158 research outputs found

    Gastrointestinal perforations clinical study and management

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    INTRODUCTION: Gastro Intestinal Tract Perforations represent one of the most common acute abdominal emergencies in the surgical field and is still a dreaded condition having a high morbidity and or mortality. Differences in the clinical presentation of Gastro Intestinal tract perforations vary from the typical severe acute abdominal pain at one end, to subtle or no symptoms in the hospitalized patients for unrelated illness at the other end1. The various atypical presentations that mimic other abdominal conditions throw a real challenge over the diagnosis to the emergency surgeon. A careful clinical history, methodical clinical examination and radiological study plays a major role in the early diagnosis of this acute abdominal emergency. There are multiple factors that influence the prognosis and outcome of the patient. Preoperative resuscitation, appropriate administration of broad-spectrum antibiotics and good postoperative care are the mainstay in the management of Gastro Intestinal Perforations. The operative management depends upon the cause of perforations. Surgeons must continually reassess standard method of treatment and be receptive to new ideas. AIM OF THE STUDY: 1. To study the presentation of various Gastrointestinal perforations admitted in the General Surgical Department of Tirunelveli Medical College Hospital. 2. To analyse the etiology & clinical features of Gastrointestinal perforations. 3. To compare the reliability of physical findings versus radiological signs in cases of Gastrointestinal perforations. 4. To study various types of managements of gastrointestinal perforations and merits & demerits of them. 5. To study the mortality, morbidity in various groups followed in the management of these cases ,with ref to their manifestation. MATERIALS AND METHODS: This study was conducted in the Department of General Surgery, Tirunelveli Medical College Hospital, Tirunelveli for a period of 21 months from November 2004 to August 2006. 127 cases of gastro intestinal perforations were studied during the period. The diagnosis was established by the Duty surgeon provisionally based on the clinical presentation. Definitive diagnosis established at the time of operation. As pre operative evaluation following investigation done. 1. Relevant biochemical tests, 2. Blood grouping typing, 3. X-ray chest , Abdomen, 4. USG (Ultra Sonogram), 5. E.C.G, 6. Abdominal paracentesis whenever warranted. Peroperative finding: Operative details included the 1. Site of the perforation, 2. Size of the perforation, 3. nature and quantity of peritoneal fluid & soiling, 4. The gross appearance of the bowel bearing the perforation, 5. The nature of surgical procedure performed, 6. Tissue biopsies for histologic confirmation were taken in appropriate cases. Post Operatively: Morbidity was analysed in terms of associated complications following surgery and duration of hospital stay. Following details were observed from the clinical course and recorded in case records. 1. Patients name, age, sex, inpatient number (pt identity). 2. Clinical features and abdominal findings. 3. Delay in hours between symptoms and surgery. 4. Operative findings. 5. Procedures done. 6. Post operative complications. 7. Duration of hospital stay. All case included in this study were observed / assisted /operated by the presentor. Inclusion criteria: All cases admitted with signs of peritonitis included irrespective of etiology. Exclusion Criteria: 1. Cases of Oesophageal rupture 2. Cases of perforations of hepatobiliary system 3. Cases of iatrogenic perforation during laparotomy 4. Cases of delayed presentation with shock and septicemia whose general condition did not warrant any operative management even after all resucitative measures. CONCLUSION: • Duodenal ulcer perforation was the commonest cause of gastrointestinal perforation with a male preponderance. • More common in the fourth and fifth decade of life. • Smoking and alcohol were the main aggravating factors. • Perforation was the first manifestation of peptic ulcer disease in a small percentage of patients. • The role of nonsteroidal anti-inflammatory drugs as the cause of perforation was little in this study group. • Radiological evidence of pneumoperitoneum could not be established 10% cases. • Ultrasonogram – useful diagnostic tool to establish free fluid in acute abdomen. • Simple closure with omental patch with thorough peritoneal toileting was very much effective. • Definitive ulcer surgery was not warranted in the emergency and treatment with H2 blockers and H. Pylori eradication achieved good control over the disease in the follow up period. • The prognostic indicators were early hospitalization, adequate fluid replacement and absence of co-existing medical illness. • Gastric perforations were common in the fifth & sixth decade. • The role of biopsy in gastric perforation was established with a case proving positive for malignancy. • Delayed hospitalization was the major cause of perforation in appendicitis. • Jejunal perforations were rare and trauma was the single major cause of jejunal perforation. • Closure in two layers was very much effective in small bowel perforations. • Inspite of recent advances in duodenal perforation - closure by laparoscopy, still simple closure with omental patch is widely practiced in this study group. • The most common post-operative complication was wound infection. • Deaths were due to septicemia, renal failure or cardiac arrest. • The actual mortality was higher than the mortality in the study group since cases of delayed presentation with shock and septicemia did not warrant anesthesia and were excluded from the study group

