Role of water soluble contrast in adhesive small bowel obstruction, a prospective randomised control trail

Background: The aim of this study was to assess the diagnostic and therapeutic role of urografin (water soluble contrast agent) in patients with adhesive small bowel obstruction.Methods: This was a prospective study conducted in the department of surgery in association with the department of Radiology, in S.C.B.M.H, Cuttack. Odisha India. Total patients with clinical and radiological evidence of adhesive SBO were selected for this study. The primary outcome in the diagnosis role of WSCA was its ability to predict the need for surgery.in the therapeutic role, the following were evaluated, resolution of SBO without surgery, time from admission to resolution, duration of hospital stays, complications and mortality.Results: 129 prospective patients were included. The appearance of contrast in the colon within 4-24 Hrs, after administration had a sensitivity of 96 percent and specificity of 98 percent in predicting resolution of SBO.Conclusions: Water soluble contrast agent (urografin) was effective in predicting the need for surgery in patients with adhesive SBO. In addition, it reduced the need for operation and shortened hospital stay

Comparative study between pre- and post- operative clinical and electrophysiological parameters in determining the recovery of carpal tunnel syndrome

Background: Carpal tunnel syndrome (CTS) is a neuropathy caused by entrapment of the median nerve at the wrist. CTS is the most well-known and frequent form of median nerve entrapment and accounts for 90% of all entrapment neuropathies. CTS, in the form of median nerve entrapment, remains a perplexing and debilitating disorder. We report a comparative study between the Boston questionnaire (BQ) and median nerve conduction study parameters in patients with CTS treated by division of the flexor retinaculum through a short incision at the palm.Methods: The prospective cross-sectional, hospital-based study was conducted in department of burns, plastic and reconstructive surgery at SCB Medical College, Cuttack.Results: The average age was 44.49 years (SD=10.51; range=24-70), and the average symptom duration was 19.9 months (range=6-36). There are 36 hands in the severe group, 22 with the moderate group, and 12 with the mild category. The mean symptom severity scale score for severe group A was 40.92 (SD=5.84) and for moderate group B was 31.67 (SD=5.72), and for the mild group, C was 26.0 and SD=3.82). We found significant correlation between symptomatic recovery and Boston severity scales.Conclusions: Clinical correlation of pre- and post-op symptoms is the only full proof way to predict recovery after surgery in CTS‑affected, patients

“An unusual presentation of colonic mucormycosis mimicking carcinoma colon- a surgeon’s perspective”

Introduction: Mucormycosis caused by order mucorales, an ubiquitous saprophytic mold found in soil and organic matter worldwide, is a rare but invasive opportunistic fungal infection. Gastrointestinal mucormycosis is the most uncommon clinical presentation being particularly rare, accounted for 4–7% of all cases. Presentation of case: We report an unusual presentation of mucormycosis of ascending colon that was simulating carcinoma colon. Discussion: GI mucormycosis most commonly involves the stomach (57.5%), followed by the colon (32.3%) and the ileum (6.9%). Initial presentations may be abdominal pain and distension, fever, and diarrhoea. Colonic mucormycosis presenting as a mass with altered bowel habit, melena and abdominal pain in our case is extremely difficult to differentiate it from carcinoma colon. A definitive diagnosis of mucormycosis is almost always ascertained by histopathological evidence of fungal invasion of tissue. Conclusion: Knowing these unusual presentations of this disease, surgeon need to maintain a high index of suspicion and perform timely and appropriate diagnostic evaluation to improve patient outcome. Prompt diagnosis, reversal of predisposing conditions, and aggressive surgical debridement remain cornerstones of therapy for this deadly disease