scholarly journals Fistula in ano: open method compared to lift method ligation of intersphincteric fistula track

2017 ◽  
Vol 4 (11) ◽  
pp. 3714
Author(s):  
Vigna Sai Potula
Keyword(s):  
Internal Opening ◽  
Female Ratio ◽  
Fistula In Ano ◽  
Open Method ◽  
Intersphincteric Fistula ◽  
Fistula Track ◽  
High Level ◽  
A Prospective Study ◽  
Surgery Department ◽  
Male To Female

Background: To compare fistula in ano open method with lift method ligation of intersphincteric fistula track.Methods: This is a prospective study which consisted of 70 patients suffering from fistula-in-ano who were admitted to surgery department. All patients above 18 years of age, cases of transsphincteric low anal fistula, maturation of tract were included in the study.Results: In this study, 60 patients were included totally, of which, 10 patients were excluded as 5 patients had tuberculosis, 2 had Crohn’s disease and 3 were excluded as they lost follow up. Hence, 50 patients were included in the study. 40 were males and 10 were females with a male to female ratio of 4:1 in this study. The average age of fistula in ano was 45.34±10.39 years. The incidence of fistula in ano was maximum in the age group of 46-55 years. The minimum incidence was in the age < 30 years. The most common primary fistula is intersphincteric track (46%), followed by transsphincteric track (42%). The most common type of fistula in ano patients was discharge from the tract which was in all patients, in others, perianal pain and bleeding was observed. Fistula in ano can be divided into low and high level of fistula. High level of fistula-in-ano was found in 64 % of patients and low level of fistula-in-ano was found in 36% of patients. Recurrence was seen in 6 patients with high suprasphincteric track who were ligated below the internal opening and 10 patients had a recurrence with transsphincteric track of which 6 were obese which made identifying the fistula track difficult.Conclusions: The LIFT procedure is advantageous as no chance of incontinence prevails as the infective focus is removed without dividing any part of sphincter complex, other advantages are that it is easy to learn, perform, safe, high healing rate, low morbidity and easily treat fistula in ano at primary health care level.

scholarly journals AshwathaKsheer Sutra and UdumberKsheer Sutra in the management of Bhagandara (Fistula in ano): An Ayurvedic management protocol for treatment of fistula in ano

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1357-1361
Author(s):  
Monika Meshram ◽  
Kiran Khandare
Keyword(s):  
Internal Opening ◽  
Anal Abscess ◽  
Female Ratio ◽  
Fistula In Ano ◽  
Management Protocol ◽  
Group A ◽  
Group B ◽  
Male To Female ◽  
Single Blind

Fistula in ano is tract lined by granulation tissue having internal opening in anal canal and rectum and external opening in the perianal region. The incidence of a fistula-in-ano developing from an anal abscess ranges from 26-38%. The prevalence of non-specific anal fistula has been estimated to be 8.6 to 10/100,000 of the population per year, with a male to female ratio of 8:1.in contemporary sciences Bhagandara  can be correlated with Fistula in Ano. To compare the efficacy of AshwathaKsheer Sutra  and UdumberKsheer Sutra in the management of Bhagandara (Fistula in ano).  The present study is designed as a  Randomized single blind parallel in which 40 patients will be enrolled. Patients will be distributed in two group with 20 patients in each group. In group A AshwathaKsheerSutra and in group B UdumbarKsheerSutra will be changed after 7 days till the cure of fistula. Assessment of the patients will be done on day 1st, 8th, 15th, and 22nd after intervention, follow up will be taken on 29th day.  Results will be drawn from the observations of objective parameters. Conclusion of the study will be drawn on the basis of statistical data calculated from the collected data.

scholarly journals Ethambutol Pharmacokinetic Variability Is Linked to Body Mass in Overweight, Obese, and Extremely Obese People

2011 ◽  
Vol 56 (3) ◽  
pp. 1502-1507 ◽  
Author(s):  
Ronald G. Hall ◽  
Mark A. Swancutt ◽  
Claudia Meek ◽  
Richard D. Leff ◽  
Tawanda Gumbo
Keyword(s):  
Body Mass ◽  
Compartment Model ◽  
Obese Patients ◽  
Obese People ◽  
Time Curve ◽  
Female Ratio ◽  
Two Compartment Model ◽  
Dosing Regimens ◽  
A Prospective Study ◽  
Male To Female

