Clinical profile and management of pyogenic liver abscesses in a tertiary care hospital

Background: Pyogenic Liver abscesses are potentially life threatening if left untreated. They pose a major Diagnostic and therapeutic challenge to modern world. Interventional radiology is becoming standard of care for liver Abscesses.Methods: All patients of pyogenic liver abscess admitted to Government Medical College and hospital Jammu, J and K, India from October 2018 to November 2019 were prospectively studied. Demographics, presentation, lab reports and management strategies were evaluated.Results: Total of 60 patients of pyogenic liver abscesses were studied with 81.7% males. Alcohol was found to be most common risk factor with 55% of patients being alcoholic. Right lobe of liver was involved in 66.7% of patients. Segment VI and VII were involved in 50% of patients. The most common clinical symptom was right upper quadrant pain (98.3%), followed by fever (91.7%). The most common clinical sign was right upper quadrant tenderness (91.7%). Percutaneous drainage with catheter placement was the most common and successful modality of management associated with least hospital stay.Conclusions: Pyogenic liver abscess is a rare but serious problem. Early diagnosis and treatment are necessary to avoid mortality. Percutaneous drainage along with I.V antibiotics is the best form of management

Prevention of pain on propofol injection by lignocaine,pethidine, dexamethasone and placebo: A comparative study.

Objectives: 1) To compare the efficacy of lignocaine, pethidine, dexamethasone with placebo in prevention of pain on propofol injection; and 2) to proclaim the better drug among these in preventing such pain. Study Design: Comparative, prospective, randomized, double blind, hospital based. Participants: 100 patients of ASA class I & II undergoing upper abdominal surgeries Material & Methods: 100 patients of either sex of ASA status I & II posted for upper abdominal surgeries were allocated randomly into 4 groups of 25 each. Venous occlusion was made with tourniquet for 1 minute. The study drug, diluted in normal saline, pethidine 25 mg in 5 ml (Group I), Lignocaine 1% 2 ml in 5 ml (Group II), Dexamethasone 4 mg in 5 ml (Group III) or normal saline 5 ml (Group IV) was administered intravenously over 10 seconds accordingly to random number. Thereafter occlusion was released and intravenous propofol was given. After the first 25 % of propofol given, patients were asked for intensity of pain experienced using verbal rating scale. Results: Lignocaine, Pethidine and Dexamethasone significantly reduce pain on propofol injection in comparison to placebo (P=0.001), but there was no significant difference in pain score among group I, II & III (P=0.474). There was no significant difference in recall of pain among group I, II & III (P=0.793) although there was significant difference between placebo group and other three groups (P=0.0001) Conclusions: Lignocaine, pethidine and Dexamethasone significantly reduce pain induced by propofol injection as compared to placebo but there is no difference in efficacy for prevention of pain among these three groups