IJSS Journal of Surgery https://surgeryijss.com/index.php/IJSS <p style="text-align: justify;"><strong>IJSS Journal of Surgery</strong>&nbsp;is a peer-reviewed journal publishing articles of surgeons those who perform abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. IJSS Journal of surgery has the goal of providing its readership the highest quality rapid retrieval of information relevant to surgeons. It provides an in-depth, international forum for the most recent, authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Journal content includes Leading Articles, Reviews, Original Research Articles, Randomized Clinical Trials, Your Views and Book Reviews. All papers published in the IJSS are subject to rigorous peer review.</p> International Research Organization for Life & Health Sciences (IROLHS) en-US IJSS Journal of Surgery 2395-1893 The Prevalence of Middle cerebral artery Stenosis in Population of Bihar (A trans-cranial Doppler study) https://surgeryijss.com/index.php/IJSS/article/view/478 <p><strong>Background:</strong> The prevalence and causes of intra cranial arterial stenosis in adults’ stroke patients is largely unknown. Hence it has become a great clinical challenge for Neuro-physician, Neurosurgeon and Radiologist to find out the aetiologies of intra cranial arterial stenosis.</p> <p><strong>Method:</strong> 100 patients of aged between 25 to 60 years were selected for study. Their past history and clinical manifestations were noted TCD examination was performed with portable machine (multi-drop (R) + DWL), which is a 2MHz power motion single channel TCD, MCA was approached through temporal windows by use of standard protocol. stenosis of arterial were defined by the peak systolic flow velocity more than 140 cm/sec for MCA.</p> <p><strong>Results:</strong> The highest clinical manifestation was HTN 75%, followed by DM 58%, obesity 52% ,and hyper cholestremia 48%, smoker 38%, CAD 32% ,and least was PVD 2%. In odds ratio study HTN was highest 8.5, followed by CAD ratio was 6 and least ratio was alcoholics 1.6.</p> <p><strong>Conclusion:</strong> The present study revealed the aggravating factor like HTN, DM and CAD. Atherosclerosis causes stenosis of MCA and peak systolic velocity more than 140 mc/sec for MCA. Hence the patients having such clinical manifestations will be more prone for stenosis of MCA.</p> Deepak Karn Copyright (c) 2022 IJSS Journal of Surgery 2022-05-09 2022-05-09 8 2 1 4 Effect of Nebulized Salbutamol Premedication onPerioperative Respiratory Adverse Events in Children with Recent Respiratory Tract Infections https://surgeryijss.com/index.php/IJSS/article/view/480 <p><span style="text-decoration: underline;">Abstract<br>Background: A recent upper respiratory tract infection is linked to the development of peri-operative respiratory complications.<br>Aim of study: To evaluate the effect of salbutamol premedication on the incidence of peri-operative respiratory adverse events in children with a recent upper respiratory tract infection(PRAE). <br>Patient and method: A randomized clinical trial study that conducted at Children Welfare Teaching Hospital for a period of six months.It included 90 children aged ≤ 16 years underwent surgical operation under general anesthesia with a laryngeal mask airway or a tracheal tube and divided into three groups (had a recent URTI and received preoperative salbutamol, had a recent URTI and didn’t receive preoperative salbutamol, and healthy children group). The preferred outcome was the difference in the rate of occurrence of PRAE between children having received salbutamol and those haven’t.<br>Result:Four healthy children (13.3%) developed peri-operative respiratory adverse events.Incidence of bronchospasm and severe cough were significantly higher in patients with URTI and didn’t received preoperative salbutamol than that in those with URTI and received preoperative salbutamol.</span></p> Mustafa Mohammed Salih Hussein Talip Mohsin Copyright (c) 2022 IJSS Journal of Surgery 2022-05-09 2022-05-09 8 2 5 8 A Comparative study of 2 percent diltiazem versus lateral sphincterotomy in the management of anal fissure https://surgeryijss.com/index.php/IJSS/article/view/483 <p><span class="markedContent"><span dir="ltr" role="presentation">Introduction:</span> <span dir="ltr" role="presentation">Anal fissures are longitudinal tears in the squamous epithelium of the anal canal. Anal fissures are located distal to the dentate line,</span><br role="presentation"><span dir="ltr" role="presentation">and in around 90% of cases they are located on the posterior midline. The most common pathologies of the anorectal region and can change the</span><br role="presentation"><span dir="ltr" role="presentation">quality of life as it causes patient pain and emotional stress while defecation. With a lifetime risk of 11%, anal fissure is a common problem in</span><br role="presentation"><span dir="ltr" role="presentation">routine medical care. Anal fissure is mainly treated by relaxing the spasm of the internal sphincter either by dilating the anal canal or</span><br role="presentation"><span