Background: Gunshot injuries are range from minor superficial pellet injuries to devastating soft tissue and visceral injuries. The objective of study was to evaluate complete profile and outcome of gunshot injuries in tertiary care centre.Methods: This study was a prospective study. All gunshot injury patients who admitted in Department of Surgery, Moti Lal Nehru Medical College, Allahabad were included in study.Results: Result were analysed in terms of age, sex, rural-urban and religion wise distribution, etiology of injury, arms and ammunition, time elapsed in first aid, site of injury, associated injury, organ involved, Glasgow coma scale, injury severity score, revised trauma score, various blood and radiological investigations, treatment and complications.Conclusions: Gunshot injury was common in male patients, age group 21-30years, Hindu community and in rural areas. Most patients received injury by shotgun. Assault was most common cause followed by accidental injury. Majority of patients had Glasgow coma scale between 13-15, injury severity score below 20 and revised trauma score more than eight. Mortality and morbidity were more common in patients with high injury severity score, low revised trauma score and Glasgow coma scale below 8. Abdomen was most common site involved in gunshot injury. Most of the patients were managed conservatively as these patients had external body surface injury. Laparotomy was done for intra-abdominal injury. Wound infection was the most common complication.
Background: It has been shown that there is a transient elevation of serum liver enzymes after laparoscopic surgeries and major causative factor seemed to be the CO2 pneumoperitoneum. In most of the cases, it does not have any clinical significance in the patient with normal preoperative liver function. However, in patients with deranged liver function, these changes can have great significance.Methods: The present study was designed to determine and compare changes in liver function tests and renal function test following laparoscopic cholecystectomy and open cholecystectomy. This study was conducted on 100 patients admitted to Swaroop Rani Nehru Hospital, Allahabad, India from August 2017 to January 2019 who were having symptomatic cholelithiasis with a history of either acute cholecystitis, biliary colic or chronic cholecystitis. All patients were investigated for complete liver function tests and renal function test including serum bilirubin, SGOT, SGPT, alkaline phosphatase, LDH, S. urea, S. creatinine, S. Na+, S. K+, S. Ca+ and urinary sodium (UNa+). The laboratory tests were carried out in the same laboratory using one type of instrument.Results: In open cholecystectomy, bilirubin decreased by 11% (p value equals 0.191) and remained decreased to the preoperative value on day 1 and day 7. While, laparoscopic cholecystectomy at 14 mmHg pressure, mean bilirubin decreases by 14% immediately postoperatively (p value equals 0.1733) and returns to normal level in 7 days. These changes are clinically insignificant and statistically insignificant.Conclusions: Enzyme elevations could mostly be attributed to the adverse effects of the pneumoperitoneum on the hepatic blood flow and renal blood flow and CO2 absorption in the blood. Though, these changes do not seem to be clinically significant, care should be taken before deciding to perform laparoscopic cholecystectomy. This study suggested that laparoscopic cholecystectomy is a safe operative procedure and have added advantages. The disturbances in the function of the kidney after laparoscopic cholecystectomy are self-limited and not associated with any morbidity in patients with a healthy kidney function.
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