scholarly journals A randomized control trial to determine the need for postoperative antibiotics after laparoscopic appendicectomy in nonperforated appendicitis

2018 ◽  
Vol 5 (2) ◽  
pp. 548
Author(s):  
B. M. Kajagar ◽  
Rampurwala Jakiyuddin

Background: Acute Appendicitis is the most common cause of acute pain in the abdomen. Appropriate use of prophylactic antibiotics prevents the risk of postoperative surgical site infections (SSIs). However, there is no conclusive guideline concerning the duration of antibiotic usage. A single preoperative prophylactic dose has been recommended by many randomized control trials. Hence, the study aimed to determine the need for postoperative antibiotics after laparoscopic appendicectomy for nonperforated appendicitis.Methods: A total of 100 patients with nonperforated appendicitis undergoing laparoscopic appendicectomy divided into two groups. Group A (n=50) patients received single dose of preoperative antibiotic and group B (n=50) patients received preoperative dose, as well as three postoperative doses of antibiotics. Routine investigations including complete blood count, blood urea, serum creatinine; other investigations such as ultrasound of abdomen were also performed. Following laparoscopic appendicectomy, surgical wound was inspected after 48 h, 72 h, and on day 7 to look for any signs of postoperative SSI.Results: The mean age in group A was 30.74±10.69 years compared to 30.72±9.56 years (p=0.757) in group B. All the patients in study presented with right iliac fossa pain. Three patients in group A (6%) and two patients in group B (4%) had grade III SSIs, which were managed conservatively. The difference between both the groups for incidence of SSIs was statistically insignificant (p=1.000).Conclusions: Prophylactic postoperative doses of antibiotics confer no additional benefit over a single preoperative dose in preventing the postoperative SSIs after laparoscopic appendicectomy.

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Yongqi He ◽  
Siquan Zhu ◽  
Ming Chen ◽  
Dejiao Li

Objective. This is prospective randomized control trial to compare the mean keratometric corneal astigmatism diopter power (not surgical induced astigmatism) among preop and one-month and three-month postop phacoemulcification of either a clear temporal corneal incision or a superior scleral tunnel Incision, using only keratometric astigmatic power reading to evaluate the difference between the two cataract surgery incisions.Methods. 120 patients (134 eyes) underwent phacoemulcification were randomly assigned to two groups: Group A, the clear temporal corneal incision group, and Group B, the superior scleral tunnel incision group. SPSS11.5 Software was used for statistical analysis to compare the postsurgical changes of cornea astigmatism on keratometry.Results. The changes of corneal astigmatic diopter in Groups A and B after 3 month postop from keratometric reading were 1.04 + 0.76 and 0.94 + 0.27, respectively ( .05), which showed no statistic significance difference.Conclusion. The incision through either temporal clear cornea or superior scleral tunnel in phacoemulcification shows no statistic difference in astigmatism change on keratometry 3-month postop.


2020 ◽  
Vol 33 (1) ◽  
pp. 41-47
Author(s):  
Mohsena Akhter ◽  
Ishrat Bhuiyan ◽  
Zulfiqer Hossain Khan ◽  
Mahfuza Akhter ◽  
Gulam Kazem Ali Ahmad ◽  
...  

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


2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Jun-Beom Kim ◽  
Chi Ahn ◽  
Byeong-Seop Park

Category: Trauma Introduction/Purpose: The aim of this study was to evaluate and compare the clinical and radiological results of internal fixation with headless cannulated screw and locking compression distal ulna hook plate for the fracture at the base of fifth metatarsal bone, Zone 1. Methods: From April 2012 to April 2015, thirty cases (29 patients) were evaluated retrospectively. The mean follow up periods was 13 months. There were divided two groups based on use of the screw (group A, n=15) or the plate (group B, n=15).We measured the displacement to diastasis of the fracture on the foot oblique radiographs taken pre- and post-operatively in each group, checked the time to bone union and the difference of the reduction distance in each group. Clinical results were evaluated using American Orthopedic Foot and Ankle Society (AOFAS) midfoot score at 12 months postoperative. Results: In group A, the mean time to union was 54.2±9.3 days, the mean displacement to diastasis improved to 0.3±0.4 mm postoperatively (p<0.001), and the mean reduction distance was 2.9±1.0 mm. In group B, the mean time to union was 41.5±7.0 days, the mean displacement to diastasis improved to 0.06±0.2 mm postoperatively (p<0.001), and the mean reduction distance was 4.1±1.6 mm. AOFAS score was verified 97.7±3.4 in group A and 98.2±3.2 in group B. The time to union was significantly different between groups A and B (p=0.01).There were no complications. Conclusion: We suggest that the plate is more effective method for the shorter union time in surgical treatment of fifth metatarsal base fractures.


