scholarly journals Prospective comparative study between lateral sphincterotomy and subcutaneous fissurectomy with topical 2% diltiazem gel in the treatment of chronic fissure in ano

2019 ◽  
Vol 6 (7) ◽  
pp. 2571
Author(s):  
Dhrubajyoti Dey ◽  
Gopinath Pai
Keyword(s):  
Test Group ◽  
Lateral Position ◽  
Lateral Internal Sphincterotomy ◽  
Treatment Modalities ◽  
Control Group ◽  
Fissure In Ano ◽  
Lateral Sphincterotomy ◽  
Internal Sphincterotomy ◽  
Group A ◽  
Group B

Background: Anal fissure is defined as an ulcer in the anoderm usually in the posterior midline, less frequently in the anterior midline and rarely in the lateral position of the anal canal. Different treatment modalities include non-invasive pharmacological therapies, lateral internal sphincterotomy (LIS) which is the gold standard for treatment and new therapies that include perineal support devices, Gonyautoxin injection, fissurectomy, fissurotomy, sphincterolysis, and flap procedures. Thus, aim of the study was to compare the efficacy of outcome of lateral internal sphincterotomy and subcutaneous fissurectomy with topical 2% Diltiazem gel in the treatment of chronic fissure in ano.Methods: 50 patients with chronic fissure in ano attending OPD of Department of General Surgery, KVGMCH, Sullia were randomly selected and divided into Group A (n=25): Lateral internal sphincterotomy (control group) and Group B (n=25): Subcutaneous fissurectomy + topical 2% Diltiazem Gel (test group).Results: Patients of Group B showed much less mean duration of absenteeism (2.88 weeks) compared to Group A. Comparison between Group B and Group A showed statistically significant differences in pain relief (P<0.0001), complications (p=0.03), mean duration of sitz baths (p<0.0001), absenteeism (p<0.0001) respectively.Conclusion: Hence Subcutaneous fissurectomy with topical 2% Diltiazem gel is a better surgical option for chronic fissure in ano than conventional Lateral internal sphincterotomy. 

scholarly journals Comparative study of lateral Internal Sphincterotomy verses Topical Glyceryl Trinitrate for treatment of fissure-in-Ano

2016 ◽  
Vol 9 (4) ◽  
Author(s):  
Ajmal Farooq ◽  
Zahid Niaz
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Symptomatic Improvement ◽  
Lateral Internal Sphincterotomy ◽  
Fissure In Ano ◽  
Internal Sphincterotomy ◽  
Group A ◽  
Topical Glyceryl Trinitrate ◽  
Group B

This prospective randomized interventional study was carried in one of surgical unit of Lahore General Hospital Lahore from 1st January 2002 to 30, December 2002 a total number of 100 patients with both acute and chronic anal fissure were taken and randomly divided in two groups. Group A was treated with 0.2% GTN for 6 weeks and Group B was treated with lateral internal closed Sphincterotomy a follow up after 0, 2nd, 61h weeks and even after 6 months carried out. Peak incidence of disease was observed between 30 and 40 years of age with 56 males and 44 females. 24% patients were with acute fissure and 76% with chronic fissure. In this study with 0.2% GTN overall healing rate of 66.66% for acute fissure and 63.15% for chronic anal fissure was observed. GTN was found less effective in healing the fissure but some what good for initial symptomatic improvement in its comparison 100% healing was observed with lateral internal sphincterotomy with only 10% transient incontinence for flatus. So it was concluded that lateral internal sphincterotomy is superior to GTN and is the procedure of choice for fissure in ano.

