Comparison of the efficacy and safety of circumcision by freehand technique and Plastibell device in children

Abstract Background Circumcision has been practiced since antiquity and is one of the most commonly performed surgical procedures. The aim of the study was to compare the efficacy and safety of the two most common techniques: Freehand and Plastibell techniques of circumcision. Methods The study was a prospective randomized study that was conducted on uncircumcised males at or below the age of 5 years that presented for circumcision. All boys who satisfied the inclusion criteria and whose parents consented, were randomized into two groups. Group A had freehand circumcision, while Group B had Plastibell circumcision. Patients were followed up at day 7 and day 28 postoperatively. The variables compared were operating time, cost, complications and parents’ satisfaction. All the data obtained were entered into a proforma. The data obtained were analyzed using SPSS version 20. Results A total of 110 boys were circumcised, 55 boys in each group. The median ages in the Plastibell and freehand groups were one and three months respectively. The mean operating time was significantly shorter in the Plastibell group compared to freehand (3.53 min versus 16.7 min). Total cost implication per procedure was also cheaper in Plastibell compared to freehand (₦3700 versus ₦6600). However, complications were more in the Plastibell group compared to freehand (29.1% versus 9.1%; P = 0.008). These complications in Plastibell group were age related. Parents in both groups were equally satisfied with the outlook on day 28. Conclusion Plastibell circumcision has the advantage of being faster and cheaper than freehand circumcision. Complications were more in the Plastibell group, and they were found to be age related.

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Efficacy and Safety of Oral Ivermectin and Topical Permethrin in the Treatment of Scabies

TAJ Journal of Teachers Association ◽

10.3329/taj.v33i1.49824 ◽

2020 ◽

Vol 33 (1) ◽

pp. 41-47

Author(s):

Mohsena Akhter ◽

Ishrat Bhuiyan ◽

Zulfiqer Hossain Khan ◽

Mahfuza Akhter ◽

Gulam Kazem Ali Ahmad ◽

...

Keyword(s):

Skin Diseases ◽

Close Contact ◽

Randomized Study ◽

Sarcoptes Scabiei ◽

Efficacy And Safety ◽

Common Skin ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B

Background: Scabies is one of the most common skin diseases in our country. It is caused by the mite Sarcoptes scabiei var hominis, which is an ecto-parasite infesting the epidermis. Scabies is highly contagious. Prevalence is high in congested or densely populated areas. Individuals with close contact with an affected person should be treated with scabicidal which is available in both oral and topical formulations. The only oral but highly effective scabicidal known to date is Ivermectin. Amongst topical preparations, Permethrin 5 % cream is the treatment of choice. Objective: To evaluate the efficacy & safety of oral Ivermectin compared to topical Permethrin in the treatment of scabies. Methodology: This prospective, non-randomized study was conducted at the out-patient department of Dermatology and Venereology of Shaheed Suhrawardy Medical College & Hospital over a period of 6 months, from August 2016 to January 2017. The study population consisted of one hundred patients having scabies, enrolled according to inclusion criteria. They were divided into two groups. group A was subjected to oral Ivermectin and the group B to Permethrin 5% cream. Patients were followed up on day 7 and 14 for assessment of efficacy and safety. Result: The mean scoring with SD in group A (Ivermectin) and group B (Permethrin) were 8.26 ± 2.22 and 7.59 ± 2.01 respectively at the time of observation. The difference between the mean score of the two group is not significant (p=0.117) the mean scoring with SD in group A and group B were 4.54 ± 2.05 and 1.64 ± 1.84 respectively at 7thdays. The difference between the mean score of the two group is significant (p<0.001). The mean scoring with SD in group A and group B were 2.68± 2.35 and .36± 1.10 respectively at 14th day difference between the mean score of the group is significant (p<0.001). Conclusion: Topical application of permethrin 5% cream is more effective and safer than oral Ivermectin in the treatment of scabies. TAJ 2020; 33(1): 41-47

