scholarly journals Modified Hasson technique versus Veress technique: a comparative study

2019 ◽  
Vol 6 (9) ◽  
pp. 3246
Author(s):  
Robinson George ◽  
Mebin Mathew ◽  
Veerabhadra Radhakrishna ◽  
Ashna Rahman ◽  
Aswini Thenamangalath
Keyword(s):  
Port Site ◽  
Port Placement ◽  
College Hospital ◽  
Medical College ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B ◽  
Needle Entry ◽  
Better Than

Background: There are two techniques of port placement for laparoscopy, Veress and Hasson. Both have their own advantages of disadvantages. Plenty of new modifications of these techniques have been tried to reduce the risks. We modified Hasson’s technique and evaluated whether the technique is better than the standard Veress technique.Methods: A retrospective analysis was carried out in the Department of General Surgery, Al Azhar Medical College Hospital, India from January 2013 to December 2018.Results: There were 156 patients in group A who underwent laparoscopy by Modified Hasson technique. The Veress technique was used in 149 patients who belonged to group B. There was no difference between the two groups in terms of age and indications for the surgery. The entry time (the time to place the first port) for group A was significantly lesser than that of group B (2.08±0.65 min vs. 4.59±0.53 min; p=0.000). There were a total of two complications in group A which was significantly lesser than that of group B (14; p=0.002). There was no significant difference between the two groups in terms of extraperitoneal port placement, intraperitoneal injury, failure to enter the abdomen, port site seroma, port site infection, port site hematoma, and mortality. But, port site hematoma was significantly lesser in group A compared to group B (0 vs. 5; p=0.027).Conclusions: Modified Hasson’s entry was found to be much better than Veress needle entry due to its simplicity for beginners in laparoscopy, lesser time of achieving pneumoperitoneum and lesser duration of surgery in our study.

Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wound Infection ◽  
Port Site ◽  
Site Infection ◽  
College Hospital ◽  
Medical College ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

2020 ◽  
Vol 21 (2) ◽  
pp. 105-110
Author(s):  
Md Shawkat Alam ◽  
Sudip Das Gupta ◽  
Hadi Zia Uddin Ahmed ◽  
Md Saruar Alam ◽  
Sharif Muhammod Wasimuddin
Keyword(s):  
Comparative Study ◽  
Acute Urinary Retention ◽  
Bladder Capacity ◽  
Inclusion Criteria ◽  
College Hospital ◽  
Medical College ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

scholarly journals Intranasal Splint in Nasal Septal Surgery: Is It Necessary?

2020 ◽  
Vol 32 (2) ◽  
pp. 126-129
Author(s):  
Jahangir Alam Mazumder ◽  
Md Golam Mustafa ◽  
AHM Delwar ◽  
Shazibur Rashid ◽  
Md Mostafizur Rahaman ◽  
...  
Keyword(s):  
Complete Healing ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Septal Surgery ◽  
Significant Difference ◽  
Group A ◽  
Medicine Today ◽  
Group B ◽  
Male To Female

Introduction: After SMR/septoplasty with or without turbinate surgery, it needs to keep apart the septum and turbinates upto their complete healing otherwise there is a chance of adhesion (synechia) formation. To prevent this there are variousprocedures. To place an intranasal splint in one or both sides of the septum is one of them. Nowadays there raised thequestion of whether the splinting is necessary or not. There is no significant difference in result with or without anintranasal splint. Weighing against the co-morbidities the routine use of an intranasal splint can no longer be justified. Materials and Methods: This is a randomized control study of 200 patients of SMR/septoplasty, done for nasal septaldeviation causing symptoms in Cumilla Medical College Hospital in the period of January 2016 to December 2019. Theywere equally divided into two groups, group-A were operated placing an intranasal splint and group-B with no intranasalsplint. They were followed up for 6 weeks to detect any synechia and co-morbidities. Result: The age of our patients wasranged from 13-49 years with a mean age of 22.45 years. The male to female ratio is 1.78:1. Synechia was found in 4% ofthe splinted group and 6 of the nonsplinted groups. Co-morbidities were detected more in the splinted group than that ofnon-splinted. In INS group these were found as follows: pain in the nose, face and head (26%), faint during removal ofnasal splint (6%), nasal obstruction (38%), the anxiety of splint removal in the postoperative period (35%) and vestibulitisdue to persistent irritation by a splint (17%). Conclusion: There is little significant advantage of using intranasal splintroutinely in septal surgery to prevent synechia formation. Medicine Today 2020 Vol.32(2): 126-129

scholarly journals A comparative study of using temporalis fascia autograft and dehydrated temporal fascia homograft in tympanoplasty

