General Surgery articles list

Abstract In every hospital, Casualty department deals with the emergency cases. These emergency cases also includes medicolegal cases like road traffic accidents, Poisoning, assaults are dealt in the casualty and detailed MLC report is made here after giving the proper primary treatment and life saving measures. The police is informed about MLC as early as possible. Important preventive measures like drawing public attention and awareness towards traumatic casualties can help in the prevention or management of unnatural (medicolegal cases). Considering the importance of above points, a one year retrospective study from 1st March 2018 to 31st March 2019 was conducted in the Casualty department of Tertiary Care Centre.

Dr. Avinash Harishchandra Waghmode

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

In this paper, investigations are made to analyze the human body temperature during wound healing process due to surgery. Wound is considered after the skin graft. Skin graft is a technique used in plastic surgery. Skin is the first line of defense between the human and environment, it is very susceptible to damage. Internal body or core temperature (Tb) is one of the clinical vital signs along with pulse and respiratory rates. Any disturbance in body temperature will drive complexities in wound healing process. These studies are important in the mechanism of establishing the limits of thermal regulation of human body during the healing process in different situations and conditions. The Finite element method is used to analyze tissues temperature for normal tissues (donor site) and abnormal tissues (tissues after surgery). Appropriate boundary conditions have been framed. Numerical results are obtained using Crank Nicolson Method.

Manisha Jain

Physically unclonable function (PUF) is a hardware security module preferred for hardware feature based random number and secret key generation. Security of a cryptographic system relies on the quality of the challenge-response pair, it is necessary that the key generation mechanism must unpredictable and its response should constant under different operating condition. Metastable state in CMOS latch is undesirable since it response becomes unpredictable, this feature used in this work to generate a unique response. A feedback mechanism is developed which forces the latch into the metastable region; after metastable state, latch settle to high or state depends on circuit internal condition and noise which cannot be predicted. Obtained inter hamming variation for 8 PUF is 51% and average intra hamming distance is 99.76% with supply voltage variation and 96.22% with temperature variation.

Abhishek Kumar

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

Hydatidosis is a parasitic zoonosis caused by the larval form of Echinococcus granulosus, endemic in the Mediterranean basin, the Middle East, and South America. [1] While this pathology primarily affects the liver (50-70%) and lungs (20-30%), [2] vesicular localization is exceptionally rare, representing merely 0.1% of all hydatid localizations. [3] This rarity significantly complicates preoperative diagnosis, often leading to intraoperative discovery.

Karishma

A 28-year-old female presented with recurrent chronic abdominal pain. An abdominal ultrasound revealed cholelithiasis, characterized by two large stones and several smaller ones. Laboratory tests including liver function tests were within normal limits. A laparoscopic cholecystectomy revealed an enlarged dark black liver, with round margins suggestive of Dubin Johnson syndrome (Figure 1) , while the Gallbladder was distended with multiple calculi inside. Successful laparoscopic cholecystectomy was done with a liver biopsy. Histopathology of the gallbladder revealed chronic cholecystitis. A liver biopsy confirmed the diagnosis of Dubin Johnson Syndrome. The follow-up was uneventful.

Karishma

The aim of the study is to: assess the effectiveness of structured teaching programme on prevention of selected postoperative complications among 300 patients undergoing abdominal surgeries in selected hospitals. A pre-experimental research design and convenient sampling technique was adopted study. Data were collected by using structured interview schedule and structured questionnaire was used to assess the existing knowledge regarding prevention of selected post operative complications. Shows that majority (42.70%) subjects had inadequate knowledge and (18.30%) had moderate knowledge in pre test. In post test majority 44 (73.3%) had adequate knowledge and 16 (26.7) had moderate knowledge. The pre test mean score was 16.15 with the standard deviation of 4.65, whereas in post test the mean score was 30.7 with the standard deviation of 5.387 which indicates that structured teaching programme is statistically significant at P<0.01 level. There was significant difference between the pre test and post test knowledge scores t=20.56, P<0.01 level. There was a significant association between pre test knowledge scores with their education and no association between age, gender, religion, occupation, marital status, type of family, place of domicile, dietary pattern, personal habits and source of health information at P<0.01 level. Author concluded that that post test knowledge scores was improved after structured teaching programme. So structured teaching programme was effective in increasing the knowledge level regarding prevention on selected post operative complications among patients undergoing abdominal surgeries.

