scholarly journals The difference in outcome of patients with open inguinal hernia repair by using delayed absorbable sutures instead of non-absorbable sutures for mesh fixation

2020 ◽  
Vol 8 (1) ◽  
pp. 24
Author(s):  
Ali G. Mohammed Redha ◽  
Adil A. Jaber ◽  
Aqeel M. Nasser
Keyword(s):  
Hernia Repair ◽  
Mesh Fixation ◽  
Good Alternative ◽  
P Value ◽  
Absorbable Sutures ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
One Year ◽  
Group 1

Background: Different methods are found for mesh fixation in inguinal hernioplasty both open and laparoscopic. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Whether absorbable instead of non-absorbable sutures can be used still a matter of debate in view of hernia recurrence and post-operative complications.Methods: This is a prospective done on 158 male patients with uncomplicated unilateral inguinal hernias. Two groups of 69 patients were evaluated after periods up to 1 year after open hernioplasty by using delayed absorbable sutures in one group (group 1) and non-absorbable sutures in the other group (group 2) for fixation of mesh.Results: In spite of a noticeable reduction in complication in the group 1 in term of number and percentage when compared with group 2 mainly chronic pain, there is no significant difference (p value>0.05). However, these results are associated with zero recurrence in both groups during a period of one year follow up.Conclusions: Delayed absorbable sutures are good alternative of non-absorbable sutures in open mesh hernia repair associated with less complications and almost no increase in chance of recurrence.  

scholarly journals Efficacy and opioid-sparing effect of interpleural bupivacaine in patients undergoing laparoscopic cholecystectomy: Prospective observational study (Running title: Efficacy of inter-pleural bupivacaine in laparoscopy)

2021 ◽  
Vol 43 (5-6) ◽  
pp. 103-110
Author(s):  
A.K. Prasath ◽  
Senthil Kumar ◽  
Mohanhariraj Angamuthammal ◽  
Agnes Evangleen
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Relief ◽  
Study Groups ◽  
P Value ◽  
Number Of Patients ◽  
Significant Difference ◽  
Vas Scores ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Introduction: Laparoscopic cholecystectomy is considered minimally invasive, but pain following laparoscopy is moderate to severe, leading to increased morbidity and length of hospital stay. Various medications, including opioids, NSAIDs, and techniques like intraperitoneal local anesthetic infiltration, are used. In this study, we investigated interpleural block with bupivacaine for pain relief following laparoscopic cholecystectomy. Methods: A total of 60 patients were included in the study. 30 patients received 20 ml of 0.5% interpleural bupivacaine (group 1), and 30 patients recieved 20 ml of 0.9% normal saline (group 2). We recorded visual analog score (VAS), vital signs, and postoperative opioid requirements. Tramadol (2 mg/kg) was rescue medication if VAS ≥ 5. Results: Significant difference between study groups was recorded among VAS scores measured at 30 minutes, 1, 2, 6, 10, and 12 hours (p value < 0.05). The difference in VAS scores at 15 minutes and 14 hours between study groups was insignificant (p value > 0.05). The number of patients who received tramadol was 9 (30%) patients in group 1 and 29 (96.7%) patients in group 2. The difference in proportion for tramadol intake at 6 hours was significant among study groups (p-value < 0.05). Conclusion: Interpleural bupivacaine 20 ml of 0.5% used as analgesia reduces post-operative opioid requirement following laparoscopic cholecystectomy. Hence interpleural block can be safely used as a regional technique for pain relief following laparoscopic cholecystectomy.

A volumetric three-dimensional evaluation of invasiveness of an endoscopic and microscopic approach for transmeatal visualisation of the middle ear

2021 ◽  
pp. 1-5
Author(s):  
A H A Baazil ◽  
J G G Dobbe ◽  
E van Spronsen ◽  
F A Ebbens ◽  
F G Dikkers ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Middle Ear ◽  
Three Dimensional ◽  
Endoscopic Approach ◽  
Microscopic Approach ◽  
Significant Difference ◽  
Computed Tomography Scans ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Abstract Objective This study aimed to compare the necessary scutum defect for transmeatal visualisation of middle-ear landmarks between an endoscopic and microscopic approach. Method Human cadaveric heads were used. In group 1, middle-ear landmarks were visualised by endoscope (group 1 endoscopic approach) and subsequently by microscope (group 1 microscopic approach following endoscopy). In group 2, landmarks were visualised solely microscopically (group 2 microscopic approach). The amount of resected bone was evaluated via computed tomography scans. Results In the group 1 endoscopic approach, a median of 6.84 mm3 bone was resected. No statistically significant difference (Mann–Whitney U test, p = 0.163, U = 49.000) was found between the group 1 microscopic approach following endoscopy (median 17.84 mm3) and the group 2 microscopic approach (median 20.08 mm3), so these were combined. The difference between the group 1 endoscopic approach and the group 1 microscopic approach following endoscopy plus group 2 microscopic approach (median 18.16 mm3) was statistically significant (Mann–Whitney U test, p < 0.001, U = 18.000). Conclusion This study showed that endoscopic transmeatal visualisation of middle-ear landmarks preserves more of the bony scutum than a microscopic transmeatal approach.