2019 ◽  
Vol 5 (6) ◽  
pp. 1669
Author(s):  
Hemendra Bamaniya ◽  
Padam Chand Ajmera
Keyword(s):  
Graft Material ◽  
Age Group ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Medical College ◽  
Temporal Fascia ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> The objective of the present study was to compare the results of tympanoplasty operations performed using autograft temporalis fascia with those of dehydrated temporalis fascia homograft.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in the department of ENT of Pacific Medical College and Hospital, Udaipur in duration from February 2014 to January 2015. The study included 90 patients of chronic suppurative otitis media with dry, central perforation of tympanic membrane. The patients were divided into two groups with 45 members in each group. In group A, temporalis fascia autograft was used and in group B, dehydrated temporalis fascia homograft was used for tympanoplasty. Results were evaluated in terms of graft uptake rate and hearing improvement.  </p><p class="abstract"><strong>Results:</strong> There were 50 male and 40 female patients in the study. Most of the patients (43.33%) were of the age group 21-30 years, followed by age group 31-40 years (24.44%). Post-operatively, 95.55% patients in group A and 91.11% patients in group B showed successful graft uptake. Mean preoperative AB gap in group A patients was 31.46±6.78 dB which was reduced to 13.01±5.61 dB postoperatively. Similarly, in group B patients, AB gap was reduced from 29.81±5.99 to 12.92±6.01 dB postoperatively. No statistically significant difference was observed between groups while comparing pre and postoperative AB gap.</p><p class="abstract"><strong>Conclusions:</strong> The results of tympanoplasty done by using either homograft or autograft were the same so dehydrated temporalis fascia homograft can be used as an alternative graft material with the same success rate wherever possible with the advantage of reduction in duration of surgery.</p>

scholarly journals Efficacy of Transcutaneous Electrical Nerve Stimulation for Management of Osteoarthritis of Knee Joint: A Randomized Control Trial

2018 ◽  
Vol 3 (2) ◽  
pp. 75-79
Author(s):  
Khurshid Mahmood ◽  
Ariful Islam ◽  
Aparajeya Bivab Bikash Baral ◽  
Prasanta Kumar Chakraborty
Keyword(s):  
Knee Joint ◽  
Therapeutic Exercise ◽  
Physical Medicine ◽  
College Hospital ◽  
Electrical Nerve Stimulation ◽  
Medical College ◽  
Significant Difference ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Management of osteoarthritis of knee joint is very important.Objective: The purpose of the present study was to observe the efficacy of transcutaneous electrical nerve stimulation (TENS) in the treatment of osteoarthritis (OA) of the knee.Methodology: This study was designed as randomized control trial which was conducted in the Department of Physical Medicine at Dhaka Medical College Hospital, Dhaka Bangladesh from July 2007 to December 2007 for a period of six (06) months. Patients presented with osteoarthritis at the age group of more than 30 years to 60 years with both sexes who were attended in Physical Medicine and Rehabilitation department in the Dhaka Medical College Hospital, Dhaka were selected as study population. The study populations were included by purposive sampling method after fulfilling the inclusion and exclusion criteria and were divided into two groups designated as intervention group (group A) and control group (group B). Group A was treated with TENS, therapeutic exercise, NSAID and ADL. Group B was treated with therapeutic exercise, NSAID and ADL.Results: A total of 60 patients with osteoarthritis (OA) of the knee joint were included in the study group. The mean age of both sexes were 46.67±7.04 years and male (46.83±7.73) patients were higher than female (46.56±6.41). There was significant difference in improvement of pain between two groups after treatment for two week (p=0.002); however, finally it was found that there was no significant difference in improvement of pain between two groups after treatment for 6(six) weeks. There was no significant difference in improvement of range of movement (ROM) between two groups after treatment for six weeks (p=0.946). There was no significant difference in improvement of walking speed between two groups after treatment for six weeks (p=0.611).Conclusion: In conclusion significant decrease of pain with increase of ROM and walking speed is found in all patients group with OA knee regardless of the treatment program.Journal of National Institute of Neurosciences Bangladesh, 2017;3(2): 75-79

scholarly journals Comparison of efficacy of duloxetine with amitriptyline in terms of reduction in frequency of pain in the patients of diabetic neuropathy.