ABSTRACTWe conducted a prospective study of 18 adult volunteers (male-to-female ratio of 1) whose body mass index fell into categories of <25, 25 to 40, or >40 kg/m2, who received a single oral dose of 1,600 mg ethambutol. Only individuals with normal renal function were recruited. The minimum body mass (M) was 45.6 kg, the median was 90.8 kg, and the maximum weight was 160.4 kg. Ethambutol pharmacokinetics were best described by a two-compartment model. Inclusion of weight as a covariate dramatically improved the model, with a relative likelihood approaching infinity. The typical clearance was 42.6 liters/h. Ethambutol systemic clearance was proportional to (M/45.6)3/4and thus obeyed fractal geometry-based laws. This means that the area under the concentration-time curve (AUC) actually decreased for obese patients compared to that for leaner patients, reducing chances of concentration-dependent toxicity. On the other hand, such reduced AUCs could lead to therapy failure. Thus, new and individualized ethambutol dosing regimens need to be designed for obese and extremely obese patients.

scholarly journals Outcome of retroviral screening among patients undergoing ear, nose, throat, head and neck surgery, at the University of Benin Teaching Hospital, Nigeria

2018 ◽  
Vol 4 (4) ◽  
pp. 997
Author(s):  
Paul R. O. C. Adobamen ◽  
Johnson Ediale
Keyword(s):  
Hiv Infection ◽  
Head And Neck ◽  
Submandibular Gland ◽  
Otitis Media With Effusion ◽  
Neck Surgery ◽  
Chronic Tonsillitis ◽  
Female Ratio ◽  
Benin City ◽  
A Prospective Study ◽  
Surgery Department

<p class="abstract"><strong>Background:</strong> In Nigeria it has been estimated that 3.6% of the population are living with HIV/AIDS. Patients with different social, family, occupational and epidemiological background present for ear, nose, throat, head and neck (ENTH&amp;N) surgeries in our hospital. The aims of the study were to determine the prevalence of HIV infection among patients for ENTH&amp;N surgeries and to document the ENTH&amp;N conditions that were associated with HIV infection.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study that was carried out in the ENTH&amp;N Surgery department of UBTH, Benin City, Nigeria, between January, 2009 and December, 2010. All patients that were worked up for surgeries were enrolled into the study. Appropriate data were retrieved from the patients who gave informed consent for surgery and had retroviral screening and confirmatory tests by ELISA and Western blot methods respectively. The retroviral status of all the patients and the indications for the surgical procedures done were documented.  </p><p class="abstract"><strong>Results:</strong> There were 173 patients; 100 males and 73 females, with a male to female ratio of 1.37:1. Ages ranged from 0.83 years to 72 years, with an average age of 26.82 years. Out of a total of 168 patients screened for HIV infection in this study, 6 patients were retroviral positive. This gives a prevalence of 0.036%. Out of the 6 patients that were retroviral positive, 3 patients had chronic tonsillitis, 1 patient had chronic tonsillitis and otitis media with effusion, while the other 2 patients had submandibular gland and nasopharyngeal tumours respectively.</p><p><strong>Conclusions:</strong> A prevalence of 0.036% of HIV infection was found in patients for ENTH&amp;N surgeries. Chronic tonsillitis was the commonest presentation of HIV infection, equally followed by OME, nasopharyngeal and submandibular gland tumours. </p>

scholarly journals Study the Role of Loose versus cutting of Seton in Treatment of High Perianal fistula in a District Hospital of Health Insurance

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M S Abdelhameed ◽  
I M H Elghazawy ◽  
E A Elsayed
Keyword(s):  
Anal Fistula ◽  
Low Cost ◽  
Perianal Fistula ◽  
Dentate Line ◽  
Internal Opening ◽  
Fistula In Ano ◽  
One Year ◽  
Definition Of ◽  
A Prospective Study ◽  
High Perianal Fistula

Abstract When the track reaches the skin or another epithelialized surface then a fistula is formed. Anal fistula were classified on the basis of its relationship to the sphincters. The definition of high or low describes the height of the track as it traverses the sphincter muscles and not the position of the internal opening which is almost without exception at the dentate line. More accurately according to parks classification fistula in ano can result in an abscess between the internal and external sphincters, which in turn can spread to other parts of the perianal region. Infection can then track in many directions from this focus in the intersphincteric plane. Background Anal fistula is an abnormal communicative small channel that has an internal opening and an external opening and connected by the primary track. Our study evaluate the effectiveness of seton in high variety anal fistula. Objectives Evaluation the efficacy and safety of seton as surgical management of high anal fistula. Methods: This is a prospective study done on 30 patients in ELNile hospital in one Year period with high variety of anal fistula which is above the dentate line and were treated with seton .Outcome measured during follow up period were- successfully healed, recurrence, incontinence, percentage of complications and patients satisfaction. Result Among 30 patients mean age was 42.2+_6.8 years. Overall outcome of the patients showed-fistula completely healed in 27 patients, incontinence occurred in 3 patients and recurrence occurred in 3 patients. Conclusion Seton is relatively safe, effective and low cost for the management of high anal fistula with low rate of incontinence. It can therefore, be recommended as the standard of treatment for high variety fistula in ano.