A Comparative Study Between Preoperative Subconjunctival Bevacizumab Injection And Postoperative Topical Application In Prevention Of Recurrence After Excision Of Primary Pterygium In Egyptian Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Basma Helal Mohamed ◽  
Othman Ali Othman Ziko ◽  
Hisham M Khairy Abd El Dayem ◽  
Nancy Ezzelregal Khamis Ahmed
Keyword(s):  
Corneal Thickness ◽  
Anterior Segment ◽  
P Value ◽  
Eye Drops ◽  
Subconjunctival Injection ◽  
Fibrovascular Tissue ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1 ◽  
Primary Pterygium

Abstract Purpose to compare between recurrence incidence after primary pterygium excision when using preoperative subconjunctival injection of Bevacizumab (Avastin) and using it as a postoperative eye drops. Methods thirty two eyes of thirty patients (two patients had bilateral pterygium) with primary pterygia were clinically examined, classified into 3 groups and operated by simple excision with bare sclera technique. Group 1 included 10 patients received Bevacizumab (Avastin) in the form of eye drops (10 mg/ml) 3 times daily for 6 days postoperative. Group 2 included 10 patients received preoperative Bevacizumab in the form of subconjunctival injection (1.25 mg/0.05ml) single dose 1 week preoperative. Group 3 included 10 patients (12 eyes) 2 patients with bilateral Pterygium didn’t receive any form of Bevacizumab. Postoperative follow up was done clinically and by serial photography at 1 week, 1 month, 3 months and 6 months searching for signs of recurrence and/or complications. Results The results showed different grades of recurrence in 18 eyes of 32.True recurrence was seen in 7 patients of 18 (1 patient in group 1, 2 in group 2 and 4 in group3).Recurrence grades in group 1and 2 who used the Bevacizumab (20%grade II, 50% grade III, and 30% grade IV). Recurrence could be predicted by 100% depending on fibrovascular tissue appearing in the surgical bed at 3 months postoperative (P value 0.038).Preoperative fleshy pterygium has high statistical significance in realation to recurrence(P value = 0.006).Patient’s sex, residence and occupation had no statistically significant value in the process of recurrence (P value &gt; 0.05). Patients with recurrent Pterygia (in group 1&2) had statistically significant changes in the corneal K- readings at 3 months and 6 months.No significant difference in the limbal or central corneal thickness in the operated eye and the other eye (Pvalue &gt; 0.05). Conclusion Bevacizumab (Avastin) is a well tolerated drug with multiple drug delivery methods.The eye drops give better results than the subconjunctival injection.Appearance of fibrovascular tissue in the surgical bed at 3 months predict the recurrence by 100%. Preoperative fleshy pterygia will mostly recur again whatever Bevacizumab form was used .The corneal thickness by anterior segment OCT has no role in prediction or detection of early pterygium recurrence.

scholarly journals Drug-eluting balloon treatment in femoropopliteal in-stent restenosis of different lengths

2020 ◽  
Vol 28 (3) ◽  
pp. 460-466
Author(s):  
Berkan Özpak
Keyword(s):  
Stent Restenosis ◽  
Significant Difference ◽  
Stent Length ◽  
Drug Eluting ◽  
Group 3 ◽  
Group 2 ◽  
Drug Eluting Balloon ◽  
One Year ◽  
In Stent Restenosis ◽  
Group 1

