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 Study of Effectiveness of Ligation of Inter-sphincteric Fistula Tract in the Management of Fistulas in Ano in Telangana Population: A Prospective Study https://surgeryijss.com/index.php/IJSS/article/view/460 <p>Background: Fistula in ano is a common condition but a potentially complex disease process and characterized by purulent<br>drainage or cyclic pain associated with abscess re-accumulation followed by intermittent spontaneous decompression. There are<br>many techniques to treat anal fistula, but ligation of the Inter-sphincteric fistula tract (LIFT) is a simple, safe method.<br>Materials and Methods: About 80 adult patients were confirmed to be competent for surgery USG examination having 7–10<br>MHZ transducer passed into the anal canal which is carried out with the patient in left lateral position. Serial radial images were<br>taken to study the location and position of fistula. LIFT procedure was similar to Rojanaskul proposed method. Duration of surgery<br>and healing of wound was noted.<br>Results: As per Park’s classification 70 (87.5%) are trans-sphincteric, 8 (10%) Inter-sphincteric, 2 (2.5%) supra sphincteric,<br>Classification by course of fistula - 30 (37.5%) anterior straight, 40 (50%) posterior straight, 8 (10%) curved, and 2 (2.5%) semihorse<br>shoe. 72 (90%) had single tract, and 8 (10%) had multiple tracts.<br>Conclusion: The LIFT technique is an ideal because it is minimally invasive with high rate of rapid healing and without any<br>resultant of incontinence.</p> Y C Kishore Kumar Reddy Copyright (c) 2021 IJSS Journal of Surgery 2021-12-13 2021-12-13 7 6 1 4 Comparison of Biochemical Profiles in Pregnant and Non Pregnant Women of Bihar https://surgeryijss.com/index.php/IJSS/article/view/464 <p>Background: Pregnancy is associated with several physiological changes in the body such as metabolic changes that help the<br>growth and the survival of the fetus. However biochemical profile derangement may lead to pregnancy complications. Hence, it<br>is essential or mandatory to study the biochemical profiles in the pregnancy.<br>Materials and Methods: Fifty pregnant and 50 non-pregnant aged between 18 and 45 were selected. Body mass index (BMI),<br>lipid profile, blood pressure (BP) were studied and compared.<br>Results: About 13 (26%) women had first trimester 20 (40%) had second trimester and 17 (34%) had third-trimester pregnancy.<br>BMI mean value pregnant women was 24.82 (±1.08) and non-pregnant female was 22.19 (±1.03) t-test 12.4 and P &gt; 0.00. Mean<br>value of systolic BP in pregnant women 110 (±2.2) and 105 (±1.2) in non-pregnant women t-test 14.1 and P &lt; 0.000. Diastolic<br>BP 72 (±2.1) pregnant 70 (±1.3) in non-pregnant females t-test 5.7 and P &lt; 0.000, Glucose levels, total cholesterol, triglycerides,<br>high-density lipoprotein, and low-density lipoprotein were elevated in pregnant females as compared to non-pregnant females.<br>Conclusion: This pragmatic evaluation of biochemical profile will be helpful to obstetricians and gynecologist to predict the status<br>of pregnancies and foetal outcomes because nutritional status plays vital role in pregnancy and growth of the fetus.</p> Smita Mallick Copyright (c) 2021 IJSS Journal of Surgery 2021-12-13 2021-12-13 7 6 5 8 Clinical Study of Various Modalities of Treatment for Fistula in Ano in Haryana Population https://surgeryijss.com/index.php/IJSS/article/view/465 <p>Background: Fistula ano has been known as a common surgical ailment for over two and half a millennia. It is characterized by<br>purulent drainage or cyclic pain associated with abscess re-accumulation followed by intermittent spontaneous decompression.<br>There are many techniques to treat the fistula.<br>Materials and Methods: Ninety-two adult patients having fistula in ano were studied. PR examination, proctoscopy, and fistulogram<br>were done to for planned surgical treatment. All pre-operative routine blood examination was carried out. Patient was kept nil by<br>mouth since previous night, surgery was done under appropriate anesthesia and dissected parts were sent for histopathological<br>examination, based on histopathological report patients treated postoperatively.<br>Results: Eighty-six (93.4%) had perianal discharge, 69 (75%) had history of perianal abscess, 27 (29.6%) had pain, 89 (96.7%)<br>had swelling, 65 (70.6%) had fistulectomy, 11 (11.9%) had fistulotomy, 16 (17.3%) had seton thread technique, and recurrence<br>was in 4 (4.34%) patients.<br>Conclusion: Fistulotomy is associated with slightly high rate of recurrence but low chances of anal incontinence; it has shorter<br>operating time with less post-operative pain and less time needed for wound healing as compared to fistulectomy.