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Age related volume of cadaver-prostates in Bangladesh

Ibrahim Medical College Journal ◽

10.3329/imcj.v4i2.6501 ◽

1970 ◽

Vol 4 (2) ◽

pp. 74-77

Author(s):

Rukshana Ahmed ◽

Shamim Ara

Keyword(s):

Prostate Gland ◽

Age Groups ◽

Clinical Settings ◽

Cross Sectional ◽

Medical College ◽

Age Related ◽

Group A ◽

Key Words Prostate ◽

The Mean ◽

Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

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Banded Sleeve Gastrectomy Improves Weight Loss Compared to Nonbanded Sleeve: Midterm Results from a Prospective Randomized Study

Journal of Obesity ◽

10.1155/2020/9792518 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Paolo Gentileschi ◽

Emanuela Bianciardi ◽

Leandro Siragusa ◽

Valeria Tognoni ◽

Domenico Benavoli ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Weight Regain ◽

Randomized Study ◽

Banded Sleeve Gastrectomy ◽

Group A ◽

The Mean ◽

Group B ◽

To Receive

Background. Weight regain after laparoscopic sleeve gastrectomy (LSG) is nowadays a growing concern. Sleeve dilatation and loss of food restriction is considered the main mechanism. The placement of a silicon ring around the gastric tube seems to give benefits in the short term. We report the results of a randomized study comparing LSG and laparoscopic banded sleeve gastrectomy (LBSG) over a 4-year follow-up. Objectives. To evaluate the efficacy of banded sleeve gastrectomy compared to standard sleeve in the midterm. Methods. Between 01/2014 and 01/2015, we randomly assigned 50 patients to receive one of the two procedures. Patients’ management was exactly the same, apart from the band placement. We analyzed differences in weight loss, operative time, complication rate, and mortality, with a median follow-up of 4 years. Results. Twenty five patients were assigned to receive LSG (Group A) and 25 LBSG (Group B). The mean preoperative BMI (body mass index) was 47.3 ± 6.58 kg/m2 and 45.95 ± 5.85 kg/m2, respectively. There was no significant difference in the operative time. No intraoperative or postoperative complications occurred. At 12-month follow-up, the mean BMI was 29.72 ± 4.40 kg/m2 in Group A and 27.42 ± 4.47 kg/m2 in Group B (p=0.186). After a median follow-up of 4 years, the mean BMI in Group B was significantly lower than Group A (24.10 ± 4.52 kg/m2 vs 28.80 ± 4.62 kg/m2; p=0.00199). Conclusions. LBSG is a safe procedure, with no impact on postoperative complications. The banded sleeve showed a significant greater weight loss in the midterm follow-up. Considering the issue of weight regain observed after LSG, the placement of a perigastric ring during the first procedure may be a strategy to improve the results. This trial is registered with NCT04228185.

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HYPERCHOLESTEROLEMIA;

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.01.1924 ◽

2014 ◽

Vol 21 (01) ◽

pp. 111-115

Author(s):

Zahidullah Khan ◽

Inamullah Khan ◽

Fazle Subhan

Keyword(s):

