Background: Many laparotomy may require relaparotomy due to post-operative complication as life-saving procedure. Incidence of relaparotomy and post-operative outcome defers from patient to patient. The objectives of our study were to evaluate the indication of relaparotomy, outcome of the relaparotomy and factors affecting mortality.Methods: Data was collected between March 2017 and November 2019 in SSG hospital, Vadodara. Patient’s demographics, indication and intra-operative findings of initial surgery and relaparotomy with morbidity and mortality were studied. Patients from department general surgery and obstetrics and gynecology were included. Consent was taken in a pre-validated form.Results: Out of total 5684 laparotomy performed, 146 (2.58%) patients underwent relaparotomy. Male to female ratio was 1.5:1. Incidence was highest in 31-40 years age group (median age: 37 years). Dirty wound in initial laparotomy had highest conversion rate (3.21%) to relaparotomy. Mean interval between initial laparotomy and relaparotomy was 8.57±5.62 days. The major indication of relaparotomy was burst abdomen (39.52%) followed by leak from previously sutured site (24.65%). 50.68% patients were shifted to ICU following relaparotomy. Average days of ICU admission were 4.16±2.25 days. Mortality rate was 23.29%. Maximum mortality was noted in case of leak from anastomotic or perforation site. 14 (38.88%) deaths occurred during postoperative day second to fourth with mean hospital stay of 21.85±8.65 days.Conclusions: Although relaparotomy is life-saving procedure, it has high mortality rate. The possibility of efficiently lowering relaparotomy depends on success of the first laparotomy, patient’s status, early re-exploration with proper surgical techniques and thorough postoperative care.

Background The use of BRCA testing to guide the course of breast cancer treatment has evolved in the last 5 years; however, little is known about the use of BRCA testing in a real-world setting. This study assessed the trend in prevalence of BRCA testing and sociodemographic and clinical predictors of receiving a BRCA test among newly diagnosed patients with breast cancer. Methods This was a retrospective study conducted using the Optum Clinformatics Datamart database. Patients newly diagnosed with breast cancer, continuously enrolled in a health plan for ≥6 months before and after diagnosis were included in the study. Claims for BRCA testing were identified after diagnosis using HCPCS, ICD-9/10 procedure, and LOINC codes. The prevalence of BRCA testing was calculated for patients diagnosed in each year from 2012-2017. Multivariable logistic regression was used to assess predictors of BRCA testing controlling for sociodemographic and clinical factors. Results From a total of 81,774 breast cancer patients included, 13,529 (16.5%) received a BRCA test after diagnosis. The prevalence of BRCA testing increased from 1,721 (11.5%) in 2012 to 2,384 (17.1%) in 2013 and remained stable over time until 2017 [2,191, (18.5%)]. Of patients receiving a BRCA test, 11,688 (86%) were tested within 1 year of diagnosis. The median time to receive a BRCA test from diagnosis was 29 days (mean: 172.7 days). Results from logistic regression indicated that diagnosis at a younger age (e.g., 18-44 years versus ≥75 years, odds ratio [OR] = 25.3), diagnosis in recent years (e.g., 2017 versus 2012, OR =1.94), having a point of service versus health maintenance organization plan type (OR = 1.10), presence of metastasis (OR = 1.62), and family history of cancer (OR = 4.98) significantly (P<0.05) increased odds for receiving a BRCA test. Female gender (OR = 0.28), living in regions other than West (e.g. South, OR = 0.86), having commercial insurance versus Medicare Advantage (OR = 0.96), Charlson comorbidity index score of ≥3 vs 0 (OR= 0.83) were significantly (P<0.05) associated with lower odds of receiving a BRCA test. Conclusions Prevalence of BRCA testing among breast cancer patients increased initially in 2013 and remained stable over time until 2017. Several demographic and clinical factors were associated with the use of BRCA testing among breast cancer patients. Citation Format: Shelby Corman, Hrishikesh Kale, Pooja Shah, Gboyega Adeboyeje. Trends in BRCA testing among patients diagnosed with breast cancer -a retrospective analysis of a United States commercial claims database from the PRIOR-1 study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-78.

Background & Objectives: Maintenance of nutrition status of a patient is of paramount importance to clinicians treating medical or surgical diseases. Enteral nutrition is preferred over parental nutrition in patients who are unable to swallow. Percutaneous endoscopic gastrostomy (PEG) is the preferred route of nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition and are unable to maintain oral intake. PEG offers superior access to the gastrointestinal system over surgical methods.We aim to see utility of percutaneous endoscopic gastrostomy (PEG) for nutritional support in patients with oropharyngeal dysphagia secondary to neurological deficits and its effect on the quality of life of these patients.Methodology: we studied retrospectively 25 patients with neurological oropharyngeal dysphagia in last 2 years needing PEG insertion. We reviewed data of the patients for 3 months post insertion of PEG. Study was based on body weight, haemoglobin and serum albumin level prior to and after PEG. All complications including sepsis, perforation, hemorrhage and death were recorded.Results: Our study showed significant improvement in levels of hemoglobin, albumin and weight gain after Percutaneous endoscopic gastrostomy. There were no major complication. Conclusion:Percutaneous EndoscopicGastrostomy is an easy procedure that can be done bedside without complications in patients with neurological deficit. It improves nutritional status of the patient and also prevents aspiration pneumonia in patients with good gastric motility.

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