EARLY OUTCOME OF LASER INTERNAL SPHINCTEROTOMY VERSUSOPEN INTERNAL SPHINCTEROTOMY IN THE TREATMENT OF ANAL FISSURES

2021 ◽  
pp. 55-59
Author(s):  
Rajkumar Verma ◽  
Satyendra Kumar ◽  
Vipin Mishra ◽  
Narendra Kumar
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Pain Score ◽  
Treatment Options ◽  
Lateral Internal Sphincterotomy ◽  
Fissure In Ano ◽  
Early Outcome ◽  
Internal Sphincterotomy ◽  
Group A ◽  
Group B

INTRODUCTION : Fissure-in-Ano is one of the common and most painful anorectal conditions encountered in surgical practice. Inspite of several conservative treatment options, surgical treatment in the form of Lateral Internal Spincterotomy (LIS) remains the gold standard of treatment for anal ssure. However we compare Laser lateral internal sphincterotomy with Open lateral internal Sphincterotomy for better postoperative pain relief and lesser hospital stay. AIM: Early outcome of laser lateral internal Sphincterotomy versus open lateral internal sphincterotomy in the treatment of anal ssures. MATERIALS AND METHODS: The study was conducted on 50 cases of Laser lateral internal sphincterotomy compare with 50 cases of Open lateral internal sphincterotomy in Maharani Laxmi Bai Medical College, Jhansi between January 2020 to July 2021. RESULTS:In our study in Group A 6% were in 16-20 years, 52% in 21-30 years, 20% in 31-40 years, 20% in 41-50 years and 2% 51-60% years and Group B 2% in 16-20 years, 34% in 21-30 years, 32% in 31-40 years, 18% 41-50%, 10% in 51-60 and 4% in >60. Group A mean postoperative VAS pain score in 6 hours 5.12±0,328, 12 hours 4.32±0.768, 24 hours 3.74±0.777, 36 hours 2.76±1.379 and 48 hours 2.3±1.418. In Group B mean postoperative VAS pain score in 6 hours 5.2±0.452, 12 hours 2.7±1.741, 24 hours 1.76±1.451, 36 hours 0.58±0.971 and 48 hours 0.28±0.671. Group A 44% presented with Perianal swelling, 42% Prutis Ani and 40% atus incontinence. In Group B 6% presented with amount of blood loss 6%, 18% Perianal swelling, 6% infection, 18% atus incontinence. The mean postoperative pain score was signicantly less in Group B at 12 to 48 hours. Group A mean hospital stay was 5.02±1.237 days and in Group B 2.02±0.141 days. It was signicantly less in Group B. CONCLUSION: Laser lateral Internal Spincterotomy is better than open Lateral Internal Spincterotomy with respect to less postoperative pain and lesser hospital stay and also less postoperative complications in the treatment of anal ssure.

scholarly journals The Bone Buttress Theory: The Effect of the Mechanical Loading of Bone on the Osseointegration of Dental Implants

Biology ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 12
Author(s):  
David Chavarri-Prado ◽  
Aritza Brizuela-Velasco ◽  
Ángel Álvarez-Arenal ◽  
Markel Dieguez-Pereira ◽  
Esteban Pérez-Pevida ◽  
...  
Keyword(s):  
Dental Implants ◽  
Mechanical Loading ◽  
Bone Growth ◽  
Bone Matrix ◽  
Test Group ◽  
Control Group ◽  
Group A ◽  
Bone To Implant Contact ◽  
The Stability ◽  
Group B

Objectives: To determine the effect of mechanical loading of bone on the stability and histomorphometric variables of the osseointegration of dental implants using an experimental test in an animal model. Materials and Methods: A total of 4 human implants were placed in both tibiae of 10 New Zealand rabbits (n = 40). A 6-week osseointegration was considered, and the rabbits were randomly assigned to two groups: Group A (Test group) included 5 rabbits that ran on a treadmill for 20 min daily during the osseointegration period; Group B (Controls) included the other 5 that were housed conventionally. The monitored variables were related to the primary and secondary stability of the dental implants (implant stability quotient—ISQ), vertical bone growth, bone to implant contact (BIC), area of regenerated bone and the percentage of immature matrix. Results: The results of the study show a greater vertical bone growth (Group A 1.26 ± 0.48 mm, Group B 0.32 ± 0.47 mm, p < 0.001), higher ISQ values (Group A 11.25 ± 6.10 ISQ, 15.73%; Group B 5.80 ± 5.97 ISQ, 7.99%, p = 0.006) and a higher BIC (Group A 19.37%, Group B 23.60%, p = 0.0058) for implants in the test group, with statistically significant differences. A higher percentage of immature bone matrix was observed for implants in the control group (20.68 ± 9.53) than those in the test group (15.38 ± 8.84) (p = 0.108). A larger area of regenerated bone was also observed for the test implants (Group A 280.50 ± 125.40 mm2, Group B 228.00 ± 141.40 mm2), but it was not statistically significant (p = 0.121). Conclusions: The mechanical loading of bone improves the stability and the histomorphometric variables of the osseointegration of dental implants.

