scholarly journals Early enteral nutrition in acute pancreatitis - how beneficial is it?

2021 ◽  
Author(s):  
Shruthikamal Venkat ◽  
Rajesh Subramaniam ◽  
Vijai Raveendran
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Stay ◽  
Pain Score ◽  
Tamil Nadu ◽  
Early Enteral Nutrition ◽  
Medical College ◽  
Severe Pancreatitis ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Mean

Background: Acute pancreatitis is an inflammatory disease of pancreas and is one of the leading cause of acute abdomen requiring hospital admission. Nutritional support plays a crucial role in this hypercatabolic state in not only providing calories but also in preventing complications and decreasing recovery time.Methods: This prospective study was done among 120 patients with acute moderate and severe pancreatitis who got admitted in department of general surgery at Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India between 2018 and 2019.Results: 67 (55.8%) patients were in early enteral and 53 (44.2%) were in parenteral/delayed enteral group. Maximum number of patients were in 30-40 years age group. The mean of patient age was 40.33. Mean duration of hospital stay in enteral group was 7.06 and in parenteral/delayed enteral group it was 14.09 (p<0.001). Mean pain score in enteral group was 2.69 and in parenteral group it was 6.51 (p<0.001).Conclusions: There was significant (p<0.001) decrease in hospital stay duration and pain score in early enteral group compared to parenteral/delayed enteral group. Infections related to feeding route was found high in parenteral group. No significant difference found in complications of acute pancreatitis. Hence early enteral feeding is more beneficial in terms of shortened hospital stay, decreased pain score leading to reduction in usage of analgesics and reducing the recovery time and less nutrition related complications in management of acute moderate and severe pancreatitis.

scholarly journals A Comparative Study of Laparoscopically Assisted Vaginal Hysterectomy and Non-descended Vaginal Hysterectomy

2014 ◽  
Vol 6 (2) ◽  
pp. 101-103
Author(s):  
De Reena ◽  
Sebanti Goswami
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
P Value ◽  
Medical College ◽  
Laparoscopically Assisted Vaginal Hysterectomy ◽  
Significant Difference ◽  
The Mean ◽  
The Difference ◽  
Prospective Longitudinal

ABSTRACT Introduction The present study was done to compare nondescended vaginal hysterectomy (NDVH) and laparoscopically assisted vaginal hysterectomy (LAVH) with reference to indications, operative complications and outcome. Materials and methods This prospective longitudinal comparative study was conducted in the Department of Obstetrics and Gynecology, Medical College and Hospital, Kolkata, from November 2010 to October 2011. Judging the inclusion and exclusion criteria a sample size of 36 patients for NDVH and 31 patients for LAVH were selected randomly. The outcome of each surgical procedure was analyzed by standard statistical methods. Appropriate test of significance was applied (t-test) with p < 0.05 as level of significance. Results The mean duration of NDVH was 65 minutes and that of LAVH was 93.87 minutes. The difference was highly significant as p value was 0.000. The mean pain score analyzed by visual analog scale (VAS) in NDVH was 2.334 and 2.581. This was not statistically significant (p = 0.636). There was no significant difference in hospital stay in either group. Conclusion Laparoscopically assisted vaginal hysterectomy has the advantage of visualization of the pelvic structure from above and occasional dissection and adhesiolysis. But NDVH supersedes in its approach through the naturally created route, being faster, less expensive and results in a similar hospital stay and convalescence. How to cite this article Reena D, Goswami S. A Comparative Study of Laparoscopically Assisted Vaginal Hysterectomy and Non-descended Vaginal Hysterectomy. J South Asian Feder Obst Gynae 2014;6(2):101-103.

scholarly journals A RETROSPECTIVE STUDY COMPARING PROXIMAL FEMORAL NAIL ANTI-ROTATION WITH CEMENTLESS BIPOLAR HEMIARTHROPLASTY FOR UNSTABLE FEMORAL INTERTROCHANTERIC FRACTURE

