Inefficacy of Kinesio-Taping® on early postoperative pain after ACL reconstruction: Prospective comparative study

Open haemorrhoidectomy (OH) treatment has been reserved for prolapsing haemorrhoidal disease (third and fourth grade) and comprehends excision of haemorrhoidal tissue and is associated with significant postoperative pain. As an alternative approach, many randomized controlled trials have shown consistent advantage with haemorrhoidopexy (SH) in terms of postoperative pain, analgesic requirement, length of surgical procedure, short recovery time and early return to normal activities. This study has been conducted to compare the short-term outcome of SH with OH. A prospective comparative study, which included grade 3 and 4 haemorrhoids and comparing short Term outcomes between SH and OH was conducted in the Surgical Gastroenterology units of University Teaching Hospital. A total 44 patients, 22 in each group were compared. Age (SH 42±10.80 Vs. OH 45±13.30) and sex (SH, M:F-9:13 Vs. OH, M:F-14:8) distribution was comparable. Also, the groups were comparable in terms of symptom duration in years (SH, 3.20±2.26 Vs. OH, 2.31±2.47) and distribution of haemorrhoid grades. The SH group showed significant advantage in terms of postoperative pain (Average pain score SH, 2.73±1.20 Vs. OH, 5.20±1.91) and analgesic use (SH 2.32±0.94 Vs. OH 9.32±2.62). Similarly the operating time (time in minutes SH, 42±7.34 Vs. OH, 57.50±8.27), hospitals stay (days of stay SH, 2.90±0.68 Vs. OH, 3.77±0.86) and return to preoperative activity (days to return SH, 7.9±4.90 Vs. OH, 13.6±5.60) were also significantly shorter in the SH group than the OH group. The short-term complications were similar in both groups (P value >0.05). In conclusion, SH has better short-term outcome compared with OH and SH is a viable addition to the therapy options available for haemorrhoids.DOI: http://dx.doi.org/10.3126/jcmc.v4i4.11956

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A Prospective Comparative Study Correlating the Efficacy of Biodegradable versus Metallic Interference Screw for Tibial Sided Anterior Cruciate Ligament Reconstruction - A Unicentre Pilot Study in Jaipur, Rajasthan

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/241 ◽

2021 ◽

Vol 8 (18) ◽

pp. 1258-1263

Author(s):

Vishal Singh ◽

Alokeshwar Sharma ◽

Avinash Gundavarapu ◽

Tejas Patel ◽

Santosh Kumar M

Keyword(s):

Anterior Cruciate Ligament ◽

Comparative Study ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Interference Screw ◽

Single Bundle ◽

Interference Screws ◽

Prospective Comparative Study ◽

Anterior Cruciate ◽

Screw Group

BACKGROUND Traditionally, metallic interference screws were considered to have increased resistance to load than bio absorbable screws in anterior cruciate ligament (ACL) reconstruction. We did a comparative evaluation of biodegradable and metallic interference screws for tibial sided ACL reconstruction and also analysed complications, compared clinical outcome, did imaging study of ACL single bundle reconstruction by using titanium & newer poly–L-lactic acid (PLLA) bio absorbable screws to determine as to whether bio absorbable screw which costs double the metallic screw, is functionally better than standard metallic screws. METHODS This is a prospective comparative study conducted among 50 patients aged between 15 and 55 years with clinical and MRI confirmation of complete ACL tear, treated arthroscopically with ACL reconstruction with either bio absorbable (group 1) or metallic (group 2) interference screw and both the groups were compared on follow up for an average duration of 12 months. Lysholm and Gillquist Knee Scoring Scale were used and outcome scores were divided into excellent, good, fair and poor. RESULTS In our study 41 patients were males and 9 were females. Bio screw was used in 24 males and 6 female patients. Metallic screw was used in 17 males and 3 females. Outcome score was excellent in 26 (52 %) cases, good in 18 (36 %) cases, fair in 4 (8 %) cases, poor in 2 (4 %) cases. The mean Lysholm score in bio absorbable group was 93.13 and in metallic group was 89.70. Knee effusion was higher in bio screw group and infection rate was higher in metallic group. CONCLUSIONS In our study, the difference between bio absorbable screw group and metallic screw group was insignificant with regard to final patient outcome. Final osseointegration was better with bio absorbable screw, but increased cost of implant and almost same results compared to metallic screw does not make the bio absorbable screw superior to its counterpart. KEYWORDS ACL, Bio Absorbable Interference Screws, Metallic Interference Screws

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A Prospective Comparative Study: Stapler Hemorrhoidopexy vs Laser Hemorrhoidoplasty in the Treatment of Hemorrhoids

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i930477 ◽

2020 ◽

pp. 10-23

Author(s):

Anshuman Kaushal ◽

Aakanksha Aggarwal ◽

Amanpriya Khanna ◽

Rajesh Agarwal ◽

Dhruv N. Kundra ◽

...

Keyword(s):

Postoperative Pain ◽

Comparative Study ◽

Hospital Stay ◽

Postoperative Bleeding ◽

Early Return ◽

Severe Postoperative Pain ◽

Prospective Comparative Study ◽

Grade Ii ◽

The Mean ◽

Group 2

Aims: Stapler hemorrhoidopexy (SH) has evolved over time as a procedure of choice over conventional surgery due to less postoperative pain. Laser hemorrhoidoplasty (LH) is a novel procedure aimed at shrinking the terminal branches of hemorrhoidal arteries with fewer complications. The present study is aimed to compare these procedures (SH and LH). Study Design: Prospective comparative study. Place and Duration of Study: Patients operated for hemorrhoids at the Department of General, MI & Bariatric Surgery, Artemis Hospitals, Gurgaon from April 2018 to March 2019. Methodology: 50 patients with grade II-III hemorrhoids were allocated to two groups: Stapler hemorrhoidopexy (SH) and Laser hemorrhoidoplasty (LH) with 25 patients in each group. Results were compared and patients were followed up for minimum period of 3 months. Results: The mean operative time was 24.6 min (LH) and 28.6 min (SH) (P =.122). The average blood loss was 8.32 ml (LH) and 11.64 ml (SH) (P <.05). The mean hospital stay 21.44 hours (LH) and 32.64 hours (SH) (P <.05). Mean postoperative pain score (VAS) at 12 hours was 2.64 (LH) and 4.76 (SH) (P <.05), at 24 hours was 1.88 (LH) and 3.6 (SH) (P <.05), at 1 week was 0.36 (LH) and 0.88 (SH) (P =.054) and at 3 months 0.04 (LH) and 0.12 (SH) (P =.53). One patient in LH (4%) had postoperative bleeding on 4th postoperative day. In SH group, 2 (8%) had severe postoperative pain with VAS > 8, requiring longer hospital stay, 2 (8%) had bleeding on the same day, 1 (4%) had bleeding on follow up and 1 (4%) had recurrence. Conclusion: In terms of early postoperative pain and complications, LH offers better results as compared to SH. It was associated with a shorter hospital stay and early return to work. No significant complications were noted in LH compared to SH. LH is an extremely viable alternative to the popular SH for grade II-III hemorrhoids.

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