Seth Vc Gandhi And Ma Vora Municipal General Hospital

Mumbai, India

Seth Vc Gandhi And Ma Vora Municipal General Hospital

Mumbai, India
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Chatterjee A.S.,Seth Vc Gandhi And Ma Vora Municipal General Hospital | Renganathan D.N.,Coimbatore Medical College
Journal of Clinical and Diagnostic Research | Year: 2015

Background and Objectives: Perforative peritonitis carries considerable morbidity and mortality with the postoperative period unpredictable most of the times. It therefore becomes necessary for a scoring system that predicts the post-operative outcome. POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity) helps in predicting the post-operative morbidity and mortality in these patients. POSSUM scores are based on 12 physiological factors and 6 operative factors. In our study, we included two more factors, which are specifically important in perforative peritonitis; they are, perforation to operation time and the presence of co-morbidity. The presence of these factors significantly affects the post-operative status. Through this prospective study, we can predict which patients are at a higher risk of death or complication and give appropriate management as necessary. Materials and Methods: Our sample size was 50 patients with perforative peritonitis. The study was conducted in single unit from September 2013 to August 2014. Data was collected based on POSSUM scoring system. Outcome of the patients was recorded as death/alive; complicated/uncomplicated and statistical analysis was done by comparing the expected and observed outcomes. Results: By applying linear analysis, an observed to expected ratio of 1.005 was obtained for mortality and 1.001 for morbidity. There was no statistically significant difference between the observed and expected mortality rates (χ2 = 3.54, p = 0.316) and morbidity rates (χ2 = 2.40, p = 0.792). It was found to be comparable with other studies. The factors independently studied; perforation to operation time and presence of co-morbidity were statistically significant with respect to outcome (p<0.05). Conclusion: Although a small sample size is the limitation of this study, POSSUM scoring system is a good indicator of postoperative outcome in patients with perforative peritonitis and was applicable in our setup. It is useful in identifying high risk patients and give preferential care to them for better outcome. Inclusion of factors like perforation to operation time and co-morbid status can improve the scoring system and better care can be provided. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.


Kamath B.,Seth Vc Gandhi And Ma Vora Municipal General Hospital | Kamath P.,Dypatil Dental College And Hospital | Bhukebag P.,Hira Mongi Navneet Hospital
Journal of Clinical and Diagnostic Research | Year: 2015

Heterotopic Salivary Gland Tissue (HSGT) is salivary tissue found in locations not normally host to it. Neoplasms occurring in these heterotopic tissues are very rare. Review of literature has revealed the neck to be host to HSGT and rarely, tumourigenic changes in these inclusions have been observed. We present a clinically unsuspected case of an ectopic pleomorphic adenoma of lower neck in which the ectopic salivary tissue was found in subcutaneous plane, which to the best of our knowledge has not been reported and was proved only on cytology and histopathology. There is a probability of this tumour undergoing malignant transformation. Therefore, these tumours need to be promptly diagnosed, adequately treated and should be included in the differential diagnosis of neck masses. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.


Kamath B.,Seth Vc Gandhi And Ma Vora Municipal General Hospital | Chatterjee A.S.,Seth Vc Gandhi And Ma Vora Municipal General Hospital
Journal of Clinical and Diagnostic Research | Year: 2015

Situs inversus totalis is a rare congenital anomaly in which position of the heart and all abdominal viscera is reversed. Situs abnormalities usually go unnoticed but may be recognized by radiography or ultrasonography as an incidental finding or during evaluation for congenital heart diseases. We present such an extremely rare and to the best of our knowledge the third reported case of an injured spleen in the right hypochondrium, following seemingly trivial blunt trauma in a patient with situs inversus totalis who underwent splenectomy. The presence of associated congenital heart defects, visceral anatomical variations and mirror imaging makes the anaesthetic management as well as the surgical exercise a challenging one in such cases. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.

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