scholarly journals Tamsulosin versus tadalafil as medical expulsive therapy of distal ureteric stones: a comparative study

2019 ◽  
Vol 6 (3) ◽  
pp. 982
Author(s):  
Chirag Parikh ◽  
Vipul Gurjar ◽  
Sneh Shah
Keyword(s):  
Comparative Study ◽  
Tertiary Care ◽  
Care Hospital ◽  
Analgesic Requirement ◽  
Medical Expulsive Therapy ◽  
Significance Levels ◽  
Colicky Pain ◽  
The Difference ◽  
Primary Focus ◽  
Distal Ureteric Stones

Background: The management of patients with ureteral calculi has changed dramatically in the current era, with the conservative approach being the primary focus, its main benefit being minimum patient morbidity. The use of the expectant approach for distal ureteric stones can be extended with the use of adjuvant medical expulsive therapy (MET), which is able to reduce symptoms and facilitate stone expulsion. The present study was thus conducted to determine single best monotherapy for medical expulsive therapy of distal ureteric stones by comparing Tadalafil and Tamsulosin.Methods: A hospital based comparative study was conducted at Department of Surgery of a tertiary care hospital. A total of 60 eligible cases of lower uretric calculus were included in the study. These 60 patients were then divided into 2 groups of 30 each to receive one of the two medical therapy i.e. Tadalafil and Tamsulosin.Results: Mean expulsion of calculi was significantly earlier in patients managed by tadalafil as compared to tamsulosin (13.1 vs 16.92 days; p<0.05). Complete expulsion was seen in 86.7% cases on tadalafil as compared to only 63.3% cases on tamsulosin (p<0.05). Mean analgesic use (2.69 vs 1.81; p<0.05) and episodes of colicy pain (1.41 vs 0.43; p<0.05) were significantly higher in patients managed by tamsulosin. The number of hospital visits required during treatment was also more with tamsulosin, but the difference did not reach significance levels (2.56 vs 2.02 days; p=0.06). No difference was seen in the adverse effect profile of both drugs.Conclusions: Tadalafil also provides early stone expulsion, a greater decrease in colicky pain episodes, and a greater decrease in analgesic requirement. Both drugs are safe, effective, and well tolerated with minor side effects. Thus tadalafil is safe, efficacious, and well tolerated as medical expulsive therapy for distal ureteric stones.

scholarly journals Comparative study of Mirs’(Mushtaq and Shabir) technique of prepuce preserving minimally invasive urethroplasty with Snodgrass urethroplasty for repair of distal hypospadias without chordee…A prospective study

2015 ◽  
Vol 48 (01) ◽  
pp. 048-053
Author(s):  
Mushtaq Mir ◽  
Shabir Ahmad Mir ◽  
Muddassir Shahdhar ◽  
Mumtazdin Wani ◽  
Hakim Adil Moheen ◽  
...  
Keyword(s):  
Comparative Study ◽  
Tertiary Care ◽  
Care Hospital ◽  
Analgesic Requirement ◽  
Time Saving ◽  
Northern India ◽  
Significant Difference ◽  
Distal Hypospadias ◽  
Group 2 ◽  
Group 1

ABSTRACT Background: There is no single, universally applicable technique for hypospadias repair and numerous techniques have been practised from time to time. We compare the results of our new technique (Mirs’ technique also called Mush & Shab’s technique) to Snodgross urethroplasty. Mirs’ technique is a modified version of Thiersch-Duplay urethroplasty. Material and Methods: This prospective comparative study was carried out in a tertiary care hospital of Northern India over a period of 3 years from March 2010 to March 2013 and included 120 patients of anterior (distal penile, subcoronal, coronal and glanular) hypospadias without chordee. They underwent either Mirs’ technique (group 1 n = 60) or Snodgrass technique (group 2 n = 60). Follow-up was at 1-week, 1-month, 3 months and 6 months. Results: The mean operative time was 55 min (range: 43-70 min) in group 1 and 71.9 min (range: 60-81 min) in group 2 (P & 0.001). Urethrocutaneous fistula developed in two and four patients in group 1 and 2, respectively. Fistula closure was done at least 3 months postoperatively, and there was no significant difference in success rate between the two groups. Three cases of glanular dehiscence were detected (one in group 1 and two in group 2); the patient from group 1 had a successful repair using the already preserved prepuce. Conclusion: Mirs’ modification of Thiersch-Duplay technique for distal hypospadias is a time saving procedure with a lower overall complication rate. Valuable local tissue is preserved to deal with any complication that may occur. Analgesic requirement was significantly lower in this minimally traumatic technique. As it is less time consuming, simple and easy to learn with a short learning curve, this technique deserves application in cases of distal hypospadias.