scholarly journals Clinical and diagnostic profile of patients with anal fistula: a cross sectional study from Vilasrao Deshmukh Government Institute of Medical Sciences, Latur, Maharashtra

2020 ◽  
Vol 7 (8) ◽  
pp. 2494
Author(s):  
Praffula V. Mahakalkar ◽  
Ganesh Swami ◽  
Halnikar Chandrashekhar S. ◽  
Anant A. Takalkar
Keyword(s):  
Anal Fistula ◽  
Cross Sectional Study ◽  
Internal Opening ◽  
Age Group ◽  
Cross Sectional ◽  
Female Ratio ◽  
Fistula In Ano ◽  
Surgical Department ◽  
Male Predominance ◽  
External Opening

Background: Anal fistulas are one of the commonest causes for a persistent discharge seropurulent in nature that irritates the skin in the neighbourhood and leads to discomfort. Fistula-in-ano is seen quite frequently in perirectal perianal suppuration. The objective of this study to study the clinical profile and diagnosis of anal fistula at surgical OPD of VDGIMS.Methods: The present cross-sectional observational study was carried out in patients with fistula-in-ano admitted at surgical department of VDGIMS, Latur during the period of 2017-19 in 50 diagnosed patients. Data was analysed by using SPSS 24.0 version IBM USA.Results: Majority of the patients with anal fistula were from 41-50 years age group i.e. 15 (30%) and males were predominantly affected 40 (80%) compared to females i.e. 10 (20%). Male to female ratio was 4:1. Perianal discomfort was the commonest symptom in all patients i.e. 100%. It is followed by perianal discharge complained by 54% and perianal itching in 38% cases. The anterior position of external opening is found to be significant (p<0.05). Fistulogram showed external opening in all patients i.e. 50 cases whereas internal opening in 46 (92%) cases. Findings of MRI revealed that anal fistula was intra sphincteric in 28 cases i.e. 56%, extra sphincteric in 2 cases i.e. 4% and trans sphincteric in 20 cases i.e. 40%.Conclusions: Commonest age group affected in our study was 40-50 years with male predominance. Perianal discomfort and discharge were the commonest symptom. E. coli was the predominant organism isolated. Fistulogram and MRI is useful in detecting the aetiology of fistula in ano.

scholarly journals A prospective study on morphological alteration of megakaryocytes amongst megaloblastic anemia cases along with their clinic-haematological manifestations

2017 ◽  
Vol 5 (9) ◽  
pp. 4127
Author(s):  
Benazeer Mansuri ◽  
Komal P. Thekdi
Keyword(s):  
Bone Marrow ◽  
Megaloblastic Anemia ◽  
Bone Marrow Aspiration ◽  
Morphological Alteration ◽  
Age Group ◽  
Female Ratio ◽  
Hematological Disorders ◽  
Common Complaint ◽  
A Prospective Study ◽  
Male To Female

Background: Megaloblastic anemias are hematologic disorders in which abnormal DNA synthesis causes blood and bone marrow disorders. The cause of thrombocytopenia in megaloblastic anemia has been postulated as hypoproduction in some studies, whereas ineffective thrombopoeisis has been proposed in other. Objective was to study spectrum of clinic-hematological features in megaloblastic anemia and comparative bone marrow aspiration study of thrombocytopenia secondary to megaloblastic anemia, hypoproduction and hyper-destruction. This study was done to understand the various megakaryocytic alterations in hematological disorders presenting with thrombocytopenia due to different mechanisms.Methods: Total 85 cases of thrombocytopenia included in the study. Bone marrow finding in 33 cases of thrombocytopenia of megaloblastic etiology were compared with 34 cases of marrow proven hypo productive thrombocytopenia (aplastic anemia, acute leukemia) and 19 cases of hyper destructive thrombocytopenia (immune thrombocytopenia).Results: Most common age group presenting megaloblastic anemia is 11-20 year, with male to female ratio is1.2:1, most common complaint were generalized weakness and fever. In megaloblastic anemia 24.33%, 60% and 15.67% of the cases shows increase, decrease and normal megakaryocytes respectively. Dysplastic megakaryocytes were observed in 24.3%, 27% and 20.5% of the cases of megaloblastic anemia, acute leukaemia and immune thrombocytopenic purpura respectively.Conclusions: Both hypoproduction and ineffective thrombopoiesis are the underlying path mechanisms in megaloblastic thrombocytopenia as evidenced by the marrow findings. We hereby infer that megaloblastic thrombocytopenia is to be included as a separate category apart from hypo proliferative and hyper destructive groups. The presence of dysplastic megakaryocyte should not prompt an interpretation

