Publications by authors named "Mangta Manu"

3 Publications

  • Page 1 of 1

Surgical Versus Conservative Management of Acute Appendicitis During the COVID-19 Pandemic: A Single-Centre Retrospective Study.

Cureus 2021 Mar 24;13(3):e14095. Epub 2021 Mar 24.

General Surgery, New Cross Hospital, Wolverhampton, GBR.

Introduction The COVID-19 pandemic provoked a change to normal surgical practice in the United Kingdom and led to an increase in acute appendicitis (AA) patients being treated conservatively with antibiotics. We aim to analyse the management of patients presenting with AA to our institution during the first wave of the pandemic, comparing surgically and conservatively managed patients. Method All patients presenting to our centre with AA between March and July 2020 were included. Six-month follow-up data were collected retrospectively using electronic records. Patients were categorised into surgically and conservatively managed groups. The primary outcome was the complication rate (post-operative complications vs failure of antibiotic treatment) and the secondary outcomes were length of hospital stay and Alvarado score. Results  Fifty-seven patients (n=57) were admitted with AA, 45.6% (n=26) managed conservatively compared to 54.4% (n=31) treated surgically. Higher complication rates were observed amongst the conservatively managed group, although not found to be statistically significant (16% vs 35%; p=0.131). There was no significant difference in length of hospital stay observed between the two groups (surgical: median, 2; interquartile range, 2-3 vs conservative: median, 3; interquartile range, 2-4). White cell count (WCC) and Alvarado score were higher on admission in the surgical group with statistical significance (p=0.012 and p=0.028, respectively). Conclusions COVID-19 has led to a significant cohort of conservatively managed AA patients in the United Kingdom. We propose a stratification pathway based on clinical severity, Alvarado score and imaging to facilitate safe selection for conservative management of AA, in order to reduce failure of treatment rates in this patient group. Further UK-based studies will add to the evidence-based surrounding safe management of AA with conservative treatment.
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http://dx.doi.org/10.7759/cureus.14095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075754PMC
March 2021

Comparing Surgeon Adherence with World Health Organization Antiseptic Guidelines for Surgical Site Preparation in the United Kingdom and India.

Surg Infect (Larchmt) 2020 Sep 17;21(7):634-638. Epub 2020 Jun 17.

Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom.

Skin preparation with an antiseptic solution aims to reduce surgical site infection rates. Surgical site infections (SSIs) create a high burden on healthcare systems with impacts on morbidity, mortality, and cost. In 2016, The World Health Organization (WHO) conducted an extensive systematic review and meta-analysis of the existing evidence. From this, they recommended the use of "alcohol based antiseptic solutions based on CHG for surgical site skin preparation in patients undergoing surgical procedures." This study aimed to assess surgeon compliance with this guidance in the United Kingdom and India. A multiple-choice questionnaire was developed to assess surgeon preferences for antiseptic use in their surgical site preparation. The end point of data collection was defined after 50 responses in each region. The majority of respondents in each center was general surgeons (n = 24, 48% United Kingdom; n = 21, 45% India), and registrars (n = 22, 44% United Kingdom; n = 23, 49% India). No surgeon preferred the use of any aqueous preparation. Chlorhexidine gluconate (CHG) was the preparation used most commonly in both centers (n = 30, 64% India; n = 24, 48% United Kingdom). In India, this represented a statistically significant difference (p = 0.0008), however, this was not observed in the United Kingdom (p = 0.22). There were no statistically significant differences between surgeon's reasons between the United Kingdom and India, other than "easier to see" (p = 0.016). This data show a reduced compliance of U.K. surgeons with WHO guidance for antiseptic use compared with Indian surgeons. Although the WHO has attempted to summarize the existing data to minimize the previous uncertainty surrounding antiseptic choices, the use of CHG continues to not be adopted widely. To draw robust conclusions to provide the foundations of further guidelines, future research should focus on prospective randomized controlled trials with large numbers across multiple surgical specialties.
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http://dx.doi.org/10.1089/sur.2020.084DOI Listing
September 2020

Cystic lymphangioma of the mesocolon.

J Gastrointest Surg 2010 Sep 11;14(9):1459-61. Epub 2010 Mar 11.

The Pennine Acute Hospitals NHS Trust, Manchester, BL9 7TD, UK.

A 46-year-old gentleman presented to our hospital with a short story of abdominal pain and distension. On examination, gross ascites was noted and confirmed on subsequent imaging with no other notable features. CT scan after ascitic drainage showed a cystic mass extending from the lower pole of the spleen to the left iliac fossa in keeping with an intraperitoneal cyst. At laparatomy, a cystic lymphangioma was resected. Lymphangiomas are rare benign tumours and are reported to occur preferentially in the neck of axilla in children. Abdominal lymphangiomas are extremely rare particularly in adults but important to recognise due to a potential for serious consequences.
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http://dx.doi.org/10.1007/s11605-010-1176-0DOI Listing
September 2010
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