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Intercostal chest tube (ICD) management has been mostly determined by personal experience of surgeons and prevailing local practices rather than a scientifically validated protocol. This study was done to evaluate the impact of protocol-based management of chest tubes in patients undergoing elective thoracic surgeries. This was a prospective observational study conducted from June 2016 to March 2018 at a tertiary care hospital to study the impact of algorithmic management of chest tubes in patients undergoing non-pneumonectomy elective thoracic surgery. A preformed algorithm was followed in all the patients. Chest tube was removed if all the criteria for chest tube removal were met, i.e., stable patient, no air leak, drainage

Abdominal pain is one of the most frequent and worrisome complaints that brings a patient to the hospital. Patients with undiagnosed abdominal pain usually undergo a battery of investigations, while remaining dissatisfied. Since glucose metabolic imaging with FDG PET has been shown to detect infection, inflammation and malignancies earlier than structural imaging, we planned a pilot study to assess the causes of undiagnosed pain abdomen. The study was carried out at our tertiary care academic institution, from December 2016 to July 2018. A total of 30 patients with no aetiology found on clinical evaluation, laboratory investigations, ultrasound and computerized tomography scan underwent FDG PET CT. PET findings were correlated with clinical parameters to reach a final diagnosis. The results were analysed prospectively to find the utility of PET scan. The mean age was 33.33 years, and 66.67% were females. The number of patients in whom a final diagnosis (relating to pain abdomen) was made with the help of FDG PET was 6; therefore, the yield was calculated as 6/30 = 20.0%. A positive correlation was seen between duration and intensity of pain, raised ESR/positive or borderline Mantoux and presence of findings on PET. The negative predictive value of PET was 100%. Three patients were diagnosed to have tuberculosis, one had aorto-arteritis, one patient had infective foci in lung and one patient had subacute appendicitis. FDG PET scan might be indicated in undiagnosed pain abdomen, especially in patients with chronic pain with raised ESR or positive Mantoux.

Introduction: The world is seeing a growth of the aging population and the number of surgical treatments in this age group which is also true for spinal conditions. The greatest increase in spinal fusion surgery has been observed in patients aged 65 years and above. Only a few works of literature were available on the issue, especially in India. Materials and Methods: An observational study in which 70 patients aged 70 years and above who underwent spinal surgery for degenerative and traumatic spinal injury, from January 2013 to July 2017 in the neurosurgery department of a single institute, were reviewed. Around 53 patients were assessed for disability/functional outcome and their health-related quality of life (HRQOL) using the Oswestry disability index (ODI) and RAND 36-item health survey 1.0 scoring method (SF-36) comparing the preoperative and postoperative status. Result: The mean age was 74.19 years (range 70–91 years). Laminectomy-19 (27.14%) was the most common surgical procedure performed. Overall there were nine (12.85%) major complications with mortality of five (7.14%) patients. There was a significant reduction of crippled patients (14–9, P = 0.009) in the ODI score. SF-36: There was significant improvement in degenerative patient (P = 0.000 to P = 0.012). In traumatic patient, only pain had significant improvement (P = 0.045). Conclusion: This study showed that the age of the patient should not be the limiting factor for the surgical management of a patient with a degenerative or a traumatic spinal condition.