th... more Splenic abscess is an unusual but potentially life-threatening illness, with a 0.7% incidence. The mortality rate for splenic abscess ranges from 15-20% in previously healthy patients with single unilocular leisons to 80% for multiple abscess in immunocompromised patients. An early diagnosis can be made by combining abdominal CT and/or US and clinical features. In this retrospective study of three years, there were a total 47 patients out of which 32 were males and 15 were females and the mean age was 38 years old. The most common symptoms at presentation were left upper quadrant or abdominal pain in all patients (100%), fever in 42 patients (89.36%) and nausea and vomiting in 26 patients (55.31%), breathlessness and tachypnea in 20 patients (42.5%) and 4 patients (8.5%) presented with palpable splenomegaly. A total of eight patients had pancreatitis, there were three patients with liver cirrhosis, two patients with history of splenic trauma, two patients with hiv , one patient with...

International journal of health sciences

Introduction: Amoebic liver abscess (ALA) is the most commonly seen extra intestinal manifestatio... more Introduction: Amoebic liver abscess (ALA) is the most commonly seen extra intestinal manifestation of Entamoeba infection.[1] Out of which, a rare complication of amoebic liver abscess is rupture of liver abscess. We report 43 cases of ruptured amoebic liver abscess coming with acute abdomen which were operated at Department of Surgery, Dhiraj general hospital, Vadodara from January 2020 to December 2021. Surgical treatment in these cases should be carried out in a timely fashion prior to the presentation of systemic repercussions or death. result: Out of all patients, 37 patients were male and 6 were female and 37 patients were chronic alcoholic. The mean age was 47 years. At presentation, most cases had clinical signs of generalized peritonitis. Ultrasonography for collection in peritoneal cavity showed moderate free fluid with internal echoes suggestive of pyoperitoneum. Out of which 09 patients had free air under the diaphragm. All 43 patients underwent resuscitation and then s...

International journal of health sciences

Background: Acute pancreatitis is an inflammatory condition of the pancreas which begins in pancr... more Background: Acute pancreatitis is an inflammatory condition of the pancreas which begins in pancreatic acinar cells and triggers local inflammation that may progress to systemic inflammatory response (SIRS) causing distant organ involvement and hampering its function and ending up with multiple organ dysfunction syndrome (MODS). It remains a common disorder with devastating consequences .Although most episodes are mild and self-limiting, up to a one-fifth of patients develop a severe attack that can be fatal. Inspite of technical advances in medical and surgical field’s acute pancreatitis remains a major cause of morbidity and mortality. Aims and Objectives: Our aim is to find out the effectiveness of early addition of Ulinastatin to current standard care in Indian subjects with acute pancreatitis. The aim of this study is to compare effectiveness of with or without injection Ulinastatin in acute pancreatitis with respect to: 1) Duration of analgesic requirement, 2) Prevention of ea...

Haemorrhoids is considered to be one of the most common surgical condition nowadays. Its prevalen... more Haemorrhoids is considered to be one of the most common surgical condition nowadays. Its prevalence is4.4% i.e. 10 million world population. The purpose of this study is to observe outcomes of various proceduresand conservative management in patients respective to their grades of haemorrhoids. In our setup we useddietary and lifestyle modification, Medications (Topical/Systemic) stapled haemorrhoidopexy, MilliganMorgan Hemorrhoidectomy

Journal of Medical Science And clinical Research

Medico-Legal Update, Jan 9, 2021

Background: Acute poisoning is a medical emergency as well as a major public health problem as it... more Background: Acute poisoning is a medical emergency as well as a major public health problem as it leads to significant burden on healthcare services. It is pertinent to know the nature and outcome of poisoning for effective prevention and management strategies. Method: A comparative retrospective analysis of 622 poisoning cases admitted to a tertiary care hospital during the period from 2011-12 and 2018-19 were compared to assess the age, sex, mode of poisoning and the nature of the poisonous substance. Conclusion: The study reveals a sharp increase in the acute poisoning cases and changing trends of commonly used poisons with passage of time. Although, males outnumbered females, a steep rise in female poisoning cases, with majority (60%) being young adults especially in the age group of 21-30 years is alarming. Suicide was the most common manner of poisoning, while organophosphates and medicinal drugs were the most commonly used substances.