2014 ◽  
Vol 42 (4) ◽  
Author(s):  
Maria Angelica Zoppi ◽  
Ambra Iuculano ◽  
Giovanni Monni

AbstractWe investigated the umbilical vein volume flow (UVVF) at 11–14 weeks in monochorionic-diamniotic (MCDA) twins, focusing on the occurrence of complications. We considered 87 MCDA pregnancies. We used “E-flow” to detect the umbilical vein and measured the mean velocities and diameters of veins, also calculating the UVVF. Pregnancies were divided into four groups: a (twin-to-twin transfusion, TTTS); b (selective intrauterine growth restriction, sIUGR); c (discordance of fluid, DF); and d (with “normal” outcome). The main outcome of the study was the assessment of the difference of UVVF between twin 1 and twin 2 (larger and smaller twin). In eight of eight pairs of group a and seven of seven pairs of group b, the UVVF of fetuses 1 were significantly different than fetuses 2 (P<0.05). The UVVFs of fetuses 2 of group a were significantly lower in respect to the UVVFs of fetuses 2 of group d (P<0.05). We provide evidence of an important difference in UVVF in pairs that successively developed TTTS or sIUGR. The smaller fetuses of group a (TTTS) showed a lower venous return than fetuses 2 of group d (normal). First-trimester UVVF is lower in fetuses with a smaller crown-rump length in twin pairs at risk of TTTS or IUGR.


Author(s):  
Sakar Abdulkarim Nidhamalddin

To compare the effects of using motorized diamond burr polisher in pterygium excision versus manual polishing of the corneoscleral bed in reducing the recurrent rate. A prospective, comparative and interventional study of 90 consecutive patients with different grads of primary pterygium, who underwent pterygium excision at Shahid Aso teaching eye hospital in Sulaimani city, between August 2018 till September 2019, which was performed by single surgeon. In group A (45) eyes polishing of the corneoscleral bed done using motorized diamond polishing burr, and in group B (45) eyes using manual crescent blade for polishing. Recurrent rate was evaluated after about (8±2) months postoperatively. Ethical consideration of the risks and the benefits of the procedure was observed for each individual patient. A 90 patients with the mean age of group A (48.84±12.7) years and group B (49.67±12.3) years, complained of different grads of primary pterygium, group A had 31(68.9%) male and 14(31.1%) female, while group B had 22(48.9%) male and 23(51.1%) female. Each individual factors like age, gender, visual acuity, BCVA pre and postoperatively, IOP measurement, dryness of the eye and risk factors like smoking and UV exposure affecting the recurrence were assessed. In both groups the main indication for surgery was sign of irritation. The mean surgical time was calculated and the difference between two groups were significant. After follow-up of average six months the outcomes and recurrent rate were checked, recurrent rate was in group A 1(2.2%) while in group B was 6(13.3%) patients. it significantly decreased. Corneal scar happens in only 1(2.2%) case of group A while in 11(24.4%) cases in group B, Corneal scar was statistically significant. In both groups the change of BCVA was significant but the visual change was more significant in group A in compare to group B. Motorized diamond burr is a safe instrument for polishing the cornea during pterygium excision, it is easy to handle, low price, need lesser operative time, its effect on recurrence postoperatively is significant and beside it leaves lesser corneal scar and early visual recovery postoperatively.   


2018 ◽  
Vol 5 (5) ◽  
pp. 1668
Author(s):  
Binni John ◽  
Rajith Kishore K. K. ◽  
Vipinchandran C.

