Predictive Accuracy of PESAS Score in Emergency Abdominal Surgeries

Background: Because of their unpredictability and potential for negative outcomes, emergency abdominal procedures provide considerable clinical problems. For the purpose of optimising patient care and guiding surgical decisions, accurate preoperative assessment is crucial. In this situation, the “Physiological Emergency Surgery Acuity Score (PESAS)” has shown promise as a tool for risk categorization and prognostication. The purpose of this study was to assess how well the PESAS score predicted the outcomes of emergency abdominal surgery. Methods: 80 patients with clinical signs of an acute abdomen were enrolled in a tertiary care facility over the course of 18 months. Each patient was evaluated using the PESAS score, which is based on physiological factors such heart rate, blood pressure, breathing rate, and level of awareness. Low-risk (PESAS 8), intermediate-risk (PESAS 9–12), and high-risk (PESAS 13–15) patient categories were created. The results of the surgery, including both survival and non-survival, were documented Results: The survival rate for patients with PESAS scores of 8 or less was 100%, while the survival rate for patients with scores of 9 to 12 was 16.66%. 0% of patients whose scores were between 13 and 15 survived. These results show a significant relationship between PESAS scores and successful surgical outcomes. Conclusion: For predicting surgical outcomes in urgent abdominal procedures, the PESAS score is an invaluable preoperative tool. It facilitates decision-making, risk classification, and improved preoperative communication with patients and their families. To completely incorporate the PESAS score into clinical practise, which could result in better patient-centred treatment and resource allocation, more investigation and validation studies are required

Predictive Value of CRP and Lactate Levels for Bowel Gangrene/Strangulation in Patients with Bowel Obstruction

Background: Bowel blockage is a frequent and potentially fatal illness that requires quick identification of consequences like gangrene and strangling of the bowel. In order to diagnose intestinal gangrene/strangulation in patients with bowel obstruction, this study evaluated clinical symptoms and laboratory markers, specifically C-reactive protein (CRP) and lactate levels. Methods: One hundred patients who presented with intestinal obstruction participated in prospective observational research that we conducted. Clinical signs were evaluated, including guarding, vomiting, abdominal distension, irreducible edema, and pain in the abdomen. For the purposes of measuring lactate and CRP, blood samples were taken. Radiological findings, intraoperative assessment, and histological examination were required as part of the diagnostic criteria for intestinal gangrene/strangulation. Results: Common clinical symptoms were stomach discomfort (98%), vomiting (67%), and abdominal distension (58%). In 40% of individuals, irreversible edema was observed. In 54% of instances, a history of constipation was mentioned. Gangrenous bowel was substantially related with elevated lactate and CRP levels (p 0.001). In gangrenous bowel, mean lactate concentrations were 870.25 mmol/L compared to 536.62 mmol/L in viable bowel, and mean CRP concentrations were 141 mg/L compared to 68.23 mg/L in viable intestine. Conclusion: Bowel blockage is typically diagnosed based on clinical signs such abdominal pain and unremitting swelling. Furthermore, in these individuals, high CRP and lactate levels are useful indicators for detecting intestinal gangrene/strangulation. The incorporation of these markers into clinical practice may help patients with intestinal obstruction receive early management and experience better results. To determine precise cutoff values for these markers in everyday practice, more study is required

Clinical Profile and Surgical Management of Incisional Hernias: A Retrospective Study

Background: An iatrogenic hernia known as an incisional hernia develops at the site of prior surgical incisions and poses therapeutic difficulties. For prevention and therapy, it is essential to comprehend their clinical presentation and management. The clinical characteristics and treatment of incisional hernias at a tertiary care facility are reviewed in this study. Methods: At the Department of General Surgery, a retrospective study was done. Demographic information, clinical presentation, surgical history, hernia features, post-operative problems, and comorbidities were gathered from 60 patients who underwent incisional hernia surgery. Results: 60% of the patients were female, and the age ranges of 35 to 45 and 56 to 65 were the most common. 15% of patients reported pain prior to surgery. Lower segment cesarean sections (38.33%) and Pfannenstiel incisions (45%) were the most frequent prior surgeries. 83.33% of patients had infraumbilical hernias, and 11.67% had post-operative surgical site infections. A significant comorbidity was obesity. The chosen surgical technique was sublay (preperitoneal) meshplasty. Conclusion: Infraumbilical incisions, in particular, showed a female predominance in incisional hernias. Comorbidities, especially obesity, were associated with the development of hernias. Strenuous infection control procedures are required to prevent post-operative surgical site infections. Commonly employed is sublay meshplasty. The prevention and treatment of incisional hernias are influenced by these findings

Role of Neoadjuvant Paclitaxel Chemotherapy in Carcinoma Breast: A Prospective Study

  Objective: The purpose of this prospective study was to assess the value of neoadjuvant chemotherapy with paclitaxel in the treatment of breast cancer. Methods: There were 88 diagnosed breast cancer patients altogether, 44 in each of the two groups (paclitaxel group and control group). To verify eligibility, thorough clinical, radiological, and laboratory evaluations were made. The reduction of tumor size, pathological reactions, and safety profiles were evaluated. To compare results between groups, statistical tests were used during data processing. Results: At 12 and 24 weeks, the paclitaxel group showed significantly smaller tumor sizes than the control group. In the paclitaxel group, complete pathological responses were more common, indicating efficient tumor regression. The side effects of paclitaxel therapy were generally well-tolerated and controllable. Conclusion: In conclusion, patients with breast cancer showed encouraging improvements in histological responses and tumor size after neoadjuvant paclitaxel treatment. These results suggest the potential advantages of using paclitaxel in neoadjuvant therapy protocols, perhaps making breast-conserving surgery more feasible. In order to provide more individualized treatments, future research should investigate long-term outcomes and biomarkers indicative of paclitaxel sensitivit

Coagulation Markers as Predictive and Prognostic Factors in Carcinoma Breast Patients with Lymph Node Metastasis

  Objective: The purpose of this prospective observational study was to evaluate the predictive and prognostic value of coagulation markers in patients with lymph node metastases and cancer of the breast, as well as their associations with important histopathologic criteria. Methods: Between December 2020 and July 2022, 100 patients from the surgery department of a tertiary hospital were enrolled in the study. D-dimer, fibrinogen, and prothrombin time were assessed as coagulation indicators. Documented histopathologic characteristics included tumor grade, size, lymph node involvement, and estrogen receptor status. Chi-square tests, t-tests, Kaplan-Meier survival curves, and log-rank tests were all used in the statistical study. Results: Elevated D-dimer levels were significantly associated with higher tumor grade (p < 0.05) and lymph node involvement (p < 0.01). Elevated fibrinogen levels were linked to larger tumor size (p < 0.05). Abnormal coagulation markers were correlated with reduced disease-free survival (p < 0.001). Conclusion: In breast cancer patients with lymph node metastases, coagulation indicators have the potential to predict disease severity and prognoses. Together with established parameters, their clinical utility may result in more precise care and better patient outcome