scholarly journals Is it safe to incise skin by monopolar electrocautery? A comparative study

2019 ◽  
Vol 6 (6) ◽  
pp. 1931
Author(s):  
Nimesh B. Thakkar ◽  
Pranav Patel ◽  
Gautam Sonagra
Keyword(s):  
Skin Incision ◽  
Healing Time ◽  
Skin Wound ◽  
Cosmetic Result ◽  
Advantages And Disadvantages ◽  
Study Results ◽  
Group A ◽  
Selection For ◽  
Group B ◽  
Monopolar Electrocautery

Background: The present study of evaluation of the use of electrocautery to incise the skin has been done to evaluate and assess basically. The advantages and disadvantages of the electrocautery to incise the skin when compared with that of scalpel. The results of the use of electrocautery on skin wound are then assessed to formulate the criteria for proper case selection for this procedure.Methods: A total of 100 patients were taken for this study. 50 patients underwent electrocautry monopolar mode incision (group A) who were compared with 50 scalpel incision patients (group B). Study was done from 01 January 2016 to 30 September 2017. Variables used in this study were complication like pain, lack of apposition and skin infection at the site of incision, pain, sinus formation and induration. This method was also evaluated with respect to following parameters: days of hospitalization, cosmetic result, rate of infection, wound apposition and requirement of secondary suturing.Results: As per our study, results are in favour of electrocautry by means of hemostasis. But we found that infection rate and complications are more with it. Moreover number of dressings required and hospital stay was also more with patient undergoing skin incision with electrocautry.Conclusions: For locally overlying healthy skin with no compromise of vascularity or any oedema and there is less fat, electrocautery use for skin incision can still be recommended for better cosmetic result and shorter healing time with less complication and rapid surgery.

scholarly journals Role of Intravenous Paracetamol as Pre-Emptive Analgesic for Laparoscopic Cholecystectomy

2019 ◽  
Vol 10 (2) ◽  
pp. 159-163
Author(s):  
Sultan Reza ◽  
Ibrahim Khalilullah ◽  
Tamanna Habib ◽  
Jayed Hossain Chowdhury ◽  
Tarikul Hasan ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Skin Incision ◽  
High Rate ◽  
Analgesic Requirement ◽  
Medical College ◽  
Intravenous Paracetamol ◽  
Study Results ◽  
Group A ◽  
Group B ◽  
High Level

Background: Despite the high level of awareness about the importance of post-operative pain management, lot of investigations and study results show an unacceptable high rate of incidence of pain after surgery. Pre- emptive pain control is regional or systemic analgesics, applied before starting the surgical procedure. The effect is achieved by suppressing, central or peripheral nociceptors, either together or separately by sensitization. We studied the effect of intravenous Paracetamol as pre-emptive analgesic in patients undergoing laparoscopic cholecystectomy. Method: A total number of 60 adult patient with ASA physical status I & II scheduled for Laparoscopic cholecystectomy under general anaesthesia were randomly enrolled in this study. Patients were randomly allocacated equally into two groups A and B according to computerized random table, 30 in each group. Patients of Group A (n=30) received I.V Paracetamol 10mg/kg(100ml) 10 min before skin incision and Group B (n=30) received 100 ml of Normal saline 10 min before skin incision. It was a single blind, randomized, prospective, case-control study. Observation and management of pain, nausea, vomiting, respiratory depression, allergic reaction, amount of opioid requirement and time of analgesic demand after operation were carried out in data collection sheet. Result: The total dose of postoperative opioid needed in Group-A was significantly lower than that in the Group- B(p=0.012). The pain scores were comparatively low in case of group-A than that in Group-B from beginning to 24 hours of evaluation following operation(p=0.027). About one-third (32%) of the patient in each group experienced nausea at 1 hour interval post operatively. However, the complaint of nausea at 6 and 12 hours was much less in the Group-A than that in the Group-B. Vomiting was negligible in either group. Majority (80%) of patient in Group-B demanded analgesic (pethedine) 10 minutes earlier after operation as opposed to only 8% of patients in Group-A (p<0.001). No other side effects were recorded in either of the groups. Conclusion: Our findings indicate that pre-emptive administration of iv Paracetamol (10mg/kg) in patients undergoing Laparoscopic Cholecystectomy ensures an effective postoperative analgesia, increases the time to first analgesic requirement and reduces opioid consumption. Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 159-163

scholarly journals Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 21-24
Author(s):  
Md Abdus Salam ◽  
Md Mahbub Alam ◽  
Rezwan Ahmed ◽  
Md Sultan Mahmud
Keyword(s):  
Postoperative Pain ◽  
Postoperative Bleeding ◽  
Throat Pain ◽  
Medical College ◽  
Advantages And Disadvantages ◽  
Case Surgery ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Dissection Method

