: Acute widespread peritonitis caused by a perforated hollow viscus is a potentially fatal illness. It's a common surgical emergency in many developing-country general surgical departments, and it's often associated with substantial morbidity and mortality. Grading the severity of acute peritonitis has greatly aided decision-making and improved the therapeutic success in the management of critically ill patients. Empirically based risk assessment for major clinical events has proven to be tremendously valuable in evaluating new medicines, monitoring resource utilisation, and improving care quality. A hospital based prospective observational study was conducted on patients operated on emergency basis for hollow viscus perforation admitted to the hospital, the study was conducted from OCT 2014 – SEP 2016 at Kamineni institute Medical sciences & hospital, Narketpally, Telengana. A series of 100 cases was compiled for this study during this period. The accuracy in outcome prediction of APACHE–II system was assessed by means of receiver operating characteristic curve and Pearson correlation coefficient. The Analytical data obtained was compared and discussed with the data available in the literature. A total of 100 patients were studied. Out of which there were 86(86%) survivors and 14(14%) non-survivors. Mean APACHE–II score of the study population was 9.80 with a range of 1-30. The predicted death rate for the study population was 16% and observed death rate was 14%. Mean APACHE–II score in survivors was 8.03 where as in non-survivors it was 20.64. The area under the curve using receiver operating characteristic curve analysis was found to be 0.985. The association between the APACHE-II score and the predicted death rate was flawless, with r = 0.99 and P0.001. In patients with peritonitis caused by hollow viscus perforation, an APACHE-II score of 11-20 was found to be a stronger predictor of mortality risk. In patient groups with APACHE-II scores of 0-10 and scores > 20, predicted death did not match observed mortality. APACHI-II scoring system can be used for assessment of group out come in patients with peritonitis due to hollow viscus perforation. However, it does not provide sufficient confidence for outcome prediction in individual patient.
Benign breast disorders are usually hormone induced and therefore usually seen in the reproductive period of life with dramatic fall in incidence after menopause. As compared to breast cancers, benign breast lesions are 10 times more common. The aim of the study was to determine the spectrum and incidence of various benign breast diseases in female patients attending our institute and to compare the results with those of other studies. Material and methods: 80 cases of benign breast diseases which were clinically diagnosed and confirmed pathologically or radiologically were subjected for therapeutic interventions and the results were analysed. Results: In the present study of 80 cases, the age group most affected by benign breast diseases was 21-30 years. 63 patients (78.8 %) presented with lump in the breast and 23 patients’ common symptom is pain. In most of the cases of lump had duration between 7-12 months (38.8 %), pain for 1-5 days (13.8 %), discharge for 0-5 days (11.3 %). Both breasts were involved in 6 cases (7.5 %) whereas right and left breasts are equally involved in 47 cases each (46.25 %). Most of the patients were nulliparous (46.3 %) followed by multiparous (38.8 %) and uniparous (15.0 %). Fibroadenoma constituted in 53.8 % of patients (44 cases), breast abscess constituted 21.25 % (17 cases). The most commonly affected age group was 21-30 years. 63 patients (78.8 %) presented with lump in the breast and 23 patients presented with pain. HRUSG findings correlated with that of clinical diagnosis in 70 cases. 60 cases underwent core biopsy, and in 41 cases (68.33 %) there were fibroadenoma and 7 cases (11.66 %) fibro adenosis. 59 cases (73.75 %) underwent excision, and 18 cases (22.5 %) incision and drainage. Conclusion: The most common benign breast disease was fibroadenoma. Most common age group affected with benign breast disease was 21-30 years. 88.7 % of clinical diagnosis, 90.3 % of radiological diagnosis, 93.3 % of core needle biopsy diagnoses were correlating with the histopathology diagnosis
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