International Journal of Health Sciences (IJHS), Jul 9, 2022

Amoebic liver abscess (ALA) is the most commonly seen extra intestinal manifestation of Entamoeba... more Amoebic liver abscess (ALA) is the most commonly seen extra intestinal manifestation of Entamoeba infection. [1] Out of which, a rare complication of amoebic liver abscess is rupture of liver abscess. We report 43 cases of ruptured amoebic liver abscess coming with acute abdomen which were operated at Department of Surgery, Dhiraj general hospital, Vadodara from January 2020 to December 2021. Surgical treatment in these cases should be carried out in a timely fashion prior to the presentation of systemic repercussions or death. result: Out of all patients, 37 patients were male and 6 were female and 37 patients were chronic alcoholic. The mean age was 47 years. At presentation, most cases had clinical signs of generalized peritonitis. Ultrasonography for collection in peritoneal cavity showed moderate free fluid with internal echoes suggestive of pyoperitoneum. Out of which 09 patients had free air under the diaphragm. All 43 patients underwent resuscitation and then shifted for surgery. All underwent exploratory laparotomy for 8288 ruptured liver abscess. Intraoperatively, 05 patients had a single abscess in the right lobe, 06 had abscess in both lobes of liver and 33 had multiple abscesses in right lobe. There was no case of exclusive left lobe abscess. Out of all, 14 patients had perforation in the cecum, 03 patients had a perforation in ascending colon. Exploratory laparotomy and peritoneal wash with wash to abscess cavity was done in 26 patients. Limited resection (Caecal resection) with double barrel ileo-colostomy was done in 08 cases. Primary closure of perforation with proximal ileostomy was done in 03 patients. Right hemicolectomy with end ileostomy and transverse colostomy as mucus fistula was done 06 cases. Liver abscess in all 43 cases were amoebic as amoebic serology of pus was positive in all cases. Postoperatively, 34 patients had pleural effusion, 02 had empyema, 30 patients had sepsis and 14 patients died. Conclusion: Perforation of proximal large bowel is very frequent condition found in patients of ruptured amoebic liver abscess presenting as acute abdomen with high mortality. Surgical intervention is mandatory in all these cases.

Journal of medical science and clinical research, Aug 2, 2018

Background: Intussusception is invagination of one segment of intestine into other one. The proxi... more Background: Intussusception is invagination of one segment of intestine into other one. The proximal part known as Intussusceptum and distal part is called as Intussuscepiens. It is one of the common cause of paediatric intestinal obstruction, incidence of which may vary according to age and is common during infancy and early childhood. The male to female ratio is 3:1. The clinical presentation and aetiology may vary from patient to patients. Diagnosis is based on clinical ground and imaging methods like X rays, Ultrasonography and CT scans. Treatment may be conservative or the surgical which depends on aetiology and pathology of the disease. Aim: The study aims to find out age and sex difference, clinical symptoms and signs, seasonal variation, and various management aspects of intussusception in paediatric patients. Materials and Methods: This was a retrospective study on paediatric patients. Patients aged below 12 years and diagnosed having intussusception by clinical or radiological ground were included in the study and patients who were above 12 years of age and having diagnosis other than intussusception were excluded. Summary: Intussusception is one of the common cause of intestinal obstruction in pediatric patients. Aetiology and presentation of intussusception may be variable. Most common age of presentation is <1 year and male child were more affected [1.5:1]. Abdominal pain was commonest symptom 100%] and tenderness of abdomen was most common elicited sign [88%]. X ray abdomen and Ultrasonography was commonly used imaging technique [100%]. Most of the patients were managed conservatively [72%]. Resection and anastomosis of intestine was commonly performed procedure in those who underwent surgical intervention [57%]. Seasonal variation was observed in the study, more number of incidence were happened in the season of monsoon [56%].