dir="ltr" role="presentation">sphincterotomy. Reduction of spasticity of anal sphincters is the special treatment for fissure healing. For this purpose, the treatment of anal fissures</span><br role="presentation"><span dir="ltr" role="presentation">is performed by lateral sphincterotomy or by anal dilatation. Methods:</span> <span dir="ltr" role="presentation">Out of 100 randomly selected 50 patients with inclusion and exclusion</span><br role="presentation"><span dir="ltr" role="presentation">criteria and informed consent were treated with diltiazem ointment and 50 patients with informed consent were treated with lateral sphincterotomy</span><br role="presentation"><span dir="ltr" role="presentation">for management of anal fissure. Observations after treatment were recorded at second week, sixth week and twelfth week interval for&nbsp; pain</span><br role="presentation"><span dir="ltr" role="presentation">and healing and at the twelfth week follow up was documented to analyse the result of treatment. Result:</span> <span dir="ltr" role="presentation">Out of 50 patients undergoing</span><br role="presentation"><span dir="ltr" role="presentation">treatment with diltiazem ointment 42 patients healed completely. </span><span dir="ltr" role="presentation">. Patients in </span><span dir="ltr" role="presentation">lateral sphincterotomy group underwent surgery under spinal anaesthesia. In lateral sphincterotomy group, fissure healing was found in 49</span><span dir="ltr" role="presentation">(98%)out of 50 patients. In our study out of 50 patients, 48 (96%)were completely relieved from pain and 2 ( 4% ) had pain on follow up at the</span><span dir="ltr" role="presentation">end of 3 months. </span><span dir="ltr" role="presentation">.</span> <span dir="ltr" role="presentation">Conclusion: </span><span dir="ltr" role="presentation">Topical 2% diltiazem should be</span><br role="presentation"><span dir="ltr" role="presentation">given as the first option of treatment for anal fissure. Lateral sphincterotomy, which gives better result to relieve the symptoms but require</span><br role="presentation"><span dir="ltr" role="presentation">hospitalization, should be offered to patient who present with relapse and does not respond to pharmacological treatment</span></span></p> Apoorv Chauhan, Anurag Chauhan, Brijesh Kirar, Nishant Gupta Copyright (c) 2022 IJSS Journal of Surgery 2022-05-09 2022-05-09 8 2 9 12 Case Report A Rare case Desmoid tumour of Appendix Mimicking a Gastrointestinal Stromal Tumor. https://surgeryijss.com/index.php/IJSS/article/view/484 <p>A 48 year-old male patient with complaint of an abdominal pain and a palpable abdominal mass came to our general surgery outpatient clinic. The computed tomography revealed a well-circumscribed solid mass, approximately 12 cm in diameter, which is thought to be a gastrointestinal stromal tumor originating from the cecum. The colonoscopy detected an external pressure on the cecum. No remarkable feature was noted in the patient’s history. Right hemicolectomy was performed. Pathological examination revealed a collagen-rich hypocellular mesenchymal tumor originating from the appendiceal wall, which was negatively stained with CD117&nbsp; immunohistochemical antibodies. The histopathological diagnosis revealed a desmoid tumor(fibromatous lesions). The patient was discharged on postoperative day 6 and was transferred to the oncology department</p> Ketan S Borkhataria, Bhargav Shingala, Viral Sutaria Copyright (c) 2022 IJSS Journal of Surgery 2022-05-09 2022-05-09 8 2 13 15 The Study of Stroke due to intra cranial atherosclerosis in Population of Bihar https://surgeryijss.com/index.php/IJSS/article/view/477 <p><strong>Background:</strong> Ischemic stroke is quite heterogeneous in its patho-physiological mechanism associated with atherosclerosis. Little is known about measures for prevention of the disease apart from latest technologies and medications.</p> <p><strong>Method:</strong> 100 patients of different age groups were studied with MRA, to rule out occlusion or lesion; tropical distribution of infarction, clinical manifestations, recurrence after treatment was also noted.</p> <p><strong>Results:</strong> Clinical manifestations included 33% alcoholic, 21% homocystine, 80% HTN, 54% DM, 30% Hyper-lipidemia, 35% smoking, 48% HTN + DM, 17% HTN + DM +Hyper-lipidemia, 7% HTN + DM + Hyper-lipidemia, + smoking + Alcohol. Highest occlusion was observed 51 (39.9%) in MCA followed by 20 (14.4%) ICA, 23 (16.6%) BA, 18 (13.04%) VA and least was 2 (1.4%) in VA+BA. Highest tropical distribution of infarction was 28% cortical followed by 24% sub cortical and cortical, 23% cortical, 11% cerebellum, 8% Brainstem and recurrence was observed in 19% patients.</p> <p><strong>Conclusion:</strong> The present pragmatic study will help for efficient management and risk control for Neuro-physician and neurosurgeon because risk factor control remains the best strategy for preventing recurrence because recurrence of the stroke worsen the physical and mental conditions of the patients.</p> Deepak Karn Copyright (c) 2022 IJSS Journal of Surgery 2022-05-09 2022-05-09 8 2 16 19