Meghraj Chawada | Maharashtra University Of Health Sciences,Nashik (original) (raw)

Papers by Meghraj Chawada

New Indian Journal of Surgery, Jun 14, 2021

PARIPEX INDIAN JOURNAL OF RESEARCH, Apr 15, 2022

A hernia is defined as a protrusion, bulge, or projection of an organ or a part of an organ throu... more A hernia is defined as a protrusion, bulge, or projection of an organ or a part of an organ through the body wall that normally contains it. There is still very limited evidence regarding prevalence, particularly in low-income countries, but hernia repair is an extremely common general surgical procedure. The current hospital based prospective study was conducted among 102 patients, 51 participants enrolled in Mesh repair and 51 for Herniorrhaphy presenting to the Department of General Surgery at tertiary health care institute. with objectives to study the hernia repair with mesh versus without mesh. Outcomes like hernia recurrence, postoperative pain, duration of operation, postoperative hospital stay, time to return to activities of daily living & also to evaluate the benefits and complications of different inguinal hernia repair techniques in adults studied. Total 102 patients were considered between age group of 15 to 35 years for present study from Aug.2019 to Jan.2022,after applying inclusion and exclusion criteria. In each group 51 patients were operated. Majority of patients for mesh repair (70%) & tissue repair (60%) were belonged to 21-25 & 15-20 years of age group respectively. Mean operation time for tissue repair (41.8 4.6) was more as compare to mesh repair (39.7 4.3).Outcome like post-operative stay, post-operative pain, days required for return to daily basic activities were significantly more for tissue repair as compared to mesh repair. In case of post-operative pain scale majority of mesh group will have chronic pain compared with Tissue repair group. Hematoma & urinary retention were statistically more significant in tissue repair (p<0.05). Wound infections, seroma, recurrence, reduced testicular perfusion, reduced sperm count were more in mesh repair as compare to tissue repair out of that only seroma shows significant in mesh repair. Concluded that the tissue repairs does not use a mesh, this makes tissue repair cost effective. Postoperative pain is significantly less initially with Mesh repair but increased on day 7 and chronic pain is seen with mesh repair but is not significant statistically. Most of the complications between 2 groups are not statistically significant except for seroma significant in mesh repair,hematoma and urinary retention significant in tissue repair.

Introduction: Incidence of blunt trauma to abdomen is increasing day due to increase in incidence... more Introduction: Incidence of blunt trauma to abdomen is increasing day due to increase in incidence of Road Traffic Accident. Various diagnostic tests can be used to evaluate patients with blunt abdominal trauma. These include ultrasonography (US), diagnostic peritoneal Laparoscopy has gained widespread acceptance as a useful tool in the diagnosis and management of patients with blunt abdominal injuries. Aims and objective: Patients Materials and Method: laproscopic was performed in all the patients using standard guidelines. Hemodynamic param meticulously during the procedure. and return of bowel functions and wound complications. The patients were discharged after return of normal bowel functions, drain removal and ruling out complications if any. Information regarding mean duration of surgery, blood transfusion required, post operative nbm, drain in situ, hospital stay and stitch removal was also recorded. The collected data was analyzed and presented with appropriate table and gra...

We report a case of traumatic inguinal hernia following penetrating abdominal trauma after a bull... more We report a case of traumatic inguinal hernia following penetrating abdominal trauma after a bull horn injury and describe the circumstances and technique of repair. The patient suffered a sudden penetration of bull horn while feeding it and developed acute swelling of the right groin. USG scan confirmed the acute formation of a traumatic inguinal hernia. Surgical repair was deferred until resolution of the acute swelling and subcutaneous haematoma. But the patient develops sudden obstructive symptoms and the indication for surgery was the potential for visceral strangulation or ischaemia with the patient describing discomfort on coughing and constipation. At surgery there was complete obliteration of the inguinal canal with bowel and omentum lying immediately beneath the attenuated external oblique aponeurosis. A resection anastomosis was performed for strictured ileal loop and hernia repair was performed after reconstructing the inguinal ligament and canal in layers and approximat...