    Nemipterus delagoae Smith (Nemipteridae: Pisces) A new record from the Indian seas

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    The occurrence of Nemipterus delagoae Smith is reported here for the first time from the Indian seas based on one specimen 231 mm total length, collected from 40-m depth at 9°35'N 76°05'E along the southwest coast of India, The species is described and illustrated

    Biometrics and Radiographic Studies on the teratology of Starfish (Pentaceraster affinis) from Thoothukudi Coast of Gulf of Mannar, India

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    Biometrics and Radiographic Studies on the teratology of Starfish (Pentaceraster affinis) from Thoothukudi Coast of Gulf of Mannar, Indi

    Development of feed for blue swimmer crab, Portunus pelagicus to reduce the dependency on fresh feeds for sustainable mariculture

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    Development of feed for blue swimmer crab, Portunus pelagicus to reduce the dependency on fresh feeds for sustainable maricultur

    A remote sensing approach to monitor potential fishing zone associated with sea surface temperature and chlorophyll concentration

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    1025-1030India is the biggest seafood producing country in the world, and its economy relies, to a large extent, on fish production. Recent technologies in the remote sensing field enabled the gathering of information about the Sea Surface Temperature (SST) and Chlorophyll Concentration (CC) are used for analyzing the Potential Fishing Zone (PFZ). We used Landsat 8 images to create the base map of the Thoothukudi coastline. MODIS-AQUA satellite data were used to derive the SST and Chlorophyll-a for the Thoothukudi coast (Bay of Bengal) for the years 2013 to 2017, for the month of June. PFZ was classified into three classes: High PFZ, Medium PFZ, and Low PFZ. Results shows 2015 has highest PFZ found in the region of Sippikulam and Vembar. During 2016, PFZ identified at Kayalpattinam, Tiruchendur, and Manapad regions. The PFZ level was low during 2017 compared to the previous years. The PFZ has increased in the international maritime boundary line, which forced the fishermen to cross the territorial boundary. This study provides valuable information about fish catching areas to the fishermen and local populations, by reducing fish search time by 30 to 70 %, and consequently the fuel cost and human efforts. Additionally, also reduces the need of crossing the international maritime boundary line

    Crop protection from animals based on machine learning

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    This paper will discuss the present level of research and development on human-wildlife conflicts, there are bad interactions between humans and wild animals that are bad for both the resources of the human population as well as the ecosystems of wildlife. Animal detection has an impact on both human food security and animal welfare because it arises from the conflict between humans and wildlife over natural resources. As the population has grown and many communities' land use patterns have changed, these disputes have become more prevalent in recent years. The Mobile Net SSD type is used in this automatic intrusion and deterrent system for enhanced performance. When a dangerous animal is discovered, the system emits an alarm sound and notifies the relevant authorities, alerting them to the discovery. It is more human- friendly due to the quick detection process, and it is more animal-friendly due to the gentle repulsive process

    An Atlas of the Speed of Copy Number Changes in Animal Gene Families and Its Implications

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    The notion that gene duplications generating new genes and functions is commonly accepted in evolutionary biology. However, this assumption is more speculative from theory rather than well proven in genome-wide studies. Here, we generated an atlas of the rate of copy number changes (CNCs) in all the gene families of ten animal genomes. We grouped the gene families with similar CNC dynamics into rate pattern groups (RPGs) and annotated their function using a novel bottom-up approach. By comparing CNC rate patterns, we showed that most of the species-specific CNC rates groups are formed by gene duplication rather than gene loss, and most of the changes in rates of CNCs may be the result of adaptive evolution. We also found that the functions of many RPGs match their biological significance well. Our work confirmed the role of gene duplication in generating novel phenotypes, and the results can serve as a guide for researchers to connect the phenotypic features to certain gene duplications
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