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Satish Bobade ◽  
Sandesh Bobade ◽  
Pravin Deokate
Keyword(s):  
Retrospective Study ◽  
Hospital Stay ◽  
Intertrochanteric Fracture ◽  
Proximal Femoral Nail ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Number Of Patients ◽  
Significant Difference ◽  
Femoral Intertrochanteric Fracture ◽  
The Mean

Background: Intertrochanteric femoral fractures are one of the most common types of bone fractures that are usually caused by severe direct or indirect force. It has also been estimated that nearly 50% of all the fractures are intertrochanteric fractures and the remaining are unstable fractures. Also, it has been found that the mortality related to hip fractures is as high as 15-20%. With an increase in the life expectancy of people, there has been a substantial increase in the number of patients with postmenopausal or senile osteoporosis. Aim: To compare Proximal femoral nail anti-rotation with cementless bipolar hemiarthroplasty for unstable femoral intertrochanteric fracture Methods: It was a retrospective study carried out at the Government Medical College, Baramati for a period of 1 year. One hundred patients were included for the scope of the study. Out of which 50 patients belonged to the PFNA group, and 50 patients belonged to the CPH group. Results: The number of patients in the PFNA group was 50 and that in the CPH group was 50. Both groups show male preponderance. The mean age among both the groups was almost the same, and there was no statistically significant difference among the two groups regarding the mean age. The mean operation time for PFNA was 54.15±16.1 mins, and that of the CPH group was 76.69±15.89 mins. The mean bleeding time for PFNA was 133.12±33.16 ml, and that of the CPH group was 289.25±44.01 ml. There was no statistically significant difference among the ASAA grade scores of the two groups. There was no statistically significant difference among the Evans-Jensen classification of the two groups. The mean length of hospital stay for PFNA group was 7.89±2.0 days, and the mean hospital stay for CPH group was 6.54±1.9 days. Conclusion: The current study depicted that CPH and PFNA are both safe and effective methods of treating elderly patients suffering from intertrochanteric fractures. However, it was found in the current study that CPH was found to have more mean operative time and increased blood loss. Still, the recovery and hospitalization time was almost similar in both the groups. Both the groups had almost similar ASA and Evans Jensen scores that made both the techniques equally safe

scholarly journals Complex Regional Pain Syndrome: Current Practice Management and Referral Trends in a Closed Healthcare System

Osteology ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 39-47
Author(s):  
Connor Zale ◽  
Joshua Hansen ◽  
Paul Ryan
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Complex Regional Pain Syndrome ◽  
Healthcare System ◽  
Pain Syndrome ◽  
Occupational Outcomes ◽  
Mean Delay ◽  
Significant Difference ◽  
The Mean ◽  
Over Time

Background: Complex regional pain syndrome (CRPS) is a neurologic condition that can present with severe pain and dysfunction. Delay in treatment adversely affects outcomes. The purpose of this study is to evaluate patient outcomes as they relate to the time from diagnosis to pain management referral once the diagnosis of CRPS has been made in a closed healthcare system. Methods: A retrospective record review from a closed healthcare system was utilized for CRPS cases from 2010–2019. Demographics, injury pattern, surgeries, pain score, treatment modalities, occupational outcomes, and time to pain management referral were recorded. Results: There were 26 cases of CRPS that met inclusion criteria. The mean time from diagnosis to treatment was 55 days. 16/26 (61.5%) were medically discharged from the military. 23/26 (88.5%) were unable to return to full duty due to CRPS. There was no significant difference in the reported pain scores over time regardless of treatment (p = 0.76). A linear regression demonstrated a significantly higher Visual Analog Scale Pain Score (VAS) over time in patients that were medically discharged (p = 0.022). Conclusions: The mean delay in referral to the pain service was 55 days. The majority of patients (88.5%) did not return to full duty secondary to the diagnosis of CRPS, and 61.5% of patients required medical separation from active duty. Due to the negative impact that the diagnosis of CRPS has on occupational outcomes with a mean delay in referral of 55 days, clinics and providers should set up referral criteria and establish early pain pathways for patients diagnosed with CRPS.