Resorbable Collagen Barrier Impeding the Extrusion of Obturating Material in Primary Molars Undergoing Resorption – A Randomized Clinical Trial

2021 ◽  
Vol 45 (5) ◽  
pp. 312-316
Author(s):  
Mishra Neha Sanjeev ◽  
Harsimran Kaur ◽  
Sandeep Singh Mayall ◽  
Rishika ◽  
Ramakrishna Yeluri
Keyword(s):  
Test Group ◽  
Primary Molars ◽  
Control Group ◽  
Chi Square ◽  
Significance Level ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B ◽  
And Control

Objective: To evaluate the effectiveness of placing a resorbable collagen barrier in impeding the extrusion of obturation material in primary molars undergoing resorption. Study design: All the 94 canals in 47 mandibular molars were allocated to 2 groups- Group ‘A’- 47 canals with collagen barrier (Test group) and Group ‘B’- 47 canals without collagen barrier (Control group) based on randomization protocol. Pulpectomy was performed and obturation of both test and control canals were radiographically assessed. Pearson’s chi – square test was applied to analyze the results. The significance level was predetermined at p &lt; 0.05. Results: Among the test group, 93.6% of the canals showed no extrusion while, 6.4% showed visible extrusion of the material outside the apex. In the control group, 83% showed no extrusion whereas 17% of the canals showed visible extrusion outside the apex. But no significant difference was noted (p&gt;0.05). Conclusion: The placement of resorbable collagen barrier in the apical third of the canal prevented the extrusion of obturating material beyond the apex in resorbing primary molars.

scholarly journals Effect of Teriparatide in Fracture Healing in Lower Limbs- An Interventional Study

2021 ◽  
Author(s):  
Sanjeev Kumar ◽  
Girish Sahni ◽  
Harjit K Singh Chawla ◽  
Daljinder Singh
Keyword(s):  
Functional Outcome ◽  
Adverse Reactions ◽  
Weight Bearing ◽  
Test Group ◽  
Control Group ◽  
Dash Score ◽  
Early Weight Bearing ◽  
Group A ◽  
Group B ◽  
Radiological Union

Introduction: Many of the trauma patients presenting to the orthopaedic departments suffer from lower limb fractures. This often leads to prolonged period of morbidity and absence from work. Fracture healing can be delayed in elderly patients, postmenopausal women and in communited fractures. Teriparatide (TPH) given subcutaneously for 6 to 9 months, in such cases, may promote clinical and radiological union of bone. Aim: To know the effect of TPH in improving clinical and radiological union and also to evaluate early weight bearing, improvement in pain and functional outcome. Materials and Methods: In this prospective interventional study, a total of 125 patients were initially enrolled for the study and then after meeting inclusion criteria total 104 patients were selected for the study. They were allocated into two groups by randomisation by 1:1 method-group A was test group of 52 cases in which subcutaneous injection TPH 20 mcg daily (for six months) was given along with standard dosage of calcium and vitamin D; while in 52 cases in group B (control group) only calcium and vitamin D were given. Injection TPH was started within 10 days of fracture and given for six months. No placebo injection was given in control group. Time to weight bearing, time to clinical and radiological union and pain by Visual Analogue Score (VAS) were noted at regular follow-up at one month, three months, six months and 12 months and were compared in both the groups. Functional outcome by Disabilities of the Arm, Shoulder and Hand (DASH) score was noted as an additional tool, as DASH score questionnaire shows many activities of daily living that require mobility and stability of lower limb too. Adverse reactions were noted and compared within test and control groups. The collected data were analysed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) version 22.0 software and Mann-Whitney U test was used to calculate p-value. Results: Average time period for full weight bearing with or without support for test group A was 11±2.7 weeks and 16±1.8 weeks in control group B (p-0.001). Average time to clinical union in test group was 12±1.9 weeks and in control group 16±2.2 weeks (p-0.001). Average time to radiological union was 13±1.4 weeks in test group while 22±2.2 weeks in control group (p-0.001). Pain score by VAS and functional outcome by DASH were improved in test group (p-0.001). There was no difference in adverse reactions in both the groups (p>0.05). Conclusion: Regular intake of TPH 20 mcg subcutaneous daily for six months can reduce time to clinical and radiological fracture union, promote early weight bearing and provide better pain control. Hence, better functional outcome and prefracture ambulatory status can be achieved with no significant adverse events.