Density Lipoprotein ◽

Base Line ◽

Inclusion Criteria ◽

Blood Samples ◽

Hospital Design ◽

Single Center Study ◽

Group A ◽

The Mean ◽

Group B ◽

Study Setting

Objective: To compare the efficacy of Simvastatin with Atorvastatin in loweringLow Density Lipoprotein Cholesterol (LDL-C) in patients with Hypercholesterolemia in a tertiarycare hospital. Design: Prospective, observational, single center study. Setting: Department ofMedicine, Khyber Teaching Hospital, Peshawar. Period: December 2011 to December 2012.Subjects and Methods: A total of 200 cases having base line fasting LDL-C level of ≥ 130 mg/dland meeting the inclusion criteria were included in the study through both outpatient department(OPD) and admitted patient. After detailed history and clinical examination, all patients weredivided randomly into two groups, A and B. Patients in Group A were given Simvastatin20mg/day and Group B received Atorvastatin 20mg/day. Fasting blood samples were taken fromthe selected patients in the start of study and after 12 weeks. Results: A total of 200 subjects witha serum LDL-C level ≥ 130 mg/dL were included in the study. They were divided into 2 groupsrandomly, 100 in each group. Each group comprised of 75 male and 25 female. The mean age ingroup A was 52 years and in group B it was 54 years. The age ranges between 40 years and 73years. Mean base LDL-C level was 165 mg/dl in group A and 170mg/dl in group B. Simvastatin 20mg/dl reduced LDL-C level by 26% and Atorvastatin 20mg/dl reduced LDL-C level by 33% after 12weeks of treatment. Conclusions: Atorvastatin is a more effective drug to reduce serum LDLcholesterolthan Simvastatin in the same doses.

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Comparing efficacy and safety of sodium valproate with propranolol in paediatric migraine prophylaxis

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i1.4470 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Varsha Gajbhiye ◽

Lamture Yashwant R ◽

Sadama Quazi

Keyword(s):

Sodium Valproate ◽

Migraine Prophylaxis ◽

Efficacy And Safety ◽

Before And After ◽

Propranolol Group ◽

Paediatric Age ◽

Group A ◽

The Mean ◽

Group B ◽

The Brain

Migraine is a common disorder of the paediatric age group. Propranolol has been used in prophylaxis for migraine. The use of Sodium valproate in the prophylaxis of migraine is not known. It is postulated that it increases the level of GABA in the brain that will decrease events related to migraine in the cortex. All parents of the patient were advised to keep diaries for noting time, date, severity and duration of headache during the study period, which was for a period of 6 wks. The decreased frequency of headache more than in Group A was 68% and propranolol group was 68.89%. In group A(sodium valproate), patients showed a reduction in headache duration and 52% in Group B. 20% of them headache free in Group A and 18% in Group B. Decrease in the severity of headache in Group A was 52% while 50% in Group B. The mean headache frequency before and after treatment was reduced from 8 to 2.5 attacks per month in group A and from 8.2 to 2.6 in group B. The t-value is 11 for group A. Sodium valproate is more effective and safer in migraine prophylaxis as compared with propranolol.

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A retrospective comparative study to evaluate the efficacy and safety of mifepristone with misoprostol over misoprostol alone in induction in labor

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184981 ◽

2018 ◽

Vol 7 (12) ◽

pp. 5140

Author(s):

Reena Sharma ◽

B. R. Sharma ◽

Poojan Dogra

Keyword(s):

Comparative Study ◽

Induction Of Labour ◽

Cervical Ripening ◽

Efficacy And Safety ◽

Group A ◽

The Mean ◽

Group 2 ◽

Group B ◽

Retrospective Comparative Study ◽

Group 1

Background: The aim is to compare the improvement in pre-induction Bishop’s score, proportion of patients going in labor and induction–delivery interval after using the Misoprostol versus Mifepristone and Misoprostol as cervical ripening and labor inducing agent.Methods: It is retrospective comparative study conducted on 110 women. Women were randomized in group A and in group B of 55 patients in each group. Group A received tab Mifepristone 200 mg orally on day 1 followed by Misoprostol 25 ug after 48 hours and continued 6 hourly till maximum four tablets and group B patients received tablet Misoprostol 25ug and continued 25ug 6hrly maximum 4 doses. Women observed for improvement in Bishop‟s score, induction-delivery interval and requirement of subsequent doses of Misoprostol.Results: Present study concluded that tablet Mifepristone is an efficient cervical ripening and inducing agent of labor as pre-induction Bishop’s score was improved. 36.4%patients went into labor only with tablet Mifepristone. The mean induction-delivery interval was,19±12.2hrs in Group 1 as compare to 13.1±13.0 hrs in Group 2. Mean Bishop’s score observed in Group 1 were 2.5±1.78 and 1.67±1.25 in Group 2. It was observed that there was significant improvement in the Bishop’s score after giving Mifepristone to the patients; mean Bishop’s 24hrs after mifepristone were 4.03±1.80. Repeated dose of Misoprostol required in Group 1 was observed to be higher than group 2 as shown in table 8. Mean misoprostol doses required in group 1 was 2.56±1.15 as compared to 1.71±1.58 in group 2.Conclusions: Mifepristone with Misoprostol reduce the induction delivery interval and more potent in combination for induction of labour as compared to Misoprostol alone.

