Original Research Article
Dec. 4, 2020
Survival Rate in Patients with HBV-ACLF after Three Months of Antiviral Therapy
Dr. Sharker Mohammad Shahadat Hossain, Dr. Mamun Al Mahtab, Salimur Rahman
SAS J Surg | 371-379
DOI : 10.36347/sasjs.2020.v06i12.001
Background: A virus which primarily causes inflammation of he liver. The hepatitis B virus can be transmitted in several ways including blood transfusion, needle sticks, body piercing and tattooing using unsterile instruments, dialysis, sexual and evenless intimate close contact, and childbirth. Acute on chronic liver failure (ACLF) is an acute hepatic insult manifested as Jaundice and Coagulopathy, complicated within 4 weeks by clinical ascites and/or Encephalopathy in a patient with previously diagnosed or undiagnosed Chronic Liver Disease/Cirrhosis. It is associated with high 28-day mortality rate ranging from 30% to 70%. Reactivation of Hepatitis B virus infection and super infection with hepatitis A or E are the major causes of ACLF in the Asian region. Liver transplantation is the only definitive therapy though it is not available everywhere and not feasible always. Again MARS therapy (Molecular Adsorbent Recirculating System) didn’t reduce mortality significantly. So, antiviral therapy should be started as soon as possible in patients with ACLF due to Hepatitis B irrespective of DNA and ALT status to improve hepatic dysfunction and rescue the patients from mortality. Aims: This randomized clinical trial was carried out with an aimto see survival among patients with acute on chronic hepatitis B liver failure 03 months after the antiviral (Tenofovir or Entecavir) therapy. Methodology: In this study a total of 32 acute on chronic Hepatitis B liver failure patients (age > 18 years with both sexes but male predominant) were included in Hepatology department of Bangabandhu Sheikh Mujib Medical University, Dhaka during January 2013 to December 2015. The patients were randomized into two groups: Tenofovir group (N=16) and Entecavir group (N=16) and followed at least for 03 months. Result: The total study population was 32 Tenofovir and Entecavir ware 15, 13(86.66) tenofovir and entecavir of 7 days. 6(60.00) tenofovir and entecavir of 8-15 days. 1(14.28) tenofovir....
Multiloculated Mesothelial Cyst: A Diagnostic Dilemma
Srujana, Rajdeep Singh, Tirlok Chand, Anjali Prakash, Varuna Mallya
SAS J Surg | 368-370
DOI : 10.36347/sasjs.2020.v06i11.002
Mesothelial cyst is a rare benign lesion of mesothelial origin. It is usually asymptomatic but may have non specific symptoms. So Accurate diagnosis and optimal management of this condition remains uncertain. Case Report: We report a 14-year-old boy, who presented with abdominal pain and lump. Magnetic Resonance Imaging (MRI) revealed a large well defined multiloculated lesion in retroperitoneum in anterior right pararenal space. The differential diagnosis included benign cystic lesion, lymphangioma, cystic teratoma and duplication cyst. A laparotomy was performed due to his symptoms and size of the cyst. Macroscopically, a 14 × 10 × 5 cm cystic lesion with necrotic fluid and multiple ridges was found. It was resected en bloc. Histology revealed a diagnosis of Mesothelial cyst. The patient recovered well and had no recurrence at 1-year follow-up. Conclusion: Because of rarity and nonspecific symptoms pre operative diagnosis was difficult. Treatment of choice is complete surgical excision.
Original Research Article
Nov. 5, 2020
Meckel’s Diverticulum in Paediatric Age Group: A Spectrum of Clinical Presentations and its Management
Dr. Rajshekhar Patil, Dr. Sharan Gubbi, Dr. Karthik Dhaded, Dr. Sanjay K
SAS J Surg | 364-367
DOI : 10.36347/sasjs.2020.v06i11.001
Meckel,s Diverticulum is a true diverticulum which is seen in approximately 2% of the population. The presentation of which may range from asymptomatic to gastrointestinal bleeding to intestinal obstruction. This wide range of presentations makes it a difficult entity to diagnose. In view of this, we conducted a study between the period of Jan 2017 to Dec 2017 including all suspected cases of Meckel’s Diverticulum, in order to study the various modes of presentation, the intraoperative management and the postoperative outcome. In our study, out of a total of 14 patients, 6 patients presented with intestinal obstruction, 3 patients with peritonitis, 2 patients were suspected to have appendicitis and in 3 patients, Meckel’s Diverticulum was an incidental finding. In all the above patients, wedge resection of the Diverticulum was performed.