The Role of Plateau Pressure in Predicting Wound Dehiscence in Patients Undergoing Exploratory Laparotomy

Background: Wound dehiscence is a serious surgical complication associated with exploratory laparotomy, often leading to significant morbidity and mortality. Identifying predictive parameters for wound dehiscence is essential for improving patient outcomes. This retrospective study aimed to evaluate the utility of plateau pressure, a parameter typically used in mechanical ventilation, as a predictive tool for wound dehiscence in patients undergoing exploratory laparotomy. Methods: Data were collected from 100 patients admitted to tertiary care Centre, Karad, between December 2020 and May 2022. Demographic characteristics, etiological aspects, preoperative albumin levels, and diabetes mellitus status were recorded. Plateau pressure values were obtained from mechanical ventilation records. The primary outcome was the occurrence of wound dehiscence. Statistical analysis included descriptive statistics, chi-squared tests, t-tests, Mann-Whitney U tests, and multivariate logistic regression. Results: Among the 100 patients, 12 (12%) developed wound dehiscence. Patients with plateau pressures greater than 25 cmH2O exhibited the highest incidence of wound dehiscence (53.6%). A significant association was found between higher plateau pressure values and an increased risk of wound dehiscence (p < 0.05). Multivariate logistic regression confirmed this association, adjusting for potential confounding factors. Conclusion: This study suggests that elevated plateau pressure may serve as a valuable predictive parameter for wound dehiscence in exploratory laparotomy patients. The findings highlight the potential clinical significance of incorporating plateau pressure into preoperative risk assessment and preventive strategies, ultimately contributing to improved patient care and outcomes. Further research is warranted to validate and expand upon these findings

The Significance of the Southampton Wound Grading System in Surgical Site Infections

Objective: This study aimed to assess the significance of the Southampton wound grading system in predicting and managing surgical site infections (SSIs) among patients undergoing surgery. Methods: A retrospective cohort study was conducted at tertiary care center, involving 120 surgical patients, comprising 105 elective surgeries and 15 emergency surgeries. Patients were categorized based on the Southampton wound grading system, and data on age, gender, surgery type, and SSI occurrence were collected. Statistical analysis included chi-squared tests and Fisher's exact tests. Results: Higher-grade wounds, particularly Grade V, exhibited a significant association with SSIs, emphasizing the system's clinical relevance. Elective surgeries displayed a lower SSI rate (18.75%) compared to emergency surgeries (81.25%). Gender-wise distribution revealed a slightly higher SSI rate among females (18.75%) compared to males (81.25%). Conclusion: The Southampton wound grading system proves valuable in risk stratification, aiding clinicians in tailoring preventive measures. While higher-grade wounds are at greater risk, comprehensive patient assessment and adherence to infection control protocols remain pivotal in SSI prevention. Future research should explore patient-specific variables and surgical practices to refine preventive strategies. Overall, this study underscores the importance of proactive SSI management in diverse surgical setting

Urine Trypsinogen 2 as a Diagnostic Marker for Acute Pancreatitis: A Prospective Study

Background: Acute pancreatitis presents diagnostic challenges due to its diverse clinical presentation and limitations of traditional serum biomarkers. This study explores the diagnostic potential of urine trypsinogen 2 in acute pancreatitis, an area relatively unexplored in our institution. Methods: A prospective study involving 96 patients admitted between December 2020 and June 2022 with symptoms suggestive of pancreatitis was conducted. Urine trypsinogen 2 levels were quantitatively assessed alongside serum amylase and lipase. Radiological investigations were employed when necessary. The final diagnosis integrated clinical, biochemical, and radiological findings. Results: Urine trypsinogen 2 exhibited a sensitivity of 88.4% and a specificity of 91.7%, outperforming serum amylase and approaching serum lipase. Comparative analysis revealed significant advantages of urine trypsinogen 2 in sensitivity, specificity, and predictive values. Conclusion: Urine trypsinogen 2 emerges as a non-invasive, accurate, and early diagnostic marker for acute pancreatitis, with the potential to enhance diagnostic precision and improve patient outcomes. Further validation in diverse clinical settings is warrante

Diagnostic Efficacy of Abdominal Contrast-Enhanced Computed Tomography in Acute Abdominal Conditions: A Retrospective Study"

