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Sreekar H.,Christian Medical College | Saraf V.,Amrita Institute of Medical science and Research Center | Pangi A.C.,s Hospital and Research Center | Sreeharsha H.,SMS Medical College | And 2 more authors.
Indian Journal of Surgery | Year: 2011

Splenic abscess is an uncommon and life-threatening condition. Due to its nonspecific clinical picture, it remains a diagnostic challenge. Multiple radiological modalities are used for the diagnosis. In this retrospective study we analyzed 75 patients treated between 1999 and 2009. The patients were divided into three groups depending on the treatment received. Group I (n = 14) consisted of patients treated with only antibiotics, Group II (n = 19) patients were treated with percutaneous drainage and Group III (n = 42) with splenectomy. We tried to establish epidemiologic and clinical features and therapeutic options in splenic abscess. Our study suggests that percutaneous drainage is a safe and effective alternative to surgery especially in unilocular or bilocular abscesses thus allowing preservation of the spleen. It should be considered as the first line of treatment although splenectomy remains the final definitive procedure if percutaneous drainage fails. © 2011 Association of Surgeons of India.


Sreeharsha H.,SMS Medical College | Sreeharsha H.,MVJ Medical College | Rai S.P.,Kasturba medical college | Sreekar H.,MVJ Medical College | Reddy R.,Vijaynagar Institute of Medical science
Polski Przeglad Chirurgiczny/ Polish Journal of Surgery | Year: 2014

Monitoring of surgical outcome is increasingly important part of governance of surgical activity. The aim of the study. POSSUM scoring system was applied prospectively to determine how it performed in predicting morbidity and mortality in patients undergoing emergency laparotomy in our hospital, a group known to be at high risk of complications and death. Material and methods. A total of 100 cases of emergency laparotomies were studied in patients admitted in general surgery department during the period of May 2008 to August 2010. The study group consisted of the following cases. Duodenal perforation (37 cases), intestinal obstruction (27 cases), gastric perforation (8 cases), ileal perforation (8 cases), appendicular perforation (7 cases), blunt trauma (4 cases) and others (9 cases). They were scored using POSSUM scoring system. Physiological scoring was done at the time of admission and operative scoring was done intraoperatively. They were followed up for the first 30 day post operative period for any complications and the outcome was noted. The observed morbidity and mortality rates were compared with the POSSUM predicted morbidity and mortality rates. Results. 15 patients died (mortality rate of 15%). The POSSUM predicted mortality was 20 deaths. O:E ratio of 0.71 was obtained. There was no statistically significant difference between the observed and predicted mortality rates (?2=1.72, p=0.974). 71 patients experienced complications. The POSSUM predicted morbidity was 61 patients. O:E ratio of 1.19 was obtained. There was no statistically significant difference between the observed and predicted morbidity rates (?2=1.594, p=0.991). Conclusions. POSSUM scoring is an accurate predictor of mortality and morbidity following emergency laparotomy and is a valid means of assessing adequacy of care provided to the patient. POSSUM can be used for surgical audit to assess and improve the quality of surgical care and helps in better outcome to the patient.


Indumati V.,Vijaynagar Institute of Medical science | Vidya.Patil S.,SDMCMS | Krishnaswamy D.,Vijaynagar Institute of Medical science | Satishkumar D.,Vijaynagar Institute of Medical science | And 3 more authors.
International Journal of Pharma and Bio Sciences | Year: 2011

Diabetic dyslipidemia consists of elevated LDL cholesterol, Triglycerides and decreased levels of HDL Cholesterol. More recent data suggests that measurement of Non -HDL Cholesterol level (calculated as Total Cholesterol minus HDL Cholesterol) could be more representative of all atherogenic, apolipoprotein (apo) B containing lipoproteins. Although apolipoprotein B can be assessed directly, measurement of Non-HDL Cholesterol can be considered as a surrogate marker for apolipoprotein B in routine clinical practice. Here an attempt is to evaluate the Lipid profile including Non-HDL Cholesterol levels and LDLC/ HDL-C ratio in type II Diabetic Patients as markers of diabetic dyslipidemia. Our study group comprised of age and sex matched 50 normal, 50 type II diabetic subjects. There was a significant increase in Non-HDL cholesterol (p<0.001) and LDLC/ HDL-C ratio(P<0.05) in diabetic patients compared to age and sex matched controls. Hence Non-HDL Cholesterol along with LDL-C/HDL-C ratio can be used as markers of dyslipidemia in Type II Diabetic patients.


