scholarly journals Tympanoplasty under Local Anesthesia (LA) Without Sedation

2020 ◽  
Vol 7 (07) ◽  
pp. 4882-4886
Author(s):  
Md. Ashraful Islam ◽  
Towsif Bin Mamoon ◽  
Farid Uddin Milki ◽  
Nazmul Hossain Chowdhury ◽  
Saif Rahman Khan
Keyword(s):  
Hospital Stay ◽  
Local Anesthesia ◽  
Operative Time ◽  
Primary Objective ◽  
Care Hospital ◽  
Facial Nerve Function ◽  
Monitoring Equipment ◽  
Patients Satisfaction ◽  
Bloodless Field ◽  
Anesthesia Machines

Background & Objectives: Local Anesthesia (LA) is getting popularity in comparison to general anesthesia (GA) in underdeveloped and developing countries in many otolaryngological operations. The rationale for LA is the lack of trained anesthesia staff, lack of adequate anesthesia machines and monitoring equipment. LA is safe; and ability to perform more cases in a shorter period of time. This study aimed to find out patients compliance in the operative procedures under LA without sedation. Methods: 7905 patents underwent tympanoplsty under LA without sedation from 1999 to 2019 in the different hospital of Bangladesh. Preoperative thorough counselling with psychological motivation, advantages of LA, intraoperative surgeon patient conversation and watching surgical steps on monitor, tests of facial nerve function were explained to the patient. LA with different Adrenaline concentrations (1: 1000 to 1: 200,000) was used either by injection or topically. Patients’ satisfaction, vertigo, drowsiness, hangover, orientation and other parameters ware recorded.  Results: Amongst 7905 patients; male 56.2% and 43.8% was female. Maximum numbers (26.3) were found between 26 year to 35 year of age. Patients’ intraoperative compliance showed excellent without sedation. Operative time was short with a bloodless field. The overall safety was good and needed shortest hospital stay (Hour/day); and of course very less expensive. Conclusion: Patient’s safety is the primary objective considered in all patients. The advantages recorded as day/hour care hospital stay, patients comfort, less bleeding, ability to assess patient’s hearing during surgery and cost effectiveness  

scholarly journals Our experience with laparoscopic total gastrectomy for gastric cancer: A case series

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Manash Ranjan Sahoo ◽  
Satyajit Samal ◽  
Jyotirmay Nayak
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Hospital Stay ◽  
Total Gastrectomy ◽  
Median Time ◽  
Operative Time ◽  
Laparoscopic Total Gastrectomy ◽  
Oral Feeding ◽  
Care Hospital ◽  
Intraoperative Blood Loss

Background: Though laparoscopic distal gastrectomy has become a standard procedure for treatment of gastric cancer, laparoscopic total gastrectomy has not been widely accepted as it requires more dexterity and lack of evidence about its feasibility and safety. Methods: Here retrospectively we review a series of 12 cases of gastric cancer undergone laparoscopic total gastrectomy with D1 or D2 lymphadenectomy over a period of 7 years at a tertiary care hospital. The patient demographic characteristics were reviewed and the outcomes after surgery was analyzed in terms of extent of lymphadenectomy, mean operative time, mean intraoperative blood loss median number of lymph nodes harvested, median time for postoperative ambulation, median time for postoperative oral feeding, median time of postoperative hospital stay, postoperative complications and mortality. Results: All patients had total gastrectomy entirely through laparoscopic method. Mean operative time was 282 minutes, mean intraoperative blood loss was 120 ml, median time for ambulation and oral feeding was 3 days and 6 days respectively. Median time of hospital stay was 16 days and 2 patients had complications as pancreatic fistula and port site abscess. No mortality was observed. Conclusion: With zero mortality and accepted rate of complications, laparoscopic total gastrectomy appears to be technically feasible and safe for management of gastric cancer. But more studies have to be conducted with comparison to other standard gastrectomies and long term follow up to be done to establish its standardized application.

scholarly journals Efficacy and Safety of Laparoscopic Appendectomy for Complicated Appendicitis in Children in Tertiary Care Hospital