International Journal of Health Sciences (IJHS), Aug 11, 2022

Splenic abscess is an unusual but potentially lifethreatening illness, with a 0.7% incidence. The... more Splenic abscess is an unusual but potentially lifethreatening illness, with a 0.7% incidence. The mortality rate for splenic abscess ranges from 15-20% in previously healthy patients with single unilocular leisons to 80% for multiple abscess in immunocompromised patients. An early diagnosis can be made by combining abdominal CT and/or US and clinical features. In this retrospective study of three years, there were a total 47 patients out of which 32 were males and 15 were females and the mean age was 38 years old. The most common symptoms at presentation were left upper quadrant or abdominal pain in all patients (100%), fever in 42 patients (89.36%) and nausea and vomiting in 26 patients (55.31%), breathlessness and tachypnea in 20 patients (42.5%) and 4 patients (8.5%) presented with palpable splenomegaly. A total of eight patients had pancreatitis, there were three patients with liver cirrhosis, two patients with history of splenic trauma, two patients with hiv , one patient with hbsag, two patients with tuberculosis and one patient 7976 with gastric neoplasm i.e. GIST. The majority of 41 patients i.e. 87.23% in our study had leukocytosis while other 19 patients i.e. 40.42% had anemia and 5 patient had blood culture positive. Chest xray was abnormal in 23 patients (49%) and the most frequent finding was a left pleural effusion in 36%. All 47 patients underwent ultrasonography out of which most common finding was single unilocular splenic abscess in 33 patients (70%) while 14 patients (29.78%) had multiloculated abscess and no patient had ruptured abscess. Out of all 47 patients, 10 patients (21.27%) underwent CT scan.A total of 32 of 47 patients had received only intravenous antibiotics, seven patients underwent Percutaneous needle aspiration while four patients underwent percutaneous catheter drainage and four patients(8.51%) underwent splenectomy. In a total of 4 out of 47 patients i.e. 8.51%, mortality was seen in multilocular splenic abscess and none in unilocular splenic abscess. Thus, the treatment of the patient of all splenic abscesses should be individualised based on clinical condition of patient, laboratory investigations and imaging features. The triad of clinical examination, laboratory investigations and radiological reports should be used to finalise the treatment.

Minnesota medicine, 1949

Background : Intestinal obstruction is one of the common abdominal emergencies and if not treated... more Background : Intestinal obstruction is one of the common abdominal emergencies and if not treated and delayed it may lead to bowel ischemia. Hence diagnosis and management of the patient with intestinal obstruction is one of the most important and challenging step to decrease its morbidity and mortality. This mortality due to acute intestinal obstruction can be decreased with better understanding of pathophysiology, improvement in diagnostic techniques, fluid and electrolyte correction, much potent antimicrobial hence our study focuses on early diagnosis of obstruction, skill full operative management, proper technique during surgery and intensive postoperative treatment and carries grateful results. Aim and Objectives : 1. To study the various causes of intestinalobstruction. 2. To study the symptomatology of intestinalobstruction. 3. To study the various Modalities of treatment(surgical) and also the role of imaging studies in determining the etiology and intervention in intestinal obstruction. Conclusion : Through our study we came to the conclusion that men are more commonly involved than females. Plain X-ray abdomen and ultrasonography were important for diagnosing out of which Plain X-ray erect abdomen was almost conclusive in all cases. Where diagnosis was inconclusive an ultrasonography was carried out. Amongst the causes, Postoperative adhesions are the common cause to produce intestinal obstruction. Intestinal obstruction with tuberculosis intestine are more likely to develop postoperative complications, proper anti-tubercular management is necessary to prevent mortality and morbidity. Early operations depending upon the etiology of obstruction are mandatory to avoid perforation, the development of peritonitis and systemic sepsis associated with multisystem organ failure. Through our study, Adhesiolysis followed by resection and anastomosis were the two procedures which were commonly performed. In Postoperative period, few patients had wound infection followed by would dehiscence, chest infection, septicemia and fecal fistula. Morbidity increased in old age patients and those whose presentation was late.

