Background: The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is widely used to predict the morbidity and mortality in a variety of surgical settings and provides a tool for risk adjustment and comparison. The aim of this study was to assess the predicting morbidity and mortality in hollow viscus perforation by applying POSSUM and Portsmouth modification of POSSUM scores. Methods: This study was a prospective study conducted on 33 patients admitted in the Department of General Surgery, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, from September 2016 to August 2017, and present detailed records of the parameters under evaluation of patients admitted to surgical wards with the clinical diagnosis of hollow viscus perforation (gastric/duodenal/ileal perforation). Results: During the present study period, a total of 136 patients were operated on small bowel, and of these 33 cases fulfilled all the criteria and were selected for this study. The overall mortality in this study was 6 (18.18% of the study), while the morbidity was noted in 17 cases (51% of study). Mortality rates differed with POSSUM scores over predicting the mortality. On applying POSSUM, using exponential analysis, we found that the expected number of deaths for our study group is 10 (O:E = 1.66). Conclusion: On applying POSSUM using the exponential analysis, we found that the expected number of deaths for our study group is 10 (O:E = 1.66). We found the difference between expected and observed mortality rates using the exponential analysis.

Background: Significant morbidity and mortality is caused by acute pesticide poisoning. Reliable data are not available regarding the morbidity and mortality from India. Objective: The objective of this study is to study the clinical spectrum of organophosphorus poisoning. Materials and Methods: A hospital-based, cross-sectional study was carried out among 120 patients admitted with organophosphorus poisoning at a rural medical college. Patients with acute poisoning were included. Detailed history, clinical examination, and required investigations were done and noted in the study questionnaire. Results: Males (56.7%) were more than females (40.8%). Majority of the study participants belonged to the age group of 30–39 years (43.3%) followed by 20–29 years of age, i.e., 29.2%. The most common clinical feature was miosis 88.2% in males and 86.5% in females followed by nausea and vomiting (76.5%) in males and pain abdomen (63.5%) in females. The most common poison consumed by both males and the females was malathion, i.e., it was consumed by 42.6% of males and 36.5% of females. The next most common poison consumed was diazinon by 32.4% of males and 30.8% of females. In males, it has been observed that the incidence of organophosphate (OP) poisoning decreased from 42.6% in the rainy season to 27.9% in the summer season. However, in females, it was the same, i.e., 38.5% for both rainy season and the winter season, but like in males, it decreased in the summer season. Conclusion: Males are more affected than females, miosis was most common and malathion was most commonly consumed agent. The incidence of OP poisoning was more in the rainy season.

Background: Correct incidence of the spinal cord injuries in India is not known. Prevention is better than cure as there is no proper cure for the spinal cord injuries. Hence, study of clinical profile of patients with spinal cord injuries is required. Objectives: The present study was undertaken to study the clinical profile of spinal cord injuries in tertiary care hospital in rural area. Materials and Methods: This was a hospital-based cross-sectional study conducted among 56 patients with spinal cord injuries. Detailed history, required investigations were recorded. The data was analyzed using proportions. Results: Younger age groups from 20 to 49 were more commonly affected than older age group of 50 years and above. The most common site of spinal cord injuries was at the level of thorax (64.3%) followed by lower cervical level in 21.4% of the cases. 39.2% of the study subjects had complete spinal cord injury and 60.8% had incomplete spinal cord injury. Majority had both variety of injuries in the thoracic cord. Conclusion: It can be concluded that spinal cord injuries are common in the younger age group, thoracic site being the most common for injury and incomplete type of injury is common.

Background: Stenotrophomonas maltophilia, once regarded as an organism of low virulence, has evolved as a significant opportunistic pathogen causing severe human infections in both hospital and community settings, especially among highly debilitated patients. Objectives: (1) Identification of S. maltophilia in sepsis and (2) assessment of sensitivity pattern/minimum inhibitory concentration (MIC) of S. maltophilia and its multidrug resistance by VITEK 2 Compact system and by Kirby–Bauer (KB) disk diffusion method. Materials and Methods: This is a retrospective laboratory-based study analysis conducted in a tertiary care center, i.e., Bangalore Medical College and Research Institute, from July 2018 to June 2019. Samples from clinically suspected sepsis patients were processed by standard microbiological methods. VITEK 2 compact (Biomerieux) was used for final identification and MIC. Antibiotic susceptibility was tested by KB disk diffusion method for cotrimoxazole (1.25/23.75 μg) and levofloxacin (5 μg) following the Clinical and Laboratory Standards Institute guidelines M100. Results: Among 18,949 samples collected from suspected sepsis patients, during a 1-year period, 50 isolates were identified as S. maltophilia. Nineteen were isolated from blood; 6 from pus and ascitic fluid; 4 from cerebrospinal fluid, endotracheal aspirate, and pleural fluid; 1 from urine and cornea; and 4 from other sites. The organisms showed multidrug resistances and were sensitive to trimethoprim-sulfamethoxazole and levofloxacin. Conclusion: S. maltophilia was found to be the third most common nonfermenters after Acinetobacter spp. and Pseudomonas aeruginosa with multidrug resistance. As its isolation is increasing, it is important to study the epidemiology, antimicrobial susceptibility profile, and clinical outcomes of these isolates.

Antepartum death of one twin is an infrequent obstetric complication. It complicates about 6% of twin pregnancies. Death of one twin in second or third trimester is more deleterious with risk for the surviving twin and also risk of disseminated intravascular coagulation to the mother has been reported. Risks are far higher in monochorionic pregnancy than in dichorionic pregnancy. The common foetal circulation between the live and the dead twins may result in foetal cerebral, renal and skin abnormalities. Management depends on the gestational age, chorionicity and the condition of the surviving fetus. High risk obstetric management is required and a careful neonatal and paediatric follow up is advocated.

Leiomyomas are the most common benign tumors of the uterus. Majority of the leiomyomas occur in the body of the uterus; only 1%–2% of cases are confined to the cervix. A cervical leiomyoma is usually single and is either interstitial or subserosal; rarely, it becomes submucous and polypoidal. Here, we report an uncommon case of cervical leiomyoma. A 45-year-old female para 2 live 2 admitted with complaints of burning micturition and retention of urine. Ultrasound revealed a well-defined heteroechoic lesion measuring 9.6 cm × 7.5 cm × 7.5 cm noted along the posterior wall of the cervix suggestive of partially exophytic fibroid. Single posterior wall fibroid 10 cm × 8 cm was noted intraoperatively. Enucleation followed by hysterectomy was done successfully without injury to the bladder and ureters.

The coronavirus disease-2019 (COVID-19) pandemic has been reported across 216 nations and territories since its emergence in the Wuhan city of China. It has been envisaged that the use of medical mask is one of the preventive strategies to limit the spread of transmission for many respiratory infections, including COVID-19. However, it is important to note that the use of the mask alone cannot provide complete protection, unless it is coupled with other infection prevention and control measures like hand hygiene. At present, the extensive usage of masks by healthy people in the community setting is not advocated owing to the shortage of masks for health-care personnel and the lack of evidence to support that wearing a mask by healthy people in community settings will prevent the acquisition of infection. In conclusion, in the fight against COVID-19 infection, the use of masks in community, home, and health-care settings needs to be clearly defined and streamlined to promote its rational usage. These masks play an important role in reducing the risk of transmission, provided it is supplemented with other infection prevention and control measures.