COMPARATIVE STUDY BETWEEN LIFT PROCEDURE VERSUS SETON PLACEMENT IN THE MANAGEMENT OF FISTULA IN ANO

2021 ◽  
pp. 61-64
Author(s):  
S. Yashwanth ◽  
T. Praneeth
Keyword(s):  
Postoperative Pain ◽  
Fistula Tract ◽  
Internal Opening ◽  
Fistula In Ano ◽  
Medical College ◽  
Group 12 ◽  
Group A ◽  
Intersphincteric Fistula ◽  
Group B ◽  
Seton Placement

INTRODUCTION: A stula-in-ano, is a chronic abnormal communication, usually lined by granulation tissue, which runs outwards from the anorectal lumen. The standards of anal stula surgery are to obliterate the stula, prevent recurrence and maintain sphincter work. Ligation of Intersphincteric Fistula Tract (LIFT) is the most promising surgical technique based on secure closure of the internal opening and removal of the infected crypto glandular tissue through intersphincteric approach. AIMS: To compare the effectiveness of LIFT over SETON procedure based on Postoperative pain on day 1 and2, Short term recurrence, Healing, Procedural visits PATIENTS AND METHODS: A prospective, single centered, interventional study in 60 patients with stula-in-ano admitted to general surgical wards in Narayana Medical College and Hospital, Nellore. From November 2018 to November 2020. Patients were divided into two groups, group A including patients undergoing LIFT procedure and group B, including patients undergoing SETON placement of Fistula-in- ano. RESULTS: Maximum patients were in 41-60 years in the LIFT Group 18(60%), 51-60 years in the SETON group 12(40%). Maximum patients were male 21 in each group (70%), and female were 9 in each group (30%). In the present study, Visual Analog Scale (0,1,2,3) in LIFT group on POD 1, were 2, 20, 6, 2 and in SETON group on POD 1 were 0, 9, 16, 5 respectively. Similarly, visual analogue scale (0,1,2,3) in LIFT group on POD 2, were 19.8.3.0 and in SETON group on POD 2 were 5, 20, 5, 0respectively. Patients who underwent LIFT procedure had a satisfactory postoperative period and the wound healed in all the cases. CONCLUSION: we conclude that LIFT gives good outcomes in terms of Postoperative pain on day 1 and 2, wound healing rate, single time procedure and recurrence during our short follow-up period of 6 months.

PATHOLOGICAL STUDY OF BODY FLUIDS IN A TERTIARY CARE CENTER IN SOUTH INDIA.

2021 ◽  
pp. 60-61
Author(s):  
Earla Lakshmi Bai ◽  
Buddaiahgari Swathi ◽  
Siva Chaithanya Bangi
Keyword(s):  
Cell Count ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Pathology ◽  
Major Type ◽  
Pathology Laboratory ◽  
Female Ratio ◽  
Atypical Cells ◽  
A Prospective Study ◽  
Male To Female

Body cavities uid analysis is done routinely in both clinical pathology and cytology departments of Pathological laboratory. Any imbalance between uid 1. formation and removal leads to effusion, as stated by Starling's law The peritoneal, pleural, cerebrospinal and pericardial uids comprise the major chunk of 2 body uids . Accumulation of uid in various body cavities can occur in vast range of benign conditions and it also a frequent clinical presentation and complication of malignant disorder. METHODS: A prospective study was conducted in the Department of Pathology, Osmania general hospital Hyderabad, Telangana, India, during January 2020 to December 2020 and analyzed 880 uid samples collected from patients for cell count and cytology. The data collected was tabulated using Microsoft excel and analyzed using standard statistical tools. RESULTS -Of total 880 uids analyzed peritoneal uid (42%) constitutes the major type of uid sent frequently for analysis followed by cerebrospinal uid (41%) with male to female ratio of 1.9:1. 62.7% of uids had clear gross appearance . Of total 880 uid samples analyzed 649 samples (73.7%) had shown lymphocyte predominance. Of total 880 uids samples analyzed 9 samples (1%) were found positive for atypical cells, conrmed on cytology suggesting there malignant origin. CONCLUSION: uid aspiration from body cavities constitutes one of the common day care procedures for clinicians. Effusion uid analysis is key in delineating the background cause in the patient ranging from reactive, inammatory and malignant conditions. Fluid cell count coupled by cytological analysis of uids in pathology laboratory is a time tested tool having good sensitivity and specicity when interpreted along with biochemical parameters.