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24

scholarly journals Endoscopic 3-S Technique Tympanoplasty: Taking the Convention a Step Ahead

2019 ◽  
Vol 27 (3) ◽  
pp. 179-185
Author(s):  
Mridul Janweja ◽  
Sayan Hazra ◽  
Arindam Das ◽  
Arya Brata Dubey
Keyword(s):  
Endoscopic Surgery ◽  
Routine Activity ◽  
Middle Ear Surgery ◽  
Graft Material ◽  
Operating Microscope ◽  
Advantages And Disadvantages ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Introduction Endoscopic Surgery has immense potential for middle ear surgery and is currently favoured by many surgeons. The 3 (vascular) Strips/ 3 Flap Tympanoplasty with operating microscope is popular but Endoscopic 3-Flap Tympanoplasty remains less explored. Hence this study was conducted to compare advantages and disadvantages of Endoscopic and Microscopic 3-Flap Tympanoplasty. Materials and Methods Forty two patients with large/subtotal perforation of tympanic membrane were divided into two equal groups (Group A & B). Endoscope was used in Group A, whereas, operating microscope in Group B. Temporalis fascia was the graft material in all patients. Patients were followed up for six months. Pre and post-operative audiograms, post-operative pain, graft uptake, time taken for surgery and intra-operative visualization convenience were compared. Results Mean Air-Bone Gap closure at the end of six months was 9.23 dB (SD-0.88 dB) in the endoscope group and 8.95 dB (SD-0.66 dB) in microscope group whereas the graft uptake rate was 95.2% and 90.2% respectively. Post-operative pain, cosmesis, ease of doing surgery and time taken for surgery were better in ‘Endoscope’ as compared to ‘Microscope’ group. Conclusion The three flaps produce adequate exposure in very large or subtotal perforations, very thin anterior rim or with anterior bony overhang. Results in terms of mean hearing gain and graft uptake were comparable. In terms of morbidity (post-op pain), recovery (return to routine activity), mean duration of surgery and cosmesis, endoscopic surgery produced better outcome.

scholarly journals Comparison of outcome of two plate fixation with one plate fixation along with arch bar in management of parasymphysis; A Randomized Control Trial.

2020 ◽  
Vol 27 (09) ◽  
pp. 2007-2013
Author(s):  
Mohammad Umar ◽  
Jawad Ahmad Kundi ◽  
Muhammad Sulaiman ◽  
Muhammad Zaib Khan ◽  
Ali Altaf
Keyword(s):  
Plate Fixation ◽  
Maxillofacial Surgery ◽  
Treatment Protocol ◽  
Advantages And Disadvantages ◽  
Arch Bar ◽  
Group A ◽  
Group B ◽  
Inferior Border ◽  
Two Miniplates

Objectives: The aim of this study is to compare two plate fixation and one plate along with arch bar in the treatment of parasymphsis, and to analyze the advantages and disadvantages over one another. Study Design: Randomized Clinical Trial. Setting: Department of Oral and Maxillofacial Surgery Sardar Begam Dental College and Northwest General Hospital Peshawar. Period: Over a period of one year from June 2017 to August 2018. Material & Methods: 60 patients with parasymphysis fracture after diagnosis established on clinical and radiological examination were equally divided into two groups, 30 patients in each. Group (A) were treated with two miniplates, while Group (B) one miniplate along with arch  bar under general anesthesia with proper antibiotics coverage in the pre- and post-operative period. Results: The infection rate 4 (13.3%) patients in Group B while 0 in Group A. No Loosening /fracture of screw or plate occur in any subject in group A at any follow up visit, while it occurred in 4 subjects in group B at 15 days follow up period. 9 patients in Group A and 6 in Group B presented with immediate post of paresthesia, which was reduced to 7 patients in group A and 6 in group B at 15 days follow up, and to 4 patients in Group A and 5 in Group B at 1 month follow up. Similarly, no subject had inferior border misalignment in group A at any follow up period while 3 subjects have immediate post -op inferior border discrepancy in group B and 6 subjects in the same group shows inferior border discrepancy at 15 days , but the overall result of this variable was also statistically non-significant. Conclusion: Isolated mandibular parasymphysis fracture can be treated with either two miniplates or one miniplate along with arch bar for 6 weeks. Both treatment protocol shows advantages and disadvantages with the aim of achieving the best treatment outcome for the patients.

scholarly journals Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Abdominal Surgery ◽  
Wound Infection ◽  
Skin Incision ◽  
P Value ◽  
Wound Area ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

scholarly journals WOUND DEHISCENCE;