2018 ◽  
Vol 28 (Number 1) ◽  
pp. 21-26
Author(s):  
Md. Anisuzzaman ◽  
ASM A Kabir ◽  
Md. A R l Sadiq ◽  
Md. A Matin ◽  
I Ahmed ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Complicated Appendicitis ◽  
Safe Procedure ◽  
Care Hospital ◽  
Efficacy And Safety ◽  
The Mean

Laparoscopic appendectomy for uncomplicated appendicitis is associated with good outcomes but the role of laparoscopy in complicated appendicitis is more controversial because of high incidence of infectious complications. The aim of this current study is to evaluate the efficacy and safety of laparoscopic appendectomy in complicated appendicitis in children. This interventional study was carried out during the period from January 2015 to May 2018 in Holy Family Red Crescent Medical College Hospital. The study included 43 patients, age ranges from 3 years to 15 years who underwent laparoscopic appendectomy for complicated acute appendicitis. The following variables were analyzed : age, sex, operative findings, operative time, return of bowel function, resumption of oral feeds, length of hospital stay, postoperative complications such as deur, wound infection and intraabdominal abscess etc. The mean age of studied cases was 7.1 years. In 41 patients (95.3%) the procedure was completed laparoscopically. Two (4.7%) patients required conversion to open appendectomy. The operative time was 83.5+,25.8 minutes. Two patients (4.6%) had post-operative ileus. Four patients (9.7%) developed superficial wound infection. Three patients (7.3%) developed infra-abdominal collections. One (2.4%) patients were readmitted because of recurrent abdominal pain One patients (2.4%) developed postoperative pyrexia due to pneumonitis and Three patients (7.3) developed gastroenteritis. The mean length of hospital stay was 5.8±2.1 days. No mortality was recorded.Laparoscopic appendectomy can be the first choice for cases of complicated appendicitis in children. It is a feasible, safe procedure and is associated with acceptable post-operative morbidity with rapid recovery and better cosmetic results.

scholarly journals Local anesthesia versus general anesthesia for evacuation of chronic subdural hematoma in elderly patients above 70 years old

2022 ◽  
Vol 13 ◽  
pp. 13
Author(s):  
Ahmed Ashry ◽  
Hieder Al-Shami ◽  
Medhat Gamal ◽  
Ahmed M Salah
Keyword(s):  
Elderly Patients ◽  
Hospital Stay ◽  
Local Anesthesia ◽  
Subdural Hematoma ◽  
Complication Rate ◽  
Operative Time ◽  
Chronic Subdural Hematoma ◽  
Length Of Hospital Stay ◽  
Group A ◽  
Group B

Background: The aim of this study was to assess the safety and efficacy of chronic subdural hematoma (CSDH) evacuation by two burr-hole craniostomies under local versus general anesthesia (GA) in elderly patients over 70 years. Methods: This retrospective study included 45 patients with CSDH aged over 70 years old treated from March 2018 to April 2020. The cases were subdivided into Group A (n = 22) that underwent evacuation under local anesthesia and Group B (n = 23) that was treated under GA. Patients’ demographics and history of comorbidities were recorded. Variables including pre- and post-operative neurological status and Markwalder’s score, complication rate, operative time, and length of hospital stay were evaluated. Results: The mean and standard deviation of patients’ age of groups (A) and (B) were 74.3 ± 2.5 and 73.2 ± 1.7 years, respectively. Postoperative Glasgow Coma Scale of group (A) was statistically higher than Group B at postoperative day 1 (P = 0.01). Operative time was statistically shorter in Group A than B (P < 0.0001). The length of hospital stay was found to be longer in group (B) than (A) (P = 0.0001). The complication rate was found to be higher in group (B) than (A) (P = 0.044). Conclusion: Evacuation of CSDH under local anesthesia in elderly patients over 70 years is effective, safe, and economic with less complication rate than the traditional technique with GA.

scholarly journals OUTCOME OF LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH GALLSTONE DISEASE AT A SECONDARY LEVEL CARE HOSPITAL

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Ahmed TAKI-ELDIN ◽  
Abd-Elnaser BADAWY
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Gallstone Disease ◽  
Care Hospital ◽  
Biliary Leakage ◽  
Port Site Hernia ◽  
Conversion To Open Cholecystectomy ◽  
Secondary Hospital