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Cryosurgery as a Single Agent and in Combination with Intralesional Corticosteroids Is Effective on Young, Small Keloids and Induces Characteristic Histological and Immunohistological Changes: A Prospective Randomized Trial

Dermatology ◽

10.1159/000511624 ◽

2020 ◽

pp. 1-11

Author(s):

Christos C. Zouboulis ◽

Eftychia Zouridaki

Keyword(s):

Treatment Failure ◽

Normal Skin ◽

Randomized Study ◽

Single Agent ◽

Interferon Γ ◽

Efficacy And Safety ◽

Rete Ridge ◽

Group A ◽

Group B

Background: As the pathogenesis of keloids is poorly understood, there is no sound biological basis of keloid management. Few controlled therapeutic studies have been published, and recurrences are a major reason for treatment failure. Objective: To detect efficacy and safety of cryosurgery regimens on keloids and the occurring biological changes caused by the treatment. Methods: This prospective randomized study compared efficacy and tolerability as well as histological/immunohistochemical effects of liquid nitrogen contact cryosurgery as a single regimen (group A) and combined with intralesional corticosteroids (group B) on young (<2 years old), small (≤10 cm2) keloids in 40 patients (2-sided effect, α-error 1%, power 95%). Results: Marked flattening of the lesions was achieved by both regimens. Median lesional volumes decreased from 106 to 7 mm3 in group A (p = 0.001) and from 138 to 6 mm3 in group B (p < 0.0001; ns, between groups). Good to excellent responses were registered in 83.3 and 90% of patients in groups A and B, respectively, by evaluating the lesional volume, in 80 and 95% of patients by the physician’s evaluation and in 95% of patients in either group by the patient’s assessment. Follow-up of 6–36 months revealed no further significant changes. Cryosurgery was generally well tolerated, with minor pain during treatment not requiring (27.5%) or requiring local anaesthesia (5%) – but not analgesics –, and hypopigmentation (25%). Histological examination showed increased vessel number and lumen dilatation after treatment in group B and reduction of rete ridge length in both groups with more prominent changes in group A. Tenascin C staining demarcated keloids from normal skin before therapy, while after therapy the entire treated tissue was labelled. Interferon-γ expression was significantly decreased after therapy both regarding positively stained cells and intensity in both groups. Conclusion: Cryosurgery without and with intralesional corticosteroids is effective and safe on young, small keloids not only as a destructive physical procedure, but also by inducing biochemical and immunological scar rejuvenation.

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The use of folic acid in dengue: has it any value?

Tropical Doctor ◽

10.1177/0049475519827110 ◽

2019 ◽

Vol 49 (2) ◽

pp. 85-87 ◽

Cited By ~ 1

Author(s):

Ahsan Ali Syed ◽

Saad Bin Zafar ◽

Asif Ali Shah ◽

Safia Awan

Keyword(s):

Folic Acid ◽

Medical Records ◽

Dengue Infection ◽

Inclusion Criteria ◽

Time Period ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B ◽

Mean Time

Folic acid is used in dengue patients. Our study aims to compare the duration of recovery of thrombocytopenia in patients with dengue infection who received folic acid and those who did not. We retrospectively reviewed the medical records of adult patients admitted over six years with a diagnosis of dengue. Of 2216 patients, 1464 fulfilled the inclusion criteria. Group A were those patients who received folic acid and group B were those who did not. A total of 1322 (90.3%) patients received folic acid. The mean time period required for platelets to double the nadir was 1.7 (±2.2) days in both groups A and B ( P = 0.89). In conclusion, there is no significant difference in the recovery of thrombocytopenia in patients with dengue fever who received folic and those who did not receive folic acid.

