scholarly journals Small intestine anastomosis by full thickness, single layer and interrupted suture technique: results of a comparative study

2019 ◽  
Vol 6 (3) ◽  
pp. 675
Author(s):  
Shobhit K. Nemma ◽  
Sarbjeet Singh ◽  
Amritpal Singh Rana ◽  
Rohit Kapoor ◽  
Puneet Bansal
Keyword(s):  
Small Intestine ◽  
Double Layer ◽  
Single Layer ◽  
Stoma Closure ◽  
Full Thickness ◽  
Layer Technique ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Background: Since the dawn of surgery intestinal anastomosis has remained a controversial topic in respect to suture material, anastomotic technique, distance between stitches and borders. Technique of anastomosis is an important determinant in process of anastomosis healing. Despite a large amount of work done on anastomosis techniques, a clear superiority of one technique over another has not been established.Methods: Patients of ileostomy reporting to surgery department for stoma closure were used for study. 80 patients of ileostomy reporting for stoma closure were used as material for the study and randomized in two groups. In single layer group, using 3-0 silk suture, we performed small intestine anastomosis applying single layer of interrupted sutures taking full thickness bite. In double layer group, anastomosis was performed anastomosis by applying first layer of full thickness sutures and second layer of seromuscular sutures. The results were compared in terms of operative time, post operative complications, mortality, hospital stay and cost of the suture material.Results: The mean age of the patients was 33.55 yr in group A (single layer) and 35.85 yr in group B (double layer). Total 7 patients developed anastomotic leak. 5 (12.5%) patients were with double layer anastomosis and 2 (5%) patients were in single layer group. The difference in anastomosis leak in two groups was statistically insignificant (p = 0.232). The mean duration of whole procedure in group A (single layer) was 52.5min and 71.5min in group B (double layer). The difference in mean duration of the procedure was found to statistically significant (P = 0.00).Conclusions: We concluded the single layer technique to be a safe, efficient and more cost effective as compared to double layer technique.

scholarly journals Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study

2021 ◽  
Vol 17 (2) ◽  
pp. 95-99
Author(s):  
Layth Saleh Owaid ◽  
Imad Wajeeh Al-Shahwani ◽  
Zuhair B. Kamal ◽  
Laith Naif Hindosh ◽  
Abbas Farman Abdulrahman ◽  
...  
Keyword(s):  
Double Layer ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Anastomosis Group ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Cost ◽  
Mean Time

Background: The main objective was to compare the outcome of single layer interrupted extra-mucosal sutures with that of double layer suturing in the closure of colostomies. Subjects and Methods: Sixty-seven patients with closure colostomy were assigned in a prospective randomized fashion into either single layer extra-mucosal anastomosis (Group A) or double layer anastomosis (Group B). Primary outcome measures included mean time taken for anastomosis, immediate postoperative complications, and mean duration of hospital stay. Secondary outcome measures assessed the postoperative return of bowel function, and the overall mean cost. Chi-square test and student t-test did the statistical analysis.. Results:  Thirty-two patients were allocated to group A and 35 patients to group B. The mean time taken for anastomosis was significantly shorter in group A (23.25 ± 1.20 min in group A vs. 36.71 ± 1.93 min in group B; P<0.001). A significant shorter duration of hospital stay was seen in group A (7.00 ± 1.778 days in group A vs. 9.74 ± 1.990 days in group B; P<0.001). The detection of bowel sound was substantially quicker in group A as compared to group B (4.56 ± 0.50 days in group A vs. 6.46±0.50 days in group B; P<0.001). There was no significant discrepancy between the two groups regarding anastomotic leak rates (P= 0.543). The mean cost of double layer intestinal anastomosis method was significantly higher than that of single layer anastomosis (P<0.001). Conclusions: The use of single layer extra-mucosal anastomosis of the intestine has the advantage of taking less time, less morbidity and cost-effective to perform with the same rate of anastomotic leak in the closure of colostomy.

