Role of height of an individual and low lying pubic tubercle as risk factors of inguinal hernia: case controlled study

Background: Hernia is defined as abnormal protrusion of whole or a part of a viscus through the wall that contains it. Among all external abdominal hernias, inguinal hernia is one most typically encountered. Many factors are responsible for the formation of hernia. We intended to study the risk of inguinal hernia in low lying pubic tubercle. Methods: The study was conducted on patients in AJIMS, India. It is a case-control study with 80 cases and 80 control meeting inclusion criteria, in all patients, following parameters SS line, ST line, height, weight was recorded and evaluated. Results: The average SS value for case which was much above the average in control.ST value was higher case group than control group, and p<0.0001 which was significant. when it comes to the mean of (SS/ST ratio)/height was higher in the case group than control group. Results developed show majority of the subjects with a low-lying pubic tubercle were inguinal hernia patients. Conclusions: Based on my study, interspinal distance (SS line) and pubo-spinal distance (ST line) are more in cases compared to control. Configuration of bony pelvis seems to be a major contributing factor in determining the risk of development of inguinal hernia as evidenced by the variations in ST length. This low-lying pubic tubercle is very important before selecting the patient for any surgical correction. So, the proper demonstration of anatomy of inguinal region is very important before selecting the surgical technique

Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients

Background and Objectives: Febrile neutropenia (FN) is considered a medical emergency. Patients with hematological malignancies (HM) commonly experience FN. Broad spectrum antibiotics have to be started empirically to prevent complications. This study depicts the clinical profile, microbiological profile, antibiotic sensitivity pattern, and outcome in high risk HM. Materials and Methods: In this prospective study, 72 patients with hematologic malignancies, diagnosed and treated for 108 high risk febrile neutropenic episodes from August 2011 to January 2013 at a Regional Cancer Center, in South India were analyzed. Cefoperazone-sulbactum was used as a first-line empiric antibiotic. Results: Majority of the patients with FN episodes had acute myeloid leukemia. Overall culture positivity was 29.62%. The most common organisms isolated were Gram-negative bacilli (63.64%), with Escherichia coli being the most frequent pathogen. All Gram-negative organisms were sensitive to imipenem, whereas sensitivity pattern to other antibiotics were as follows: 85.71%, 78.26%, 69.52%, 63.64%, 41.66% and 47.05% for pipercillin-tazoactum, meropenem, cefoperazone-sulbactum, amikacin, ceftazidime, ciprofloxacin respectively. Overall mortality was 13.5%. Most of the patients responded to empiric antibiotic cefoperazone-sulbactum. Conclusions: In the hematologic malignancies particularly in acute leukemia, there is high risk of developing FN. Empiric therapy with cefoperazone-sulbactum as a first line leads to satisfactory outcome in high risk FN and therapy should be tailored to the most appropriate antibiotics according to the bacterial culture results