Background: In this study, we present one-year results of drug-eluting balloon treatment of femoropopliteal in-stent restenosis. Methods: A total of 62 patients (48 males, 14 females; mean age 64.2±9.1 years; range, 54 to 81 years) who underwent drug-eluting balloon stenting for femoropopliteal in-stent restenosis between August 2013 and October 2017 were included in the study. The patients were classified into three groups based on the narrowing length of stenosis in the stents. Group/Class 1 (n=17): narrowing <1/2 of the stent length; Group/Class 2 (n=22): narrowing >1/2 of the stent length, not totally occluded; and Group/Class 3 (n=23): totally occluded. In-stent restenosis was treated with drug-eluting balloon treatment. Results: There was a significant difference among all classes in terms of in-stent restenosis. The length of stenosis was a predictor for in-stent restenosis. The mean stent length was 107.7±24.6 mm in Group 1, 164.6±17.9 mm in Group 2, and 180±19.3 mm in Group 3. For non-occluded in-stent restenosis, restenosis rate at one year after balloon angioplasty was 47.1% in Group 1, 86.4% in Group 2, and 95.7% in Group 3. Femoropopliteal bypass was performed in five patients in whom treatment failed. None of the patients required amputation. Conclusion: The length of in-stent restenosis in the femoropopliteal arterial stents is an important predictor for recurrent stenosis, when re-flow is achieved with drug-eluting balloons.

scholarly journals Comparison of Inflammatory Reactions Following Two Different Cesarean Section Techniques: The Modified Misgav-Ladach Versus the Pfannenstiel-Kerr; A Prospective Randomized Trial

2018 ◽  
pp. 1
Author(s):  
Baris Buke ◽  
Hatice Akkaya ◽  
Cigdem Karakukcu
Keyword(s):  
Cesarean Section ◽  
Inflammatory Reaction ◽  
Operation Time ◽  
Blood Samples ◽  
Inflammatory Reactions ◽  
Tnf Α ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
Group 1

<p><strong>Objectives:</strong> There is not yet a consensus on the optimal surgical technique for cesarean section. This is the first study comparing two different (Cesarean Section) with respect to the following inflammatory reaction in means of changes in inflammatory marker levels.<br />To evaluate the differences in inflammatory reactions following two different (Cesarean Section) techniques, the modified Misgav-Ladach versus the Pfannenstiel-Kerr technique.</p><p><strong>Study Desıgn:</strong> The study population included 88 pregnant women who met the inclusion criteria. These women were randomized into two groups according to Consolidated Standards of Reporting Trials guidelines: Group 1 (Misgav-Ladach group) and Group 2 (Pfannenstiel Kerr group). To compare the inflammatory reactions following surgery, Interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) levels were measured in venous blood samples drawn from the patients just before (0 hour) and 24 hours (24th hour) after the surgery. In 5 women from Group 1 and 2 women from Group 2, the 24th hour blood samples could not be obtained or were lost. Thus, a total of 81 women, 39 women from Group 1 and 42 women from Group 2, comprised the population of study. The differences in inflammatory reactions between the 0 and 24th hours were analyzed by calculating the percent change in IL-6 and TNF-α levels, and these percentages were then compared between the groups.</p><p><strong>Results:</strong> There was a statistically significant difference between Group 1 and Group 2 regarding the serum IL-6 level change between 0 and 24th hour (530±653% and 196±168%, respectively, p=0.022. The difference in TNF-α was also higher in Group 2, but the difference was not statistically significant (229±306% vs. 571±824%, p=0.12). The mean operation time was significantly shorter in Group 1 (9.44 min. vs. 16.86 min, p=0.0001).</p><p><strong>Conclusions:</strong> The results of this study indicate that the modified Misgav-Ladach technique has a weaker inflammatory reaction, which indicates fewer short- and long-term surgical complications.</p>

Endovascular reflux-elimination of perforating veins by RFITT and foam sclerotherapy

Phlebologie ◽  
2015 ◽  
Vol 44 (01) ◽  
pp. 13-17
Author(s):  
J. Duben ◽  
J. Gatek ◽  
T. Saha ◽  
G. Hnatkova ◽  
L. Hnatek
Keyword(s):  
Varicose Veins ◽  
Control Group ◽  
Foam Sclerotherapy ◽  
Perforating Veins ◽  
Significant Difference ◽  
Power Setting ◽  
Group 3 ◽  
Group 2 ◽  
One Year ◽  
Group 1