International Surgery Journal, Mar 26, 2020

Any breach in the skin or in the mucous membrane which results in the molecular death is defined ... more Any breach in the skin or in the mucous membrane which results in the molecular death is defined as an ulcer. 1 Chronic leg ulcers are those ulcers on the leg which do not heal even after giving proper treatment for more than six weeks or those ulcers on the leg which do not heal even after one year. Thus, this tendency of healing slowly is one of the criteria of chronic leg ulcers. 2 Many studies have reported that chronic leg ulcers not only have physical impact on the patient but also social, financial and psychological impact due to chronicity of the leg ulcers. 3 Treatment of chronic leg ulcer is not easy. Appropriate diagnosis and proper treatment are the cornerstone for successful outcome. Various risk factors for chronic leg ulcers are diabetes, increasing age, smoking, obesity. The prevalence of chronic leg ulcers in the age group of 60 years and above is around 0.6-3%. It increases with age. Among the developed countries it is estimated that about 1 to 2 % of the people will experience a chronic leg ulcer during their lifetime. Very few Indian studies have been done on the epidemiology of ulcers. 4 Neuropathy, diseases of the venous and arterial system are some important causes of chronic leg ulcers. Other causes are infections, disorders of metabolism and ABSTRACT Background: Treatment of chronic leg ulcer is not easy. Appropriate diagnosis and proper treatment are the cornerstone for successful outcome. To study the profile of patients with chronic leg ulcers. Methods: Hospital based observational study was carried out in 108 cases. All patients coming to surgery OPD in our set up with chronic leg ulcers of duration of more than 6 weeks were advised admission if they were willing for the same. Then detailed history was recorded. Detailed examination of venous system was done for varicosities, incompetent perforators, sapheno-femoral or poplitio-femoral junction incompetence. In case of patient's peripheral vascular diseases, detailed examination of arterial system was done. Descriptive statistics like frequencies and percentage for categorical data, mean and SD for numerical data has been depicted. Results: Majority of study subjects were in age range of 60 to 70 years. percentage of male patient (76.9%) was higher than that of the female (23.1%). 43.5% of participants with ulcer on left side and 56.5% participants had ulcer on right side. 47% of participants had complaints between 7 to 8 weeks. main etiological factor was infective etiology in 38.9% patients. 54.1% ulcers were found in lower 1/3rd of the leg. About 88.9% cases had positive culture. The most common organism grown was of pseudomonas in 45.8% cases. Conclusions: The most common etiology of chronic leg ulcer in this study is infective followed by traumatic ulcer. The most common associated condition found in chronic leg ulcer is diabetes mellitus.

International Surgery Journal, Mar 26, 2020

Background: Conventional antibiotic therapy during operation not only increases the financial bur... more Background: Conventional antibiotic therapy during operation not only increases the financial burden on patient, not only increases chances of adverse reactions among them but also not effective in reducing the infection rate after surgery. Single dose prophylactic antibiotic or maximum 24 hours dosing during or before surgery was found to be equally effective. Objective was the to study utility of single shot antibiotic prophylaxis in patients undergoing surgery Methods: This prospective study includes 100 clean elective surgical cases randomized to groups of 50 each. Single dose prophylactic antibiotic was given to cases in the study group and conventional antibiotic therapy was given to cases in the control group. Study group cases received Injection Ceftriaxone in the dose of 2 gm intravenously. This was given at induction or half an hour before the incision was given. Second dose was given if there was delay in starting the surgery for more than three hours. Dose of the antibiotic was adjusted for children, underweight and obese persons. For cases in the control group. Injection ceftriaxone 1 gm was given intravenously twice a day for three days. Surgical site infection incidence was recorded. Results: Both the groups were comparable for age, sex, diagnosis and hence the type of surgery performed. The incidence of fever, redness, swelling and wound discharge which are the signs of surgical site infection after surgery was not found to be statistically significantly different. Management protocol was also not significantly different after the surgery. Conclusions: Single shot antibiotic before surgery is equally effective in reducing the incidence of surgical site infections (SSIs) compared to conventional antibiotic therapy.