scholarly journals DETERMINATION OF SENSITIVITY AND SPECIFICITY OF ULTRASONOGRAPHY IN ACUTE APPENDICITIS: COMPARISON WITH PER-OPERATIVE FINDINGS AND HISTOPATHOLOGICAL REPORT

2017 ◽  
Vol 10 (9) ◽  
pp. 151
Author(s):  
Sasmita Parida ◽  
Bibekananda Nayak ◽  
Jayashree Mohanty
Keyword(s):  
Acute Appendicitis ◽  
Reproductive Period ◽  
Bowel Loop ◽  
Predictive Values ◽  
Female Ratio ◽  
Operative Findings ◽  
Sensitivity Specificity ◽  
A Prospective Study ◽  
Histopathological Results ◽  
Male To Female

  Objective: This study was under taken to compare the ultrasonographic findings with pre-operative findings and histo-pathological report and to evaluate the sensitivity, specificity, positive and negative predictive values and accuracy of ultrasonography in the diagnosis of acute appendicitis.Methods: It was a prospective study done in the department of radio-diagnosis, SCBMCH, Cuttack. Patients with provisional diagnosis of acute appendicitis were subjected to ultrasound of abdomen and pelvis. Patients with positive USG findings were followed up for pre-operative findings and histo-pathological results. All the obtained data were tabulated and subjected to statistical analysis.Results: Among the 100 cases studied, 77 cases were proved as acute appendicitis based on surgical and histopathological results. Male to female ratio was 1.5:1. The disease was found to be more prevalent in second and third decade of life. Location of affected appendix was most commonly retro caecal. Mean diameter of the appendix was 8.56 mm. Target sign and non-compressible bowel loop was the most commonly detected ultrasonographic sign and the ultrasonographic sensitivity was 96.1% and specificity was 95.65% in our study.Conclusion: High resolution sonography with graded compression is a very useful diagnostic tool for diagnosis of appendicitis in problematic cases and in women in their reproductive period. It is also helpful in detecting complications of appendicitis and other abdominal diseases that mimic acute appendicitis.

scholarly journals Complications of Total Thyroidectomy in 50 Cases in The Department of Endocrine Surgery in BSMMU

2019 ◽  
Vol 17 (1) ◽  
pp. 25-29
Author(s):  
Md Alamgir Hossain Sikder ◽  
AEM Mahfuzur Rahman ◽  
Abul Khair ◽  
Md Jahangir Alam ◽  
Mohammed Rafiqul Lslam
Keyword(s):  
Total Thyroidectomy ◽  
Multinodular Goiter ◽  
Endocrine Surgery ◽  
Published Data ◽  
Female Ratio ◽  
Male Female Ratio ◽  
A Prospective Study ◽  
Surgery Department

Objective: To determine the complications of the patients undergoing total thyroidectomy. Method: A prospective study was held at Department of Endocrine Surgery in BSMMU from January 2006 to December 2006 Method: Fifty patients with multinodular goiter and carcinoma thyroid of both sexes were selected from admitted patient of endocrine surgery department. All patients were evaluated preoperatively and total thyroidectomy was done and post operative was followed up. Out of 50 patients 35 patients were female and 15 patients male, male - female ratio 1 :2.3. 40 patients were carcinoma thyroid, 10 patients were multinodular goiter. The overall incidence of postoperative complication in this series was 4. out of 50 patients 1 patient developed haematoma. 1 patient developed wound infection and 1 patient developed transient tetany on 2nd postoperative day which was improved later on. 1 patient developed a thyroid nodule 6th month after total thyroidectomy for carcinoma thyroid. In long term from total thyroidectomy 40 patients were followed up, 10 patients did not attend an subsequent follow up. Out of 40 patients 36 patients were out of complication. Conclusion: The results are comparable with the current published data and demonstrate that total thyroidectomy can performed with minimum complication rate. Journal of Surgical Sciences (2013) Vol. 17 (1) : 25-29

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