scholarly journals Ep.Th.654Home Based Pre-Rehabilitation in Hepatic & Pancreatic Oncological Surgery- A Way Forward for Improved Patient Outcome

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nauman Ahmed ◽  
Rami Obeidallah ◽  
Daren Subar
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Cost Effective ◽  
P Value ◽  
Oncological Surgery ◽  
Operative Outcomes ◽  
Home Based ◽  
Group I ◽  
Operative Complications ◽  
Group Ii

Abstract Aims To ascertain the impact of ‘’Cost effective home-based pre-rehabilitation’’ on post-operative outcomes in patients undergoing major hepatic and pancreatic oncological surgery. Methods In this non-randomized comparative study (2019-2021), we included 36 patients having pancreatic or hepatic malignancy. In group I, patients were signed up for home-based pre-rehabilitation program and dietary modification. Group II; included patients who did not have rehabilitation. The two groups were compared for post-operative outcomes (post-operative complications, length of ITU and hospital stay) Results Mean age was 69.05±9.68 years in group I and 67.50±8.75 years in group II (p-value 0.61). Open approach was used in 02 (11.0%) patients in group I and in 09 (50%) patients in group II (p-value 0.01). More patients in group II needed admission in intensive care unit (ICU); 18 (100%) versus 11 (61.1%) in group II (p-value 0.0003). The group I had shorter length of hospital stay as compared to Group II (p-value 0.0001). There was no significant difference in post-operative complications between the groups. Conclusion Home based pre-rehabilitation, has shown beneficial outcomes in terms of less requirement for ITU admission post operatively, shorter length of hospital stay and cost effective method of pre rehabilitation.

Evaluation of the effectiveness of vacuum-assisted closure in the treatment of Fournier gangrene

2021 ◽  
pp. 1
Keyword(s):  
Hospital Stay ◽  
Wound Closure ◽  
Length Of Hospital Stay ◽  
Vacuum Assisted Closure ◽  
Analgesic Requirement ◽  
Vac Therapy ◽  
Fournier Gangrene ◽  
Group I ◽  
Group Ii ◽  
Closure Method

Background and objective: To evaluate the effectiveness of vacuum-assisted closure (VAC) in the treatment of Fournier gangrene (FG). Material and methods: Forty-eight male patients treated for Fournier gangrene were included in the study. The patients were divided into two groups (Group I: conventional dressing, Group II: VAC therapy). Characteristics of the patients, laboratory parameters, number of debridement procedures, daily number of dressings, visual analogue scale (VAS) during dressing, analgesic requirement, colostomy requirement, time from the first debridement to wound closure, wound closure method, length of hospital stay, and mortality rates were compared. Results: Group I comprised 33 patients and Group II comprised 15 patients. The number of dressings, VAS score and daily analgesic requirement were statistically significantly lower in Group II (p < 0.05) than in Group I. The number of debridement procedures, colostomy requirement, orchiectomy rate, time from first debridement to wound closure, length of hospital stay, wound closure method and mortality rate were similar between these two groups (p > 0.05). Conclusion: The clinical results of conventional dressing and VAC therapy were similar for treating FG. VAC therapy is an effective postoperative wound care method that offers less requirement for dressing changes, less pain, less analgesic requirement and more patient satisfaction compared to conventional dressing.

scholarly journals Comparative Efficacy of Nebulized 3% Hypertonic Saline versus 0.9% Normal Saline in Children with Acute Bronchiolitis

2018 ◽  
Vol 42 (3) ◽  
pp. 130-137 ◽  
Author(s):  
Khandaker Tarequl Islam ◽  
Abid Hossan Mollah ◽  
Abdul Matin ◽  
Mahmuda Begum
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Severity Score ◽  
Oxygen Therapy ◽  
Length Of Hospital Stay ◽  
Clinical Severity ◽  
Acute Bronchiolitis ◽  
Group I ◽  
Group Ii