In the absence of symptoms of the primary disease, most patients with bile duct strictures (bilia... more In the absence of symptoms of the primary disease, most patients with bile duct strictures (biliary strictures) remain asymptomatic until the lumen of the bile duct is sufficiently narrowed to cause resistance to the flow of bile. Occasionally, patients may have intermittent episodes of right upper quadrant pain (biliary colic), with or without laboratory features of biliary obstruction. Patients most often present with features of obstructive jaundice. On occasion, a patient may present dramatically with sepsis and hypotension due to ascending cholangitis. We report a case of benign CBD stricture in an operated case of gastro-jejunostomy who was operated with cholecystectomy and choledoco-jejunostomy and she recovered fully.

The commonest complaints for which the patients seek hospital care are Upper gastrointestinal (GI... more The commonest complaints for which the patients seek hospital care are Upper gastrointestinal (GI) symptoms. It has been estimated that the prevalence of these symptoms ranges from 8% to 54%. Some of the most common of them are ‘dyspepsia, dysphagia, gastrointestinal bleeding, progressive unintentional weight loss, persistent vomiting or of unknown cause, anemia or epigastric mass’. Endoscopy is the most commonly offered investigation for these cases. Helicobacter pylori are a non-spore forming, gram negative bacterium with a helical shape. Curved forms occur and the bacillus also converts to a coccoid morphology under environmental stress. It has multiple flagella at one pole (1-5) and is actively motile. Flagella play important role in motion and adhesion. H. pylori can survive in an acid environment for a short time but is not an acidophile. H pylori are oxidase positive and catalase positive and are a strong producer of urease.

Background: In hemorrhoids, the anal canal venous plexuses become engorged. It can lead to bleedi... more Background: In hemorrhoids, the anal canal venous plexuses become engorged. It can lead to bleeding, thrombosis, prolapse, pain. Study of surgical profile helps to educate the patients to take proper precautions to avoid the severe forms of it. The objective of the study was to study the surgical profile of patients with hemorrhoids at a tertiary care hospital.Methods: Present study was hospital based cross sectional study. It was carried out at a tertiary care hospital in the department of general surgery among 100 patients who presented with symptoms suggestive of hemorrhoids during the study period from 1st January 2017 to 31st October 2018.Results: Majority of the patients 41% were in the age group of 35-45 years. The number affected by hemorrhoids was more in males i.e. 56%. Incidence of hemorrhoids was more in upper class. Incidence of hemorrhoids was less i.e. 21% among those who took only vegetarian diet. Majority of the patients (78%) presented after one year of occurrence ...

New Indian Journal of Surgery

New Indian Journal of Surgery

New Indian Journal of Surgery

New Indian Journal of Surgery

International Surgery Journal

Background: Post-operative wound infections have been a problem since surgery was started as a tr... more Background: Post-operative wound infections have been a problem since surgery was started as a treatment modality. Post-operative infections were responsible for 70-80% of deaths until Ignaz Semmelweis and Joseph Lister, in middle of 19th century, introduced methods of infection control by use of antiseptics. Objective was to study the incidence of postoperative infection in tertiary rural hospital.Methods: A hospital based cross sectional study was carried out at Department of General Surgery, SRTR Rural Government Medical College from September 2015 to August 2016 among 1250 patients. Detailed history, complete and thorough clinical examination was carried out for each and every individual included in the present study. The patients are assessed pre operatively and post operatively.Results: It was found that the maximum cases belong to the age group of 26-35 years i.e. 28.32% followed by age group of 36-45 years (25.68%). The proportion of males was slightly more than females. The...

