No abstract

Aims and Background: Like any other drug, therapeutic use of blood and its components has its own side effects, adverse reactions and risks involved. Overall use of blood has been on the increase in most tertiary care hospitals. Since the guidelines for blood and its components use in a clinical setting are well defined, but not practiced in reality, the present study aims at defining the problems associated with blood transfusion in the light of its risks and benefits as a drug. Materials and Methods:We carried out prospective survey of 1453 units of blood and components for 696 patients during period of 6 months and recorded the indications for usage and transfusion reactions associated with its usage.Results: Out of 1453 units' blood/blood component transfused, 48 (3.30%) units of blood developed transfusion reactions. Of these, 41 were produced by whole blood, (85.41%) & 5 units (10.42%) by packed cells. FFP 1 unit (2.08 %) for a patient with alcoholic liver disease produced reaction. 1 unit of fresh whole blood (2.08%) has produced reaction. Medical cases produced the more number of blood transfusion reactions (14 patients). Most of the blood transfusion reactions were allergic (50%) and most of the reactions were produced after multiple transfusions. Conclusion:There is lack of blood transfusion committee in IGGGH&PGI, Puducherry Hospital, which has produced inappropriate transfusions due to absence of strict transfusion triggers.Transfusion Trigger: Hb% < 7 gms% is an indication for blood transfusion and hematocrit < 27% is an indication. Blood transfusion should be started immediately after its issue from blood bank, if not used within ½ hour and then replaces it to blood bank for cold chain maintenance.Transfusion reactions (3.3%) more common agent is whole blood, since it contains all unnecessary components, which produces allo-immunization.Blood component usage should be increased which will reduce the incidence of transfusion reaction.as yet prior to the discovery of blood group antigens, approximately one third of human transfusions resulted in adverse outcome, often death [4]. With the discovery of blood group antigens in 1901, by Karl Landsteiner, transfusion therapy changed from a hazardous proposition to a relatively safe procedure. Safety from transfusion transmitted diseases improved with advancement of technology. The recent testing facilities have lowered the incidence of transfusion-transmitted diseases to minimum [5]; however, the incidence of adverse events due to human errors [6], ABO incompatibility, alloimmunization, bacterial contamination and immunomodulation phenomena remain a matter of concern.

Diverticular disease of the appendix was first described by Kelynack in 1893. Diverticula are commonest in the descending and pelvic loops of the colon, but they not infrequently occur at other sites extending from the pharynx to the rectum. It is rare, however, to find diverticula in the vermiform appendix. Pathologists state the incidence varies from 0-2 to 2-23 per cent in postoperative and necropsy findings. Here we present one such rare case of appendicular diverticulosis with appendicitis.

Approximately, 10 to 20% of patients with peptic ulcer suffer a perforation of stomach or duodenum in which chemical peritonitis develop initially from gastric and duodenal secretion but in a few hours bacterial contamination superimpose the disease. The disease could be life-threatening, early diagnosis and treatment is extremely important. The mortality will increase up if perforation exists more than 24 to 48 hours. Usually the only surgical procedure that is necessary is simple closure with omental patch. When repair of perforated ulcer can be achieved by suture closure, laparoscopic approach seems to be appropriate. This study aims at evaluating efficacy, safety and outcome of laparoscopic surgery for perforated duodenal ulcer. Patients admitted with perforated duodenal ulcer perforation, during the period of January 2010 to January 2011 at RL Jalappa Hospital and Research Center were evaluated. A total 61 cases were diagnosed as peritonitis secondary to duodenal perforation were involved in study. Thirty underwent laparoscopic closure and 31 underwent open surgeries which were nonrandomized. The results of study revealed lesser antibiotic open: lap (5:4.03 days; p = 0.001), analgesic requirement (7:4.87 days; p = 0.001) and lesser hospital stay (8:6.17 days; p = 0.001) and reduced postoperative complications open-three (9%): lap-one (3%) patients. The duration of surgery was more with laparoscopic surgery (open-56: lap-62.17 minutes; p = 0.003) since we are at initial stages at laparoscopic management for DU perforation, also depend on skill of surgeon but it had no effect on the overall outcome. Three (9.6%) patients in lap group were needed conversion to open surgery.

Lipoma is one of the commonest benign mesenchymal tumors in body and found almost in all organs where the fat exists. It is usually small but giant lipomas can be present in thigh, shoulder and trunk. The present study describes a 46 year old male with a huge mass right loin which on histopathology revealed features suggestive of lipoma.