This study's objective was to evaluate the diagnostic value of abdominal contrast-enhanced computed tomography (CECT) in people who had sudden abdominal symptoms. Methods: From eligible patients between the ages of 18 and 75, clinical data including demographics, clinical history, and laboratory findings were gathered. Using a standardised imaging technique, abdominal CECT was performed on all patients. To find acute abdominal diseases and check for consequences, seasoned radiologists analysed the CECT pictures. To assess the effectiveness of CECT, sensitivity, specificity, and other diagnostic measures were calculated. Results: For a variety of acute abdominal diseases, including appendicitis, diverticulitis, bowel obstructions, ischemia, and traumatic injuries, abdominal CECT consistently showed sensitivity and specificity above 90%. Appendicitis was the most prevalent condition, followed by diverticulitis and intestinal obstructions, according to the distribution of diagnoses. In a small number of patients, complications such the development of abscesses, perforations, and thickening of the gut wall were noted. Conclusion: Abdominal contrast-enhanced computed tomography is an essential technique for identifying specific pathologies and potential complications early on, providing high diagnostic accuracy for the diagnosis of acute abdominal disorders. These results underline how crucial it is to incorporate CECT into the diagnosis process for patients presenting with acute abdominal symptoms, eventually improving patient treatment and outcome

Evaluation of Breast Disease Using Triple Assessment Test with Ultrasonography as the Fourth Component

Breast disease is a significant health concern, with varying clinical presentations and diagnostic challenges. This study aims to assess the accuracy and utility of ultrasonography (USG) as an adjunct component to the Modified Triple Assessment Test (MTT) in the screening and diagnosis of breast diseases. A total of 40 patients with breast complaints, including lumps, nipple discharge, or retraction, were included. The MTT, consisting of clinical examination, mammography, fine-needle aspiration cytology (FNAC), and histopathological examination (HPE), was performed on all patients under informed consent. USG was added as a fourth component. Data on age distribution, parity, menstrual status, side of breast lump, location of tumors, and histopathological findings were collected and analyzed. In the 30-39 age group, breast lumps were common, with nulliparous women showing more malignant cases. Pre-menopausal women had benign lumps, while peri-menopausal and post-menopausal women had more malignancies. Left-sided lumps prevailed, and the upper outer quadrant was the common location. Clinical examination had high accuracy, as did ultrasonography (USG). This study underscores the importance of personalized breast health approaches, considering age, parity, and menstrual status. The combination of clinical examination, mammography, FNAC, and USG (MTT) provides a reliable diagnostic tool for breast disease, with MTT serving as a valuable modality for breast carcinoma diagnosis and treatment planning

PREVALENCE OF THYROID DISEASE ALONG WITH BREAST CANCER

Some authors have observed a higher prevalence of AITDs in BC patients compared to age-matched controls; thus, this association is not new. Some studies have found that the presence of TPO antibodies is associated with a significantly better outcome among BC patients and that this improvement is comparable to that seen with other prognostic indices such as axillary node status and tumor size, though the exact significance of this association is unclear.Therefore, the purpose of this study was to assess TD with BC in relation to the female population. All cases that meet the inclusion criteria will be considered after receiving approval from the IEC. The demographic characteristics, clinical, medical, social, and family H/O were documented using a semi-structured, standardized, and pre-validated case record. In addition, a comprehensive and systematic evaluation was conducted on all patients diagnosed with breast cancer. This evaluation included clinical, radiological, and laboratory screenings, involving a total of 69 patients. In our study, we found that the occurrence of abnormal TFT results was more frequently linked to cases of BC in comparison to the control group. The data was analyzed using the Chi-square test, which yielded a highly statistically significant result with a p-value of 0.0006. The findings of our study demonstrate a substantial correlation between BC and TD. Further investigation is necessary to validate this correlation

Comparison of Conventional Sutures Versus Cyanoacrylate Glue in Clean Operative Wound Closure

Objective: The purpose of this study was to compare the efficiency and results of cyanoacrylate glue and traditional sutures in the closure of clean surgical wounds. Methods: This randomized controlled experiment was conducted between December 2020 and June 2022, enrolling 100 patients who met strict inclusion criteria. To close wounds, patients were given a random choice between using cyanoacrylate glue or traditional sutures. Wound healing, infection rates, patient satisfaction surveys, and cosmetic evaluations were all included of the postoperative assessments. Results: There were no appreciable differences between the two closure techniques in the rates of infection or wound healing. Patients in the cyanoacrylate glue group expressed considerably greater levels of satisfaction with their postoperative discomfort and pain reduction. Cosmetic assessments showed better results in the cyanoacrylate glue group, with lower ratings for scarring, erythema, and uneven skin texture. Conclusion: For a clean surgical wound closure, both traditional sutures and cyanoacrylate glue work well. Cyanoacrylate glue has benefits in terms of improved cosmetic results and patient comfort. The selection of the closure technique should take into account the unique characteristics and desires of the patient, highlighting the significance of patient-centered care in surgical decision-making. It is necessary to do additional study with larger sample numbers and long-term follow-up to validate these findings and investigate their relevance in various clinical setting