Comparing titanium elastic nailing and plate osteosynthesis in treating both bone diaphyseal fractures of forearm in children

Background: The present study aimed to compare the outcome of fixation of diaphyseal fractures of both bones of forearm using plate osteosynthesis (PO) and titanium elastic nail (TEN).Methods: This comparative non-randomized clinical trial was done on children aged 5 to 15 years, with diaphyseal fractures of both bone forearm fractures, operated and managed at the department of orthopedics, Assam Medical College and Hospital, Dibrugarh. Intra- and post-operative findings were compared between PO and TEN group patients.Results: Duration of hospital stay was significantly lower in patients in the TEN group (44.75±6.38 minutes) as compared to those in the PO group (69.71±5.91 minutes), p value <0.01. Similarly, duration of hospital stay was significantly lower in patients in the TEN group (5.01±0.67 days) as compared to those in the PO group (8.32±1.44 days), p value <0.05. Based on price criteria, 80% of the patients in the PO group and 85% in TEN group had excellent functional outcome. Radiological union time, maximum radial bow and location of maximal radial bow were found to be statistically similar in the two groups. Complication rate was similar in the two study groups.Conclusions: Based on the results of the present study, we conclude that both PO and TEN are be safely performed in children with diaphyseal both bone forearm fractures. With comparable functional and radiological outcomes, future studies are required before one technique can be recommended over the other.

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Evaluating efficacy of oral zinc as adjuvant therapy in acute diarrhea in children.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.08.4318 ◽

2020 ◽

Vol 27 (08) ◽

pp. 1626-1630

Author(s):

Nathumal Maheshwari ◽

Nadeem Noor ◽

Adnan Bashir ◽

Bilawal Hingorjo ◽

Arshad Ali ◽

...

Keyword(s):

Adjuvant Therapy ◽

Hospital Stay ◽

Acute Diarrhea ◽

Control Group ◽

Study Group ◽

Once Daily ◽

Medical College ◽

Duration Of Hospital Stay ◽

Control Study ◽

Stool Volume

Objectives: To evaluate the efficacy of oral zinc as adjuvant therapy in acute diarrhea comparing frequency and volume of stool and duration of diarrhea in children. Study Design: Case Control study. Setting: Department of Paediatrics, Shaheed Muhtrama Benazir Bhutto Medical College Layari General Hospital, Karachi. Period: September 2017 to August 2018. Material & Methods: A sample of 200 children, age 5- 15 years, suffering from acute diarrhea was divided into control and cases (study group). Oral zinc therapy (20 mg once daily) was given 14 days and its efficacy was observed in terms of stool frequency, stool volume and duration of diarrhea. Variables were noted at 24 hours and 48 hours and on 7th day of hospitalization. Data was analyzed on SPSS statistical software (version 22.0) at 95% confidence interval (P≤ 0.05). Results: Mean ± SD age in control and study group was noted as 9.1± 5.43 years and 9.5±6.02 years respectively (P=0.053). 89% of children of study group were discharged on 3rd day of hospitalization compared to only 45% from control group. Zinc treated study group shows significant decrease in frequency of loose stools, stool volume and lesser duration of hospital stay. Conclusion: Oral zinc therapy was effective in decreasing the frequency of loose stools and volume and lesser duration of hospital stay in children.

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Study on outcome of laparoscopic donor nephrectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20173424 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2811

Author(s):

Subha Kanesh S. K. ◽

Govindarajan P.

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Operating Time ◽

Donor Nephrectomy ◽

Laparoscopic Donor Nephrectomy ◽

Analgesic Requirement ◽

Ischemic Time ◽

Medical College ◽

Duration Of Hospital Stay ◽

The Mean

Background: Laparoscopic donor nephrectomy is being performed in increasing numbers since 1995. Now laparoscopic donor nephrectomy has been accepted as good alternate to open procedure as seen in various other abdominal surgeries. This was the basis of the present study. So, the present study was designed to analyse and compare the outcome of Laparoscopic donor nephrectomy and Open donor nephrectomies.Methods: The prospective and observational study was conducted at Stanley Medical College in Department of Urology in 61 Patients aged between 25-50 years who underwent left donor nephrectomy The Mean operating time, warm ischemic time, blood loss, analgesic requirement and duration of hospital stay were recorded and analysed statistically.Results: Out of 61 donor nephrectomies, 16 kidneys harvested by laparoscopic method with only 2 (12%) conversion to open due bleeding. Mean operating time was 179.9±47.6 minutes. Present study showed mean blood loss of (163±93 ml). Analgesic requirement of the LDN (mean 1.25 days) was significantly lower when compared to open group (mean 3.75 days). The present study shows duration of hospital stay was lower in LDN (mean 5.1days).Conclusions: Laparoscopic donor nephrectomy is an effective, safe and rewarding though it is time consuming and technically challenging. The analgesic requirement, duration of hospital stay and the blood loss were less with the laparoscopic surgery. Results of graft functioning of kidneys in both procedures were equivalent. So laparoscopic donor nephrectomy can be made as the procedure of choice in future.