International Surgery Journal

Background: Many factors affect the incidence of surgical wound infection, in addition to the sur... more Background: Many factors affect the incidence of surgical wound infection, in addition to the surgeon’s skill and the hospital environment. Host attributes, such as age over 60 years, diabetes mellitus, malignant disease, obesity, malnutrition, length of preoperative stay or pre-existing infection may influence risk, as may such operation characteristics as site, urgency, duration and time of skin shaving. Objective was to study the preoperative, intra-operative and postoperative factors responsible for postoperative wound infection.Methods: This descriptive study was designed to study the problem of postoperative wound infection at tertiary health care center at rural set up over a period of two years during 2014 to 2016. Initial assessment of intra operative findings divided these cases into clean, clean contaminated and contaminated cases.Results: As the length of pre-operative stay increased, the occurrence of SSIs increased. As the duration of post operative hospital stay incre...

International Surgery Journal, 2016

INTRODUCTION Peptic ulcer disease (PUD) remains one of the most prevalent diseases of the gastroi... more INTRODUCTION Peptic ulcer disease (PUD) remains one of the most prevalent diseases of the gastrointestinal tract with annual incidence 1 ranging from 0.1% to 0.3% in India. Cases of peptic ulcer perforation are commonly encountered in our institute. The high incidence of mortality and morbidity associated with this condition, promoted us to carry out an in depth study of this condition. There are well known two major precipitating factors: Helicobacter pylori infection and the use of non-steroidal anti-inflammatory drugs (NSAIDs) and the ulcer incidence increase with age for both duodenal and gastric ulcers.

International Surgery Journal, 2016

Peptic ulcer perforation is one of the common surgical emergencies which need immediate surgical ... more Peptic ulcer perforation is one of the common surgical emergencies which need immediate surgical intervention. 3 For many years, the routine upper laparotomy still seems to be the routine treatment of ABSTRACT Background: Peptic ulcer perforation is one of the common surgical emergencies which need immediate surgical intervention. For many years, the routine upper laparotomy still seems to be the routine treatment of perforated peptic ulcer. The improvement of technology and an increase in laparoscopic experience have been central to the development of laparoscopic surgery. Objective of the study was to assess the efficacy of laparoscopic approach in perforated peptic ulcer repair. Methods: The present study is based on the analysis of 30 cases of peptic ulcer perforation admitted to our hospital between 2013 and 2015. Post-operative mobilization of every patient was done after 6 hours and H 2 receptor antagonist or proton pump inhibitor was given with fluid, antibiotics and nasogastric suction. Post-operation analgesics (IV tramadol ± IM diclofenac SOS) were given according to visual analogue score (VAS). Results: 22 (73.33%) patients were having duodenal ulcer perforation and 8 (26.67%) were having gastric ulcer perforation. Postoperatively out of 30 patients, 18 patients were presented with VAS 4. The most common complication was trocar site infection seen in 2 patients (6.6%). 3 patients (10%) needed to covert laparoscopic procedure into open procedure due to large size of perforation (>10 mm). The hospital stay varied from 4-16 days. Conclusions: Laparoscopic repair of perforated peptic ulcer is safe and reliable technique. It gives the patient all the advantages of laparoscopic surgery with accepted post-operative morbidity and mortality rates. However, laparoscopic closure of the perforation is technically demanding. It should be considered as a good choice in the presence of reasonable laparoscopic skills and experience. It had less postoperative pain and reduced analgesic usages, shorter postoperative hospital stay and early return to oral feeding and normal daily activities.

International Surgery Journal, 2016

Recent studies suggest that the use of tissue adhesive for closure of both traumatic lacerations ... more Recent studies suggest that the use of tissue adhesive for closure of both traumatic lacerations and incisional surgical wounds leads to cosmetic outcome comparable to conventional sutures. 3

Head & Neck Surgery, 1979

The anatomy, design, and blood supply of the pectoralis major myocutaneous island flap are descri... more The anatomy, design, and blood supply of the pectoralis major myocutaneous island flap are described. This versatile, nondelayed flap has, for the most part, replaced the usual cutaneous flaps. Clinical examples of its use in head and neck reconstructive surgery are presented.

Head & Neck Surgery, 1979

The anatomy, design, and blood supply of the pectoralis major myocutaneous island flap are descri... more The anatomy, design, and blood supply of the pectoralis major myocutaneous island flap are described. This versatile, nondelayed flap has, for the most part, replaced the usual cutaneous flaps. Clinical examples of its use in head and neck reconstructive surgery are presented.