2018 ◽  
Vol 25 (08) ◽  
pp. 1143-1146
Author(s):  
Ammrah Tahir ◽  
Muhammad Sajid Hameed Ansari ◽  
Abdul Waheed Khan
Keyword(s):  
Controlled Trial ◽  
Wound Dehiscence ◽  
Midline Laparotomy ◽  
Mass Closure ◽  
Generalized Peritonitis ◽  
Study Results ◽  
Group A ◽  
Continuous Mass ◽  
Group B ◽  
Laparotomy Incision

Objectives: To compare the continuous and interrupted closure in term offrequency of wound dehiscence in emergency midline laparotomy incision. Study Design:Randomized controlled trial. Setting: Surgical Unit-I, Allied Hospital Faisalabad. Period: From15th March 2014 to 15th November 2014. Material and Methods: Two hundred patients werediagnosed clinically by taking thorough history and examinations were included. Fascial layerof wound of the patients sampled for group A was closed with interrupted mass closure withprolene no.1 whereas in group B was closed by continuous mass closure with prolene no1. All included patients were kept nothing by mouth. Resuscitation was done with, ringerslactate and blood transfusion if needed until adequate urine output (0.5 ml/kg/hr). Base lineinvestigations were done. After resuscitation and giving preoperative antibiotics, patients wereexplored through mid-line incision. Obvious source of contamination was dealt with accordingly.Variables wound were examined daily for any sign of dehiscence. Temperature pulse wasmeasured daily along with surgical site examination for any kind of discharge, stitches cutthrough and gut visibility through wound. In case of no complication patient was discharged ontenth postoperative day, which was the end point of study. Results: There were 61 (61%) malesand 39 (39%) females in group A, while in group B, 63 (63%) males and 37 (37%) females withmean ages of patients were 39.77+10.16 and 38.61+9.75 respectively. The wound dehiscencewere found 7 (7%) in Group-A and 18(18%) in Group-B while remaining 93 (93%) in Group-Aand 82 (82%) in Group-B had no morbidity statistically (p<0.01). Conclusion: It is concludedthat wound dehiscence is significantly higher in continuous closure as compare to interruptedclosure for emergency midline laparotomy incision for generalized peritonitis.

PSXIV-22 Selection for low fecal egg count estimated breeding value correlates with greater circulating antibody in sheep

2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 494-494
Author(s):  
Desirae Smith ◽  
Kelsey Bentley ◽  
Scott A Bowdridge
Keyword(s):  
Intestinal Parasites ◽  
Breeding Value ◽  
Fecal Egg Count ◽  
Group A ◽  
Selection For ◽  
Estimated Breeding Values ◽  
Polypay Sheep ◽  
Group B ◽  
Circulating Antibody ◽  
Total Immunoglobulin

Abstract Sheep selected for resistance to gastro-intestinal parasites have been shown to have greater survivability to weaning. Data from Katahdin sheep indicates that selection based on post-weaning fecal egg count estimated breeding values (PWFEC EBV) may further improve generalized immunity. However, no data exists to confirm this increased circulating antibody occurs in breeds genetically unrelated to Katahdins. In the fall of 2020 post-weaning blood and fecal samples were collected from Shropshire sheep (n = 42) and Polypay sheep (n = 91). The blood samples were analyzed for total immunoglobulin-G (IgG) using ELISA. Shropshire sheep were sorted into low (PWFEC EBV &lt; 0) and high (PWFEC EBV &gt; 0) groups based on fecal egg count (FEC), which were analyzed via a modified McMaster’s method. Polypay sheep were sorted into three groups by PWEC EBV; A (&lt; -50) B (&gt;-50 &lt; +50) and C (&gt;+50). In Shropshire group, individuals with low FEC had greater average IgG concentration (87.9 µg/mL) than those with high FEC (62.4 µg/mL) (P &gt; 0.05). In the Polypay group, sheep in PWFEC EBV group A had numerically higher IgG concentration (86.2 µg/mL) than sheep in group B (71.2 µg/mL) and group C (53.1 µg/mL) (P &gt; 0.05). While data in either breed were not significant, the trend observed across breeds indicate that sheep with a lower PWFEC EBV have numerically greater circulating antibody.

scholarly journals Impact of the Surgical Approach: A Comparative Study between Transcanal and Posterior Tympanotomy Approach for Cochlear Implantation

2020 ◽  
Vol 3 (01) ◽  
pp. 10-15
Author(s):  
Neeraj Suri ◽  
Satya Sandilya ◽  
Ruta Sayani ◽  
Amit Anand
Keyword(s):  
Speech Intelligibility ◽  
Rating Scales ◽  
Advantages And Disadvantages ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Posterior Tympanotomy ◽  
Auditory Integration ◽  
Group B ◽  
Approach Group

