A study on incidence and etiology of cervical lymphadenopathy in community

Background: The etiologies for cervical lymphadenopathy fall under a wide range spectrum and usually, history and physical examination alone may lead to a diagnosis. Posterior cervical LAP may occur with Epstein-Barr virus (EBV) infection, tuberculosis, lymphoma, or head and neck malignancy (either lymphomas or metastatic squamous cell carcinoma). However, a stepwise methodological approach to LAP can lead to an accurate diagnosis with minimal discomfort to the patient and also less time-consuming for the clinician.Methods: In this series, 320 cases were studied with taking a detailed clinical history, physical examination, and investigations. After a physical examination and reaching a clinical diagnosis, confirmation was done by fine needle aspiration cytology (FNAC) and biopsy.Results: Incidence of tuberculous LAP is much higher in lower socioeconomic class groups people versus middle or higher socioeconomic class groups. Incidence of tuberculous LAP is higher in urban areas compared to rural areas due to overcrowding, and poor sanitation.Conclusions: Tuberculosis is a potentially serious infectious disease, one of the commonest diseases affecting lymph nodes. It is curable with anti-tubercular drugs if administered as per the accepted regimen

Replicate and evaluate the results of peptic ulcer perforation score in our setup as a predictor of mortality following a peptic ulcer perforation

Background: Scores commonly employed to risk stratify perforated peptic ulcer patients include ASA (American Society of Anesthesiologists), Boey and peptic ulcer perforation score (PULP). Accurate and early identification of high-risk surgical patients with a perforated peptic ulcer is important for triage and risk stratification. The objective of the present study was to replicate and re-evaluate the results of this score in our setup, compared to the cohort study carried out in Denmark.Method: A prospective study was conducted on 40 surgically treated patients for peptic ulcer perforation for period of one year. There was no age restriction. The predefined outcome measure was mortality within 30 days of surgical procedure for peptic ulcer perforation. Different Variables used are age, co-morbid disease, liver cirrhosis, steroids use, shock on admission, the time lapse between perforation and admission, serum creatinine, as well as ASA score 2 to 5.Results: A total of 40 patients were studied in a single hospital over one year. Nearly 12.5% (5 patients) died within 30 days of surgery. Out of total deaths, most deaths occurred in patients with a PULP score of more than 7, and the risk of mortality increases with an increase in the PULP score. So, the risk stratification is classified into low risk and high risk according to pulp score.Conclusions: The PULP score can be used to predict 30-day mortality in patients with peptic ulcer perforation who have undergone surgery almost accurately and thus assist in risk stratification and triage. This study hence replicates the cohort study in Denmark in our setup

Obstetric-associated lower urinary tract injuries: a single-center study

Background: Urinary tract injury is a known complication of obstetric and gynecologic surgery. Intraoperative identification of injury permits prompt repair and potentially lessens postoperative sequelae including patient morbidity and cost. Delayed diagnosis of urinary tract injuries can result in physical complications beyond the site of the injury, such as genitourinary fistula formation, renal injury, sepsis, death, and psychosocial dysfunction.Methods: We describe the management of 27 patients with such injuries, including their demographic profile, associated factors, and complications at a tertiary institution in a retrospective study from February 2013 to March 2021.Results: Bladder injuries were the most common (81.5%), mostly occurring during emergency cesarean delivery, with previous cesarean delivery and adhesions being risk factors. A primary repair was attempted at the referring institution in 18.5% of cases. Repair at the tertiary institution was mostly performed by consultants (66.7%).Conclusions: Early recognition and primary repair are associated with fewer complications