Effect of serial night shifts on the cognitive, psychomotor, and moral performance of residents in the department of Emergency Medicine.

Objectives: The objective was to study the effect of serial night shifts on the cognitive, psychomotor, and moral performance of emergency medicine residents of an academic Emergency Medicine Department.

Methods: This prospective case-crossover study compared emergency medicine residents' sleep time, subjective sleepiness, cognitive function, moral judgment, and psychomotor skills after 5 consecutive days versus night shifts using sleep diaries, activity monitors, and multiple performance tests. Paired t-tests and Wilcoxon signed-rank tests were used to analyze data based on normality.

Clinico-Demographic Profile and Factors Affecting Duration of Hospital Stay Among Burn Patients in an Emergency Department of a Tertiary Care Center, South India: A Hospital-Based Cross-Sectional Study.

Background Burns continue to be a serious public health problem in India. It persists as an endemic disease in spite of implementing various preventive measures at the individual and community levels. Etiology and factors influencing burns are varied.

Intact Parathyroid Hormone Levels in Predicting Postoperative Hypocalcaemia After Total Thyroidectomy in South Indian Population: Cross Sectional Study.

Hypocalcaemia being one of the most common complications after total thyroidectomy may not be avoidable in all cases. This study evaluated the effectiveness of intact Parathyroid hormone (iPTH) measured at 1-h after total thyroidectomy in predicting postoperative hypocalcaemia in early postoperative period in South Indian population. Patients who underwent total thyroidectomy in our institute from 2016 to 2018 were included.

Pattern of expression of CDX2 in colorectal cancer and its role in prognosis.

Background: CDX2, a nuclear protein, is essential for the proliferation and development of intestinal epithelial cells and is frequently down-regulated during tumorigenesis. We have evaluated the pattern of CDX2 expression in all stages of colorectal cancer (CRC) and its association with prognosis.

Methods: We performed CDX2 staining by immunohistochemistry (IHC) on the available biopsy blocks of patients of CRC registered in our institute from January 2014 to January 2018.

Use of a Clinical Audit System in Implementing Surviving Sepsis Campaign Guidelines in Patients With Peritonitis.

Background Sepsis is the predominant cause of morbidity and mortality in patients with peritonitis. "Surviving Sepsis Campaign" (SSC) is an international effort in reducing mortality based on evidence-based guidelines. This study aims to assess the impact of audit-based feedback in a Plan-Do-Study-Act (PDSA) format on improving the implementation of the SSC guidelines in patients with generalized peritonitis at our center.

A Rare Case of Large Bowel Obstruction Secondary to Bone Grafting.

Anterior abdominal wall incisional hernias can occasionally present as acute intestinal obstruction. Incisional hernias occurring at uncommon sites or after uncommon surgeries may contribute to diagnostic dilemmas. Herein, we report the case of a 53-year-old lady who presented with obstructed incisional hernia following autologous iliac bone grafting.

Utility of nutritional indices in preoperative assessment of cancer patients.

Background: Malnutrition is an important but neglected predictor for outcomes and healthcare costs in cancer patients. A simple screening tool for detecting malnutrition may have clinical utility in their preoperative assessment.

Objectives: This study compared three validated indices, for their predictive ability for prolonged length of stay (LOS) and 30-day postsurgical complications in malignancies in a tertiary hospital in South India.

Clinical Significance of Candida in an Intraoperative Peritoneal Specimen with Perforation Peritonitis: An Institutional Perspective.

Introduction Fungal infection of the peritoneum has become more common in recent years, the most common cause of which is Candida. Candida peritonitis is considered as a severe disease and is regarded as an independent risk factor for mortality in postoperative peritonitis. This study was planned to find out the clinical significance of Candida isolation on the outcome of the patients with peritonitis in terms of morbidity and mortality.

A Surgical Conundrum in Feeding Jejunostomy-Jejunojejunal Intussusception: A Case Series.

Intussusception is a common cause of intestinal obstruction in the pediatric population. Usually, it is primary and benign and can be managed by nonoperative interventions in 80% of the cases. Adult intussusception accounts for only 5% of all cases of intussusception and 1%-5% of all cases of intestinal obstruction.

Role of Methylene Blue in the Maintenance of Postinduction Hemodynamic Status in Patients with Perforation Peritonitis: A Pilot Study.