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Dexamethasone Versus Ondansetron in Preventing Postoperative Nausea and Vomiting In Laparoscopic Surgery

Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University ◽

10.48036/apims.v17i3.512 ◽

2021 ◽

Vol 17 (3) ◽

pp. 222-226

Author(s):

Anum Malik ◽

Arshad Shahani ◽

Jawad Zahir ◽

Hassam Zulfiqar ◽

Tabassum Aziz

Keyword(s):

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

P Value ◽

Inclusion Criteria ◽

Significant Difference ◽

Quasi Experimental ◽

Group A ◽

The Mean ◽

Group B

Objective: To compare the efficacy of dexamethasone 8mg versus ondansetron 4mg in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy Methodology: This quasi-experimental study was conducted at the Department of Anaesthesia and Intensive Care, Holy Family Hospital from 29th July 2018 to 28th January 2019. Anesthesia was induced with propofol (2mg/kg IV) and Atracurium (0.5 mg/kg IV) was given to facilitate tracheal intubation. Nalbuphine (0.2mg/kg) was used as analgesic.Patients were randomly divided into two groups. Patients in Group A received 4mg ondansetron at end of surgery and Group B received 8mg dexamethasone at induction. Results: A total of 90 patients were included according to the inclusion criteria of the study. The mean age (years) in the study was 37.11+10.60 years. Frequency and percentage of nausea (up to 24 hours) among both the groups was 28 (62.2) and 28 (62.2) respectively (p-value = 1.0) while the frequency and percentage of vomiting (within 24 hours after extubation) was 28 (62.2) and 27 (60.0) respectively (p-value = 0.829) Conclusion: The study concluded that there was no significant difference dexamethasone and ondansetron in preventing postoperative nausea and vomiting.

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The Accuracy of Patient Specific Three-Dimensional Digital Ostectomy Template for Mandibular Angle Ostectomy

Aesthetic Surgery Journal ◽

10.1093/asj/sjab330 ◽

2021 ◽

Author(s):

Guoping Wu ◽

Zhiyang Xie ◽

Wensong Sahngguan ◽

Wenwen Zhang ◽

Shu Wang ◽

...

Keyword(s):

Operating Time ◽

Three Dimensional ◽

Patient Specific ◽

Mandibular Angle ◽

Significant Difference ◽

Postoperative Drainage ◽

Group A ◽

The Mean ◽

Group B ◽

Mean Time

Abstract Background Despite the three-dimensional (3D)-printed digital ostectomy template (DOT) helps surgeons perform mandibular angle ostectomy (MAO) more precisely and safely, the clinical application of DOT is problematic. Objectives The aim of this study was to evaluate the accuracy of DOT and improve the precision of MAO. Methods A total of 20 patients with a prominent mandibular angle (PMA) were allocated into two groups with 10 patients in each group. The conventional digital ostectomy template (CDOT), and the novel digital ostectomy template (NDOT) were applied to guide MAO in group A and B, respectively. The mean time taken for curved osteotomy and the volume of postoperative drainage on one side within 24 hours were recorded. The deviations between the simulated and postoperative lower border of the mandible were measured on both sides. Results All the patients were satisfied with the cosmetic outcomes. Statistical results showed that the mean time taken for curved osteotomy in group B was shorter than that of group A, and the volume of postoperative drainage on one side within 24 hours was similar between the two groups. The deviations at the anterior and posterior parts of the inferior border showed the accuracy of osteotomy in group B was higher than that in group A, and there was no significant difference between the two groups in the middle part. Conclusions The NDOT is easy to be located and fixed tightly, which reduced the operating time and increased the safety and precision of the procedures.

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