New Indian Journal of Surgery, Jun 14, 2021

PARIPEX INDIAN JOURNAL OF RESEARCH, Apr 15, 2022

A hernia is defined as a protrusion, bulge, or projection of an organ or a part of an organ throu... more A hernia is defined as a protrusion, bulge, or projection of an organ or a part of an organ through the body wall that normally contains it. There is still very limited evidence regarding prevalence, particularly in low-income countries, but hernia repair is an extremely common general surgical procedure. The current hospital based prospective study was conducted among 102 patients, 51 participants enrolled in Mesh repair and 51 for Herniorrhaphy presenting to the Department of General Surgery at tertiary health care institute. with objectives to study the hernia repair with mesh versus without mesh. Outcomes like hernia recurrence, postoperative pain, duration of operation, postoperative hospital stay, time to return to activities of daily living & also to evaluate the benefits and complications of different inguinal hernia repair techniques in adults studied. Total 102 patients were considered between age group of 15 to 35 years for present study from Aug.2019 to Jan.2022,after applying inclusion and exclusion criteria. In each group 51 patients were operated. Majority of patients for mesh repair (70%) & tissue repair (60%) were belonged to 21-25 & 15-20 years of age group respectively. Mean operation time for tissue repair (41.8 4.6) was more as compare to mesh repair (39.7 4.3).Outcome like post-operative stay, post-operative pain, days required for return to daily basic activities were significantly more for tissue repair as compared to mesh repair. In case of post-operative pain scale majority of mesh group will have chronic pain compared with Tissue repair group. Hematoma & urinary retention were statistically more significant in tissue repair (p<0.05). Wound infections, seroma, recurrence, reduced testicular perfusion, reduced sperm count were more in mesh repair as compare to tissue repair out of that only seroma shows significant in mesh repair. Concluded that the tissue repairs does not use a mesh, this makes tissue repair cost effective. Postoperative pain is significantly less initially with Mesh repair but increased on day 7 and chronic pain is seen with mesh repair but is not significant statistically. Most of the complications between 2 groups are not statistically significant except for seroma significant in mesh repair,hematoma and urinary retention significant in tissue repair.

Introduction: Incidence of blunt trauma to abdomen is increasing day due to increase in incidence... more Introduction: Incidence of blunt trauma to abdomen is increasing day due to increase in incidence of Road Traffic Accident. Various diagnostic tests can be used to evaluate patients with blunt abdominal trauma. These include ultrasonography (US), diagnostic peritoneal Laparoscopy has gained widespread acceptance as a useful tool in the diagnosis and management of patients with blunt abdominal injuries. Aims and objective: Patients Materials and Method: laproscopic was performed in all the patients using standard guidelines. Hemodynamic param meticulously during the procedure. and return of bowel functions and wound complications. The patients were discharged after return of normal bowel functions, drain removal and ruling out complications if any. Information regarding mean duration of surgery, blood transfusion required, post operative nbm, drain in situ, hospital stay and stitch removal was also recorded. The collected data was analyzed and presented with appropriate table and gra...

We report a case of traumatic inguinal hernia following penetrating abdominal trauma after a bull... more We report a case of traumatic inguinal hernia following penetrating abdominal trauma after a bull horn injury and describe the circumstances and technique of repair. The patient suffered a sudden penetration of bull horn while feeding it and developed acute swelling of the right groin. USG scan confirmed the acute formation of a traumatic inguinal hernia. Surgical repair was deferred until resolution of the acute swelling and subcutaneous haematoma. But the patient develops sudden obstructive symptoms and the indication for surgery was the potential for visceral strangulation or ischaemia with the patient describing discomfort on coughing and constipation. At surgery there was complete obliteration of the inguinal canal with bowel and omentum lying immediately beneath the attenuated external oblique aponeurosis. A resection anastomosis was performed for strictured ileal loop and hernia repair was performed after reconstructing the inguinal ligament and canal in layers and approximat...

