A study of morbidity pattern in Misgav Ladach technique of caesearean section

Background: There has been progressive increase in C-section (CS) rate globally since last 10 years. Issues related to maternal choice, Mode of delivery for non-cephalic presentation at term, vaginal delivery after previous scar have been the focus of attention. The objective of the study was to determine whether Misgav Ladach caesarean section technique offers benefits over Traditional Method of caesarean section with regards to Duration of surgery, Time taken for abdominal entry, Total operation time, Amount of blood loss and Postoperative morbidity.Methods: A randomized control study was carried out on 460 patients who underwent Caesarean section at Krishna hospital, Karad, Maharashtra, India between November 2013 to June 2015.Results: 460 cases of caesarean section admitted to Krishna institute of medical sciences, karad during the period of November 2013 to June 2015 were studied with respect of clinical pattern, majority of the cases who underwent, caesarean section by both the methods were in the age group of 21-25 years. The main indication for caesarean section was fetal distress. Fetal distress accounts for 29% in Misgav Ladach method and 31% in traditional method, failed induction accounts for 6% in Misgav Ladach and 8% in traditional method. The total operation time was 31 min average in Misgav Ladach and 37 min in traditional group. The mean blood loss for the Misgav Ladach group was 486 ml and 521 ml for the traditional group, which was significantly different (p<0.001). The postoperative morbidity due to fever was 4% in the both groups.Conclusions: Substantial reductions in operating time and blood loss were noted in the study, which may benefit the women in reducing the exposure time to anesthesia

A rare case report: unscarred uterus rupture in pregnancy with intra-abdominal missing foetal limb

Ruptured uterus is an obstetric and surgical emergency that can lead to maternal or fetal death. Spontaneous rupture of an unscarred uterus during pregnancy is a rare occurrence. The incidence of ruptured uterus is 0.3 to 1.7% in women with scarred uterus, and 0.03 to 0.08% among women with unscarred uterus. We report a rare case of spontaneous uterine rupture at 30 weeks of gestation with missing fetal limb. Later on, after doing emergency laparotomy the missing limb was found in the abdominal cavity of the patient who had an unscarred uterus. Uterine rupture occurring in an unscarred uterus is sometimes an unpredictable event. Abdominal pain occurring on a pregnant woman should be seriously managed. Ultrasound scan and external electronic fetal monitoring should be carried out rapidly so as to diagnose the uterine rupture at the earliest

A study of morbidity pattern in Misgav Ladach technique of caesearean section

Background: There has been progressive increase in C-section (CS) rate globally since last 10 years. Issues related to maternal choice, Mode of delivery for non-cephalic presentation at term, vaginal delivery after previous scar have been the focus of attention. The objective of the study was to determine whether Misgav Ladach caesarean section technique offers benefits over Traditional Method of caesarean section with regards to Duration of surgery, Time taken for abdominal entry, Total operation time, Amount of blood loss and Postoperative morbidity.Methods: A randomized control study was carried out on 460 patients who underwent Caesarean section at Krishna hospital, Karad, Maharashtra, India between November 2013 to June 2015.Results: 460 cases of caesarean section admitted to Krishna institute of medical sciences, karad during the period of November 2013 to June 2015 were studied with respect of clinical pattern, majority of the cases who underwent, caesarean section by both the methods were in the age group of 21-25 years. The main indication for caesarean section was fetal distress. Fetal distress accounts for 29% in Misgav Ladach method and 31% in traditional method, failed induction accounts for 6% in Misgav Ladach and 8% in traditional method. The total operation time was 31 min average in Misgav Ladach and 37 min in traditional group. The mean blood loss for the Misgav Ladach group was 486 ml and 521 ml for the traditional group, which was significantly different (p&lt;0.001). The postoperative morbidity due to fever was 4% in the both groups.Conclusions: Substantial reductions in operating time and blood loss were noted in the study, which may benefit the women in reducing the exposure time to anesthesia

Endoscopic Retrograde Cholangiopancreatography Scope‑induced Duodenojejunal Flexure Perforation: The World’s First Case

Duodenojejunal (DJ) flexure perforation is very rare. DJ flexure perforation following endoscopic retrograde cholangiopancreatography (ERCP) has not be documented till date. They are associated with significant morbidity and mortality. We present an ERCP‑induced DJ flexure perforation which has been treated with primary closure in two layers at our institution. To the best of our knowledge, this is the world’s first case. Such site of ERCP‑induced perforation has not been reported in literature till date. A 75‑year‑old female patient underwent repeated ERCP for obstructive jaundice. There was perforation during the third ERCP while removing the larger stone. Emergency laparotomy was performed with primary closure of perforation in two layers. ERCP‑induced DJ flexure perforation has not yet been documented. It is potentially life‑threatening. Early recognition may lead to a better prognosis through earlier intervention

Laparoscopic subcutaneous onlay mesh repair for ventral hernia: Our early experience

Introduction: Repair of the ventral hernia is an ongoing challenge in surgery, and a number of surgical techniques have been developed ranging from direct suturing techniques to the use of various mesh types in different planes of the abdominal wall to close the defect and strengthen the musculofascial tissue. Laparoscopic subcutaneous onlay mesh (SCOM) repair is a novel procedure developed recently for ventral hernia repair. We would like to share our experience with laparoscopic SCOM repair. Patients and Methods: This is a prospective observational study of patients who have undergone ventral hernia repair at Bangalore Endoscopic Surgery Training Institute and Research Centre from June 2020 to June 2022. A total of 20 patients are included in this study. Statistical Analysis Used: The data were entered into MS Excel and analysed. Results: A total of 20 patients underwent SCOM repair with a defect size measuring up to 8 cm × 8 cm and a mean operative time of 117 min. Three patients had seroma formation and one patient had surgical site infection. No recurrence is seen after 1-year 2-month follow-up. Conclusion: SCOM repair is the newer approach to ventral hernia repair with the advantage over open onlay mesh repair in terms of less pain and better cosmesis. SCOM repair avoids intraperitoneal dissection which may lead to visceral injuries as well as subsequent intraperitoneal adhesions. The acceptance of such surgeries would depend on further long-term studies

Case report: A rare case of eccrine carcinoma

Introductions: Sweat gland carcinoma is very rare with a reported incidence of less than 0.005% of all tumour specimens resected surgically (Tulenko and Conway, 1965) [1]. Case report: A sixty year old male patient presented to us with a solitary swelling over the left chest wall since two months. Discussion: Cutaneous apocrine gland carcinoma, a subtype of sweat gland carcinoma, is a very rare malignant neoplasm arising in areas of high apocrine sweat gland density. The variability of the histological features even in the same tumour, and its rarity, have contributed to some confusion regarding the classification of sweat gland carcinoma. Conclusions: Sweat gland carcinomas are a rare group of tumours with potential for local destruction as well as distant metastasis. Wide surgical excision along with regional lymph node dissection in the presence of clinically positive nodes is the recommended treatment. However, a frequent follow up is essential to detect early recurrence as well as distant metastasis