BACKGROUNDAfter obesity, thyroid disorders are the most common cause of metabolic disturbances, with surgery forming the mainstay of treatment of many thyroid swellings.The major complications include postoperative haemorrhage, respiratory obstruction, hyperthyroid storm, hypoparathyroidism, and laryngeal nerve injuries. Surgery of the thyroid takes place in an area of complicated anatomy and in which a number of physiological functions and special senses are controlled. Thyroid gland being related to vital structures poses a challenge for the operating surgeon. But still, thyroid surgery in the hands of experienced surgeons is currently one of safest surgeries performed.This study intends to assess the occurrence of various postoperative complications following the different thyroidectomy procedures and the role of adequate preoperative patient preparation, careful, meticulous surgical technique and early recognition of postoperative complications with the prompt institution of treatment in reducing morbidity and providing the patient with the best chance of a satisfactory outcome.
: Multiple scoring systems have been addressed to identify those patients who need emergency appendicectomy as the risk of delay could be avoided. Of these, the consideration of both sore related to the Alvarado and Tzanakis is essential for the study to understand the effective diagnose of acute appendicitis. The study aims to compare and evaluate Alvarado and Tzanakis score for diagnosing the acute appendicitis. This study was conducted in the department of General Surgery associated with the M.K.C.G, Medical College and Hospital, Berhampur from August, 2018 to July, 2020. A total of 96 patients were being considered for carrying out a systematic study after carefully verifying a variety of the inclusion and exclusion criteria. To conduct the study in a systematic manner, the doctor has analyzed and given the score of Alvarado and Tzanakis. On the basis of score of these two approaches, the medical team has provided the treatment to these patients. The proper identification of score has helped to select the method of operation and surgery. In addition to this, the comparison of score focusing on the NPV and PPV has also allowed for identifying the sensitivity. The Alvarado and Tzanakis score was found to have sensitivity along with the specificity of 94.44% and 83.33% respectively. However, the PPV and NPV was found to be 98.84% and 50.00% respectively as compared to Alvarado score where sensitivity, specificity, PPV and NPV was found out to be 77.77%, 66.66%, 97.22% and 16.66% respectively. From the study, it has carried out that the Tzanakis scoring system has been addressed a more reliable for analyzing the condition of patients and offering the treatment. Diagnostic. Alvarado score, with the former achieving higher sensitivity and PPV.
BACKGROUND Acute pancreatitis is a common condition involving the pancreas. The estimated incidence is about 3% of cases presenting with pain abdomen in the UK. The hospital admission rate for acute pancreatitis is 9.8/100,000 per year in UK and annual incidence may range from 5-50/100,000 worldwide. Gall stone disease and alcohol account for greater than 80% of all patients with acute pancreatitis, with biliary disease accounting for 45% and alcohol found in 35% of patients. Given the wide spectrum of disease seen, the care of patients with pancreatitis must be highly individualised. Patients with mild acute pancreatitis generally can be managed with resuscitation and supportive care. Aetiological factors are sought and treated, if possible, but operative therapy essentially has no role in the care of these patients. Those with severe and necrotising pancreatitis require intensive therapy, which may include wide operative debridement of the infected pancreas or surgical management of local complications of the disease. AIM OF THE STUDY 1. To study the age and sex prevalence of acute pancreatitis. 2. To study the various aetiological factors of acute pancreatitis. 3. To study the clinical presentation and management of acute pancreatitis. MATERIALS AND METHODS Patients admitted to the Department of General Surgery at M.K.C.G Medical College and Hospital, Berhampur were taken up for the study. Totally, 49 patients with 53 episodes of acute pancreatitis were studied from September 2013 to August 2015. RESULTS AND CONCLUSIONS Acute pancreatitis is a common cause of acute abdomen in patients presenting to the surgical emergency department. Alcohol being the most common cause of acute pancreatitis in this part of the country, it has a male preponderance and most commonly presents in the 4th decade of life. It is mainly a clinical diagnosis supplanted with biochemical and radiological findings. The management is mainly conservative, with surgery reserved for patients with biliary pancreatitis and those developing complications secondary to acute disease. In those developing necrosis, there is a trend toward delaying necrosectomy. Recent results support the use of minimally invasive procedures for the various complications associated with acute pancreatitis.
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