International Surgery Journal, Mar 26, 2020

Any breach in the skin or in the mucous membrane which results in the molecular death is defined ... more Any breach in the skin or in the mucous membrane which results in the molecular death is defined as an ulcer. 1 Chronic leg ulcers are those ulcers on the leg which do not heal even after giving proper treatment for more than six weeks or those ulcers on the leg which do not heal even after one year. Thus, this tendency of healing slowly is one of the criteria of chronic leg ulcers. 2 Many studies have reported that chronic leg ulcers not only have physical impact on the patient but also social, financial and psychological impact due to chronicity of the leg ulcers. 3 Treatment of chronic leg ulcer is not easy. Appropriate diagnosis and proper treatment are the cornerstone for successful outcome. Various risk factors for chronic leg ulcers are diabetes, increasing age, smoking, obesity. The prevalence of chronic leg ulcers in the age group of 60 years and above is around 0.6-3%. It increases with age. Among the developed countries it is estimated that about 1 to 2 % of the people will experience a chronic leg ulcer during their lifetime. Very few Indian studies have been done on the epidemiology of ulcers. 4 Neuropathy, diseases of the venous and arterial system are some important causes of chronic leg ulcers. Other causes are infections, disorders of metabolism and ABSTRACT Background: Treatment of chronic leg ulcer is not easy. Appropriate diagnosis and proper treatment are the cornerstone for successful outcome. To study the profile of patients with chronic leg ulcers. Methods: Hospital based observational study was carried out in 108 cases. All patients coming to surgery OPD in our set up with chronic leg ulcers of duration of more than 6 weeks were advised admission if they were willing for the same. Then detailed history was recorded. Detailed examination of venous system was done for varicosities, incompetent perforators, sapheno-femoral or poplitio-femoral junction incompetence. In case of patient's peripheral vascular diseases, detailed examination of arterial system was done. Descriptive statistics like frequencies and percentage for categorical data, mean and SD for numerical data has been depicted. Results: Majority of study subjects were in age range of 60 to 70 years. percentage of male patient (76.9%) was higher than that of the female (23.1%). 43.5% of participants with ulcer on left side and 56.5% participants had ulcer on right side. 47% of participants had complaints between 7 to 8 weeks. main etiological factor was infective etiology in 38.9% patients. 54.1% ulcers were found in lower 1/3rd of the leg. About 88.9% cases had positive culture. The most common organism grown was of pseudomonas in 45.8% cases. Conclusions: The most common etiology of chronic leg ulcer in this study is infective followed by traumatic ulcer. The most common associated condition found in chronic leg ulcer is diabetes mellitus.

International Surgery Journal, Mar 26, 2020

Background: Conventional antibiotic therapy during operation not only increases the financial bur... more Background: Conventional antibiotic therapy during operation not only increases the financial burden on patient, not only increases chances of adverse reactions among them but also not effective in reducing the infection rate after surgery. Single dose prophylactic antibiotic or maximum 24 hours dosing during or before surgery was found to be equally effective. Objective was the to study utility of single shot antibiotic prophylaxis in patients undergoing surgery Methods: This prospective study includes 100 clean elective surgical cases randomized to groups of 50 each. Single dose prophylactic antibiotic was given to cases in the study group and conventional antibiotic therapy was given to cases in the control group. Study group cases received Injection Ceftriaxone in the dose of 2 gm intravenously. This was given at induction or half an hour before the incision was given. Second dose was given if there was delay in starting the surgery for more than three hours. Dose of the antibiotic was adjusted for children, underweight and obese persons. For cases in the control group. Injection ceftriaxone 1 gm was given intravenously twice a day for three days. Surgical site infection incidence was recorded. Results: Both the groups were comparable for age, sex, diagnosis and hence the type of surgery performed. The incidence of fever, redness, swelling and wound discharge which are the signs of surgical site infection after surgery was not found to be statistically significantly different. Management protocol was also not significantly different after the surgery. Conclusions: Single shot antibiotic before surgery is equally effective in reducing the incidence of surgical site infections (SSIs) compared to conventional antibiotic therapy.