Background: Surgical site infections (SSI’s)are the major risk factors of postoperative morbidity and mortality. The incidence of these SSI’scan be minimized by taking prophylactic measures such as using effective preoperative antiseptics such as chlorhexidine (CHG) or povidone-iodine (PVI). The aim of the present study was to compare the efficacy of 2.5% chlorhexidine-alcohol with that of 10% povidone iodine for preventing SSI’sin clean contaminated elective surgeries.Methods: This prospective study included 100 patients who were undergoing for clean contaminated elective surgeries at Government Medical College, Kottayam from April 2014 to September 2015. Group A included 50 patients in which 2.5% chlorhexidine alcohol (chlorhexidine 2.5% in 70% ethanol) was used for preoperative skin cleansing and Group B included 50 patients in which 10%povidone-iodine aqueous was used. Incidence of SSI’s in terms of efficacy was compared between the groups.Results: Female preponderance was seen in both the groups, but the difference was not significant statistically. The SSI’swere seen in 5 patients in group A and in 12 patients in group B and this difference was found statistically significant (p=0.0084).Out of 5, in group A, 3 sites were culture positive showing the presence of S. aureus culture in 1 case and E. coli in 2 cases and in group B, out of 12, 6 sites were culture positive consisting of S. aureus and E. coli in 3 cases each.Conclusions: Chlorhexidine (2.5%) significantly reduced the risk of postoperative SSIs and colonization of bacteria in elective surgeries when compared to 10% povidone iodine.


2015 ◽  
Vol 22 (10) ◽  
pp. 1298-1303
Author(s):  
Tayyaba Majeed ◽  
Rabia Adnan ◽  
Irum Mubshar ◽  
Hamis Mahmood ◽  
Kanwal Saba ◽  
...  

Objectives: To compare the efficacy of Metformin with insulin in gestationaldiabetes mellitus in terms of fetomaternal outcome. Study Deign: Randomized clinicaltrial study. Setting: Lady Aitchison Hospital Lahore. Period: January 2014 to March 2015.Methodology: Total 500 pregnant females with GDM were included in the study through nonprobability,consecutive sampling. Patients were divided into 2 equal groups (A: B). Patientsin group A were given tablet metformin 500 mg by oral route and group B was administratedregular injection Insulin by subcutaneous route. Results: The mean age of females was32.14±6.13 years. The mean gestational age was 31.07±3.8 weeks. There were 78 (15.6%)females who had 0 parity, 107 (21.4%) females had parity 1, 175 (35%) females had parity2, 95 (19%) females had parity 3, 33 (6.6%) females had parity 4 and 12 (2.4%) femaleshad parity 5.There were 54 (10.8%) cases had PTB, out of which 12 (4.8%) had PTB withmetformin while 42 (16.8%) had PTB with insulin. There were 115 (23%) neonates requiredNICU admission, out of which 37 (14.8%) neonates with metforminand78 (31.2%) neonateswith insulin. There were 87 (17%) neonates who had neonatal hypoglycemia, out of which23 (9.2%) neonates with metformin and64 (25.6%) neonates with insulin. The difference wassignificant between both groups for all fetal outcomes (P<0.05). Conclusion: The metforminis more effective in preventing adverse fetal and maternal outcome as compared to insulin.


2016 ◽  
Vol 44 (1) ◽  
pp. 8-10
Author(s):  
Hosna Ara Perven ◽  
Abu Sadat Mohammad Nurunnabi ◽  
Dilruba Siddiqua ◽  
Fatema Johora ◽  
Halima Afroz ◽  
...  