Prof.K.C Yadav

Inguinal hernia repair is one of the most common procedures performed in general surgery. Approximately 20 million hernia surgeries are performed every year worldwide. Conventionally, hernial repair is carried out with the open Lichtenstein technique; however, laparoscopic and robotic inguinal hernia repairs have been developed as a minimally invasive alternative to the classic Lichtenstein repair. The prosthetic mesh can be placed by totally extraperitoneal and transabdominal pre-peritoneal approaches. Choosing the best technique for repairing an inguinal hernia is a challenge because the available data are contradictory. However, a growing number of studies have claimed that robotic-assisted hernia repair is not only feasible and safe, but it is associated with outcomes that are comparable to those obtained with laparoscopy and open surgery, including shorter hospital stay, and fewer complications. The aim of the review article is to provide an overview of the current practice of inguinal hernia repair, with a focus on the advances in robotic-assisted inguinal hernia repair, as well as the advantages and disadvantages of this surgical procedure compared to the laparoscopic technique in view of the current reports in the literature.

Karishma

Iatrogenic splenic infarction is a rare clinical entity that can result from various abdominal surgical and invasive procedures. We report a case of iatrogenic splenic infarction in a 29-year-old female who presented with hemoptysis and was found to have pulmonary sequestration. During the embolization of the anomalous artery supplying the pulmonary sequestration, she developed severe pain and was found to have a splenic infarction, caused by a part of the coil that dislodged during the procedure. The patient showed good response to conservative management and was discharged in good condition.

Karishma

Background: In a Benghazi medical center, this observational study assessed the role of laparoscopic cholecystectomy (LC) in the early stages of acute gallbladder illness. Materials and Methods: From January 2022 to December 2022, all emergency and urgent admissions for acute gallbladder disease were identified, and additionally, data from hospital medical records were then evaluated retrospectively. Results: Out of a total of 334 patients with gallstone diseases, we found 321 individuals (206 with acute biliary colic, 115 with acute calculous cholecystitis), and 13 with acalculous cholecystitis. Early laparoscopic surgery for acute calculous cholecystitis had a greater conversion rate than procedures for acute biliary discomfort (19% vs. 4%; p=0.002). When surgery was performed 72 h from the onset of the symptoms for patients with acute calculous cholecystitis, the conversion rate was considerably lower (one out of 25) than when surgery was postponed past 72 h (14 out of 53) or later performed electively (seven out of 23) (p=0.014). In comparison to elective surgery for acute biliary colic (three of 66), elective surgery for prior acute cholecystitis was linked to a higher conversion rate (seven of 22 patients) (p=0.002). Conclusion: LC for acute calculous cholecystitis needs to be done within 72 h of the onset of symptoms, and it is worthwhile.

Karishma

Vesical explosion during transurethral resection of the prostate (TURP) is an extremely rare, serious and dreadful complication, which should be considered as a blast injury requiring urgent exploratory laparotomy and repair. Until 2019, only 38 cases have been reportedin the International English literature. The underlying mechanism for this rare intravesical explosion is the generation and trapping of explosive gases under the dome of the bladder, which eventually detonates by sparks from the cutting electrode during TURP. Herein, we repor0low-up. Although uncommon, vesical explosion during TURP may occur and some preventive measures, discussed here, can be carried out to avoid this dreadful complication. In addition to the discussion of its mechanism, we will discuss the preventive measures of this dreadful event. To the best of our knowledge, this is the first case of a vesical explosion reported in our department.

Karishma

Foreign bodies (FBs) in the scalp are a common incident following head trauma, especially in traffic accidents, and are detected in the early post-traumatic period. The persistence of these FBs may cause pain and paresthesia. We report a case of 41 years old man, whose victim it’s been 20 years of physical aggression, in which the victim was hit by a brick occasioning a frontal wound stitched at the time without sufficient exploration. Months later, the patient presented several episodes of a frontal scalp nodular lesion with pus leakage (Fig. 1). The lesions were only treated with local antibacterial agents. Four years before the patient consults at our level, he consulted a dermatologist who performed a removal of the skin lesion. Months later, the lesion reappeared. At our level the clinical examination suspected a bone lesion, so CT was performed. Brain imaging was strongly evoking bone tumors or osteitis (Fig. 2). The patient was operated on under general anesthesia. First, a carcinogenic removal of the scalp lesion was performed; then, when reaching the bone, hard red friable bodies well separated from proportionally healthy bone were found. Those findings raise suspicion of the presence of FBs nested in the bone from the first head trauma. Hence, a carcinologic removal of the affected bone was postponed, and simple curettage was performed (Fig. 3). The post-operative course was without complications. The histological study confirmed per-operative findings: Multiple stony FBs associated with inflammatory reaction especially lymphocytes around vessels and the FBs.

Karishma