scholarly journals Closed versus open lateral internal anal sphincterotomy in a chronic anal fissure

2017 ◽  
Vol 4 (3) ◽  
pp. 1055 ◽  
Author(s):  
Anandaravi B. N. ◽  
Ramaswami B.
Keyword(s):  
Anal Fissure ◽  
Recurrence Rate ◽  
Chronic Anal Fissure ◽  
Randomized Study ◽  
Lateral Internal Sphincterotomy ◽  
Internal Sphincterotomy ◽  
Closed Technique ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Anal fissure is a common proctological problem, which presents with pain in the anal region during and after defecation. The aim of the study was to determine the best technique for surgical treatment of chronic anal fissure patients.Methods: The study was designed as a prospective randomized study. The study was conducted in surgical unit, K.R. Hospital, MMCRI, Mysore, India from January 2015 to June 2016. A total of 100 patients undergoing surgery were divided into two groups. In group A there were 50 patients who were treated by closed lateral internal anal sphincterotomy, and in group B there were 50 patients who were managed by open lateral internal anal sphincterotomy method. Patients were followed up for 6 months following surgery to observe for pain, bleeding, infection, incontinence, and recurrence. The exclusion criteria were patients who had in addition haemorrhoids or any other anorectal diseases.Results: There was acceptable difference in postoperative acute complications between the two methods of internal anal sphincterotomy. However, in group A, three patients (6%) versus 10 (20%) were complicated with incontinence postoperatively, whereas the recurrence rate was 4 versus 4% in group A versus group B, respectively (P = 0.015).Conclusions: There was significant difference between closed and open methods of lateral internal sphincterotomy in recurrence rate, healing rate, and other complications. Closed lateral internal sphincterotomy is treatment of choice for chronic anal fissure and can be done effectively and safely with acceptable rate of complications. Our recommendations are that closed technique should be adopted by experienced surgeons and Trainee should be initially trained by open technique then be shifted to closed technique.

scholarly journals Serum Periostin Level in Asthmatic Children with Exercise Induced Bronchospasm

2020 ◽  
pp. 53-67
Author(s):  
Reem M. Soliman ◽  
Mohamed B. Hamza ◽  
Rasha M. El-Shafiey ◽  
Hesham A. Elserogy ◽  
Nabil M El-Esawy
Keyword(s):  
Test Group ◽  
Mean Value ◽  
Control Group ◽  
Asthmatic Children ◽  
Group A ◽  
The Mean ◽  
Exercise Induced ◽  
Group B ◽  
And Control ◽  
Serum Periostin