</p> Sumesh Kumar Garg Sandeep Arora Perveez Ahmad Malik Copyright (c) 2021 IJSS Journal of Surgery 2021-12-13 2021-12-13 7 6 9 12 Evaluation of Hemodynamic Response in Patients Undergoing Laparoscopic Surgeries Premedicated with Oral Clonidine https://surgeryijss.com/index.php/IJSS/article/view/467 <p>Background: Although laparoscopic surgeries have revolutionized the surgical field due to limited incisions, it has several<br>disadvantages such as creation of pneumoperitoneum for the surgical procedure can have several adverse hemodynamic and<br>respiratory consequences. Hence efficacy of oral clonidine as premedication in attenuation of such hemodynamic changes.<br>Materials and Methods: Forty patients needed for laparoscopy and 40 controlled (placebo) were studied. Their heart rate (HR)<br>and blood pressure were studied and compared in both groups.<br>Results: HR and blood pressure just after intubation, 5 min after intubation, 5 min after insufflations, 15 min after insufflations,<br>and 30 min after insufflations. After extubation was compared in both groups and there were significant results P &lt; 0.001.<br>Conclusion: Oral clonidine effectively attenuates the hemodynamic responses to pneumoperitoneum and also provides sedation<br>without respiratory distress. Oral clonidine drug has proved ideal anesthetic agent for laparoscopic surgery.</p> Durga Sai Swaroop Thota Chaliki Sunil Chowdary Copyright (c) 2021 IJSS Journal of Surgery 2021-12-13 2021-12-13 7 6 13 17 Role of Liver Function Test Parameters in Acute Appendicitis and its Subsequent Complications in Odisha Population: A Retrospective Study https://surgeryijss.com/index.php/IJSS/article/view/468 <p>Background: Acute appendicitis is also one of the surgical emergencies, many techniques including ultrasonography (USG),<br>magnetic resonance imaging, computed tomography scan of the abdomen, and laboratory tests confirm the acute appendicitis but<br>no technique indicate or confirm the severity of appendicitis which is more fatal as it includes gangrene or perforated appendicitis.<br>Hence liver function test (LFT) parameters were correlated with the severity of acute appendicitis.<br>Method: Sixty patients of different age groups having acute appendicitis were confirmed by USG and clinical findings. Routine<br>blood examination, LFT parameters were also studied and compared.<br>Results: Out of 66 patients elevated total Bilirubin was observed in 32 (48%), raised serum glutamic oxaloacetic transaminase in<br>17 (25.7%), raised serum glutamic pyruvic transaminase in 5 (7.5%) raised alkaline phosphatase in 6 (9.09%) patients. Specificity<br>sensitivity positive predictive value and P value were highly significant (P &lt; 0.001) in complicated appendicitis.<br>Conclusion: The elevated parameters of LFT have significant results in complicated appendicitis which included gangrene/<br>perforated appendicitis. Hence, LFT parameters can be used as diagnostic value to predict the severity of acute appendicitis and<br>avoid the morbidity and mortality of the patients.</p> Avinash Pattjoshi Sunil Kumar Habada Copyright (c) 2021 IJSS Journal of Surgery 2021-12-13 2021-12-13 7 6 18 22 Perspective Study of Twins in Maharashtra Population https://surgeryijss.com/index.php/IJSS/article/view/469 <p>Background: Twin pregnancy is no longer a navel occurrence. Advances in reproductive technologies have been the main driver<br>of this increase, but the clinicians need to maintain a high level of suspicion when certain characters are detected, because more<br>than half of twin gestations are undiagnosed until intrapartum period and viewed in USG.<br>Materials and Methods: Out of 325 pregnancies 6 (18%) had twins, USG and routine blood examination Apgar score at birth<br>weight types of pregnancy conditions of pregnant mothers at gestational period was noted.<br>Results: Maternal age of 2 (33.3%) pregnant women was 21–25, 3 (50%) was 26–28, 1 (16.6%) was 30 years if age, 2 (33.3%)<br>had premature labor, 3 (50%) were anemic, 1 (16.6%) had placenta pervia, 2 (33.3%) had vaginal delivery, 4 (66.6%) had<br>cesarean delivery.<br>Conclusion: This pragmatic study will help obstetrician and gynecologist to manage the survival of twin fetus the live fetus can<br>be salvaged</p> Gajanan R Daiv Madhavi Sahastrabudhe Copyright (c) 2021 IJSS Journal of Surgery 2021-12-13 2021-12-13 7 6 23 25 Investigation of Factors Affecting Mortality Rate of Penetrating Small Bowel Injuries: A Prospective Cohort Study https://surgeryijss.com/index.php/IJSS/article/view/470 <p>Introduction: Penetrating abdominal trauma is the generally caused by gunshot or stabbing, in which most commonly affected<br>regions include small bowel, liver, large bowel, and intra-abdominal vasculature. In the past decades, management of the patients<br>with PAI needs optimization regarding accurate decision making for prompt treatment.<br>Objectives: The study described the organ injury patterns, the source of organ injury, treatment options, and factors associated with<br>mortality in PAI patients in active war zone. Further, this paper attempted to provide better insights regarding possible differences<br>and decision making system in improving the patient’s care and outcome. In addition, this paper focussed on duodenal, jejunal,<br>and ileal injuries.