scholarly journals Comparison of tonsillectomy by coblation and tonsillectomy by conventional method

2020 ◽  
Vol 6 (5) ◽  
pp. 923
Author(s):  
Neha Mihir Karathia ◽  
Atul H. Kansara
Keyword(s):  
Blood Loss ◽  
Pain Score ◽  
Harmonic Scalpel ◽  
Cross Sectional Study ◽  
Open Wound ◽  
Cross Sectional ◽  
Secondary Intention ◽  
Post Operative Pain ◽  
Secondary Haemorrhage ◽  
Time Required

<p class="abstract"><strong>Background:</strong> Operations on tonsils and adenoids are performed since many years. Tonsillectomy produces an open wound that heals by secondary intention. Tonsillectomy is still a very common surgical procedure. There are various modalities to perform surgery (diathermy, laser, harmonic scalpel, radiofrequency cautery, cryosurgery and coblation). Among these, dissection and snare method are commonly done by ENT surgeons.</p><p class="abstract"><strong>Methods:</strong> We carried out the prospective cross-sectional study to compare intraoperative blood loss, time taken for the surgery, post-operative pain score, degree of slough formation and complications between these two methods.  </p><p class="abstract"><strong>Results:</strong> Average time for surgery on coblation side was less (15.1 min) than conventional side (36.04 min). For haemostasis on conventional side, all patients required bipolar cauterization while on coblation side only 8 patients (16%) required hemostasis. Average blood loss on coblation side (left) was 3.40ml while on conventional side (right) 25.57 ml. In my study, mean pain score on 1st day, 2<sup>nd</sup> day, 5<sup>th</sup> and 10<sup>th</sup> day of surgery was 6.18, 4.10, 2.30 and 1.64 on conventional side and 4.36, 3.00, 1 and 0 on coblation side. In my study, only one patient had Secondary haemorrhage on conventional side on 7<sup>th</sup> day.</p><p class="abstract"><strong>Conclusions:</strong> The use of coblator reduces the time required for surgery, per-operative blood loss is very much less, chances of damage to surrounding structures are less, charring of tissue is less, post-operative severity of pain after 24 hours is very much less than that of dissection method. Slough formation was more on coblation side as compared to conventional side.</p>

scholarly journals The association between bone mineral density and postoperative drainage volume following cruciate-substituting primary total knee arthroplasty: a cross-sectional study

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Yuthasak Peerakul ◽  
Jirapong Leeyaphan ◽  
Karn Rojjananukulpong
Keyword(s):  
Blood Loss ◽  
Primary Total Knee Arthroplasty ◽  
Cross Sectional Study ◽  
Postoperative Blood Loss ◽  
Mineral Density ◽  
Cross Sectional ◽  
Total Hip ◽  
Drainage Volume ◽  
Hip Bmd ◽  
Postoperative Drainage

Abstract Background The prevalence of osteoporosis in patients who undergo a primary total knee arthroplasty (TKA) is increasing. Low bone mineral density (BMD) is related to unfavorable outcomes following TKA such as migration of uncemented tibial components. Postoperative blood loss in TKA is an important complication. Non-modifying predicting factors for postoperative blood loss in patients undergoing primary TKA need further elucidation. Studies on the association between BMD and blood loss after TKA are limited. We aimed to demonstrate the relationship between BMD and postoperative drainage volume following primary TKA. Methods A cross-sectional study was conducted between January 2014 and August 2020. A total of 119 primary varus osteoarthritis knees with BMD results were included in the study. Patients with secondary causes of osteoporosis were excluded. Results The median postoperative drainage volume of participants in the normal total hip BMD group and the normal trochanter BMD group was higher than that of patients in the low total hip BMD group and the low trochanter BMD group (285.0 ml vs 230.0 ml, P = 0.003; 282.5 ml vs 240.0 ml, P = 0.013, respectively). Multivariate regression analyses showed that operative time, spinal anesthesia, and normal total hip BMD status were significant predictive factors associated with increased postoperative drainage volume (P = 0.014, 0.022, and 0.013, respectively). No association was identified between the lumbar spine BMD status and postoperative drainage volume. Conclusions The relationship between BMD and postoperative blood loss in primary TKA was identified in this study. Normal total hip BMD was found to be associated with an increased postoperative drainage volume after primary TKA compared with low BMD.