Background: There are few biomarkers that can be easily accessed in clinical settings and may reflect refractory Th2-eosinophlic inflammation and remodeling of the asthmatic airways. Serum periostin may be one such biomarker to aid our understanding of the patho-bio-physiology of asthma and exercise induced asthma. The aim of the study is to explore the relationship between serum periostin level and exercise induced bronchoconstriction in asthmatic children. Materials and Methods: This cross-sectional study was carried out on (90) children both sexes aged from 6 to 15 years including, (60) children with bronchial asthma and (30) children were enrolled as control group in the period from January 2018 to January 2019. Patients were randomly classified into two groups: I) Patient group: divided into 2 groups according to standardized treadmill exercise challenge test: Group A: (30) asthmatic children with positive test. Group B: (30) asthmatic children with negative test. II-Control group: (30) children apparently healthy with no personal or family history of asthma. All children were subjected to the following Investigations: Chest x-ray, pulmonary functions tests (FEV1 & PEFR) except controls, Laboratory investigations as CBC and Serum periostin level. Results: The mean values of both the percentage of PEFR and FEV1 after exercise in group A were significantly lower than those in group B and the percentage of PEFR and FEV1 after exercise in each group were significantly lower than the percentage before exercise in the same group. The mean value of eosinophilic count in group A was significantly higher than (group B and control group) and the mean value of eosinophilic count in group B was significantly higher than control group. The mean value of serum level of periostin in group A was significantly higher than (group B and control group), however, there was no significant difference between group B and control group as regard to serum level of periostin. Chest tightness, cough and wheezes after exercise and eosinophilic count in patients with high serum periostin level were significantly higher than patients with low serum periostin level, and both PEFR and FEV1 after exercise in patients with high serum periostin level were significantly lower than patients with low serum periostin level. Also the normal serum periostin levels vary among different age groups. Conclusion: Serum periostin level can be considered as a useful biomarker for diagnosis of Exercise induced bronchospasm (EIB) in asthmatic children especially when lung function test cannot be done However, cautious is required in evaluating serum periostin levels in children because it varies with age.

scholarly journals A comparison of segmental internal sphincterotomy versus lateral internal sphincterotomy in management of chronic fissure in ano

2017 ◽  
Vol 4 (9) ◽  
pp. 3044
Author(s):  
Anil M. Kad ◽  
Murtaza Akhtar ◽  
Rajiv Sonarkar ◽  
Divish Saxena ◽  
Kanav Kumar ◽  
...  
Keyword(s):  
Anal Incontinence ◽  
Internal Sphincter ◽  
Lateral Internal Sphincterotomy ◽  
P Value ◽  
Fissure In Ano ◽  
Lateral Sphincterotomy ◽  
Female Ratio ◽  
Internal Sphincterotomy ◽  
Perianal Sepsis ◽  
Surgical Modality

Background: Fissure in ano is one of the commonest benign and painful proctologic condition encountered in surgical practice treated by conservative line of management. Lateral sphincterotomy is the ideal treatment option for chronic refractory fissure in ano. A newer modality segmental internal sphincterotomy shows good promise in terms of early resolution of symptoms, fissure healing and prevention of anal incontinence involving division of the internal sphincter at two different levels.Methods: In comparative nonrandomized trial patients with chronic fissure in ano satisfying the inclusion and exclusion criteria were allocated to lateral sphincterotomy and segmental internal sphincterotomy groups. The outcome factors were perianal sepsis, pain relief using VAS as assessed on passing the first motion, duration of healing of fissure, assessment of incontinence using Wexner’s continence score on 30th post-operative day.Results: A total of 54 cases were enrolled, of them 31 patients underwent lateral internal sphincterotomy and 23 underwent segmental internal sphincterotomy with the mean age of patient was 34.76 years and a male to female ratio of 1.07:1. The pain score (VAS) on passing stool for the first time postoperatively was 4.5 with lateral sphincterotomy and 3.91 with segmental internal sphincterotomy which was statistically significant (P value < 0.010). The duration of postoperative healing was observed to be 27.94 days and 28.09 days in lateral sphincterotomy and segmental internal sphincterotomy group respectively. The post-operative anal incontinence was evaluated by using Wexner’s continence grading after one month which was not statistically significant between two groups.Conclusions: Segmental internal sphincterotomy could be a good surgical modality with its healing effect on fissure in ano and post-operative complications which are similar to standard lateral internal sphincterotomy.

scholarly journals A clinical study to evaluate the efficacy of Murivenna application on Episiotomy Wound

