Background: Appendectomy is the most common abdominal surgery performed today. Appendicitis consists of vast spectrum ranging from acute to chronic to recurrent forms however existence of recurrent and chronic appendicitis is still doubted by many. In spite of various scoring systems and appendectomy being the ultimate treatment, its timing remains still controversial especially in chronic and recurrent variants of appendicitis.Methods: A total of 100 consecutive cases of suspected appendicitis who were admitted investigated and treated at our centre were taken up for this observational study. Data pertaining to clinical, operative and histopathological findings were collected and tabulated. Mean and SD were used for continuous data and for categorical data, frequency and percentages were calculated. A chi-square test was used for categorical data to find statistical significance.Results: Per operatively the appendix appeared non-inflamed in 57% of patients suggestive of chronic (recurrent) form and inflamed in 43% of patients suggestive of an acute form of appendicitis. The histopathological studies revealed chronic inflammatory cells in 63% of the resected specimens, suggestive of chronic appendicitis and acute inflammatory cells in 37% of the specimens, suggestive of acute appendicitis.Conclusions: We conclude that the correlation of clinical findings, operative findings and the histopathological findings correlate with one another (p<0.001). The surgeon’s clinical and operative findings have specificity of around 87.30% and 90.47% respectively. Hence the diagnostic accuracy of the surgeon is directly dependent on the surgeons’ expertise and there is no substitution for an experienced surgeon’s judgement.
Background: Appendicitis being the one the most common cause of right iliac fossa pain that leads to emergency abdominal surgery. The existence of non-perforating or non-acute forms of appendicitis is doubted to this day despite clinical, intraoperative, radiological and histo-pathological findings. Appendectomy though being curative, yet the decision on its timing is still controversial especially in non-acute variants of appendicitis.Methods: A retrospective observational study on 200 consecutive cases of suspected appendicitis who underwent appendectomy in department of General surgery, Adichunchangiri Hospital and Research Centre during a period between January 2020 and January 2021. The data was accrued from patient data base retrospectively and analysed.Results: We found in our study that the ultrasonographic findings had a sensitivity of 100% and a specificity of 44.44% as compared to the clinical diagnosis of appendicitis. The histopathological studies revealed chronic inflammatory cells in 63% of the resected specimens, suggestive of chronic appendicitis and acute inflammatory cells in 37% of the specimens, suggestive of acute appendicitis.Conclusions: We conclude that the clinical findings, ultrasonological findings and the histopathological findings correlate with one another (p<0.001). The diagnostic accuracy of ultrasonogram was reported to range from 71 to 97% when used in the right setting (acute forms) and it is user dependent. When clinical findings compliments radiology, the existence and diagnostic accuracy of such conditions (acute and non-acute) increase drastically and can be confirmed on histopathology.
Introduction: In an era in which the cost of treatment is an increasing source of concern in wound management in surgery, wound infection increases costs and hospital stay. Aim: To study the microbial spectra, antibiotic sensitivity, different modalities of wound management and the outcome of treatment in surgical side infections and ulcerations. Materials and Methods: This cross-sectional study was conducted at a tertiary rural centre with a total of 60 cases of wounds with various aetiologies for duration of two years at AIMS, Mandya, Karnataka, India, from January 2020 to December 2021 to study demographics, prevalence and management outcome. Categorical data was represented in the form of frequencies and proportions. Results: Total 60 wound cases were further divided into three groups with 20 patients each having non specific ulcer, Surgical Site Infection (SSI) and Diabetic Ulcers (DU). The SSI was most common in patients belonging to age group 20-31 years. A total of 65% of patients who had SSI were observed among clean contaminated surgeries. Methicillin Resistant Coagulase Negative Staphylococci (MRCNS) was the most common organism causing infection in postoperative wounds, showing maximum sensitivity to vancomycin and resistance to amoxicillin. A 70% of the diabetic wounds underwent skin grafting and 70% of SSI patients underwent secondary suturing and 75% patients having an Arterial or Venous ulcers (A/V) were allowed to heal by secondary intention. Conclusion: A thorough understanding of microbial spectra and their antibiotic sensitivity is required in addition to effective wound management to improve the outcome of ulcer management.
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