<br>Materials and Methods: This prospective cohort study comprised 322 patients with penetrating abdomen injuries in Al Kadhimiya<br>teaching hospital during May 2006 to October 2008. The study mainly considered injuries due to gunshots, shells, and stabs.<br>Results: The paper found that majority of patients aged from 20 to 29 years sustained small bowel injuries such as duodenal<br>injuries, jejunal injuries, and ileal injuries. jejunum is found to be affected largely followed by ileum but the mortality rate for<br>duodenum tops among the small bowel injuries.<br>Conclusion: This study concludes that when compared to patients with jejunoileal injuries duodenal injuries had significantly<br>higher mortality, morbidity and hospitalization period.</p> Hussein Saleh Ali Ali Ridha Hassoon Hadeel Mohamad Said Alhilaly Copyright (c) 2021 IJSS Journal of Surgery 2021-12-13 2021-12-13 7 6 26 34 Safety and Efficiency of Harmonic Laparoscopic Dissecting Hook in Gallbladder Dissection and Hemostasis of Gallbladder Bed in Comparison to Electrocautery Hook During Laparoscopic Cholecystectomy https://surgeryijss.com/index.php/IJSS/article/view/471 <p>Background: Many devices have been used during surgery for dissection and hemostasis of gallbladder (GB) from liver bed;<br>the most commonly used are electrocautery and ultrasonically activated devices. Harmonic hook (HH) can achieve cutting and<br>coagulation device offering dissection and hemostasis in a way equivalent to electrocautery hook (EH).<br>Materials and Methods: This is a prospective comparative study where sample of 60 Iraqi patients of either gender was selected.<br>Sample was divided into two groups; 30 in the first group, EH was used for dissection, and 30 in the second group, HH was used<br>for achieving the dissection (laparoscopic dissecting hook Ethicon Endosurgery LLC©).<br>Results: The total number of patients who were candidate for laparoscopic cholecystectomy was 60. Sample divided into two<br>groups. The first is EH group operative time was calculated with mean time of 60 ± 13.7 min and GB dissection mean time<br>(24.5 ± 8.5 min). Intraoperative challenges were recorded as minor bleeding in 25 patients (83.33%), moderate in 2 (10%) and<br>no bleeding in 3 patients (6.67%), GB perforation in 18 patients (60%), bile leak in 1 patient (3.33%), stone spillage in 6 (20%)<br>patients, and need for scope lens cleaning in 23 (76.67%) patients. The second is HH group mean operative time (50 ±14.3 min)<br>and GB dissection mean time (18 ± 4.8 min). Intraoperative challenges were recorded as minor bleeding in 9 patients (30%) and<br>no bleeding in 21 patients (70%), GB perforation in 1 patient (3.33%), no bile leak nor stone spillage was recorded, and need for<br>scope lens cleaning in 2 patients (6.67%).<br>Conclusion: Ultrasonic dissection by HH is safe and effective modality of dissection of GB and hemostasis in laparoscopic<br>cholecystectomy and can replace electrocautery for this purpose if available at operative theater.</p> Hadeel Mohamad Said Alhilaly Ali Ridha Hassoon Hussein Saleh Ali Azzam K Agha Copyright (c) 2021 IJSS Journal of Surgery 2021-12-13 2021-12-13 7 6 35 42 The Comparison of outcome of locking plate fixation and closed intramedullary inter locking Nail in the management of extra articular distal tibial fractures in Telangana Population https://surgeryijss.com/index.php/IJSS/article/view/473 <p><strong>Background:</strong> Distal tibial fractures are very commonly encountered by orthopaedic surgeons.Management of distal tibia fractures are most challenging due to its superficial nature and propinquity to the ankle joint. Hence two different techniques were compared to study rate of healing, functional outcome and complications.</p> <p><strong>Method:</strong> Out of 50 patients 25 were operated with inter looking nail and 25 with locking plate fixation patients were regularly followed up to 1 year post-operatively, assessed clinically and radiology to rule out any complications and treated properly.</p> <p><strong>Results:</strong>Duration of surgery in ILN technique 18 (72%) patients had 40-60 minutes in plating technique, 9 (36%) patients had 40-60 minutes, 9 (36%) patients had 60-80 minutes and 7 (25%) patients had &gt; 80 minutes surgery. More duration of weeks for body weight bearing after surgery was observed in plating technique (&gt;14 weeks) Union of fracture was earlier in ILN than plating technique 16 (± 1.46) in ILN, 20.7 in plating and p&lt;0.00. Post-surgical complication was more or less same in both patients.</p> <p><strong>Conclusion:</strong> Closed intermedullary interlocking Nail technique was more preferred than plating technique because of early weight bearing, early union of fractures and decreased implant related problems.</p> S D G K Kaleelulla Copyright (c) 2021 IJSS Journal of Surgery 2021-12-27 2021-12-27 7 6 43 48