scholarly journals Minimally invasive direct coronary artery bypass versus off-pump coronary surgery through sternotomy

2013 ◽  
Vol 95 (7) ◽  
pp. 481-485 ◽  
Author(s):  
R Birla ◽  
P Patel ◽  
G Aresu ◽  
G Asimakopoulos
Keyword(s):  
Coronary Artery ◽  
Blood Transfusion ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Off Pump ◽  
Opcab Group ◽  
Significant Difference ◽  
The Mean

Introduction Although it is not a new technique, minimally invasive direct coronary artery bypass (MIDCAB) is employed only by a few surgeons in the UK. We compared our experience with MIDCAB with that of single vessel off-pump coronary artery bypass (OPCAB) graft surgery through a standard median sternotomy. Methods Patients who underwent either MIDCAB or OPCAB between April 2008 and July 2011 were reviewed. Exclusion criteria included patients with an ejection fraction of <0.5 or previous cardiac surgery. Data were obtained retrospectively from our prospective database, medical records and through general practitioners. Results Overall, 74 patients were analysed in the MIDCAB group and 78 in the OPCAB group. Their demographics and EuroSCORE (European System for Cardiac Operative Risk Evaluation) values were comparable (p>0.05). There was no statistically significant difference in the two groups in terms of mortality, recurrent myocardial infarction, postoperative stroke, wound infection, atrial fibrillation or need for reintervention. The MIDCAB group had six conversions to a sternotomy. Eight patients in each group required blood transfusion, with the average transfusion being 1.8 units in the MIDCAB group and 3.2 units in the OPCAB group. The mean duration of ventilation and intensive care unit stay was 5.0 hours and 38.4 hours in the MIDCAB group and 5.4 and 47.8 hours in the OPCAB group. The mean hospital stay was significantly reduced in the MIDCAB population (6.1 vs 8.5 days, p<0.05). Conclusions MIDCAB can be performed safely in appropriately selected patients with outcomes comparable with OPCAB. The potential benefits include shorter hospital stay, reduced need for blood transfusion and faster recovery.

scholarly journals Diverticular fistulation is associated with nicorandil usage

2010 ◽  
Vol 92 (6) ◽  
pp. 463-465 ◽  
Author(s):  
James McDaid ◽  
Claire Reichl ◽  
Ihsan Hamzah ◽  
Samantha Fitter ◽  
Laura Harbach ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Fistula Formation ◽  
Control Group ◽  
Number Of Patients ◽  
Significant Difference ◽  
Patient Groups ◽  
The Mean ◽  
Uncomplicated Diverticular Disease ◽  
And Control ◽  
Control Study

INTRODUCTION We observed that a number of patients presenting to our clinic with diverticular fistulation were taking nicorandil for angna. Recognised side effects of nicorandil include gastrointestinal and genital ulceration. The aim of our study was to determine whether nicorandil is an aetiological agent in diverticular fistulation. PATIENTS AND METHODS We conducted a case-control study of patients with diverticular disease related enteric fistulae. Two patient groups were identified: a study group of patients with diverticular fistulae, and a control group with uncomplicated diverticular disease. The proportion of patients who had ever used nicorandil was compared between the two groups. RESULTS A total of 153 case notes were analysed, 69 patients with fistulae and 84 control patients with uncomplicated diverticular disease. Female to male ratio in both groups was 2:1. The mean age was 71 years in the fistula group and 69 years in the control diverticular disease group (P = ns). Of those with colonic fistulae, 16% were taking nicorandil compared with 2% of the control group (odds ratio 7.8; 95% confidence interval 1.5–39.1; P = 0.008). There was no significant difference in rates of ischaemic heart disease between fistula and control groups. CONCLUSIONS Nicorandil is associated with fistula formation in diverticular disease.

scholarly journals TO STUDY THE ONSET AND PROGRESSION OF AIRWAY ABNORMALITY IN TERMS OF ALTERATION IN PFT IN ASYMPTOMATIC SMOKERS.