In the absence of symptoms of the primary disease, most patients with bile duct strictures (bilia... more In the absence of symptoms of the primary disease, most patients with bile duct strictures (biliary strictures) remain asymptomatic until the lumen of the bile duct is sufficiently narrowed to cause resistance to the flow of bile. Occasionally, patients may have intermittent episodes of right upper quadrant pain (biliary colic), with or without laboratory features of biliary obstruction. Patients most often present with features of obstructive jaundice. On occasion, a patient may present dramatically with sepsis and hypotension due to ascending cholangitis. We report a case of benign CBD stricture in an operated case of gastro-jejunostomy who was operated with cholecystectomy and choledoco-jejunostomy and she recovered fully.

The commonest complaints for which the patients seek hospital care are Upper gastrointestinal (GI... more The commonest complaints for which the patients seek hospital care are Upper gastrointestinal (GI) symptoms. It has been estimated that the prevalence of these symptoms ranges from 8% to 54%. Some of the most common of them are ‘dyspepsia, dysphagia, gastrointestinal bleeding, progressive unintentional weight loss, persistent vomiting or of unknown cause, anemia or epigastric mass’. Endoscopy is the most commonly offered investigation for these cases. Helicobacter pylori are a non-spore forming, gram negative bacterium with a helical shape. Curved forms occur and the bacillus also converts to a coccoid morphology under environmental stress. It has multiple flagella at one pole (1-5) and is actively motile. Flagella play important role in motion and adhesion. H. pylori can survive in an acid environment for a short time but is not an acidophile. H pylori are oxidase positive and catalase positive and are a strong producer of urease.

Background: In hemorrhoids, the anal canal venous plexuses become engorged. It can lead to bleedi... more Background: In hemorrhoids, the anal canal venous plexuses become engorged. It can lead to bleeding, thrombosis, prolapse, pain. Study of surgical profile helps to educate the patients to take proper precautions to avoid the severe forms of it. The objective of the study was to study the surgical profile of patients with hemorrhoids at a tertiary care hospital.Methods: Present study was hospital based cross sectional study. It was carried out at a tertiary care hospital in the department of general surgery among 100 patients who presented with symptoms suggestive of hemorrhoids during the study period from 1st January 2017 to 31st October 2018.Results: Majority of the patients 41% were in the age group of 35-45 years. The number affected by hemorrhoids was more in males i.e. 56%. Incidence of hemorrhoids was more in upper class. Incidence of hemorrhoids was less i.e. 21% among those who took only vegetarian diet. Majority of the patients (78%) presented after one year of occurrence ...

New Indian Journal of Surgery

New Indian Journal of Surgery

New Indian Journal of Surgery

New Indian Journal of Surgery

International Surgery Journal

Background: Post-operative wound infections have been a problem since surgery was started as a tr... more Background: Post-operative wound infections have been a problem since surgery was started as a treatment modality. Post-operative infections were responsible for 70-80% of deaths until Ignaz Semmelweis and Joseph Lister, in middle of 19th century, introduced methods of infection control by use of antiseptics. Objective was to study the incidence of postoperative infection in tertiary rural hospital.Methods: A hospital based cross sectional study was carried out at Department of General Surgery, SRTR Rural Government Medical College from September 2015 to August 2016 among 1250 patients. Detailed history, complete and thorough clinical examination was carried out for each and every individual included in the present study. The patients are assessed pre operatively and post operatively.Results: It was found that the maximum cases belong to the age group of 26-35 years i.e. 28.32% followed by age group of 36-45 years (25.68%). The proportion of males was slightly more than females. The...

International Surgery Journal

Background: Many factors affect the incidence of surgical wound infection, in addition to the sur... more Background: Many factors affect the incidence of surgical wound infection, in addition to the surgeon’s skill and the hospital environment. Host attributes, such as age over 60 years, diabetes mellitus, malignant disease, obesity, malnutrition, length of preoperative stay or pre-existing infection may influence risk, as may such operation characteristics as site, urgency, duration and time of skin shaving. Objective was to study the preoperative, intra-operative and postoperative factors responsible for postoperative wound infection.Methods: This descriptive study was designed to study the problem of postoperative wound infection at tertiary health care center at rural set up over a period of two years during 2014 to 2016. Initial assessment of intra operative findings divided these cases into clean, clean contaminated and contaminated cases.Results: As the length of pre-operative stay increased, the occurrence of SSIs increased. As the duration of post operative hospital stay incre...