SummaryIntroduction: During the last years, many endovascular techniques have been developed in order to eliminate not only the reflux in stem veins but in perforating veins and their tributaries, too.Aim: The aim of this study was to use endo -vascular RFITT and the foam sclerotherapy for the occlusion of perforating veins as the prime source of reflux and their tributaries.Material and Methods: The Celon method was used for the thermal treatment. Polydocalon with the concentration 1% and 2% with DSS technique was used for the foam sclerotherapy. The RFITT was accomplished in 127 perforating veins in total. This group was divided into three subgroups. The first one consists of patients where only RFITT was carried out (n= 41), in the second, there were patients with RFITT realized with sclerotherapy during one session (n= 48), in the third, RFITT was completed with sclerotherapy in one month after the RFITT intervention (n= 38). The control group included perforating veins treated only with sclerotherapy (n= 81). The power setting 6W was used on the generator during the RFITT with CelonProSurge micro and 18W for usage of Celon ProCurve probe.Results: The effectiveness of the procedure in the group 1 was 8.8%, in the group two 93.7%, in the group three 92.1% and in the control group 76.5% in one year follow up. There was no significant difference between the effectiveness in groups 1, 2 and 3. The marginal difference was among all three groups with RFITT and the control group. Significant differences were in the parameter of the extinction of visible varicose veins with the reflux from perforators. The extinction was faster in group 3 than in group 2 and in the control group and the slowest was in group 1. The significant difference was observed between groups 2 and 3 compared with group 1 and the margin difference was between groups 2 and 3 compared with the control group. No significant difference was observed between groups 1 and the control group.Conclusions: All procedures are effective. The most important is the combination of RFITT and the sclerotherapy one month after thermal intervention. This is associated with a low risk of recanalization and the fastest extinction of visible varicose veins.

scholarly journals Zinc supplementation in preterm neonates with jaundice: is it beneficial?

2020 ◽  
Vol 21 ◽  
Author(s):  
Mohamed Shawky Elfarargy ◽  
Ghada M Al-Ashmawy ◽  
Sally Abu-Risha
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Zinc Supplementation ◽  
University Hospital ◽  
Preterm Neonates ◽  
P Value ◽  
Indirect Bilirubin ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background: Neonatal jaundice is a common neonatal disease which had adverse effect in the neonates especially preterm neonates when the level of indirect bilirubin is high enough to pass the blood brain barrier causing bilirubin encephalopathy or kernicterus. Aim: The aim of this study is to investigate the value of zinc (Zn) supplementation in preterm neonates with jaundice and if it will be beneficial or not. Patients and methods: A prospective randomized clinical trial (RCT) study, identification number is TCTR20200504007, which was done at Tanta University Hospital (TUH) from July 2016 to March 2018 on 200 preterm neonates suffering from neonatal jaundice. The studied neonates were divided into 2 groups: group 1, which received Zn and phototherapy, and group 2, which received phototherapy only and did not take Zn. In the group 1, 100 preterm neonates with jaundice received Zn as 0.6 ml(cm3 ) of zinc origin/kg/day orally through oro/nasogastric tube divided into 2 doses (/12 hours) which is equal 1.2 mg elemental zinc/kg/day orally for 10 day. Results: There was no significant difference in serum bilirubin between the 2 groups in the 2nd, 4th and 6th day of admission while the serum bilirubin was significantly decreased in neonates who were treated by Zn and phototherapy in group 1, compared with neonates of group 2 who were treated with phototherapy only in the 8th , 9th and 10th day of admission where the p value was 0.045* ,0.027* and 0.004* respectively. Conclusion: Zn administration in jaundiced preterm neonates is beneficial in decreasing serum bilirubin. Recommendation: Zn supplementation for jaundiced preterm neonates.

scholarly journals PELATIHAN LONCAT NAIK TURUN TRIBUN DAN PELATIHAN LONCAT NAIK TURUN BANGKU MENINGKATKAN DAYA LEDAK OTOT TUNGKAI PADA PESERTA EKSTRA KURIKULER BOLA VOLI PUTRA SMA NEGERI 1 TEGALLALANG

2019 ◽  
Author(s):  
I Putu Agus Budi Sudarsana ◽  
J. Alex Pangkahila ◽  
Bagus Komang Satriyasa ◽  
Wayan Weta ◽  
I Nengah Sandi ◽  
...  
Keyword(s):  
High School ◽  
T Test ◽  
P Value ◽  
Public High School ◽  
Jump Training ◽  
Explosive Power ◽  
Significant Difference ◽  
Before And After ◽  
Group 2 ◽  
Group 1

ABSTRACTThis study was conducted to determine the increase in limb muscle explosive power. The training was conducted with 5 reps of 3 sets over six weeks in the field of Tegallalang 1 Public High School starting at 17.00 WITA until completion. In this study using 2 groups, namely the 1st group given jump training up and down the stands, the 2nd group was given jump training up and down the bench. The sample for each group is 8 people who have met the requirements of the male volleyball extra-curricular participants of Tegallalang 1 Public High School. Data from leg muscle explosive results obtained from 3 jumps taken before and after training. The results obtained before and after the Group-1 training were 57.5 cm to 70.875 cm and Group-2 were 57.375 cm to 65.75 cm. Hypothesis testing uses an independent t-test at a significance limit of 0.05 (p <0.05). Based on the differences in the results of the intergroup test analysis using independent t-test obtained group-1 and group-2 for p = 0.935 which showed no significant difference before being given treatment with a p value greater than 0.05. Whereas after treatment the group-1 and group-2 were obtained at p = 0.007 which showed a significant difference between groups 1 and 2 groups with a p value smaller than 0.05. It can be concluded that jumping up and down the stands is more effective than jump training up and down the bench in increasing the explosive power of the leg muscles. For this reason, it is expected that sports coaches to apply jumping up and down the stands as an alternative in increasing athletes' explosive power.Keywords: Training jumping up and down the stands, training jumping up and down the bench, explosive muscle power.