scholarly journals Differences in Surgical Outcome in Near Total Thyroidectomy for Benign Nodular Goiter: A Comparison of LigaSure Vessel Sealer versus Conventional Clamp Knot Tie Technique

2021 ◽  
pp. 65-69
Author(s):  
Shiraz Shaikh ◽  
Champa Sushel ◽  
Ahsan Ali Laghari ◽  
Qamber Ali Laghari ◽  
Zameer Hussain Laghari ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Total Thyroidectomy ◽  
Calcium Level ◽  
Operative Time ◽  
Nodular Goiter ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Post Operative Pain ◽  
Significant Difference ◽  
One Year

Objective: To compare the efficacy of LigaSure Vessel Sealer in Near Total Thyroidectomy versus Conventional Clamp Knot Tie Technique in terms of bleeding, operative time and postoperative drainage. Methodology: This comparative cross sectional study was conducted at Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro. Study duration was one year from November 2019 to October 2020. All patients of any age with benign multinodular goiter and either of gender were included. The study subjects were grouped into two categories by randomization (odd / even). The odd numbers were given to patients operated for ligasure and even numbers were given to patients operated with conventional clamp knot tie technique.  Outcomes were observed with respect to post-operative calcium level, intra-operative bleeding, operative time, post-operative pain & post-operative hospital stay. All the data was recorded via study proforma. Data was analyzed by using SPSS version 20. Results: Total 55 patients were observed. Mean age was 33.25±10.60 years in clamp knot tie procedure group and 35.16±07.96 years in ligasure technique group; without significant difference (p-0.448). Pre and post-operative calcium levels were statistically insignificant among both groups (p-0.358 and 0.163), while loss of blood, hospital stay, post-operative pain and operative duration were significantly greater in clamp knot tie technique group in comparison to ligasure technique group (p-<0.001). Conclusion: LigaSure Vessel Sealer is a feasible and reliable surgical technique and significantly more effective as compared to conventional clamp knot tie technique in terms of post-operative bleeding, operative time, post-operative pain and post-operative hospital stay. However, calcium level was statistically insignificant.

Exploration of pain management following implementation of WHO pain guidelines

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19646-19646
Author(s):  
S. Subongkot ◽  
S. Khounnikhom ◽  
N. Pratheepawanit Johns ◽  
A. Sookprasert
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Daily Life Activities ◽  
Naive Group ◽  
Who Guideline

19646 Background: Pain is among the most common symptoms encountered in cancer patients and remains the first priority of care. Methods: This cross sectional study aimed to explore a pattern of pain management at KKU Hospital by utilizing a numeric rating scale (0–10). Cancer pain patients were categorized based on prior analgesic exposure into two groups; Naïve group, and Routine group. Treatments were defined according to WHO as 1) drug treatment relevant to pain severity, 2) analgesics being prescribed as around-the- clock and 3) analgesics used for break-through pain for patients receiving strong opioid. Results: From Dec 2005 to Jul 2006, 261 patients were enrolled. 93.1% (n=243) were in advanced stages and 88.5% (n=231) were in moderate to severe pain. This pain interfered with patient’s daily life activities mildly to moderately as each pain score increased (p-value<0.01). In Naive group (n=159), 32.7% (n=52) were given analgesics following the WHO on both days 1 and day 3 of admission whereas 40.2% (n=64) patients were not. A decreased pain score was greater (2.61, SD±1.5) in a group following the WHO on day 1. Additionally, a decreased pain score was greater (3.91, SD±1.8) in a group following the WHO on day 3 (p-value <0.0001). This pain score decreased was also clinically significant as pain score reduced more than 3 points. In Routine group (n=102), 32 (31.4%) were given analgesics following the WHO guideline on both day 1 and day 3 of admission. In contrast, 36 (35.3%) were not. A decreased pain score was greater (2.59, SD±1.8) in a routine group following the WHO on day 1. Moreover, a decreased pain score was greater (3.95, SD±1.8) in a group following the WHO on day 3. The clinical significance of pain score reduced was also found on day 3. Of the 261 evaluable patients, the pattern of analgesics usage following the WHO guideline was increased in both groups comparing to at the beginning of the study. Conclusions: The results demonstrated that patients who received pain management following the WHO guideline reported significantly lower pain intensity than those not following the WHO. No significant financial relationships to disclose.