Background: Acute bronchiolitis is leading cause of hospitalization in infants below 2 years of age. Bronchiolitis being a viral disease, there is no effective treatment. 3% nebulized hypertonic saline and 0.9% nebulized normal saline are often used, although there is disagreement over their efficacy. The aim of this study was to evaluate the efficacy of 3% hypertonic saline in children with acute bronchiolitis in reducing clinical severity and length of hospital stay. Methodology: A randomized control trial carried out in the Department of Pediatrics, Dhaka Medical College Hospital from January 2013 to December 2013.Ninty children from 1 month to 2 years of age hospitalized with clinical bronchiolitis were randomized to receive 3% nebulized hypertonic saline(Group-I) or 0.9% nebulized normal saline (Group-II). Nebulization was done 8 hourly until discharge. Outcome variable were clinical severity score, duration of oxygen therapy and length of hospital stay. Results: Baseline clinical severity score and O2 saturation were in group-I 9.0±1.0 and 94.9±1.7 and in group- II 9.3±1.8 and 94.6±2.6 respectively (p>0.05). At 72 hours, the mean severity score for the group-I was 1.64±0.99 and that for the group-II was 3.0 ± 1.48 (95% CI -2.17 to - 0.53, p=0.002). The cases of group-I required a shorter duration of oxygen therapy compared to those of group-II (15.0±6.0 hours vs 26.4±5.37 hours, 95% CI -20.35 to -2.44, p<0.05). Forty two (93.3%) of the group-I children recovered by the end of72 hours and discharged whereas 26 (57.8%) of the group-II children recovered during the same period (p<0.05). Length of hospital stay was shorter in group-I compared to group-II (58.1±22.0 hours vs 74.7±27.2 hours, 95% CI -26.89 to- 6.17, p=0.002). None of the cases encountered any side-effects. Conclusion: Nebulization with 3% hypertonic saline significantly reduced clinical severity, length of hospital stay and duration of oxygen therapy in case of acute bronchiolitis in comparison to 0.9% normal saline and was safe. Bangladesh J Child Health 2018; VOL 42 (3) :130-137

scholarly journals Degloving injuries of trunk and limbs: comparison of outcomes of early versus delayed assessment by the plastic surgery team

2015 ◽  
Vol 42 (3) ◽  
pp. 143-148 ◽  
Author(s):  
Daniel Francisco Mello ◽  
José Cesar Assef ◽  
Sílvia Cristine Soldá ◽  
Américo Helene Jr
Keyword(s):  
Hospital Stay ◽  
Plastic Surgery ◽  
Skin Flap ◽  
Length Of Hospital Stay ◽  
Lower Limbs ◽  
Trauma Patients ◽  
Early Assessment ◽  
Group I ◽  
Group Ii ◽  
Degloving Injuries

<sec><title>OBJECTIVE:</title><p> to analyze cases of degloving of the trunk and limbs, comparing outcomes of early versus delayed assessment by the plastic surgery team.</p></sec><sec><title>METHODS:</title><p> we conducted a retrospective analysis of medical charts. Patients comprised two groups: Group I - early assessment, performed within 12 hours post trauma; and Group II - delayed assessment, performed more than 12 hours post trauma. We defined primary grafting as the use of skin from the traumatized skin flap. We excluded cases involving hands, feet or genitalia.</p></sec><sec><title>RESULTS:</title><p> there were 47 patients treated with degloving injuries between 2002 and 2010. The mean body surface area affected was 8.2%. Lower limbs were the most frequently affected site (95.7%), whether alone or in association with lesions to other sites. Delayed assessment by the plastic surgery team occurred in 25 cases. Mean hospital stay was 36.1 days for Group I and 57.1 days for Group II (p=0.026). Regarding the number of surgical operations (skin grafts), Group I received a mean of 1.3, while Group II underwent 1.6 (p=0.034).</p></sec><sec><title>CONCLUSION:</title><p> based on length of hospital stay and number of operations in trauma patients with degloving of the trunk and limbs, plastic surgery assessment should be carried out early.</p></sec>

scholarly journals Impact of Spleen Size on Outcomes in Laparoscopic Splenectomy in Children

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Cetin Ali Karadag ◽  
Basak Erginel ◽  
Ozgur Kuzdan ◽  
Nihat Sever ◽  
Melih Akın ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Splenectomy ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Time Rate ◽  
Open Procedure ◽  
Group I ◽  
Longitudinal Length ◽  
The Mean ◽  
Group Ii