International journal of health sciences

Splenic abscess is an unusual but potentially life-threatening illness, with a 0.7% incidence. Th... more Splenic abscess is an unusual but potentially life-threatening illness, with a 0.7% incidence. The mortality rate for splenic abscess ranges from 15-20% in previously healthy patients with single unilocular leisons to 80% for multiple abscess in immunocompromised patients. An early diagnosis can be made by combining abdominal CT and/or US and clinical features. In this retrospective study of three years, there were a total 47 patients out of which 32 were males and 15 were females and the mean age was 38 years old. The most common symptoms at presentation were left upper quadrant or abdominal pain in all patients (100%), fever in 42 patients (89.36%) and nausea and vomiting in 26 patients (55.31%), breathlessness and tachypnea in 20 patients (42.5%) and 4 patients (8.5%) presented with palpable splenomegaly. A total of eight patients had pancreatitis, there were three patients with liver cirrhosis, two patients with history of splenic trauma, two patients with hiv , one patient with...

International journal of health sciences

Introduction: Amoebic liver abscess (ALA) is the most commonly seen extra intestinal manifestatio... more Introduction: Amoebic liver abscess (ALA) is the most commonly seen extra intestinal manifestation of Entamoeba infection.[1] Out of which, a rare complication of amoebic liver abscess is rupture of liver abscess. We report 43 cases of ruptured amoebic liver abscess coming with acute abdomen which were operated at Department of Surgery, Dhiraj general hospital, Vadodara from January 2020 to December 2021. Surgical treatment in these cases should be carried out in a timely fashion prior to the presentation of systemic repercussions or death. result: Out of all patients, 37 patients were male and 6 were female and 37 patients were chronic alcoholic. The mean age was 47 years. At presentation, most cases had clinical signs of generalized peritonitis. Ultrasonography for collection in peritoneal cavity showed moderate free fluid with internal echoes suggestive of pyoperitoneum. Out of which 09 patients had free air under the diaphragm. All 43 patients underwent resuscitation and then s...

International journal of health sciences

Background: Acute pancreatitis is an inflammatory condition of the pancreas which begins in pancr... more Background: Acute pancreatitis is an inflammatory condition of the pancreas which begins in pancreatic acinar cells and triggers local inflammation that may progress to systemic inflammatory response (SIRS) causing distant organ involvement and hampering its function and ending up with multiple organ dysfunction syndrome (MODS). It remains a common disorder with devastating consequences .Although most episodes are mild and self-limiting, up to a one-fifth of patients develop a severe attack that can be fatal. Inspite of technical advances in medical and surgical field’s acute pancreatitis remains a major cause of morbidity and mortality. Aims and Objectives: Our aim is to find out the effectiveness of early addition of Ulinastatin to current standard care in Indian subjects with acute pancreatitis. The aim of this study is to compare effectiveness of with or without injection Ulinastatin in acute pancreatitis with respect to: 1) Duration of analgesic requirement, 2) Prevention of ea...

Haemorrhoids is considered to be one of the most common surgical condition nowadays. Its prevalen... more Haemorrhoids is considered to be one of the most common surgical condition nowadays. Its prevalence is4.4% i.e. 10 million world population. The purpose of this study is to observe outcomes of various proceduresand conservative management in patients respective to their grades of haemorrhoids. In our setup we useddietary and lifestyle modification, Medications (Topical/Systemic) stapled haemorrhoidopexy, MilliganMorgan Hemorrhoidectomy

Journal of Medical Science And clinical Research