Is the routine use of antibiotics justified in adult tonsillectomy?

2003 ◽  
Vol 117 (5) ◽  
pp. 382-385 ◽  
Author(s):  
B. J. O’Reilly ◽  
S. Black ◽  
J. Fernandes ◽  
J. Panesar
Keyword(s):  
General Practitioner ◽  
Pain Score ◽  
Prospective Trial ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Post Operative Pain ◽  
Perioperative Antibiotics ◽  
Secondary Haemorrhage ◽  
Gp Visits ◽  
Adult Tonsillectomy

Pain and secondary haemorrhage are the commonest complications of adult tonsillectomy, occurring mostly in the community. This is a randomized, double-blind, placebo-controlled, prospective trial of the effect of perioperative amoxycillin on these complications. The incidence and severity of post-operative haemorrhage was measured. For the first 10 post-operative days patients provided a linear pain score, a record of GP visits, and their use of additional antibiotics and analgesics.Of 95 patients considered: 23 suffered a secondary haemorrhage; 54 consulted their general practitioner (GP) because of pain; additional antibiotics were used by at least 31 and additional analgesics by at least 41. No significant differences were demonstrated between the active and placebo groups for any of these measures.This study demonstrates that secondary haemorrhage is common after adult tonsillectomy. Post-operative pain remains a major problem requiring frequent GP consultations. There appears to be no justification for the routine use of perioperative antibiotics.

scholarly journals Proportion of immediate severe postoperative pain in laparoscopic sterilization under general anaesthesia: A cross-sectional study (postoperative pain in laparoscopic sterilization)

2021 ◽  
Vol 43 (5-6) ◽  
pp. 111-116
Author(s):  
Girijanandan Menon ◽  
Manjit George
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Post Operative Pain ◽  
Severe Postoperative Pain ◽  
Numerical Rating ◽  
Laparoscopic Sterilization

Background: Effective control of immediate post operative abdominal pain following laparoscopic sterilization is challenging. The objective of the study was to estimate the incidence of immediate severe postoperative pain following laparoscopic sterilization under general anaesthesia by the proportion of patients with the pain assessed on a numerical rating scale. Methods: A cross sectional study was conducted with the approval of institutional review board and ethics committee. Fifty seven participants with written informed consent underwent the study over a period of six months. Pain was assessed by a trained recovery nurse and data was collected and analyzed. The main outcome measure was immediate severe post operative pain on numerical rating scale (NRS). Results: Among the 57 participants, 14 (24.6%) had immediate severe post operative pain with median score of five in the inter quartile range of 0 to 5.75 and 43 (75.4%) participants had no severe pain. Conclusion: The incidence of immediate severe postoperative abdominal pain after laparoscopic sterilization under general anaesthesia is high. Therefore, the management of pain following laparoscopic sterilization requires individually based multimodal analgesia.

scholarly journals IRON DEFICIENCY ANEMIA;

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Naresh Kumar Seetlani ◽  
Khalid Imran ◽  
Kashif Sadruddin ◽  
Asif Ali ◽  
Pyar Ali ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Loss ◽  
Iron Deficiency Anemia ◽  
Cross Sectional Study ◽  
Deficiency Anemia ◽  
Outcome Variable ◽  
Gi Tract ◽  
Cross Sectional ◽  
Common Causes ◽  
Hospital Stays