ABSTRACT Background: Laparoscopic cholecystectomy is the most commonly performed operation of the digestive tract. )It is considered as the gold standard treatment for cholelithiasis. Aim: To evaluate the outcome of it regarding length of hospital stay, complications, morbidity and mortality at a secondary hospital. Methods: Data of 492 patients who underwent laparoscopic cholecystectomy were retrospectively reviewed. Patients’ demographics, co-morbid diseases, previous abdominal surgery, conversion to open cholecystectomy, operative time, intra and postoperative complications, and hospital stay were collected and analyzed from patients’ files. Results: Out of 492 patients, 386 (78.5%) were females and 106 (21.5%) males. The mean age of the patients was 49.35±8.68 years. Mean operative time was 65.94±11.52 min. Twenty-four cases (4.9%) were converted to open surgery, four due to obscure anatomy (0.8%), 11 due to difficult dissection in Calot’s triangle (2.2%) and nine by bleeding (1.8%). Twelve (2.4%) cases had biliary leakage, seven (1.4%) due to partial tear in common bile duct, the other five due to slipped cystic duct stables. Mean hospital stay was 2.6±1.5 days. Twenty-one (4.3%) developed wound infection. Port site hernia was detected in nine (1.8%) patients. There was no cases of bowel injury or spilled gallstones. There was no mortality recorded in this series. Conclusions: Laparoscopic cholecystectomy is a safe and effective line for management of gallstone disease that can be performed with acceptable morbidity at a secondary hospital.

scholarly journals A comparative study of two layer versus three-layer repair of mediolateral episiotomy

2020 ◽  
Vol 9 (8) ◽  
pp. 3412
Author(s):  
Manasi V. Gaikwad ◽  
M. Vijaya Sree ◽  
Swapnil V. Bobde
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Wound Complications ◽  
Layer Versus ◽  
Care Hospital ◽  
Suture Materials ◽  
Mediolateral Episiotomy ◽  
Significant Difference

Background: Since majority of the women attending study hospital are belonging to lower socioeconomic strata and active involvement of paramedical staff in providing obstetric care, this study was undertaken to find the utility of a two-layer repair of mediolateral episiotomy and compare it with the standard method of closure in relation to its simplicity, cost-effectiveness and superiority if any, over the traditional three-layered repair of episiotomy.Methods: This was a prospective interventional study comparing 100 women who underwent two-layer closure with 100 women who underwent three-layer closure of episiotomy in a tertiary care hospital in Pune, India over a period of 2 years from October 2012 to October 2014. The parameters assessed were operative time, number of suture materials required, immediate post procedure pain and complications at follow-up. Qualitative and quantitative data was analysed using unpaired t-test, chi square test and Fisher exact test.Results: Both the groups were comparable in terms of hospital stay and wound complications such as oedema, dehiscence, hematoma, requirement of resuturing, cosmesis and long-term complications such as dyspareunia. However, two-layer repair required less operative time, lesser number of suture materials and decreased pain during hospital stay as there was statistically significant difference observed between the two groups.Conclusions: In this study experience, it can be concluded that two-layer repair of episiotomy is faster, with less post-operative pain and more cost effective. Hence it provides mother with better services.

scholarly journals Laparoscopic Appendectomy in Children: Experience in a Single Centre in Chittagong, Bangladesh

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Md. Jafrul Hannan
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Tertiary Care ◽  
Operating Time ◽  
Safe Procedure ◽  
Care Hospital ◽  
Operative Techniques ◽  
Abdominal Abscesses ◽  
Operative Findings

Background. Since the latter half of 1980s laparoscopy has become a well accepted modality in children in many surgical procedures including appendectomy. We present here the experience of laparoscopic appendectomy in children in a tertiary care hospital in Bangladesh.  Subjects & Methods. From October 7, 2005 to July 31, 2012, 1809 laparoscopic appendectomies were performed. Laparoscopy was performed in all the cases using 3 ports. For difficult and adherent cases submucosal appendectomy was performed. Feeding was allowed 6 h after surgery and the majority was discharged on the first postoperative day. The age, sex, operative techniques, operative findings, operative time, hospital stay, outcome, and complications were evaluated in this retrospective study.Results. Mean age was 8.17 ± 3.28 years and 69% were males. Fifteen percent were complicated appendicitis, 8 cases needed conversion, and 27 cases were done by submucosal technique. Mean operating time was 39.8 ± 14.2 minutes and mean postoperative hospital stay was 1.91 days. About 5% cases had postoperative complications including 4 intra-abdominal abscesses.Conclusions. Laparoscopic appendectomy is a safe procedure in children even in complicated cases.