2020 ◽  
Vol 5 (05) ◽  
pp. 65-71
Author(s):  
Keerthy P ◽  
Savita S. Patil
Keyword(s):  
Wound Care ◽  
Vaginal Wall ◽  
Treatment Modalities ◽  
Control Group ◽  
Fetal Head ◽  
Safe Delivery ◽  
Second Stage Of Labor ◽  
Group A ◽  
Group B ◽  
Prolonged Hospital

A surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labor is called episiotomy (Perineotomy). It is in fact an inflicted second-degree perineal injury. It is the most common obstetric operation performed. This is done to enlarge the vaginal introitus to facilitate easy and safe delivery of the fetus and to minimize overstretching and rupture of the perineal muscles and fascia thus to reduce the stress and strain on the fetal head. This wound of episiotomy is associated with a delicate area of the female with immense pain and discomfort and seeks appropriate medical care and attention. If ignored, it may lead to puerperal wound infections and delayed healing that can interfere mother-infant interaction, lactation and prolonged hospital stay. Episiotomy wound care should be start immediately after suturing the wound in order to reduce pain and inflammation. The surgical wound of episiotomy can be considered as Sadyo Vrana. Different treatment modalities have been told in Ayurveda for Vrana Chikitsa. Drugs having Shodhana and Ropana qualities are essential for healing. In this research study total 30 patients were registered and treated in two groups, group A with application of Jatyadi Taila on episiotomy wound after Ushna Jala Parisheka as a standard control group and Group B with application of Murivenna after Ushna Jala Parisheka as a trial group. Encouraging results were observed in Murivenna. Study emerges that Murivenna possess better pain relieving and tenderness diminishing properties.

scholarly journals To Compare the Effect on IOP Following Primary Trabeculectomy with MMC 0.2% versus Trabeculectomy without MMC in Primary Open Angle Glaucoma

2021 ◽  
pp. 475-480
Author(s):  
Zakaullah Gopang ◽  
Shabeer Ahmed Bhutto ◽  
Naeem Akhtar Katpar ◽  
Arslan hassan Rajper ◽  
Vijay Nagdev
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Test Group ◽  
Control Group ◽  
Open Angle ◽  
Primary Procedure ◽  
Group A ◽  
Group B ◽  
Medical University

Objective: To determine the effect on intraocular pressure following primary Trabeculectomy with MMC 0.2% versus Trabeculectomy without MMC in Primary Open Angle Glaucoma. Study Design: This is a prospective and experimental Study. Setting: Study carried out at Ophthalmology Department, Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from 01-03-2020 to 31-08-2020 (06 Months). Materials and Methods: The patients with primary open angle glaucoma were selected from glaucoma clinic after taking careful history and clinical examination. Patients selected for trabeculectomy into two groups. Group A includes 43 patients while Group B also includes 43 patients. Among Group A patients adjunctive MMC 0.2mg/ml for a period of 3 minutes was used during trabeculectomy as a primary procedure (Test Group) while Group B patients were operated without MMC 0.2% (Control Group). Follow-up period of 06 months was observed in both groups. The span of study was from 01-03-2020 to 31-08-2020. Results: The total of 86 Eyes of 86 patients of POAG were included in this study. Group A patients were operated for trabeculectomy with MMC while group B patients were operated for trabeculectomy without MMC. The mean IOP before surgery of Group-A was 25.39±2.42 mmHg while in Group-B it was 26.23±4.23mmHg. At day 1 of surgery in Group-A patients IOP was 13.20±3.05 mmHg while in Group-B patients IOP, was 14.09±4.04 mmHg. After 3 months in Group-A, IOP was 13.04±3.81 mmHg in Group-B IOP was 14.01±4.18 mmHg. Out of 43 patients in Group-A, 41(95.3%) were succeeded while in Group-B, 39(90.7%)were succeeded. Significant result was found for IOP reduction after 6 months of surgeryin group-A IOP was 13.48 + 2.86 mmHg while in group-B, IOP was 15.09 ±2.64 (P=0.754). Conclusion: Trabeculectomy with MMC as a primary procedure seems to be more effective than trabeculectomy without MMC.

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