Background. The aim of our study is to compare the efficacy of laparoscopic splenectomy (LS) between enlarged spleens and normal sized spleens.Methods. From June 2006 to September 2012, 50 patients underwent LS. The patients consisted of 24 girls and 26 boys with the mean age of 8.64 years (1–18). The patients are divided into two groups according to spleen’s longitudinal length on the ultrasonography. Group I consisted of the normal sized spleens; Group II consisted of spleens that are exceeding the upper limit. Groups are compared in terms of number of ports, operative time, rate of conversion to open procedure, and length of hospital stay.Results. The mean number of ports was 3.27 and 3.46, the mean length of the operation was 116.36 min and 132.17 min, rate of conversion to open procedure was 9.09% and 10.25%, and the mean length of hospital stay was 3.36 days and 3.23 days, respectively, in Group I and Group II. Although there is an increase in the number of the ports, the operative time, rate of conversion to open procedure, and the length of hospital stay, the difference was not significant between groups (P>0.05).Conclusion. LS is safe and effective in enlarged spleens as well as normal sized spleens.

scholarly journals A single-center experience of steroid therapy for COVID-19 management

2021 ◽  
Author(s):  
Aamir Shaukat ◽  
Ahmad Ayaz Sabri ◽  
Umair Ahmed ◽  
Nazir Ahmad ◽  
Dilshad Muhammad ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Recovery Rate ◽  
Primary Outcome ◽  
Length Of Hospital Stay ◽  
P Value ◽  
Single Center Experience ◽  
Group 4 ◽  
Group I ◽  
The Mean

Aim: There is an emerging role of steroids in the management of COVID-19. We aimed to compare the outcome of COVID-19 patients (recovery versus mortality) who were treated with steroids with those who were not treated with steroids during their course of hospital stay. Methods: A retrospective analysis of all moderately to severely ill COVID-19 patients, meeting the inclusion and exclusion criteria, admitted to our center during the study period of four months, was performed. The patients were categorized into two groups: Group I included 25 patients who were given steroids, and Group II also included 25 patients who were not given any steroids during their hospital stay. The primary outcome (recovery versus mortality), length of hospital stay as well as other features were compared between the two groups. Results: The mean length of hospital stay was 9.3 days in the steroids group and 10.9 days in the non-steroids group with a p value of 0.249. None of the patients was shifted to a ventilator in either group. One patient in the steroids group (4%) and two patients in the non-steroids group (8%) needed to be put on high flow nasal cannula. One patient died in the steroids group with a recovery rate of 96%, while two patients died in the non-steroids group with a recovery rate of 92% (p value 0.552). Conclusion: Treatment with steroids in moderately to severely ill COVID-19 patients did not decrease the length of hospital stay or mortality in our study.

scholarly journals Managing bilateral inguinal hernia laparoscopically: is it gold standard?

2016 ◽  
Vol 4 (1) ◽  
pp. 296
Author(s):  
Kalpesh H. Patel ◽  
Jayesh B. Gohel ◽  
Bhumika J. Patel
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Bilateral Inguinal Hernia ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background:Even after many studies done in recent years, no consensus has been achieved on the surgical technique of inguinal hernia repair. It was believed that in bilateral inguinal hernia cases laparoscopic surgery is very much advantageous as it can be done through same incisions as unilateral laparoscopic inguinal hernia repair (no additional incision required), whereas in open surgery for bilateral case separate groin incision for each side required. Aim of this study is to evaluate and compare results of bilateral inguinal hernia patients operated by laparoscopic (transabdominal preperitoneal) or open (lichenstein) repair.Methods: A prospective comparative study was conducted in a tertiary care teaching hospital over the period of two years. 60 patients with bilateral inguinal hernia were taken up and randomly divided into two groups. Group I (study group) includes patients operated by bilateral laparoscopic hernia repair (TAPP) and Group II (control group) includes patients operated by open hernia repair (lichenstein tension free hernioplasty). All patients were followed up for 18 months post-operatively. All patients of both groups were monitored for operative time, conversion rate, length hospital stay, post-operative complications and recurrence, time to return to work.Results:Statistically there was significant difference between both groups in terms of length of hospital stay and time to return to work. Group I patients where TAPP surgery performed, 22 patients (73.33%) were discharged within 36 hours of surgery, whereas in Group II patients - control group where open surgery performed, only 4 patients (13.33%) discharged within 36 hours. All 30 patients (100%) in group I had joined their routine work within 10 days of surgery; whereas in Group II patients only 4 cases (13.33%) joined duties on or before 10 days and most of the patients 26 (86.67%) had taken more than 10 days to resume their duties. But there was no significant difference between operative time, complication rates and recurrence rates. All cases in group I were completed laparoscopically (no conversion to open repair).Conclusions:Simultaneous bilateral inguinal hernia repair laparoscopically does not increase the risk for the patient and has an equal morbidity compared with unilateral repair, length of hospital stay, and return to normal work and over all recovery after laparoscopic repair is faster than after open bilateral simultaneous repair. Laparoscopic inguinal hernia repair of bilateral hernias should be recommended as the gold standard.

