Background: Sigmoid volvulus an uncommon source of bowel obstruction in middle-aged individuals.. This perilous condition pervades globally, with a pronounced predilection for elderly population burdened by concurrent health ailments. While both genders can fall victim, males (1) are more frequently affected. Case Report: A middle aged gentleman presented to emergency center reporting pain abdomen, vomiting , obstipation. On palpation generalized tenderness , guarding present, X – ray abdomen showed classic coffee bean (volvulus) immediately underwent emergency laparotomy - found sigmoid colon was distended and gangrenous. Sigmoidectomy with Hartmann’s performed. Conclusion: This case underscores the criticality of swift action in addressing this life-threatening ailment. Its evaluation should be of utmost importance among the potential diagnoses for individuals reporting with abdominal distention and pain, vomiting,obstipation. An abdominal X-ray (3) both erect and supine positions provides excellent diagnostic results
Fistula in ano is an abnormal communication between anal canal or rectum and perianal skin which causes chronic inflammatory response, explained by Park’s Cryptoglandular theory. Main complaint of patient is intermittent or constant discharge. There is a history of pain, swelling, recurrent abscess that ruptured spontaneously, surgically drained. DRE, proctoscopy remains main stay of diagnosis in anorectal fistulas. Surgery is mainstay, aim to cure while preserving sphincter mechanism & prevent recurrence. Aims And Objectives: • Clinical Evaluation of Patients presenting with Fistula In Ano. • Evaluation of Management Protocol of Fistula in Ano in tertiary care. • To study recurrences of fistula in ano & various Modalities of Treatment. Method: Type of study: Descriptional study Sample size: 80 cases Period of study: March 2022 – March 2024 Place of study – Tertiary care center Detailed clinical history, examination of patient was recorded. All investigations relevant to study done in patients. Appropriate surgical management performed. Post operative findings noted. Results: Out of 80 cases, mean age - 40 years (range 20-70 yrs), presenting complaints were pain, discharge, itching. Intersphincteric type being most common, the surgical outcome was best achieved by fistulectomy. Conclusion We conclude there is a male preponderance of disease and Fistulectomy remains the commonest procedure in our study series. The diagnosis by clinical methods is accurate & cost effective. The conventional technique of surgery is cost effective, has a low learning curve & all patients could have easy access to these techniques.
People experience choking by accidental slipping of food bolus in their respiratory tract in their daily lives. Most of the people recover from it but a few experience obstruction of the respiratory tract that cannot be cleared and may prove fatal. Accidental choking is the commonest manner of choking. Dead body of a 26 years old male subject was brought for postmortem examination. On autopsy examination, along with the signs of asphyxial death both externally and internally, congestion and erosion was seen in the trachea. Some traces of puffed rice was also visible along the respiratory tract by naked eyes. History furnished by the police was also corroborative. While having puffed rice with milk in his house, he suddenly became restless and turned unconscious; when taken to hospital, he was declared brought dead. This case reports about a fatal choking due to food bolus.
Background and aims: To study the effect of oral paracetamol in PDA closure in preterm neonate.Patent ductus arteriosus (PDA), in which there is a persistent communication between the descending thoracic aorta and the pulmonary artery that results from failure of normal physiologic closure of the fetal ductus. Aims: To study the effect of oral paracetamol in PDA closure in preterm neonates. Methods: An observational study to see the effect of oral paracetamol in PDA closure in preterm neonates. Results: We report 10 preterm neonates born at gestational age 27–33 weeks with birth weight range 800 grams to 1400 grams admitted to our NICU. All these preterm neonate were diagnosed to have haemodynamically significant (features of congestive cardiac failure) PDA at 4 – 7 days of life. Each of these neonate were given oral paracetamol in the dosage of 15mg/kg 8hrly for 48hrs. The ductal closure was achieved in all neonate by 48 hrs of administration. The ductal closure was confirmed with repeat echocardiography after 72hrs of administration of oral paracetamol. These neonates did not suffer any complication related to paracetamol. Conclusions: The exact mechanism use of oral paracetamol in ductal closure has not been studied on large scale, however with this study it is evident that oral paracetamol is equally effective in ductal closure with no side effects which was there with Brufen/Indomethacin. However a large randomized study is needed to validate this interesting observation.
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