scholarly journals A comparative study of single layer extra mucosal versus conventional double layer anastomosis of intestines in elective and emergency laparotomy

2019 ◽  
Vol 7 (1) ◽  
pp. 184
Author(s):  
K. Lohit Sai ◽  
C. Sugumar
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Anastomotic Leak ◽  
Double Layer ◽  
Single Layer ◽  
Duration Of Hospital Stay ◽  
Key Skills ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Gastrointestinal anastomosis has been a part of research since decades and is one of the key skills in surgeon’s armamentarium. This study compared the outcome of single layer anastomosis with double layer anastomosis.Methods: The study was designed as a prospective comparative study and 29 cases were included in the study during December 2016 to September 2017, who consented for being part of the study. Patients were alternatively allotted into the either group. Group A underwent single layer anastomosis and Group B underwent double layer anastomosis. Outcome parameters were analysed in the form of ‘duration required to perform anastomoses, ‘duration of hospital stay’ and ‘dnastomotic leak.Results: Mean duration required to perform anastomosis in Group A is 21.64±1.60 minutes and in Group B is 29.6±2.02 minutes. The difference between the mean duration required for anastomosis between the two groups were statistically significant (p<0.005). Mean duration of hospital stay in Group A was 12.35±1.72 days and Group B was 12±2.44 days (difference was statistically insignificant), 3 (10%) cases in Group A and 2 (6.8 %) cases in Group B developed anastomotic leak and the difference was statistically insignificant.Conclusions: Our study concluded that there is statistically significant difference between the single layer anastomosis and double layer anastomosis in terms of time taken to perform anastomosis, however there is no difference in postoperative anastomotic leak and duration of hospital stay.

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

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

scholarly journals Comparison of two different techniques of uterine closure in caesarean section: Continuous single layer technique versus Babu and Magon technique

2018 ◽  
Vol 7 (6) ◽  
pp. 2197
Author(s):  
S. Vinayachandran ◽  
Vedhapriya Sudhakar
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Single Layer ◽  
Adverse Outcomes ◽  
Caesarean Scar ◽  
Duration Of Surgery ◽  
Layer Technique ◽  
Observational Prospective Cohort Study ◽  
Group A ◽  
Group B

Background: To compare size of the caesarean scar and residual myometrial thickness (RMT) between continuous single non-interlocking and Babu and Magon technique for uterine closure following primary elective caesarean section (CS).Methods: An observational prospective cohort study was conducted at 6 weeks and 4 months postpartum following primary elective CS. Group A included 25 patients who underwent continuous single layer technique and Group B included 25 patients who underwent Babu and Magon technique for uterine closure. Baseline demographic profile, obstetric score, details of the CS and associated complications were studied. Two-dimensional Transvaginal ultrasonography (TVS) measurements of the length, width and depth of the caesarean scar and RMT were compared.Results: Mean age of study population was 29.6 years. Malpresentation (44%) was the most common indication for CS. Mean Bishops score at the time of CS was <4. The duration of surgery (-2.8 min, 37.96 ±5.660min) and estimated amount of blood loss (-51.6 ml, mean 671.20 ±136.208ml) was less in Group A compared to Group B (40.76 ±4.68min, 722.80±132.083ml respectively). The caesarean scar measurements were similar in both groups at both visits. The mean RMT in Group B at 6 weeks and 4 months postpartum (8.05mm±2.06 and 7.10mm±2.04 respectively) was statistically higher than Group A (6.23mm ± 1.76 and 5.36mm ± 1.70 respectively), p=0.002.Conclusions: We conclude that Babu and Magon technique for uterine closure in caesarean section could result in better healing of the scar and probably reduce the adverse outcomes in subsequent pregnancies.

scholarly journals Which Surgical Method is More Effective in the Fifth Metatarsal Base Fracture?