Patterns of Recurrence and Mechanisms of Failure after Open Ventral Hernia Repair with Mesh

2017 ◽  
Vol 83 (11) ◽  
pp. 1275-1282 ◽  
Author(s):  
Jeremy A. Warren ◽  
Sean P. McGrath ◽  
Allyson L. Hale ◽  
Joseph A. Ewing ◽  
Alfredo M. Carbonell ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Mesh Fixation ◽  
Wound Complications ◽  
Light Weight ◽  
Group 2 ◽  
Clean Contaminated ◽  
Recurrence Group ◽  
Group 1

Recurrence after ventral hernia repair (VHR) remains a significant complication. We sought to identify the technical aspects of VHR associated with recurrence. Patients who underwent open midline VHR between 2006 and 2013 (n = 261) were retrospectively evaluated. Patients with recurrence (Group 1, n = 48) were compared with those without recurrence (Group 2, n = 213). Smoking, diabetes, and body mass index were not different between groups. More patients in Group 1 underwent clean-contaminated, contaminated, or dirty procedures (43.8 vs 27.7%; P = 0.021). Group 1 had a higher incidence of surgical site occurrence (52.1 vs 32.9%; P = 0.020) and surgical site infection (43.8 vs 15.5%; P < 0.001). Recurrences were due to central mesh failure (CMF) (39.6%), midline recurrence after biologic or bioabsorbable mesh repair (18.8%), superior midline (16.7%), lateral (16.7%), and after mesh explantation (12.5%). Most CMF (78.9%) occurred with light-weight polypropylene (LWPP). Recurrence was higher if the midline fascia was unable to be closed. Recurrence with midweight polypropylene (MWPP) was lower than biologic (P < 0.001), bioabsorbable (P = 0.006), and light-weight polypropylene (P = 0.046) mesh. Fixation, component separation technique, and mesh position were not different between groups. Wound complications are associated with subsequent recurrence, whereas midweight polypropylene is associated with a lower overall risk of recurrence and, specifically, CMF.

scholarly journals Comparison of placental grading at different periods of gestation in PIH patients and their outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4747
Author(s):  
Sneha S. ◽  
Sreelatha S. ◽  
Renuka Ramaiah
Keyword(s):  
Birth Weight ◽  
P Value ◽  
Medical College ◽  
Medical Disorders ◽  
Biophysical Profile ◽  
Significant Difference ◽  
Fetal Complications ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Background: The current study follows grannum grading of placenta. It is well known that there is accelerated placental maturation in PIH patients and the ultrasonic appearance of grade 3 placenta before 37 weeks may signify placental dysfunction and is associated with development of low birth weight babies, IUGR meconium stained liquor, low APGAR score. Hence this study was conducted to emphasize on placental grading at different periods of gestation to predict and prevent increased obstetric and fetal compromise and to compare the outcomes.Methods: Obstetric scans were performed in all PIH patients attending antenatal OPD and inpatients at ESIC and PGIMSR medical college, Bangalore to know the placental grading and biophysical profile. These women were followed till their delivery for obstetric and fetal outcomes.Results: Grade 3 placenta is seen in 17 patients in group 1(50%) and 39 patients (59%) in group 2. For statistical analysis grade 1 and 2 were combined and compared with  grade 3. P-value 0.198 which was not statistically significant. There was no statistically significant difference in age and gravidity between two groups. The medical disorders were more in group 2 i.e., between 37 - 40 weeks. The complications of PIH were also more in group 2. There were more number of LSCS (n=19 versus 14) in 34-36 weeks group which was not statistically significant. Fetal outcomes like IUGR and IUD were more in group 2 which was not statistically significant. The mean birth weight in group 1 was 2 kg as compared to 2.7 kg in group 2. All associated medical disorders were more in group 2.Conclusions: In hypertensive women there is accelerated placental maturation leading to maternal and fetal complications. Hence women with accelerated placental maturity in ultrasound should be closely monitored and appropriately managed. However, we recommend larger randomized studies are necessary.

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