2020 ◽  
Vol 27 (09) ◽  
pp. 1891-1894
Author(s):  
Asif Javeed ◽  
Muhammad Absar Alam ◽  
Atif Maqsood ◽  
Amna Azher ◽  
Muhammad Arif ◽  
...  
Keyword(s):  
Diabetic Neuropathy ◽  
Pain Score ◽  
Base Line ◽  
College Hospital ◽  
Medical College ◽  
Significant Difference ◽  
Reduction Of Pain ◽  
History Of ◽  
Group A ◽  
Group B

Objectives: To compare the efficacy of Duloxetine with Amitriptyline in Terms of Reduction in Frequency of Pain in The Management of Patients of Diabetic Neuropathy. Study Design: Randomized Control Trial. Setting: Medical OPD of ABWA Medical College Hospital Faisalabad. Period: Six Months from 01-01-2019 to 30-06-2019. Material & Methods: A total of 200 cases (100 in each group) between the age 20-65 years of any gender, ≥ 5 years history of diabetes, symptoms of peripheral neuropathy for at least six months, having HbA1c >7.5% were included. Two groups were formed Group A was given 60mg Duloxetine each day and Group B was given 75mg amitriptyline in a single dose. After 3 weeks, an additional three weeks supply of medication was dispensed and patient were scheduled to return at week 6 for the final evaluation that recorded by me in terms of reduction in pain score and also assessed for 50% reduction in pain score from base line that was labeled as reduced. Results: 62%(n=62) in Group-A and 35%(n=35) in Group-B were treated effectively, which shows a significant difference between the two groups. Conclusion: The duloxetine was more effective than amitriptyline in terms of reduction of pain in diabetic neuropathy.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

Association of Adverse Outcomes in Patients with Cirrhosis Presented with COVID-19

2021 ◽  
Vol 15 (5) ◽  
pp. 1134-1135
Author(s):  
M. A. Chhutto ◽  
A. H. Mugheri ◽  
A. H. Phulpoto ◽  
I. A. Ansari ◽  
A. Shaikh ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Adverse Outcomes ◽  
Chronic Liver ◽  
P Value ◽  
College Hospital ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
Disease Study

Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis presented with coronavirus disease. Study Design: Retrospective/observational study Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1st March 2019 to 31st December 2020. Methodology: Two hundred and twenty covid-19 patients of both genders with or without chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (with cirrhosis 60 patients) and group B (without cirrhosis 60 patients). Outcomes in term of mortality between both groups were examined. Results: There were 38 (63.33%) males and 22 (36.67%) were females with mean age 46.14±8.44 years in group A while in group B, 40 (66.67%) and 20 (33.33%) patients were males and females with mean age 45.26±9.34 years. Patients with cirrhosis had high mortality rate as compared to patients without cirrhosis (33.33% Vs 13.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients with coronavirus disease. Keywords: Chronic Liver Disease, Corvid-19, Mortality

scholarly journals Surgery for primary intracerebral haemorrhage: is it safe and effective?