scholarly journals A COMPARATIVE ANALYSIS OF PER AND POST-OPERATIVE COMPLICATIONS IN PATIENTS UNDERGOING EARLY AND DELAYED INTERVAL TONSILLECTOMIES

2021 ◽  
Vol 31 (04) ◽  
pp. 190-194
Author(s):  
Arshad Abbas ◽  
Mazhar Iftikhar ◽  
Ghulam Dastgir Khan ◽  
Muhammad Ilyas ◽  
Muhammad Iqbal ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Single Case ◽  
Needle Aspiration ◽  
Postoperative Hemorrhage ◽  
Peritonsillar Abscess ◽  
Female Ratio ◽  
Group I ◽  
Operative Complications ◽  
Group Ii ◽  
Post Operative Complications

Abstract: Background: Peritonsillar abscess is most prevalent deep neck space infection and treatment is mainly medical and surgical. There are three major surgical procedures namely incision & drainage, interval tonsillectomy and needle aspiration. Aim: To compare per and post-operative complications in patients of PTA undergoing early and delayed interval tonsillectomies in respect of pain, hemorrhage and hospital stay. Material and Methods: It was a randomized control trial study of sixty patients of peritonsillar abscess. Among thirty patients early interval tonsillectomy was performed while other thirty patients underwent delayed interval tonsillectomy. The study was conducted in ENT Department of Lahore General Hospital, Lahore. Results: The age range in both groups was 13-46 years. The male to female ratio was 2.3:1 and 1.3:1 in group I and II respectively. Per-operative hemorrhage in group I, mild in 53.3% patients, moderate in 36.7% and severe in 10.0% patients while in group II, mild in 43.3%, moderate in 40.0% and severe in 16.7% patients. A Single case in group II had secondary hemorrhage. Post-operative pain in group I was mild in 66.7%, moderate in 26.7% and severe in 6.7% patients while in group II, it was mild in 26.7%, moderate in 56.7% and severe in 16.7% patients. The duration of hospital stay less than one week was 76.7% in group I and 13.3% in group II. Conclusion: Early interval tonsillectomy has a lower incidence of postoperative hemorrhage and pain with less hospital stay as compared to delayed interval tonsillectomy.    

Comparison of Complications between Manual Small Incision Cataract Surgery and Phacoemulsification

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Israr Ahmed Bhutto ◽  
Maria Nazish Memon ◽  
Irshad Ali ◽  
Abdul Qadeem Soomro ◽  
Abdul Haleem Mirani
Keyword(s):  
Cataract Surgery ◽  
Senile Cataract ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Group I ◽  
Significant Difference ◽  
Operative Complications ◽  
Group Ii ◽  
Post Operative Complications

Purpose:  To compare per-operative and early post-operative complications between Manual Small Incision cataract surgery and Phacoemulsification in patients with Senile Cataract. Study Design:  Quasi experimental study. Place and Duration of Study:  Al-Ibrahim Eye Hospital Karachi from December 2018 to October 2019. Methods:  Two hundred and seventy patients with senile Cataract were recruited for this study by convenient sampling technique. They were divided equally into two groups. Group I underwent Manual Small Incision Cataract Surgery (MSICS), whereas Group II underwent Phacoemulsification. Per-operative and early post-operative complications were recorded on day 1 in both groups. Data was analyzed using SPSS 24.0. Independent t-test was carried out with P-value of ?0.05 was considered statistically significant. Results:  Mean age group – I was 54.95 ± 11.0 and in Group – II was 57.09 ± 10.59 (p = 0.546). There were 72 (53.3%) males in group – I and 74 (54.8%) in group – II with a non-significant difference (p-value > 0.01). There was significant difference for posterior capsule rupture and striate keratitis between the two groups (p = 0.031 and 0.044 respectively). Rest of the study parameters was not statistically different in the both group. None of the groups had a nucleus drop and vitreous prolapse. No significant difference was seen between the two groups concerning iris trauma (p = 0.56), wound leakage (p = 0.15) and hyphema (p = 0.32). Conclusion:  There is no significant difference between per-operative and early post-operative complications between MSICS and Phacoemulsification in patients with senile cataract except posterior capsular rupture and striate keratopathy which were more common in phacoemulsification group. Key Words:  Cataract, Senile Cataract, Phacoemulsification, Small Incision Cataract Surgery.