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A comparison of lung function in pranayama trained and untrained medical students

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171230 ◽

2017 ◽

Vol 5 (4) ◽

pp. 1377

Author(s):

Thirupathi C. ◽

Aanandha Subramaniam K.

Keyword(s):

Medical Students ◽

Lung Function ◽

Study Groups ◽

P Value ◽

Study Group ◽

Breathing Exercise ◽

Medical College ◽

Chest Expansion ◽

Before And After ◽

Madras Medical College

Background: Pranayama is a form of breathing exercise. It is a very useful in reducing the weight and improving the respiratory function. The study was designed to assess the effect of pranayama on pulmonary Function among adult male students.Methods: The control and the study groups each consisted of 50 number of male MBBS students aged between 16 to 22 years, studying at Madras Medical College, were recruited for the present study. The study group were taught pranayama and allowed to practice it daily twice in morning and evening for 15 minutes for 10 weeks under supervision. Parameters like weight, BMI, chest expansion, respiratory rate and spirometric parameters like FVC, FEV1 and PEFR were recorded before and after the study.Results: A significant increase in chest expansion, FVC, FEV1 and PEFR with p value <0.05were recorded in study group in comparison with control group.Conclusions: Pranayama improves the lung function among medical students.

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Triaging patients with upper gastrointestinal bleeding: the utility of Glasgow-Blatchford score

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195614 ◽

2019 ◽

Vol 8 (1) ◽

pp. 42

Author(s):

Namita Mohanty ◽

Arjun Nataraj Kannan

Keyword(s):

High Risk ◽

Blood Transfusion ◽

Gastrointestinal Bleeding ◽

Hospital Stay ◽

Upper Gastrointestinal Bleeding ◽

Positive Likelihood Ratio ◽

Low Risk ◽

P Value ◽

Duration Of Hospital Stay ◽

Upper Gastrointestinal

Background: Glasgow-Blatchford bleeding score (GBS), was developed to predict the need for hospital-based intervention (transfusion, endoscopic therapy or surgery) or death following upper gastrointestinal bleeding. Study evaluated the Glasgow Blatchford score’s (GBS) ability to identify high risk patients who needed blood transfusion in patients with UGI haemorrhage.Methods: A total of 270 cases admitted with upper gastrointestinal bleeding in the Medical ICU/Wards of MKCG Medical College were put on Blatchford scoring system and classified as those requiring (high risk = GBS >1) and not requiring blood transfusion (low risk) based on the score assigned on admission and a correlation between initial scoring and requirement of blood transfusion was done.Results: Units of blood transfusion required, the GBS and duration of hospital stay were significantly lower among the low risk group, all with p value <0.001. No blood transfusion was required in patients with GBS <3. There was significant correlation between GB score and requirement of blood transfusion (p <0.001) and duration of hospital stay (p <0.001). GBS had 100% sensitivity, negative predictive value and positive likelihood ratio, when a cut off of > 16 was used in predicting mortality.Conclusions: Patients presenting with Upper GI bleeding can be triaged in casualty with Glasgow Blatchford scoring. Patients with a low score of less than or equal to 3 can be safely discharged and reviewed on follow up thereby reducing admission, allowing more efficient use of hospital resources.

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Duration of Hospital Stay and Treatment Pattern among Patients Undergoing Common Operative Procedures at tertiary care hospital in Nepal

Janaki Medical College Journal of Medical Science ◽

10.3126/jmcjms.v7i2.30691 ◽

2019 ◽

Vol 7 (2) ◽

pp. 27-35

Author(s):

Sanjay Chaudhary ◽

Lokeshwar Chaurasia ◽

Jitendra Kumar Singh

Keyword(s):

