Background: Gall stone disease is a chronic recurrent disease of hepatobiliary system characterised by formation of gall stones due to impaired metabolism of bile acids, cholesterol and bilirubin. The prevalence of cholelithiasis is variable and has been reported as 2-29% in India with differences in interstate and interregions. The objective of the present study was mainly focuses on the total clinical study with surgical management and their outcome.Methods: A prospective study for a period of one year was done after approval from ethical committee. The socio-demographic factors, clinical history, physical examination, laboratory investigations with ultrasound abdomen were done in all the cases. Surgical repair by Laparoscopic and open cholecystectomy was done.Results: Females were more predominant with male: female ratio of 1:1.97. Mean age of study population was 34.12±6.2 years and was more common during 5th decade of life. Pain in the hypochondrium was most common sign. Mixed stones were most common and mostly observed in cases of mixed diet. Laparoscopic cholecystectomy was most commonly performed with zero conversion rate. Wound infection was the most common post-operative complication in both the types of repair.Conclusions: To conclude, from the present study females were more commonly affected by cholelithiasis than males with a ratio of 1:1.97. Females are more prone during fertile age and reasons are multifactorial due to hormones, parity and hormonal contraceptives. Gall stone disease is more common during fourth and fifth decade of life in both males and females. Mixed diet (non-vegetarian) is associated with increased risk of developing gall stones than vegetarian diet.
Background: Urinary stone disease or Urolithiasis is on a surge of increase with an incidence of 6.3% among men and 4.1% among women. The site of development of the calculi is variable and dependable on various factors. The aim of study was to identify the various predisposing and causative factors, with clinical presentations and complications and to identify identifying various modalities of treatment.Methods: A prospective observational study was conducted for a period of one year after ethical committee approval. All the cases of Urolithiasis confirmed by ultra-sonogram was included and socio demographic data, clinical and laboratory investigations were performed on all the cases and the data was entered in Microsoft excel and analyzed. Surgical approach to all the cases were recorded.Results: 150 cases with 64% males and 36% females were included in the study and mean age was 38.21 years. Pain abdomen was the most common symptom. Calculus was most common on right side with upper pole of the kidney being most common site of calculus in the study. Mean size of calculus in the study was 12.5mm. Statistically significant association was found with Diabetes mellitus, Obesity and low water intake (P value <0.05) in the study. Ureteroscopy (URS) was performed in 36 cases (24%), PCNL in 22 cases (14.67%), ECSWL in 46 (30.67%), cystolithotomy in 34 (22.67%) and urethral extraction in 12 cases (8%).Conclusions: For renal calculi, PCNL is the best treatment modality as of now, but it is associated with greater post-operative morbidity. For stone less than 1cm size, ECSWL is a good alternative to PCNL, but has poor clearance rate and thus greater need for auxiliary procedure. For ureteral calculi, both ECSWL and ureteroscopy have given good results but ECSWL is better tolerated by the patients.
Background: Typhoid fever is an acute febrile illness caused by gram negative bacilli, Salmonella enteritidis serovars typhi. The incidence of typhoid fever varies globally from 140 episodes per 10000-person years in Kolkata to 273 per 10000 in Delhi, India. The present study was done with an aim to assess the risk factors, complications and different surgical techniques in cases of typhoid ileal perforation. The study also identifies and focuses on the post-operative complications in cases of perforation due to typhoid fever.Methods: A prospective study was conducted for a period of two years from June 2105 to May 2017 at a tertiary care hospital on all the cases admitted and operated for typhoid perforation. The data collected was analyzed using SPSS version 15.0 for windows 7.Results: 104 cases with an incidence rate of 8.4% of perforation were included in the study. Males were majority and mean age of the study group was 21.8±10.1 years. The peak incidence of study group was 31-40 years and >60 years. Fever and abdominal pain (rebound tenderness) was the common sign and symptoms. Free fluid and air collection under the diaphragm was the commonest finding in radiographs and ultrasound. Majority of the cases had single perforation (84.62%) and ileum was the most common site of perforation (84.62%). Simple closure with double layering was the commonest surgical procedure performed and the incidence of post-operative complication was 36.5%. Overall mortality in the study was 3.8%. SSI was the commonest post-operative complication.Conclusions: To conclude from our study, typhoid still remains as an endemic disease in spite of improved awareness and better sanitation facilities. Inadequate treatment, misdiagnosis and mismanagement of cases by non-medical practitioners at rural settings may increase the risk of complications
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