A comparative study between continuous and interrupted sutures in open pyeloplasty

2021 ◽  
pp. 039156032110151
Author(s):  
Sandeep Gupta ◽  
Ankit Verma ◽  
Dilip Kumar Pal
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Operative Time ◽  
Postoperative Hospital Stay ◽  
Continuous Group ◽  
Care Hospital ◽  
Time Duration ◽  
Group A ◽  
Group B ◽  
Operative Drainage

Background: Pelvi-ureteric junction obstruction (PUJO) is one of the common causes of obstructive uropathy dealt by urologists around the globe. The management of PUJO requires surgical intervention and pelvi-ureteral anastomosis is most time-consuming step in surgery and suturing plays a critical role for the good outcome of the surgery. Objective: To assess the outcomes of continuous or interrupted suturing in open pyeloplasties done for PUJ obstruction. Materials and methods: This comparative study was conducted in the department of Urology in a tertiary care hospital of eastern India. A total of 60 patients with pelviureteric junction obstruction were included as per inclusion and exclusion criteria and divided into two groups depending upon whether continuous (Group A) or interrupted (Group B) suturing was done. Both groups were compared for mean operative time, mean suturing time, duration of post-operative drainage, mean drain output, post-operative hospital stay, postoperative GFR and improvement in GFR. Results: Out of 60 patients continuous and interrupted suturing was done in 30 patients in both arms. Out of 60 cases there were 46 (76.66%) males and 14 (23.33%) females with a M:F ratio of 1:0.30. The mean age in group A and group B was found to be 30.06 ± 8.28 and 27.63 ± 6.07, respectively. Mean operative time, mean suturing time, duration of post-operative drainage, mean drain output and postoperative hospital stay were found to be higher in interrupted suture group and the difference was found to be statistically highly significant ( p < 0.0001). The complication rates and recurrence rates were found comparable in both the cases with no statistically significant difference ( p > 0.05). Conclusion: Continuous suturing technique for pyeloplasty is preferable as it is found to have a lower mean operative time, mean suturing time, duration of post-operative drainage, mean drain output and postoperative hospital stay.

scholarly journals Experience of Tympanoplsty Done Under Local Anesthesia without Sedation

2020 ◽  
Vol 5 (7) ◽  
pp. 942-946
Author(s):  
Md. Ashraful Islam ◽  
Tareq Mohammad ◽  
Nazmul Hossain Chowdhury ◽  
Towsif Bin Mamoon ◽  
Farid Uddin Milki ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Operative Time ◽  
Chronic Otitis Media ◽  
Cost Effective ◽  
Great Success ◽  
Bloodless Field ◽  
Common Operation ◽  
The Common ◽  
Preoperative Counseling ◽  
Almost All

Tympanoplsty is the common operation for chronic otitis media that is performed under local Anesthesia (LA) or general anesthesia (GA). LA is more popular than GA in the underdeveloped and developing countries in almost all ear surgeries. The authors have been using LA without sedation for more than 20 years. LA without sedation is relatively safer, less expensive and perform more surgeries in a shorter period of time. This study aimed to share the experience of LA without sedation in tympanoplsty. Patients and Method: 7050 patents underwent tympanoplsty under LA without sedation from 1999 to 2019 in the different hospital of Bangladesh. Patients were thoroughly evaluated preoperatively, explained the advantages of LA without sedation in details LA was used with different Adrenaline concentrations (1: 1000 to 1: 200,000) either by injection or topically. Patients’ compliance, pain, discomfort, drowsiness, and other parameters ware recorded. Results: Amongst 7050 patients, 3877 were male and 3173 were female. The youngest patient was 14 year boy and oldest patient was of 58 year male. Operative time was short with a bloodless field. Mean operative time was 45 minutes. The overall safety was good and needed shortest hospital stay (Hour/day); and of course very less expensive. Conclusion: Tympanoplsty under local anesthesia without sedation is safer, relatively cost effective, can be performed as a day/hour care case. Suitable patient selection and adequate preoperative counseling is essential to achieve a great success

scholarly journals Laparoscopic Treatment of Hydatid Cyst of Liver: Outcome at Tertiary Care Hospital