scholarly journals ACUTE APPENDICITIS: DELAYED SURGERY DOES NOT INCREASE THE NUMBER OF POSTOPERATIVE COMPLICATIONS

2018 ◽  
Vol 28 (2) ◽  
pp. 52-56
Author(s):  
Romualdas Riauka ◽  
Povilas Ignatavičius ◽  
Žygimantas Tverskis ◽  
Žilvinas Dambrauskas
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Pathology Report ◽  
Perforation Rate ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Introduction. Historically appendicitis is tending to be operated as soon as possible to prevent future complications. Recent discussions show, that urgent operation does not always reduce the rate of postoperative complications. Immediate appendectomy can be delayed in some cases. Methods. Retrospective, non-randomized, single center, cohort study was performed. During one-year period 167 consecutive patients diagnosed with acute appendicitis were included in the study. The study population was divided into two groups according to the time from the onset of the symptoms to the operation. Group I (≤ 24 hours) - 74 patients and Group II (≥ 24 hours) – 93 patients. Primary (postoperative complications) and secondary (operating time, length of hospital stay and perforation rate at the final pathology report) endpoints were evaluated and compared. Results. There was no statistically significant difference in the rate of postoperative complications when comparing both groups. In Group I – 21.9% patients (87.5% Grade I) and in Group II – 25.8% patients (83% Grade I) had postoperative complications. Operating time was similar between the groups (72.97±29.1 (Group I) vs 79.95±35.4 minutes (Group II)). Length of hospital stay was longer in Group II, but no statistically significant difference was found (2.85±2.3 vs 3.34±4.88 days accordingly). Perforation rate at the final pathology report was twice higher in Group II (8 (10.8%) vs 17 (18.3%)), but no statistically significant difference was found. Conclusions. This study findings support earlier reports showing that delayed appendectomy is safe surgical procedure without higher rate of postoperative complications and may be applied in certain cases.

scholarly journals Comparison of percutaneous cystolitholepexy with vesicolithotomy in peadiatric age group for safety and efficacy.

2020 ◽  
Vol 27 (08) ◽  
pp. 1742-1746
Author(s):  
Imran Hussain ◽  
Mohammed Farhan Qurashi ◽  
Shayan Rahim Kanjoo ◽  
Asima Rashid
Keyword(s):  
Hospital Stay ◽  
Stone Formation ◽  
Treatment Options ◽  
Urinary Calculi ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Common Disease ◽  
Average Hospital ◽  
Group I ◽  
Group Ii

Objectives: Urolithiasis is the common disease of tropical and subtropical areas and in children, the urinary bladder is the most common site for stone formation in the lower urinary tract. Which account for 5% of urinary calculi .Most common cause of vesical stone is dietary deficiencies, treatment options are continuously refine from vesicolithotomy to scar less procedures, aim of this refinement to reduce the morbidity and complication. The purpose of study to evaluate post-operative outcome in terms of safety and accuracy of percutaneous cystolitholapaxy (PCVL) with open vesicolithotomy in children having Vesical stones. Study Design: Retrospective Comparative study. Setting: Department of Urology Sheikh Zayed Hospital Rahim Yar Khan. Period: January 2018 to December 2018. Material & Methods: Data collected of 15 patient who underwent for open vesicolithotomy (group-I) and 15 children underwent for PCCL (group II) the patients' age ranged from 1 year to 10 years. The stone size ranged from 1cm to 3cm in both groups, the procedure was performed under anesthesia with intubation. Dilation of the tract was made with help of alken metallic dilators. We use the adult nephroscope with 24Fr sheath, the same which used for PCNL. Pneumatic fragmentation was required for stones larger than 1.5 cm. Results: Procedures completed with complete stone clearance. The average hospital stay was 2.1 days in group I and 1.0 in group II. Analgesia requirement were 29.3 vs 12.3mg. in group I, six patients (40%) had fever while in group II only one patient(6.7%) has fever. 5 patients observed with hematuria in group I while In group II it was observed in 2 patients. Conclusions: PCCL is a minimal invasive procedure with less morbidity in term of postoperative pain, urinary leakage, fever and hospital stay, and it is a cost effective option for small vesical stones.

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