scholarly journals A prospective randomized comparative study of rapidly absorbing polyglactin 910 versus chromic catgut for episiotomy repair at tertiary care hospital Bikaner, Rajasthan

2021 ◽  
Vol 10 (9) ◽  
pp. 3445
Author(s):  
Priyanka Singh ◽  
Monica Soni ◽  
Neetu Verma
Keyword(s):  
Comparative Study ◽  
Tertiary Care ◽  
Chromic Catgut ◽  
Care Hospital ◽  
Dose Requirement ◽  
Polyglactin 910 ◽  
Medical College ◽  
Analgesic Dose ◽  
The Difference ◽  
Better Than

Background: The aim of our study was to compare rapidly absorbing polyglactin 910 with chromic catgut as a suture material for episiotomy repair, in relation to post episiotomy complications and maternal morbidity.Methods: This prospective, randomized, comparative study of rapidly absorbing polyglactin 910 versus chromic catgut for episiotomy repair was conducted in the department of obstetrics and gynaecology, PBM hospital, associated with Sardar Patel medical college Bikaner, Rajasthan.Results: RAPG-910 was associated with significantly lesser analgesic dose requirement for pain relief than chromic catgut. Use of chromic catgut was associated with a higher incidence of hematoma formation, wound gaping, need of re-suturing of wound and need of re-admissions for management of post-episiotomy complications than RAPG-910 although, the difference was statistically insignificant. RAPG-910 was associated with better wound condition & healing as compared to chromic catgut.Conclusions:To conclude, rapidly absorbing polyglactin 910 was better than chromic catgut in relation to post episiotomy complications and maternal morbidity with a significantly lesser incidence and severity of post episiotomy pain, lesser dose of analgesia required, lesser wound gaping and infection, better wound healing, faster suture reabsorption.  

A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (41) ◽  
pp. 3559-3566
Author(s):  
Abdul Salam R. T. ◽  
Shahul Hameed A. ◽  
Meera Rajan
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Tertiary Care ◽  
Operation Time ◽  
Care Hospital ◽  
Adenoid Tissue ◽  
Significant Difference ◽  
Tube Function ◽  
Prospective Comparative Study ◽  
The Mean

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

scholarly journals Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin

2014 ◽  
Vol 86 (2) ◽  
pp. 103 ◽  
Author(s):  
Vittorio Imperatore ◽  
Ferdinando Fusco ◽  
Massimiliano Creta ◽  
Sergio Di Meo ◽  
Roberto Buonopane ◽  
...  
Keyword(s):  
Side Effects ◽  
Lower Incidence ◽  
Retrograde Ejaculation ◽  
Inclusion Criteria ◽  
Expulsion Rate ◽  
Analgesic Requirement ◽  
Medical Expulsive Therapy ◽  
Peripheral Vasodilation ◽  
The Mean ◽  
Distal Ureteric Stones

Objectives: To compare the efficacy and safety of tamsulosin and silodosin in the context of medical expulsive therapy (MET) of distal ureteric stones. Patients and methods: Observational data were collected retrospectively from patients who received silodosin (N = 50) or tamsulosin (N = 50) as MET from January 2012 to January 2013. Inclusion criteria were: patients aged ≥ 18 years with a single, unilateral, symptomatic, radiopaque ureteric stone of 10 mm or smaller in the largest dimension located between the lower border of the sacroiliac joint and the vesico-ureteric junction. Stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use, incidence of side effects were compared. Results: Stone-expulsion rate in the silodosin and in the tamsulosin groups were 88% and 82%, respectively (p not significant). Mean expulsion times were 6.7 and 6.5 days in the silodosin and tamsulosin group, respectively (p not significant). Mean number of pain episodes were 1.6 and 1.7 in the silodosin and tamsulosin group, respectively (p not significant). The mean number of analgesic requirement was 0.84 and 0.9 for the silodosin and tamsulosin group, respectively (p not significant). Overall, incidence of side effects was similar in both groups. Patients taking silodosin experienced an higher incidence of retrograde ejaculation but a lower incidence of side effects related to peripheral vasodilation when compared to patients taking tamsulosin. Subgroup analysis demonstrated significantly lower mean expulsion times and pain episodes in patients with stones ≤ 5 mm in both groups. Conclusions: Tamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associatd with a lower incidence of side effects related to peripheral vasodilation but an higher incidence of retrograde ejaculation when compared to tamsulosin.

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