Hospital Stay ◽

Operative Procedure ◽

Tertiary Care ◽

Treatment Pattern ◽

Operative Procedures ◽

Care Hospital ◽

Third Generation ◽

Medical College ◽

Duration Of Hospital Stay ◽

Significant Difference

Background and Objectives: Appendectomy, cholecystectomy, fistulectomy, and herniotomy or herniorrhaphy are the most common surgical operations in Nepal. Despite the high prevalence and complexity of the patient population served by general and universal surgery services, little has been reported about the services, treatment procedures and outcomes. Therefore, the study is designed to investigate the duration of hospital stay, and treatment pattern among patients undergoing common surgical operative procedures at Janaki Medical College, Janakpur, Nepal. Material and methods: A prospective observational study was conducted among patients undergoing common surgical operative procedures at surgery department of Janaki Medical College (JMC) over a period of one year from January 2018 to December 2018. Patients of all age groups and gender undergoing surgical operative procedures; appendectomy, herniotomy cholecystectomy and fistulectomy were included in the study. The patients were assessed preoperatively, intra-operatively and postoperatively. Results: In a total of 325 patients, 11.1% of patients underwent fistulectomy, 14.5% underwent appendectomy, 35.4% underwent herniorrhaphy and 39.1% underwent cholecystectomy. Mean duration of stay at hospital for cholecystectomy was slightly higher (8.13±2.40 days) than other operating procedures: fistulectomy (5.44 ±1.48 days), appendectomy (7.40±2.00 days), and operative procedure of hernia (6.17±1.59 days). Most commonly used antibiotic for control of preoperative and post operative infection was third generation cephalosporin’s, ceftriaxone and cefixime. Conclusion: The study demonstrates longer duration of hospital stay for cholecystectomy as compared to other operating procedures like fistulectomy, appendectomy, herniorrhaphy, hernioplasty and herniotomy with significant difference by types of surgery. Most commonly used antibiotic for control of infection was third generation cephalosporin, ceftriaxone and cefixime.

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Evaluation of the nutritional status in children with acute lymphoblastic leukemia and its effect on the outcome of induction in a developing country.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e22004 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e22004-e22004

Author(s):

Arifa Khalid ◽

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Nutritional Status ◽

Hospital Stay ◽

Nutritional Support ◽

Lymphoblastic Leukemia ◽

P Value ◽

Z Score ◽

Female Ratio ◽

Duration Of Hospital Stay ◽

End Of Treatment

e22004 Background: Acute Lymphoblastic Leukemia (ALL) is the most frequently occurring cancer among the children and adolescents. Cure rate is improved up to 90% with early diagnosis and better supportive care. Under nutrition among pediatric acute leukemia patients is more in developing countries 60% as compared to 10% in developed countries. The poor nutritional status is found to be associated with poor outcome. Therefore, optimum nutritional support can play a vital role in the outcome of induction. Methods: The population of research was newly diagnosed patients of ALL, reported from June 2016 to January 2017, in the Pediatric Hematology & Oncology Department of Children’s Hospital, Lahore. A sample of 151 patients of Acute Lymphoblastic Leukemia was analyzed prospectively. The study subjects were stratified into undernourished & well nourished based on the Z-score for weight for age.The data was collected irrespective of any discrimination based on demographic factors. and the following characters were recorded in both the groups: Mid treatment & end of treatment bone marrow response, culture proved infection, duration of hospital stay & outcome. Results: Among the 151 patients of ALL 80.1 % (n = 121) were Pre-B and 19.8% (n = 30) were Pre-T .Male to female ratio was 1.5:1. Malnutrition was established in 98 (64.9%) patients on the bases of Z-score. The undernourished group had significantly increased rate of culture proven sepsis (11% vs. 2%) respectively and required longer duration of hospital stay (p < 0.001).Rapid early response was observed in 21.8% malnourished and 32.8% well-nourished patients. End of treatment complete response was recorded in 63% vs. 69.1% respectively with significant p value. Expiry was observed in 9.1% malnourished patients. Conclusions: On the basis of this study it is concluded that the nutritional status at the initial presentation had a significant impact on the induction outcome. The undernourished patients of ALL are more prone to infections, requiring longer duration of hospital stay. Therefore, optimum nutritional support to such patients can help to decrease the chances of infections & ultimately improve the outcome.

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IF NEEDED TO BE SURGICALLY INTERVENED UPON, IN THE PAEDIATRIC DIAPHYSEAL FRACTURES, WHICH IS THE BETTER AMONG THE AVAILABLE FIXATION DEVICES-A CASE SERIES CONSIDERATION.