Abstract Introduction The aim of our study is to compare the surgical complications of the transcanal and posterior tympanotomy approach and to evaluate the advantages and disadvantages of both techniques. Materials and Methods It is a prospective study involving 252 pediatric cochlear implant patients operated in the Department of ENT, GMERS Medical College and General Hospital, Gandhinagar, Gujarat, India. Out of these, 126 patients were operated by transcanal approach (group A) and 126 patients were operated by posterior tympanotomy approach (group B). Results No significant difference in the mean duration of surgery (p > 0.064) was observed in both the groups. Major complications occurred in 60.2% of group A and 3.1% of group B and minor complications occurred in 65% of group A and 3.1% in group B, which is highly significant (p < 0.0134). The categories of auditory perception, speech intelligibility rating scales, meaningful auditory integration scale, and meaningful use of speech scale were assessed in both groups. Conclusion Complication rate in the transcanal approach is higher as compared with posterior tympanotomy approach. A complete alignment and introduction of electrode array into the basal turn of cochlea is more favorable in the posterior tympanotomy approach. Transcanal technique even as an alternative may not be useful. Outcomes may be affected depending upon the technique chosen.

Caiman Versus LigaSure Hemorrhoidectomy: Postoperative Pain, Early Complications, Long-Term Follow-up, and Costs

2020 ◽  
Vol 27 (3) ◽  
pp. 272-278
Author(s):  
Chiara Eberspacher ◽  
Pietro Mascagni ◽  
Domenico Di Nardo ◽  
Daniele Pironi ◽  
Stefano Pontone ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Operative Time ◽  
Healing Time ◽  
Visual Analog Score ◽  
Historical Cohort ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B

Purpose. Recently, the use of radiofrequency for hemorrhoidectomy has minimized incidence of postoperative complications. Effectiveness of LigaSure is demonstrated, but it is quite expensive. This study aims to compare LigaSure with Caiman, a cheaper instrument that uses radiofrequency for hemorrhoidectomy. Methods. A total of 35 patients were enrolled in this study between January 2015 and December 2017: 35 (Group A: Caiman) patients were matched with 35 control patients (Group B) from our historical cohort, treated with LigaSure. They were checked at 1 week after operation, at 4 weeks, and then after 2, 6, and 12 months. We considered different factors: intraoperative (operative time, number of piles removed, necessity of stiches or ligation), immediate postoperative (pain, bleeding within 4 weeks, incontinence, soiling within 4 weeks, healing time of anal wounds, return to working activities), and with a long-term follow-up. Results. There were no statistically significant differences between the 2 groups in analyzed intraoperative data: operative time (Group A 35 minutes vs Group B 33 minutes; P = .198) and stitches used. Postoperative data were comparable too, in particular pain (Group A 1 day Visual Analog Score = 6.25 vs Group B = 5.4, P = .178; Group A 1 week Visual Analog Score = 2.7 vs Group B = 1.14, P = .22) and bleeding (Group A = 2 vs Group B = 4; P = .2). Conclusions. According our initial experience, Caiman can be a safe and cheaper alternative to LigaSure for hemorrhoidectomy.

scholarly journals EFFICACY AND TOLERABILITY OF FLUPIRTINE VERSUS TRAMADOL IN THE TREATMENT OF MODERATE CHRONIC LOW BACK PAIN

2019 ◽  
pp. 84-87
Author(s):  
VINEELA KARTHIK NAGURI ◽  
RAVI BABU KOMARAM ◽  
TAMILISETTI VIDYA SAGAR
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Adverse Drug Reactions ◽  
Tertiary Care ◽  
Care Hospital ◽  
Low Back ◽  
Drug Reactions ◽  
Study Results ◽  
Group A ◽  
Group B

Objective: The objective of the study was to assess and compare the efficacy and tolerability of flupirtine versus tramadol in patients with chronic moderate low back pain (LBP). Materials and Methods: A prospective study was conducted in the outpatient department of orthopaedics at tertiary care hospital, Rajamahendravarm. After meeting the inclusion criteria, a total of 60 patients were randomly allocated to tablet flupirtine 100 mg in Group A and tablet tramadol 50 mg in Group B. The efficacy of the study drugs was assessed at baseline and the end of treatment by numerical rating scale11, visual analog scale-100 mm, physician’s, and patient’s global assessment. Statistical analysis was done using paired and unpaired t-test and data were presented as mean±standard deviation. Adverse drug reactions were monitored during the treatment. Results: The study results showed that 90% of the patients in Group A and 78% of the patients in Group B had shown a good response to their respective drugs. 30% of flupirtine group patients reported adverse drug reactions which were mild. Conclusion: Both the drugs are effective in the treatment of moderate chronic LBP, but the advantage of flupirtine was, the incidence of adverse drug reactions was less when compared to tramadol group.

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