2013 ◽  
Vol 38 (3) ◽  
pp. 74-78
Author(s):  
MMH Talukder ◽  
KMT Islam ◽  
M Hossain ◽  
MU Jahan ◽  
F Mahmood ◽  
...  
Keyword(s):  
Intracerebral Haemorrhage ◽  
Glasgow Outcome Scale ◽  
Control Group ◽  
Intracerebral Haematoma ◽  
College Hospital ◽  
Conservative Group ◽  
Best Medical Treatment ◽  
Significant Difference ◽  
Group A ◽  
Group B

This prospective study was conducted to compare the outcome between medical and surgical treatment of primary intracerebral haemorrhage at the department of Neurosurgery, Dhaka Medical College Hospital from January 2006 to October 2007. All patients with primary intracerebral haematoma with Glasgow Coma Scale (GCS) 5-15 (on admission) and heamatoma volume 30 cc or above admitted at Neurosurgery department managed conservatively or surgically were included in this study. Total 60 patients were selected, of them 30 patients managed conservatively and 30 patients managed surgically. Conservatively managed patients regarded as control group (Group-A) and surgically managed patients regarded as experimental group (Group-B). Patients or attendants refused to operate were included in the conservative group. All the selected patients were evaluated on the basis of detailed history, clinical examination (general and neurological examination) and CT scan findings. Outcome was evaluated in term of Glasgow Outcome Scale (GOS). Best medical treatment was given for conservative group and operations were done for surgical group and followed up after surgery till discharge by observing GCS and GOS at discharge. Number of death were 15 (50%) patients in group- A and 13 (43%) patients in group-B. There was no significant difference in mortality rate between two groups but outcome was relatively better in group-B. According to Glasgow Outcome Scale, dependency in group-A and group-B was 26.6% and 23.4% respectively. So dependency were more in group-A. But there was no significant difference statistically. Seven (23.4%) patients were independent in group-A but 10(43.3%) patients were independent in group-B. However in relative terms of outcome of group-B was better than that of group-A. In our study we found no statistically significant difference in outcome between medical and surgical management of primary intracerebral haemorrhage. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14328 Bangladesh Med Res Counc Bull 2012; 38(3): 74-78 (December)

scholarly journals Maintenance treatment of diabetic patients, associating arterial obstructive tibio-peroneal disease

1995 ◽  
Vol 113 (1) ◽  
pp. 701-705
Author(s):  
Nelson Wolosker ◽  
Ruben Miguel Ayzin Rosoky ◽  
Baptista Muraco Neto ◽  
Berilo Langer
Keyword(s):  
Maintenance Treatment ◽  
Diabetic Patients ◽  
Type I ◽  
Group I ◽  
Significant Difference ◽  
Therapeutic Procedures ◽  
Arterial Pulsation ◽  
Group A ◽  
Group B ◽  
Better Than

When a melito-diabetic patient presents trophic infected injury on the limb, it is essential an evaluation of the circulatory conditions for therapeutic procedures orientation. In some circumstances, although arterial pulsation is absent, there is no ischemia of tissues. In these cases, the maintenance treatment, with eventual resection of the necrosed and infected tissues may be adopted. Evolution of 70 diabetic patients with trophic injuries on extremities were submitted to a maintenance treatment. Age of patients varied from 28 to 88 years, with an average of 56.8. The most occurrence was verified in women, with 42 cases. Diabetes non-dependant on insuline (type II) was observed in 64 patients (91.5%), being the remaining 6 patients of type I. Diabetic retinopathy was observed in 14 (20%) of the patients, neuropathy in 22 (31%) and nephropathy in 8 patients (11.4%). All the patients presented arterial pulsation until the popliteal region. They were divided in 2 groups, considering trunk arteries of legs: Group I, pervial legs arteries, composed by 48 patients; Group II, occluded legs arteries, with 22 patients. In what refers to the anatomic local of the injuries, patients were classified in three groups: Group A, formed by 32 patients (45.7%), presenting injuries in one or two toes only, without affecting the metatarsic region; Group B, formed by 16 patients (22.9%), trophic injuries affecting the metatarsic region and Group C, formed by 22 patients (31.4%), injuries affecting the calcaneous region. Injuries in both of the groups were caused by mechanical traumatism. Duration of the injury in the inferior member varied from 7 to 48 days, resulting in a 12 days average. Analyzing pervicacity in trunk arterias and evolution of patients, it may be observed that there has been a significantly better result in those with all the pulses present (81.3% x 45.5%)(p<0,01). Studying the injury locals associated to the evaluation of the cases, we may observe that for injuries in the extreme digital, result is significantly better than in locals more nearly. When distal pulses are absent, there is no significant difference in the result of the treatment, being performed in distal injuries or in the more near ones (p>0,05)(Table IV).

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