10.36106/5424952 ◽

2021 ◽

pp. 45-48

Author(s):

Arun Kumar.C ◽

Vibishek Raj ◽

Sathish Babu ◽

Venkatachalam K ◽

Danial Arun ◽

...

Keyword(s):

Plate Osteosynthesis ◽

Excellent Result ◽

Case Series ◽

P Value ◽

Dash Score ◽

Age Group ◽

Fixation Devices ◽

Paediatric Age ◽

Diaphyseal Fractures ◽

Radiographic Grading

Humeral fractures, in the paediatric age group, have two peaks of incidence. It has a high incidence in babies below three years of age, and again also in children, above 10 years of age. The objective of our study, was to compare the most popular operative techniques for handling humeral diaphyseal fractures, in the paediatric age group, such as Plate Osteosynthesis (Locking Compression Plate), Elastic Stable Intramedullary Nailing System (ESIS), and the External Fixation devices (EF). This prospective study was conducted at Chettinad Hospital and Research Institute (CH&RI), Kelambakkam, from July 2017 to June 2020. A total of 15 patients were a part of this study, of which, 8 were males and 7 were females. The functional outcomes were assessed using the DASH, the Borberg and Morrey scoring system and the radiographic assessment was done using Stan's Radiographic Grading system, in all the three methods of treatment. The Follow up period was for a minimum of twelve months. The Broberg and Morrey Score points were 88.4 (74-95) for LCP, 80.67 for ESIS (70- 91) and 83.87 (80-87) for EF (p value>0.05). In the DASH score, the average was 19.2 in the LCP group, 21.17 and 21.10, respectively, in the ESIS and EF groups. Stan's Radiographic Grading showed Grade 2 to 3 fracture union status, in all the xation modalities of our study. The prudence of the surgeon, his surgical experience, the age of the patient, the geometry of the fracture and the nature of the humeral diaphyseal fracture, all needs to be carefully weighed, analyzed and on a case-to-case basis, the decision has to be taken, regarding which xation device is best suited for that very particular fracture. All the three modalities have been showcased to highlight their pros and cons, not with-standing the fact that, all the three modalities have faired superiorly in giving good to excellent result outcomes.

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COMPARISON OF EFFICACY OF TRANEXAMIC ACID 10 MG/KG AND 15 MG/KG IN REDUCING BLEEDING AND TRANSFUSIONS IN TOTAL KNEE ARTHROPLASTY

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2019.v12i3.31006 ◽

2019 ◽

pp. 535-538

Author(s):

HIMA R NAMBIAR ◽

SHAILA S KAMATH

Keyword(s):

Total Knee Arthroplasty ◽

Tranexamic Acid ◽

Hospital Stay ◽

Knee Arthroplasty ◽

P Value ◽

Duration Of Hospital Stay ◽

Institutional Ethics ◽

Number Of Patients ◽

Total Knee ◽

Group B

Objective: The objective of this study was to compare the efficacy of tranexamic acid 10 mg/kg and 15 mg/kg in reducing bleeding and transfusions in total knee arthroplasty. Methods: After approval from the Institutional Ethics Committee, KMC, Mangaluru, 88 patients fulfilling the inclusion criteria of this study undergoing total knee replacements were informed of the study details and consent was obtained for the same. They were randomized into two groups using computer-generated block randomization, i.e., Group A and Group B, and were administered tranexamic acid 10 mg/kg and 15 mg/kg intravenously, respectively. Intraoperatively, hemodynamic parameters were noted. Postoperatively, hemoglobin levels were assessed on days 1 and 3. Transfusions, thromboembolic complications, and duration of hospital stay were noted. Results: Of the 88 participants of the trial, 44 in Groups A and B each, there were no significant differences in the parameters observed in this study such as intraoperative hemodynamic changes, post-operative fall in hemoglobin on day 3, number of patients requiring transfusions, number of thromboembolic events, and duration of hospital stay. A significant p-value was observed in the fall in hemoglobin in the post-operative day 3 (p=0.043). Conclusion: About 15 mg/kg tranexamic acid proved to have a lesser fall in hemoglobin on day 3 postoperatively when compared to the 10 mg/kg group. However, the fall of hemoglobin on day 3 was statistically significant and warranted a blood transfusion in two patients in the 10 mg/kg group but did not prolong their hospital stay.