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Hitesh Kumar Solanki ◽  
Dr. Omnath P Yadav ◽  
Dr. Anita J Gojiya
Keyword(s):  
Lung Function ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Group I ◽  
Significant Difference ◽  
History Of ◽  
Young Smokers ◽  
The Mean ◽  
Group Ii

The study was conducted in department of physiology, B J Medical College, Ahmedabad from Mar. 2012 to Feb. 2013. This was a cross-sectional study to evaluate the effect of smoking on lung   function and serum lipids in asymptomatic smokers   and comparable non   smokers. The mean of the various spirometric parameters were calculated of the subjects for both the groups. The mean FVC in group I and group II was 2.60 ± 0.62 L and 4.10 ± 0.64L respectively. The mean FEV1 in group I was 1.91 ± 0.57L and     3.19 ± 0.77L in group II Group I had mean FEF25% - 75% and PEFR of 1.98 ± 0.67L/sec and 4.50 ± 1.57L/sec respectively. Group II had mean FEF25 – 75% of 4.22 ± 1.23L/sec and a mean PEFR of 7.22 ± 1.42L/sec. In young smokers and asymptomatic, still the spirometric values were significantly deranged as compared to controls. Even smokers with history of less pack years of smoking also had significant abnormalities of lung function. All he spirometric values in the two groups had statistically highly significant difference and were higher in non-smokers as compared to smokers. The spirometric values were reduced in smokers with history of smoking for as low as two pack years. Keywords: Progression, PFT, Asymptomatic & Smokers

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

Thyroid Nodules in Patients with Acromegaly: Frequency According to the ACR TI-RADS Classification and its Relationship with Disease Activity

2021 ◽  
Author(s):  
Mustafa Can ◽  
Muhammet Kocabaş ◽  
Melia Karakose ◽  
Hatice Caliskan Burgucu ◽  
Zeliha Yarar ◽  
...  
Keyword(s):  
Disease Activity ◽  
Thyroid Nodules ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Control Subjects ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Abstract Purpose: In our study, we aimed to determine the frequency of thyroid nodules in patients with acromegaly according to the American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS) classification and its relationship with acromegaly disease activity. Methods: A total of 56 patients with acromegaly and age, sex, and body mass index matched with 56 healthy control subjects were included in our study. Thyroid-stimulating hormone, free thyroxine, and anti-thyroperoxidase antibody levels of patients and control subjects were measured. In addition, patients and healthy controls were evaluated by ultrasonography to determine thyroid structure, thyroid volume, and thyroid nodules and to make ACR TI-RADS classification. Results: Thyroid nodules were present in 31 (55.4%) of 56 patients in the acromegaly group and 20 (35.7%) of 56 subjects in the control group, and the frequency of thyroid nodules was significantly higher in the acromegaly group (p=0.038). The mean number of nodules in the acromegaly group and control group was 1.27±1.43 and 0.48±0.73, respectively, and the mean number of nodules was significantly higher in the acromegaly group (p=0.003). The number of patients with TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules in the acromegaly group was higher than the control group (p=0.026, p=0.049, p=0.007, respectively). No difference was found in terms of cytological findings between those who have undergone FNAB in the acromegaly group and control group. Conclusion: In our study, we found that the frequency of thyroid nodules, the number of thyroid nodules, and the number of TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules increased in patients with acromegaly. There was no significant difference between acromegaly disease activity and thyroid nodule frequency, number of thyroid nodules, and TI-RADS classifications.

