New Indian Journal of Surgery

 Introduction Dry eye is a frequent ocular problem in the middle and elderly population and is often under diagnosed. Aims and objectives To find out the occurrence of dry eye in an urban slum eye hospital outpatient population, identify the socio-demographic profile, risk factors for development of dry eye. Materials and methods A cross sectional study, conducted at the Rotary Eye Hospital in a resettlement colony of Trilokpuri, Delhi. Study included patients of age 40 and above and willing to participate. Patients previously diagnosed with dry eye and drug treatment for the same, recently operated patients and those with complaints of pain, redness etc were excluded. The McMonnies questionnaire was used to evaluate symptoms and their frequency. Objective methods (Schirmer-I and Tear Breakup time) of dry eye assessment were then applied to evaluate the tear film. Particulars of the patients along with chief complaints and relevant ophthalmic examination were recorded. Results and discussion The sample size comprised of 32 patients aged between 40 to 70 years. The occurrence of dry eye was 21.88% as inferred by the McMonnies questionnaire. According to the Schirmer-I and BUT tests, which are the objective methods, 21 patients (65.62%) were labeled as dry eye. Dry eye in age group of 40- 50yrs was maximum (34.37%), it was significantly higher in females, 2.5:1 (p value= 0.002) .The occupation profile was as followsHousebound people which includes housewives, tailors and retired (71.42%), Farmers/Labourers (23.8%), Drivers/Cooks (4.7%). Mean TV viewing hours were 2.33+2.03 hrs and that for exposure to Sun was 4.61+2.71 hrs. Due to low literacy level of the study population, the reliability of the McMonnies questionnaire in this cohort is questionable. Conclusion Our study reveals that this disorder is common in urban slums. The objective tests like Schirmer-I and BUT should be carried out regularly for early diagnosis and prevention of further complications of dry eye. Increasing duration of exposure to Sun and TV viewing predispose to dry eye therefore avoiding such modifiable risk factors is essential.

Keywords: Dry eye; Mcmonnies questionnaire; Schirmer-I; BUT.

No Abstract

Introduction - Intussusception is defined as telescoping of one segment of the gastrointestinal tract into an adjacent one. Approximately 5%of peripheral NHL arise in ileum and mostly seen in adults. We report a case of primary NHL of ileum presenting as intussusception in a child. Case- A 14 year old boy presented with pain abdomen, vomiting and obstipation of 5 days duration. Per abdomen – tenderness and guarding in RIF with lump and hyperperistaltic bowel sounds. USG abdomen was indicative of intussusception. Emergency laparotomy revealed ileocolocolic intussusception as the cause of obstruction. Patient underwent right hemicolectomy with restoration of the bowel continuity. Histopathology revealed the mass to be a B-cell lymphoma. Conclusion - Aim of this reporting is to recognize NHL as a cause of intussusception in child and its correct management.

Introduction: Mucocele of appendix is a rare condition which majority of time is diagnosed incidentally or during working up for a pelvic cause. Clinical presentation is non specific, Majority of cases presents to gynaecologists with suspicion of adnexal pathology. Accurate preoperative diagnosis is difficult to arrive at, given the findings of USG and CT may be confusing. As it can be associated with malignancy, operative handling of specimen should be optimum. Case Presentation: Two cases of Am were diagnose preoperatively by USG and CECT . Patient underwent surgery with exicision of the appendix. Conclusion: A female patient presenting with complaints of lower abdominal pain with no findings in pelvis should be considered for differential diagnosis of Appendiceal mucocele.

Abstract not provided.

Key words: cancer, stem cells

Background: Despite advances in diagnostic modalities, surgical approach, antimicrobiological therapy and intensive care support, ileal perforations continue to be a potentially fatal affliction in a tropical country. Most ileal perforations are considered to be of typhoid etiology simply based on the clinical presentation of fever of two weeks duration followed by an ileal perforation on the antimesenteric border of terminal ileum.While the surgical management of these perforations does not change a great deal when compared with other causes of ileal perforations, the antimicrobial therapy and the overall outcome is affected by the underlying etiology. Against this background a prospective study was conducted over a period of one year with an aim to establish the underlying pathology and whether these “suspected” typhoid perforations are truly of typhoid etiology. Material and methods: A prospective cohort of fortyseven patients of ileal perforations of suspected typhoid etiology was evaluated over a period of one year. The surgical management was based on a standardized protocol using APACHE II scoring system. Blood culture, peritoneal fluid, ulcer edge and mesenteric lymph nodes biopsies were subjected to culture to determine the predominant aerobic bacterial isolate and its anti microbiological sensitivity. Results :In this series male to female ratio was 36: 11, with an average age of 27.3 years. The average duration of fever was 6.67 days; average hospital stay was 10.14 days with a mortality rate of 17.72%. Salmonella typhi could be isolated in only 10.53% of the patients. Conclusions: The classical presentation of these so called “typhoid perforations” is not commonly observed. Salmonella typhi is rarely isolated from the blood/tissue cultures and the diagnosis of typhoid perforations is essentially clinical. Since ileal perforations are the most common surgical emergency managed by a resident trainee particularly in the developing and underdeveloped countries, a trainee proof and standardized surgical protocol based on APACHE-II scoring system is recommended in order to reduce the mortality.

Key words: Typhoid, enteric, ileal, perforations

Background. Abdominal trauma is a leading cause of morbidity and mortality among all age groups.. This retrospective study has been undertaken to analyse the pattern of abdominal trauma with respect to epidemiology, etiology and visceral injuries. Methods. All the in-patient records of patients, who were admitted with abdominal trauma in the emergency department of Teerthankar Mahaveer Medical College & Research Centre, located on N.H.24, during the period from 1st November 2009 to 30th October 2010 were analysed. Results: Total 87 cases of abdominal trauma, with or without involvement of other body regions were studied. 51 victims were in 2nd to 4th decades of life, 12 in 5th decade, 11 in 1st decade and the remaining 12 patients were in either extremes of age groups. The male to female ratio was 3.3:1. Blunt injuries were more common than penetrating injuries with 61 blunt injuries and 26 cases of penetrating injuries.Accidents were the leading cause of both blunt and penetrating abdominal injuries. Most commonly injured viscus in cases of blunt trauma was bowel, and in cases of penetrating injuries was spleen. The mortality rate was 4.6%.

Key words: Abdominal Trauma, Penetrating Trauma, Blunt Trauma