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Harmonic scalpel versus titanium clips and l-hook in the ligation of cystic duct and artery and gall bladder dissection in laparoscopic cholecystectomy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20175075 ◽

2017 ◽

Vol 5 (12) ◽

pp. 5145

Author(s):

Anand Vijayvargiya ◽

S. K. Jain ◽

Varsha Soni

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Hospital Stay ◽

Cystic Duct ◽

Harmonic Scalpel ◽

P Value ◽

Duration Of Hospital Stay ◽

Significant Difference ◽

Conversion To Open Cholecystectomy ◽

Duration Of Surgery

Background: Laparoscopic cholecystectomy is a gold standard for gall bladder stone surgery. The Aim and objective of study was to compare the total duration of surgery, intraoperative complication like bile leak from cystic duct stump, spillage of bile from gallbladder and post op pain and abdomen distension and jaundice.Methods: Study was carried out in dept. of gen Surgery, Govt medical college Kota in yr. 2015-16 in a total of 50 patients with cholelithiasis with cholecystitis. Patient were equally divided randomly into two groups (a) Harmonic scalpel group and (b) Titanium Clip and L hook group. All patients with medical comorbidities, Concomitant CBD calculi, cirrhosis and portal HT were excluded from study. Intraoperatively adhesions, bile spillage from GB and cystic duct stump noted Postoperatively complain like pain abdomen, Jaundice, and fever were noted. Duration of hospital stay was observed. All results were statistically analyzed using Chi square and ANOVA test.Results: Both groups were comparable on the basis of age and sex distribution, as no statistically difference was noted (P value 0.867 and 0.999 respectively). Intraoperative findings were adhesions 5 in clip group and 7 in harmonic group. Spillage from gall bladder was 2 in Clip group and 3 in harmonic group. Mean duration of surgery was 65.20 min in clip group and 63.68 in harmonic group with no statistically significant difference in both the group (P Value 0.727). Average duration of hospital stay was similar in both the groups with a mean of 2.6 days. Postoperative complication was fever, abdomen pain and distension were 3,1,1 were respectively in the clip group and 3,2,2 respectively in harmonic group with the P value of 0.999 which was statistically insignificant. No CBD injury was noted in any case. Conversion to open cholecystectomy was not done in any case. On 1week and 1 month follow up 2 cases in clip group and 1 in HS group had collection in gall bladder fossa and none at I month.Conclusions: Harmonic scalpel offers an effective, alternative and safe method to cystic duct division and Gallbladder dissection from liver bed.

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Treatment Outcome Of Hyperglycemic Emergency And Predictors In Ethiopia

10.21203/rs.3.rs-25700/v2 ◽

2020 ◽

Author(s):

Pawlos Asfaw Tekeste ◽

Gashaw Binega Mekonnen ◽

Achenef Asmamaw Muche ◽

Bereket Molla Tigabu

Keyword(s):

Treatment Outcome ◽

Hospital Stay ◽

Goodness Of Fit ◽

Statistical Significance ◽

University Hospital ◽

P Value ◽

Continuous Variables ◽

Goodness Of Fit Test ◽

Chi Square ◽

Duration Of Hospital Stay

Abstract Background: Hyperglycemic Emergency (HE) denotes critical cases of decompensated diabetes mellitus (DM). Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the extreme cases of HE. This study aims to assess the treatment outcome of HE and predictors in Ethiopia.Method: Four-year medical records of DM patients admitted for HE at Hiwot Fana Specialized University Hospital (HFSUH) were reviewed retrospectively. Data were entered into and cleaned by Epi-InfoTM7 software. The statistical analysis was executed using the statistical package for social sciences software (SPSS) version 24. Chi-square test and student’s t-test were done to compare categorical and continuous variables. Logistic regression with the level of α set at 0.05 and AOR of 95% CI was done to determine the predictors. Statistical significance was established at AOR ≠1 within a 95% CI and P-value < 0.05. The model was verified using the Hosmer-Lemeshow goodness of fit test (P = 0.392).Results: This study included 321 eligible patients. The median duration of hospital stay was 7 days. The pooled HE mortality was 16.5%; 21.4% of HHS and 11.1% of DKA died. Infection (AOR = 3.74, 95% CI: 1.85-7.57, P <0.001), comorbidity (AOR = 2.95, 95% CI: 1.34-6.48, P = 0.007), and lower admission Glasgow Coma Scale score ≤ 8 (AOR = 2.58, 95% CI: 1.17-5.71, P = 0.019) were the independent predictors of HE mortality.Conclusion: Mortality and duration of hospital stay stand high among DM patients admitted with HE. Infection, comorbidity, and lower admission GCS ≤ 8 are the independent predictors of HE mortality.

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