Objectives: To determine the frequency of dual lesions detected by Upper and lower GI endoscopies in patients with iron deficiency anemia without obvious blood loss. Study Design: Cross sectional study. Place and Duration of Study: Department of Medicine, Civil Hospital Karachi from 1st Feb 2015 to 31st July 2015. Methodology: A total 163 patients with Iron deficiency anemia (IDA) for duration of 6 months were registered. Upper and lower GI endoscopies were done in all patients. Outcome variable were the presence of dual lesion identified by gastroenterologist during Upper and lower GI endoscopies. All the results were catered in the pre-approved performa and findings were evaluated by SPSS 17. Results: The average age of the patients was 40.64±11.17 years. Frequency of dual lesions detected by Upper and lower GI endoscopies in patients with iron deficiency anemia without obvious blood loss was observed in 38.65% (63/163) cases. Conclusion: Upper GI tract lesion like gastritis, duodenitis, gastric ulcer and duodenal ulcer were the most common causes of IDA without obvious blood loss. However, Dual lesions were not uncommon, thus both procedures (upper and lower GI endoscopies) were required in most (particularly elderly) patients. This can help to provide shorter hospital stays, reduced medical costs and faster decision making for patient care.

scholarly journals A Comparative Study of Oxytocin & Misoprostol in Active Management of Third Stage of Labour

2015 ◽  
Vol 12 (1) ◽  
pp. 22-24
Author(s):  
N Ansari ◽  
CR Das
Keyword(s):  
Blood Loss ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Active Management ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference ◽  
Third Stage ◽  
Group A ◽  
Group B

Introduction: The third stage of labour is the period which follows the completed delivery of the foetus and consists of delivery of the placenta and its attached membranes.Aims and objectives: Comparison of oxytocin & misoprostol in active management of third stage of labour.Material and Methods: This is a comparative cross-sectional study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur from March 2013 to March 2014. Group A - Oxytocin 10 IU IV bolus in 100 patients and Group B - Misoprostol 600 micro gram rectally. The collected were subjected to statistical analysis using SPSS 15.Results: After active management with bolus oxytocin, the blood loss was grossly reduced being 40-100ml in 84% cases and only 7% had blood loss more than 100ml. blood loss between 200-300ml were only 6% and only 3% had PPH, after misoprostol 80% of cases had blood loss within 40 – 100 ml., 6% cases had blood loss within 100 – 200 ml. and larger amount of blood loss i.e. between 200 – 300 ml. was observed in 7% cases, in 3% cases blood loss was between 300 – 400 ml. and 4% of women in this group had PPH.Conclusion: There was no statistically significant difference in the efficacy of oxytocin and misoprostol in reducing amount of blood loss and duration of labour rd in 3 stage of labour.Journal of Nepalgunj Medical College Vol.12(1) 2014: 22-24

Facilitation of pain sensitization in knee osteoarthritis and persistent post-operative pain: A cross-sectional study

2013 ◽  
Vol 18 (7) ◽  
pp. 1024-1031 ◽  
Author(s):  
S.T. Skou ◽  
T. Graven-Nielsen ◽  
S. Rasmussen ◽  
O.H. Simonsen ◽  
M.B. Laursen ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Post Operative Pain ◽  
Pain Sensitization

scholarly journals AB0886-HPR ASSESSMENT OF SEASONAL VARIATIONS ON CHRONIC INFLAMMATORY RHEUMATISMS ACTIVITY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1466.2-1467
Author(s):  
O. Hamdi ◽  
M. Sellami ◽  
S. Miladi ◽  
A. Fazaa ◽  
L. Souabni ◽  
...  
Keyword(s):  
Disease Activity ◽  
Pain Score ◽  
Health Care Professionals ◽  
Seasonal Changes ◽  
Morning Stiffness ◽  
Cross Sectional Study ◽  
Tender Joint Count ◽  
Tender Joint ◽  
Cross Sectional ◽  
Asas Criteria