2020 ◽  
pp. 164-168
Author(s):  
Shahida Khatoon ◽  
Altaf Talpur ◽  
Aijaz Ahmed Shaikh ◽  
Mujeeb-ur- Rehman
Keyword(s):  
Hydatid Cyst ◽  
Hospital Stay ◽  
Hydatid Disease ◽  
Operative Time ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Bile Leak ◽  
Care Hospital ◽  
Laparoscopic Treatment ◽  
Cross Sectional

Objective: To determine the outcome of laparoscopic treatment of hydatid cyst of liver at tertiary care Hospital. Methodology: This cross sectional, study was conducted at public and private sector Hospitals of Jamshoro/Hyderabad from June 2017 to Sept 2019. It includes all diagnosed patients of Hydatid cyst of liver with either of gender and age range from 15 to 65 years who were operated laparoscopically. Patient’s demographic information, postoperative complications, operative time and hospital stay were recorded via self-made proforma and data was analyzed by using SPSS version 20. Results: Total 29 patients were admitted with hydatid disease of liver and out of them 21 patients underwent laparoscopic treatment during study period; their mean age was 46.7±13 years. Males were commonest 71.42% and 28.57% were female. Mean operative time was 98.3±18 minutes. According to postoperative pain, the average of visual analog score was 07.85±1.38 at 24 hours and 3.42±1.50 at 72 hours. VAS mean was 07.8 and 3.4 respectively. Cavity related infection was noticed in 3 cases; port site infection in two cases, bile leak in two and residual cyst was also found in two patients. Mean postoperative Hospital stay was 6.6 days. Conclusion: Laparoscopic surgery for hepatic hydatid disease can be conducted safely as it provides advantages of minimal invasive surgery. Careful selection of the patient is utmost important to achieve good results especially in initial phases.

scholarly journals A Study of Factors Affecting the Length of Hospital Stay of COVID-19 Patients by Cox-Proportional Hazard Model in a South Indian Tertiary Care Hospital

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Gayathri Thiruvengadam ◽  
Marappa Lakshmi ◽  
Ravanan Ramanujam
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hazard Model ◽  
Cox Proportional Hazard Model ◽  
Care Hospital ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
South Indian

Background: The objective of the study was to identify the factors that alter the length of hospital stay of COVID-19 patients so we have an estimate of the duration of hospitalization of patients. To achieve this, we used a time to event analysis to arrive at factors that could alter the length of hospital stay, aiding in planning additional beds for any future rise in cases. Methods: Information about COVID-19 patients was collected between June and August 2020. The response variable was the time from admission to discharge of patients. Cox proportional hazard model was used to identify the factors that were associated with the length of hospital stay. Results: A total of 730 COVID-19 patients were included, of which 675 (92.5%) recovered and 55 (7.5%) were considered to be right-censored, that is, the patient died or was discharged against medical advice. The median length of hospital stay of COVID-19 patients who were hospitalized was found to be 7 days by the Kaplan Meier curve. The covariates that prolonged the length of hospital stay were found to be abnormalities in oxygen saturation (HR = 0.446, P < .001), neutrophil-lymphocyte ratio (HR = 0.742, P = .003), levels of D-dimer (HR = 0.60, P = .002), lactate dehydrogenase (HR = 0.717, P = .002), and ferritin (HR = 0.763, P = .037). Also, patients who had more than 2 chronic diseases had a significantly longer length of stay (HR = 0.586, P = .008) compared to those with no comorbidities. Conclusion: Factors that are associated with prolonged length of hospital stay of patients need to be considered in planning bed strength on a contingency basis.

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