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Jun-Beom Kim ◽  
Chi Ahn ◽  
Byeong-Seop Park
Keyword(s):  
Clinical Results ◽  
Plate Group ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
Clinical And Radiological Results ◽  
Mean Time ◽  
Screw Group

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.

Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks

2014 ◽  
Vol 42 (4) ◽  
Author(s):  
Maria Angelica Zoppi ◽  
Ambra Iuculano ◽  
Giovanni Monni
Keyword(s):  
Umbilical Vein ◽  
First Trimester ◽  
Volume Flow ◽  
Crown Rump Length ◽  
Normal Outcome ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
Group D

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.

scholarly journals The Role of Using Motorized Diamond Burr Polisher Instrument in Minimizing the Recurrent Rate of Pterygium Excision

2020 ◽  
pp. 129-136
Author(s):  
Sakar Abdulkarim Nidhamalddin
Keyword(s):  
Diamond Polishing ◽  
Corneal Scar ◽  
Group A ◽  
Iop Measurement ◽  
The Mean ◽  
Diamond Burr ◽  
Pterygium Excision ◽  
The Difference ◽  
Group B ◽  
Primary Pterygium

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.   

scholarly journals GESTATIONAL DIABETES

2015 ◽  
Vol 22 (10) ◽  
pp. 1298-1303
Author(s):  
Tayyaba Majeed ◽  
Rabia Adnan ◽  
Irum Mubshar ◽  
Hamis Mahmood ◽  
Kanwal Saba ◽  
...  
Keyword(s):  
Oral Route ◽  
Outcome Study ◽  
Neonatal Hypoglycemia ◽  
Consecutive Sampling ◽  
Pregnant Females ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
Study Setting

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.

scholarly journals Study of clinical outcome of patients undergoing intestinal anastomoses with single layer extramucosal technique and double layer anastomoses

2021 ◽  
Author(s):  
Arvind Rai ◽  
Sukantth R. J.
Keyword(s):  
Anastomotic Leak ◽  
Double Layer ◽  
Statistical Tests ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Layer Versus ◽  
Intestinal Anastomoses ◽  
Significant Difference ◽  
Group A ◽  
Group B

 Background: Intestinal anastomosis is one of the common surgeries for cases like bowel obstruction, incarcerated hernias, benign and malignant tumours of small and large bowel. The ideal intestinal anastomosis does not leak and allow normal function of the gastrointestinal tract. This study compared single layer versus double layer  intestinal anastomosis in terms of duration, postoperative complications like anastomotic leak.Methods: A total of 100 patients admitted in Hamidia hospital, based on history and clinical examinations and radiological examinations, placed in two groups, group A (single layer anastomosis) and group B (double layer anastomosis) and were operated by a qualified surgical specialist. Data analysis of anastomotic time, anastomotic leak was done and statistical tests of significance were applied. A p value less than 0.05 is considered as significant.Results: In group A (single layer) the time required to perform in 30 (60%) patients is between 16-20 minutes. In double layer, maximum were done in between 26 to 30 minutes, 32 (64%). In our study of 100 patients, there were 6 anastomotic leaks, of which four of them were in group A (single layer) and 2 of them in group B (double layer).Conclusions: In our study, the duration required to perform a single layer intestinal anastomosis is significantly lesser when compared to double layer. There is no significant difference in anastomotic leak between two groups. Less time with no difference in complications, a move towards single layer anastomosis should be preferred.

scholarly journals Histological study of proportion of cortex and medulla of the ovary in Bangladeshi women

2016 ◽  
Vol 44 (1) ◽  
pp. 8-10
Author(s):  
Hosna Ara Perven ◽  
Abu Sadat Mohammad Nurunnabi ◽  
Dilruba Siddiqua ◽  
Fatema Johora ◽  
Halima Afroz ◽  
...  
Keyword(s):  
Histological Study ◽  
Age Groups ◽  
Age Group ◽  
Cross Sectional ◽  
Medical College ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
The Right

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

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