Context: Methylene blue is an inhibitor of guanylate cyclase and hence prevents vasoplegia mediated by nitric oxide in patients with sepsis.

Aims: This study aimed to analyze the effect of methylene blue on blood pressure maintenance following induction of anesthesia in patients presenting with peritonitis.

Subjects And Methods: Thirty patients diagnosed to have perforation peritonitis were randomized into two groups (Group MB, Group NS).

Clinical audit system as a quality improvement tool in the management of breast cancer.

Introduction: Quality improvement is recognized as a major factor that can transform healthcare management. This study is a clinical audit that aims at analysing treatment time as a quality indicator and explores the role of setting a target treatment time on reducing treatment delays.

Materials And Methods: All newly diagnosed patients with breast cancer between September 2011 and August 2013 were included in the study.

Extranodal NK/T Cell Lymphoma of the Jejunum Complicated by Hemophagocytic Syndrome: Practical Problems Encountered by a Pathologist.

Extranodal NK/Tcell lymphomas (ENKTL) are rare, aggressive lymphomas. The most common primary site of involvement is the nasal cavity, nasopharynx and paranasal sinuses. The other sites of primary involvement are skin, gastrointestinal tract and testis.

Axial Torsion of Gangrenous Meckel's Diverticulum Causing Small Bowel Obstruction.

Meckel's diverticulum (MD) is a commonly encountered congenital anomaly of the small intestine. We report an extremely unusual case of an axially torted, gangrenous MD presenting as acute intestinal obstruction. A 26-year-old male patient presented to our emergency department with 3 days history of abdominal pain, distention and bilious vomiting.

Necrotizing fasciitis.

Necrotizing fasciitis (NF) is among the most challenging surgical infections faced by a surgeon. The difficulty in managing this entity is due to a combination of difficulty in diagnosis, and also of early as well as late management. For the patient, such a diagnosis means prolonged hospital stay, painful dressings, an extended recovery, and in some unfortunate cases even loss of limb or life.

Enterocutaneous fistulae: etiology, treatment, and outcome - a study from South India.

Background/aim: Enterocutaneous fistula (ECF) is a difficult condition managed in the surgical wards and is associated with significant morbidity and mortality. Sepsis, malnutrition, and electrolyte abnormality is the classical triad of complications of ECF. Sepsis with malnutrition is the leading cause of death in cases of ECF.

Sternocleidomastoid muscle myocutaneous flap for corrosive pharyngoesophageal strictures.

Background: Strictures at the pharyngoesophageal junction represent a subgroup of corrosive esophageal strictures requiring a specialized management approach. Non-dilatable cricopharyngeal strictures need surgical intervention. We report the use of the sternocleidomastoid muscle myocutaneous inlay flap (SCMMIF) for reconstruction of the cervical esophagus in patients with corrosive strictures.

Is Helicobacter pylori eradication indicated in cirrhotic patients with peptic ulcer disease?

Introduction: The association between H. pylori infection and peptic ulcer disease (PUD) and the efficacy of eradication of H. pylori in treating ulcer disease in cirrhotic patients remains controversial.

Improvement in dysphagia and quality of life with self-expanding metallic stents in malignant esophageal strictures.

Background: Carcinoma of the esophagus often presents at an advanced stage, with absolute dysphagia or aspiration. Palliative procedures have an important role in improving the quality of life (QOL) of patients who are not candidates for curative therapy. We report on the efficacy and complications of self-expanding metallic stents (SEMS) in such patients.

Delay in surgery for acute appendicitis.

Background: The present study investigates the effect of delay in appendicectomy on the outcome of surgery and also examines the contribution of patient and physician related delay to the stage of appendicitis.

Methods: During a 12-month period, 114 consecutive adult patients undergoing appendicectomy for acute appendicitis were monitored prospectively. Time of onset of symptoms, presentation to the hospital, surgery consultation, decision to operate and starting of surgery were all noted.

Postoperative intussusception in the adult: a case report.

We report the case of a 40-year-old man who presented with a history of sudden onset abdominal pain and obstipation of 1 day's duration. During laparatomy, a 5mm perforation was seen in the anterior wall of the first part of the duodenum, which was closed by a Graham patch and the abdomen was closed after peritoneal lavage. Postoperatively, the patient's condition worsened and he was posted for a laparatomy with a diagnosis of postoperative obstruction.