This cross sectional, descriptive study was done in the Department of Anatomy, Dhaka Medical College, Dhaka from January to December 2009, to determine the proportion of cortex and medulla of the ovary in di_erent age group of Bangladeshi women. This study was based on collection of 140 ovaries of 70 unclaimed female dead bodies from the morgue of Dhaka Medical College, Dhaka. The samples were divided into three age-groups including A (10-13 years), B (14-45 years) & C (46-52 years). Histological slides were prepared by using routine haematoxylin and eosin stain. Ten best prepared histological slides from each age group were examined to determine the thickness of the cortex and medulla & proportion of the thickness of the cortex and the medulla of the ovary were expressed in percentages. The mean proportion of the cortex and the medulla of the right ovary were found 80.83±0.58% and 19.17±0.58% in group A, 86.95±1.14% and 13.05±1.14% in group B, 70.53±1.53% and 29.47±1.53% in group C respectively. The mean proportion of the cortex and the medulla of the left ovary were found 80.63±0.58% and 19.37±0.58% in group A, 86.78±1.14% and 13.22±1.14% in group B, 70.41±1.50% and 29.59±1.50% in group C respectively. The difference in mean proportion of the cortex and the medulla was not signi_cant in between the ovaries. However, the difference in mean proportion of the cortex and the medulla of the ovary between group A & group B, group A & group C and group B & group C were statistically significant.Bangladesh Med J. 2015 Jan; 44 (1): 8-10


2021 ◽  
Vol 12 (3) ◽  
pp. 217-221
Author(s):  
Nasim Ilyas ◽  
Fouzia Hanif ◽  
Rajesh Kumar Panjwani ◽  
Sheikh Kashif Rahim ◽  
Asma Abdul Qadeer ◽  
...  

BACKGROUND & OBJECTIVE: De Quervain's tenosynovitis is tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons, occurs due to chronic overuse of the wrist and hand. To compare effectiveness of steroid injection with conservative management of De Quervains’s tenosynovitis. METHODOLOGY: Randomized prospective study was conducted at the various private orthopedic clinic across Rawalpindi district, along with collaboration of community medicine department, Rawal Institute of health sciences, Islamabad. The study population was divided into two groups, i.e., group A and group B. Group A was given inj. corticosteroid and group B was given conservative management. The severity of pain (Visual analogue scale) and Finkelstein test were recorded on baseline and after 3 weeks follow up. RESULTS: Our study included 96 diagnosed cases of de Quervains tenosynovitis on a positive Finkelstein test; 48 were given corticosteroid injection and 48 were conservatively treated. The mean age in corticosteroid’s injection group was 34.76+6.95 years whereas the mean age in conservative management group was 31.7+8.91 years. Post-intervention 13, 29 patients had a positive Finkelstein test in corticosteroid and conservative groups respectively. Although the difference in pre intervention pain score between the two groups was not statistically significant but significantly lesser pain scores in the corticosteroid group; (p= 0.00). CONCLUSION: Steroid injection produced better results in terms of relief in pain and negative Finkelstein test as compared to conservative treatment.


1970 ◽  
Vol 9 (1) ◽  
pp. 44-48
Author(s):  
ASM Nurunnabi ◽  
A Alim ◽  
M Sabiha ◽  
B Manowara ◽  
K Monira ◽  
...  

Context: A cross-sectional study was designed to find out the difference in weight of the thyroid gland of Bangladeshi people in relation to age and sex and to compare with previous local and foreign studies. Materials & Methods: The present study was performed on 60 post mortem human thyroid gland (39 of male and 21 of female) collected from unclaimed dead bodies which were in the morgue under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age-groups including Group A (10-20 years), Group B (21-50 years) & Group C (>50 years) and the weight of the thyroid glands were measured and recorded. Results: The mean weight of the thyroid gland in male was 15.14 gm, 19.20 gm and 14.64 gm and in female was 16.02 gm, 19.03 gm and 14.67 gm in group A, B and C respectively. The mean weight of the thyroid gland was 15.48 gm in group A, 19.15 gm in group B and 14.65 gm in group C. There was no difference in mean weight of the thyroid gland between male and female. The difference in mean weight of the thyroid gland between group A & group B and group B & group C were found statistically significant. The weight of the gland was found to increase from early childhood and puberty up to 50 years of age and then decrease. Key words: Thyroid gland; Weight of thyroid gland. DOI: 10.3329/bjms.v9i1.5230 Bangladesh Journal of Medical Science Vol.09 No.1 Jan 2010 44-48


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