Aim of treatment is to achieve skin cover to prevent infection and to allow early mobilization. Electrical injuries are a relatively uncommon. Adult electrical injuries usually occur as an occupational hazard, whereas children are primarily injured accidently. The spectrum of electrical injury is very broad, ranging from minimal injury to severe multiorgan involvement, with both occult and delayed complications and death. This is a prospective study from Indira Gandhi Government Medical College, Nagpur. A total of 98 patients presenting from June 2002 to September 2011 were included. Patients were treated with surgical excision 31 (31.63 %), fasciotomy 26 (26.53 %), escharotomy 87 (88.78 %), and amputation 12 (12.24 %). In all patients debridement was performed. After follow-up, there was 8.16 % (8 patients) mortality. Minimal mortality may be due to less surface area involved or no visceral injury. Patients survived with morbidity due to amputation. Initial management of electrical burn is imperative to optimize function and minimize long-term scarring. However, further studies are required regarding flap repair and microsurgery to minimize the rate of amputation.
Evaluation of platelet count and its significance in early detection of post burn septicemia for commencement of timely vigorous treatment against it. Studies investigating the role of platelets and platelet count in burn patients are rare, rather old and mostly presenting case reports. Septicemia is the most important cause of mortality in burns. Burn patients can only be saved if septicemia is detected early which requires very sensitive prognostic indicator. Total 594 adult burn patients were studied, by observing them for septicemia and studying their subsequent platelet counts using visual method. In non-survivors (256) gradual decline in platelet count was observed and minimal platelet count was observed before death of the patient, while in survivors (338) gradual rise in platelet count was observed. No significant variation observed in other laboratory parameters such as total neutrophil count and serum creatinine. In significant number of non survivor (62.11%) platelet count was low before their death and in significant number of survivor (86.09%) platelet count was normal before their discharge. Thus it is conclude that serial declining platelet count is a very sensitive prognostic factor in early detection of post burn septicemia.
The prospective validation of scoring system was conducted in the department of surgery, IGGMC, Nagpur. During the period from May 2002 to Jan 2012 total 683 patients with preoperative diagnosis of acute appendicitis were included in the study. We have developed a scoring system by using bedside six parameters and their scores which were proved to be significant in accurate diagnosis of acute appendicitis. RESULTS:-The number of histopathologically proved acute appendicitis patients in our study is 596. Out of these, 18 patients had perforated appendix. The overall incidence of incorrect diagnosis of acute appendicitis was 12.74%. Positive predictive value is 70.06 %. CONCLUSION:-The devised scoring system help to reduce the negative appendectomy rate and it can be good assistance in suspected cases of acute appendicitis for making an accurate diagnosis. If the present scoring system is followed the negative appendicectomy rate would be 4.69 %. However, further randomized control trial is needed to investigate the clinical benefit of practical scoring in acute appendicitis.
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