Background:Although rheumatoid arthritis (RA) and spondyloarthritis (SA) activities have been described to vary under the influence of several factors, little is known about the influence of seasonality on the activity of chronic inflammatory rheumatisms.Objectives:To assess the influence of seasonality on the activity of chronic inflammatory rheumatisms.Methods:We conducted a cross-sectional study involving patients with RA (2010 ACR/EULAR criteria) and SA (2009 ASAS criteria). Chronic inflammatory rheumatisms activity was assessed during the summer (June-September) and winter (December-February) using clinical parameters including the Patient’s Global Assessment of disease activity (PGA), 10-cm Visual Analog Scale (VAS) pain score, morning stiffness, nocturnal awakenings, and joint count for RA (tender joint count (TJC) and swollen joint count (SJC)); biological parameters including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP); disease activity scores including the SDAI, CDAI and DAS28for RA, BASDAI and ASDASCRP for SA. An analysis of variance (ANOVA) was used to assess the statistical relationship between seasonality and rheumatisms activities.Results:We enrolled 175 patients (100 RA and 75 SA) with a sex ratio of 0.5 and a mean age of 57.75 ± 10.53 years [23-83]. The mean chronic inflammatory rheumatisms duration was 12.38 ± 4.6 years. RA was erosive in 91% of cases. Rheumatoid factor and anti-citrullinated peptides antibodies were positive respectively in 84% and 85% of cases. Seventy-five percent of RA patients were on corticosteroids with a mean dose of 10.14 mg/day of prednisone equivalent and 79% of SA patients were on non-steroidal anti-inflammatory drugs. Eighty percent of our patients were treated with conventional synthetic DMARD and 44% with biological DMARD. Small joints were more affected than large joints regardless of the season in RA patients (p=0.05). The following parameters were higher in winter than in summer in RA patients: mean PGA 4.73 vs 4.64 (p=0.01); mean morning stiffness 1.6 vs 1.1 (p=0.01); mean SJC 8.7 vs 7.5 (p=0.01); mean DAS28 ESR 4.56 vs 3.99 (p= 0.05); mean DAS28 CRP 4.6 vs 3.41 (p= 0.05), mean SDAI 21.8 vs 19.5 (p= 0.05); mean CDAI 20.5 vs 18.75 (p= 0.01) and mean ESR 45.6mm/h vs 38.2 mm/h (p=0.01). As for SA, the following parameters were higher in winter than in summer: mean morning stiffness 2 vs 1.4 (p= 0.01); mean ASDASCRP 3.9 vs 3.1 (p= 0.01) and mean BASDAI 6.2 vs 4.9 (p= 0.05). However, we found no statistically significant correlation between seasonal changes and VAS pain score, nocturnal awakenings, TJC, and CRP.Conclusion:Chronic inflammatory rheumatisms activity was higher in winter. Health care professionals should take seasonal changes into account in order to improve therapeutic care.Disclosure of Interests:None declared

scholarly journals O27 THE IMPACT OF NERVE MANAGEMENT ON THE RISK FOR PERSISTING POSTOPERATIVE PAIN FOLLOWING OPEN ANTERIOR MESH REPAIR OF INGUINAL HERNIA

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Linn Westin ◽  
Ulf Gunnarsson ◽  
Gabriel Sandblom ◽  
Ursula Dahlstrand
Keyword(s):  
Postoperative Pain ◽  
Mesh Repair ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Ordered Logistic Regression ◽  
Post Operative Pain ◽  
Intraoperative Management ◽  
Mesh Hernia Repair ◽  
One Year ◽  
The Impact

Abstract Aim The impact of peripheral nerve management on post-operative pain is poorly known. The aim was to evaluate how management of the inguinal nerves during anterior mesh hernia repair affects the risk for long-term postoperative pain. Material and Methods Cross-sectional study based on the Swedish Hernia Register (SHR). Includes patients over 18 years of age with an open anterior repair during 2012-2018, who responded to a one-year follow-up questionnaire regarding pain. Ordered logistic regression analysis was applied to determine risk factors for pain. Results In total 35,720 patients who were operated with anterior mesh repair responded to the PROM questionnaire. Overall, 15.6% reported pain interfering with daily activities. The risk for persisting groin pain one year after surgery was not impacted by transecting the iilioingiounal nerve (0.49), the iliohypogastric nerve (0.17) or the genital branch of the genotiofemoral nerve (0.25) in a multivariable ordinal regression adjusting for anaesthesia, gender, age and emergency surgery. Conclusions Intraoperative management of the three main inguinal nerves was not associated with the risk for persisting pain in the operated groin one year after surgery.

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