International Surgery Journal, 2016

INTRODUCTION Peptic ulcer disease (PUD) remains one of the most prevalent diseases of the gastroi... more INTRODUCTION Peptic ulcer disease (PUD) remains one of the most prevalent diseases of the gastrointestinal tract with annual incidence 1 ranging from 0.1% to 0.3% in India. Cases of peptic ulcer perforation are commonly encountered in our institute. The high incidence of mortality and morbidity associated with this condition, promoted us to carry out an in depth study of this condition. There are well known two major precipitating factors: Helicobacter pylori infection and the use of non-steroidal anti-inflammatory drugs (NSAIDs) and the ulcer incidence increase with age for both duodenal and gastric ulcers.

International Surgery Journal, 2016

Peptic ulcer perforation is one of the common surgical emergencies which need immediate surgical ... more Peptic ulcer perforation is one of the common surgical emergencies which need immediate surgical intervention. 3 For many years, the routine upper laparotomy still seems to be the routine treatment of ABSTRACT Background: Peptic ulcer perforation is one of the common surgical emergencies which need immediate surgical intervention. For many years, the routine upper laparotomy still seems to be the routine treatment of perforated peptic ulcer. The improvement of technology and an increase in laparoscopic experience have been central to the development of laparoscopic surgery. Objective of the study was to assess the efficacy of laparoscopic approach in perforated peptic ulcer repair. Methods: The present study is based on the analysis of 30 cases of peptic ulcer perforation admitted to our hospital between 2013 and 2015. Post-operative mobilization of every patient was done after 6 hours and H 2 receptor antagonist or proton pump inhibitor was given with fluid, antibiotics and nasogastric suction. Post-operation analgesics (IV tramadol ± IM diclofenac SOS) were given according to visual analogue score (VAS). Results: 22 (73.33%) patients were having duodenal ulcer perforation and 8 (26.67%) were having gastric ulcer perforation. Postoperatively out of 30 patients, 18 patients were presented with VAS 4. The most common complication was trocar site infection seen in 2 patients (6.6%). 3 patients (10%) needed to covert laparoscopic procedure into open procedure due to large size of perforation (>10 mm). The hospital stay varied from 4-16 days. Conclusions: Laparoscopic repair of perforated peptic ulcer is safe and reliable technique. It gives the patient all the advantages of laparoscopic surgery with accepted post-operative morbidity and mortality rates. However, laparoscopic closure of the perforation is technically demanding. It should be considered as a good choice in the presence of reasonable laparoscopic skills and experience. It had less postoperative pain and reduced analgesic usages, shorter postoperative hospital stay and early return to oral feeding and normal daily activities.

International Surgery Journal, 2016

Recent studies suggest that the use of tissue adhesive for closure of both traumatic lacerations ... more Recent studies suggest that the use of tissue adhesive for closure of both traumatic lacerations and incisional surgical wounds leads to cosmetic outcome comparable to conventional sutures. 3

Head & Neck Surgery, 1979

The anatomy, design, and blood supply of the pectoralis major myocutaneous island flap are descri... more The anatomy, design, and blood supply of the pectoralis major myocutaneous island flap are described. This versatile, nondelayed flap has, for the most part, replaced the usual cutaneous flaps. Clinical examples of its use in head and neck reconstructive surgery are presented.

Head & Neck Surgery, 1979

The anatomy, design, and blood supply of the pectoralis major myocutaneous island flap are descri... more The anatomy, design, and blood supply of the pectoralis major myocutaneous island flap are described. This versatile, nondelayed flap has, for the most part, replaced the usual cutaneous flaps. Clinical examples of its use in head and neck reconstructive surgery are presented.