Download In block letters

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION.
1
Name of the Candidate
And address
(In block letters)
:
Dr. SHRIKANT BULLA
DEPARTMENT OF GENERAL SURGERY.
NAVODAYA MEDICAL COLLEGE,
HOSPITAL & RESEARCH CENTRE,
RAICHUR.- 584103
2
Name of the Institution
:
NAVODAYA EDUCATION TRUST’S,
NAVODAYA MEDICAL COLLEGE,
RAICHUR-584103.
3
4
5
Course of study and
subject
Date of admission to the
course
:
M.S. (GENERAL SURGERY)
:
26-05-2010
Title of the Topic
A CLINICAL STUDY OF AMOEBIC AND PYOGENIC LIVER ABSCESS IN
PATIENTS ADMITTED TO NAVODAYA MEDICAL COLLEGE HOSPITAL
AND RESEARCH CENTRE, RAICHUR
6 Brief Resume of the Intended Work
6.1
Need for the study :
Liver abscess is one of the most important and frequent problems in clinical
practice. The symptoms and signs simulate a great variety of diseases.
Until recently the diagnosis of liver abscess was depended upon
variable clinical criteria, characteristics of pus aspired from abscess cavity or
on a clinical response to appropriate chemotherapy. After innovation of
imaging techniques such as ultra sound, isotope scan, C.T.scan, serological
tests, the diagnosis of liver abscess can be made rapidly and accurately.
This is one illness for which there are so many effective drugs and so
much surgical help available, so that once diagnosed no patient should be
allowed to die or deteriorate.
In India, where liver abscess is common, one must consider
possibility of liver abscess in every case of abdominal discomfort or acute
abdomen.
6.2
Review of Literature:
Hepatic abscesses are a spectrum of infectious hepatic lesions which differ in
etiology, treatment options, and outcomes. Their relative incidence varies
worldwide. Significant improvements have been made in the diagnosis,
treatment, and outcome. Hippocrates is credited with the first description of a
hepatic abscess in the year 4000 BC.1
In 1875, Fredor Alekshandrevitch Losch of St. Petersburg (now Leningrad)
found amoebae in the stools of a patient with dysentery and suggested it as
the causative factor. In 1887 Robert Koch, identified amoeba as the
etiological agent in tropical liver abscess.
More recently, Ochsner's2 classic 1938 paper described this disease as one
that occurred in young males with underlying intra-abdominal infection. In
1953, McFadzean3 and associates in Hong Kong advocated closed aspiration
and antibiotics for treatment of solitary pyogenic liver abscess.
Modern times have seen a major shift in etiology, affected patient
population, and treatment of pyogenic abscesses in the liver. 1 The incidence
of pyogenic liver abscess is on the rise. Pyogenic liver abscess affected 5–13
patients per 100,000 admissions prior to 1970, and accounts for
approximately 15 cases per 100,000 admissions today.4
Huang and associates reported that 63% of patients had abscesses involving
the right lobe, 14% had abscesses involving the left lobe, and 22% had
bilobar disease.5
Amoebic liver abscess is caused by the parasitic protozoan Entamoeba
histolytica. The disease was described in association with blood and mucus
diarrheal stools in the 5th century BC by Hippocrates and other practitioners.
Councilman and LaFleur of Johns Hopkins Hospital went on to detail the
pathogenic role of amebae and coined the terms "amoebic dysentery" and
"amoebic liver abscess" in 1891.6
6.3
Objectives of the study:
1. Age and Sex distribution
2. Duration of the symptoms and Modes of Presentation.
3. Management modalities
7 Materials and Methods:
7.1
Source of Data:
7.2
Patients admitted with suspected amoebic/ pyogenic liver abscess in
Navodaya Medical college hospital and research centre will be included in
the study.
Methods of collection of Data :
INCLUSION CRITERIA:
All patients admitted with suspected amoebic/ pyogenic liver abscess in
Navodaya Medical college hospital and research centre.
EXCLUSION CRITERIA: None
7.3
Does the study require any investigation or intervention to be
conducted on patients or other humans or animals? If so, please
describe briefly.
Along with the clinical findings following examinations/tests will be carried
out.
1. Hematological examination.
1. Hemoglobin
2. Total count, differential count
3. E.S.R
2. Liver function tests.
1) Serum bilirubin
2) Serum transaminase
3) Serum alkaline phosphatase.
3. Stool examination for Entameoba- cyst/trophozoite.
4. Urine analysis.
5. X-ray chest.
6. Plain X-ray Erect abdomen
7. Abdominal Ultrasound.
8. Needle aspiration
9. Culture and Sensitivity.
7.4
Has ethical clearance been obtained from your institution in case of
7.3?
YES.
8
List of references :
1. Christians CK, Pitt HA. Hepatic abscess and cystic disease of liver.
Chapter 28 in Maingot’s abdominal operations. Zinner MJ, Ashley SW. 11ed
McGraw Hill: 2007 757-782
2. Ochsner A. Pyogenic abscess of liver. Am J Surg 1938;40:292
3. McFadzean AJS, Chang KPS. Solitary pyogenic abscess of liver treated by
closed aspiration and antibiotics: A case report of 14 consecutive cases with
recovery. Br J Surg 1953;41:141-152
4. Seeto RK, Rocky DC. Pyogenic liver abscess: Changes in etiology,
management, and outcome. Medicine 1996;75:99–113
5. Huang CJ, Pitt HA et al. Pyogenic hepatic abscess: changing trends over
42 years. Ann Surg 1996;223:600-609
6. Martinez Baez M. Historical Introduction. In. Martinez-Palomo A (Ed).
Amebiasis, Human parasitic disease Vol-2 Amsterdam, Holland:
Elsevier;1986 1-9
9.
10.
11.
Signature of the Candidate
Remarks of the Guide
11.1
Name and Designation of
Guide (In block letters)
12
11.2
Signature
11.3
Co-guide (if any)
11.4
Signature
11.5
Head of the Department
11.6
Signature
12.1
Remarks of Chairman and
Principal
12.2
Signature
Recommended and forwarded
DR. SUBHAS S. HADIMANI
ASSOCIATE PROFESSOR
DEPARTMENT OF GENERAL
SURGERY
NAVODAYA MEDICAL
COLLEGE HOSPITAL AND
RESEARCH CENTER, RAICHUR
DR.P.SUBANULLA
PROFESSOR AND HEAD,
DEPARTMENT OF GENERAL
SURGERY
NAVODAYA MEDICAL
COLLEGE HOSPITAL AND
RESEARCH CENTER. RAICHUR