Clinical Results Of A Lamina With Spinous Process And An Iliac Graft As Bone Grafts In The Surgical Treatment Of Single-Segment Lumbar Pyogenic Discitis: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Weiyang Zhong ◽  
Xinjie Liang ◽  
Xiaolin Wang ◽  
Ke Tang ◽  
Tianji Huang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Spinous Process ◽  
Bone Grafts ◽  
Clinical Results ◽  
Single Segment ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Segmental Angle

Abstract Background: A retrospective study investigated and compared the results of a lamina withspinous process (LSP) and an iliac graft (IG) as bone grafts in single-segment lumbar pyogenic discitis (LPD) through one-stage-posterior-only approach with radical debridement and internal instrumentation.Methods: Data from 37 patients were reviewed. A LSP was placed in 17 patients (group A), and an IG was implemented in 20 patients (group B). The surgery time, surgery hemorrhage, hospital stay, drainage, and follow-up (FU) were reviewed. The visual analogue scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, segmental angle, intervertebral height and bony fusion time were compared preoperatively and at the final FU.Results: All patients were followed-up for a mean of 27.94±2.35 months in group A and 30.29±1.89 months in group B, without a difference. The mean age was younger in group A than in group B (P<0.05). The surgery time, surgery hemorrhage, and hospitalization cost were lower in group A than in group B (P<0.05), except for the hospital stay and drainage time. Fever occurred in 10 patients in group A and 12 patients in group B. The ESR, CRP level, and VAS and ODI scores were significantly decreased, and there were no significant differences between the groups at the final FU. The distribution of bacterial agents in blood culture was 1 case of Aerobacter cloacae, 2 of Staphylococcus aureus, 2 of Escherichia coli, and 1 of Streptococcus viridis in group A and 1 of S. aureus，1 of Staphylococcus warneri and 2 of Klebsiella pneumoniae in group B. Pyogenic infection was observed in the pathological findings of all patients. No significant difference was found in the mean segmental angle or mean intervertebral height preoperation and at the final FU between the groups.Conclusion: The use of LSP as a new bone graft is reliable, safe, and effective for surgical management for the LPD while surgery is proposed as a good management strategy for LPD in carefully selected patients.

scholarly journals The outcomes of isolated ureteral resection and reconstruction in non-urologic cancer patients who underwent cytoreductive surgery (CRC) and hyperthermic intraperitoneal chemotherapy (HIPEC)

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Şevket Barış Morkavuk ◽  
Murat Güner ◽  
Mesut Tez ◽  
Ali Ekrem Ünal
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Postoperative Mortality ◽  
Surgical Oncology ◽  
Ureter Reconstruction ◽  
Management Of Complications ◽  
Significant Difference ◽  
The Mean

Abstract Background Urinary system resections are performed during the cytoreductive surgery with hypertermic intraperitoneal chemotherapy (CRS-HIPEC). However, isolated ureter resection and reconstruction results are uncertain. The aim of this study was to evaluate the postoperative outcomes of isolated ureteral resection and reconstructions in patients who underwent CRC and HIPEC procedure. Methods A total of 257 patients that underwent CRC and HIPEC between 2015 and 2017 in the Department of Surgical Oncology, Faculty of Medicine, Ankara University, were retrospectively analyzed. Twenty patients that had undergone isolated ureteral resection and reconstruction were included in the study. Predisposing factors were investigated in patients who developed postoperative complications. Results The mean age of the patients was 55.1 years. The mean follow-up time of all the patients was 11.6 months. Postoperative mortality occurred in two patients. The mean PCI score was 13.9. Postoperative urologic complications were observed in eight patients after ureter reconstruction. There was no statistically significant difference between the groups in terms of reconstruction techniques and postoperative complications (P = 302). There was no correlation between age (P = 0.571) and gender (P = 0.161) with complications. CRS-HIPEC was performed mostly due to gynecologic malignancy. However, there was no correlation between the primary cancer diagnosis and the development of complications (P = 0.514). The hospital stay duration was higher in the group with complications (16.3 vs 8.8 days, P = 0.208). Conclusions Ureteral resections and reconstructions can be performed for R0/1 resections in CRS-HIPEC operations. It leads to an increase in hospital stay. But there is no significant difference in the development of complications. In the management of complications, conservative approach was sufficient.

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