Yogiraj V.,Vijaynagar Institute of Medical science | Vinayaka Prasanna K.,Vijaynagar Institute of Medical science | Chaithanya R.,Vijaynagar Institute of Medical science
Indian Journal of Forensic Medicine and Toxicology | Year: 2012

The study was carried out over a period of 1-year (January 2010-December 2010), where eight hundred and twenty five autopsies were performed. Out of these One hundred and sixty two autopsies performed were deaths due to burn injuries. The male to female ratio was 0.35:1. Females succumbed to burn injuries twice frequently (65%) when compared to males (35%). The age ranged between 01-80 years(76.54% of them belonged to the 12-35years of age-group, 16% belonged to >35 years of age group and 7.4% belonged to 9 months to 11 years of age group). The total burn surface area ranged between 20% to 95% and 117 patients (72.2%) had major burns (50-95% total burn surface area). More than half of the deaths (58%, 94 cases) from burns were within 48 hrs of the incident, 25 cases (15.43%) died between 3-4 post burn days, 34 cases survived for 5 days(20.98%) and 7 cases(4.32%) survived for 10-11 days of burn injuries. Almost 74.07% (120 cases) presented with oedema of the glottis and pulmonary oedema due to inhalation of carbon monoxide and carbon dioxide. More than 50 cases had multiple organ failure. Hence the most affected organ was lung (120 cases), followed by kidney (93 cases), heart (64 cases), nervous system (58 cases), digestive system (46 cases) and liver (41 cases).


Indumati V.,Vijaynagar Institute of Medical science | Vijay V.,Vijaynagar Institute of Medical science | Shekhanawar M.S.,Vijaynagar Institute of Medical science | Rajeshwari,Vijaynagar Institute of Medical science | And 2 more authors.
Journal of Clinical and Diagnostic Research | Year: 2014

Introduction: The widespread use of effective highly active antiretroviral therapy (HAART) in HIV patients has coincided with increasing reports of complications like HIV-associated lipodystrophy syndrome and the metabolic alterations, affecting the lipid and glucose metabolism. Evidences in support of lipodystrophy and dyslipidaemia associated with First- line HAART in our area is scarce. The aim of the present study was 1) to study and compare Lipid profile in HIV positive patients on ART with that of freshly diagnosed HIV positive patients who were yet to be started on ART. 2) To assess lipodystrophy syndrome in patients on ART.Materials and Methods: Hundred newly diagnosed HIV positive patients who were yet to be started on ART were taken as controls (ART-Naïve).Hundred randomly selected HIV+ patients who were already on First-line ART regimen (Stavudine/Zudovudine + Lamivudine + Nevirapine) for more than 12 months were taken as cases (ART). This study was conducted for a period of 12 months at the VIMS ART centre, Bellary.Results: There was a significant increase (p<0.001) in serum Total Cholesterol, LDL-C, TG, VLDL, Non-HDL -C & TC/HDL-C ratio in ART patients compared to ART-naïve patients. Of the 100 ART patients 23 had lipodystrophy syndrome (buffalo hump, abnormal fat deposition around neck & back, buccal fat resorption, increase in abdominal fat).Conclusion: To conclude, it is evident from our study that there is increase in lipid profile (except HDL) in ART patients compared to ART Naïve group and twenty three ART patients showed lipodystrophy syndrome. Hence it appears reasonable to measure fasting lipid levels before and 3-6 months after antiretroviral therapy is initiated or when ART regimen is changed. © 2014, Journal of Clinical and Diagnostic Research. All rights reserved.

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