scholarly journals AshwathaKsheer Sutra and UdumberKsheer Sutra in the management of Bhagandara (Fistula in ano): An Ayurvedic management protocol for treatment of fistula in ano

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1357-1361
Author(s):  
Monika Meshram ◽  
Kiran Khandare
Keyword(s):  
Internal Opening ◽  
Anal Abscess ◽  
Female Ratio ◽  
Fistula In Ano ◽  
Management Protocol ◽  
Group A ◽  
Group B ◽  
Male To Female ◽  
Single Blind

Fistula in ano is tract lined by granulation tissue having internal opening in anal canal and rectum and external opening in the perianal region. The incidence of a fistula-in-ano developing from an anal abscess ranges from 26-38%. The prevalence of non-specific anal fistula has been estimated to be 8.6 to 10/100,000 of the population per year, with a male to female ratio of 8:1.in contemporary sciences Bhagandara  can be correlated with Fistula in Ano. To compare the efficacy of AshwathaKsheer Sutra  and UdumberKsheer Sutra in the management of Bhagandara (Fistula in ano).  The present study is designed as a  Randomized single blind parallel in which 40 patients will be enrolled. Patients will be distributed in two group with 20 patients in each group. In group A AshwathaKsheerSutra and in group B UdumbarKsheerSutra will be changed after 7 days till the cure of fistula. Assessment of the patients will be done on day 1st, 8th, 15th, and 22nd after intervention, follow up will be taken on 29th day.  Results will be drawn from the observations of objective parameters. Conclusion of the study will be drawn on the basis of statistical data calculated from the collected data.

scholarly journals 439 Conservative Versus Surgical Management of Complicated Diverticulitis - A Retrospective Study of Long-Term Outcomes

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Durity ◽  
G Elliott ◽  
T Gana
Keyword(s):  
Complicated Diverticulitis ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Female Ratio ◽  
Stoma Reversal ◽  
Group A ◽  
Grade 3 ◽  
Group B

Abstract Introduction Management of complicated diverticulitis has shifted towards a conservative approach over time. This study evaluates the feasibility and long-term outcomes of conservative management. Method We retrospectively evaluated a consecutive series of patients managed with perforated colonic diverticulitis from 2013-2017. Results Seventy-three (73) patients were included with a male to female ratio of 1:2. Thirty-one (31) underwent Hartmann’s procedure (Group A) and 42 patients were managed with antibiotics +/- radiological drainage (Group B). Mean follow-up was 64.9 months (range 3-7 years). CT Grade 3 and 4 disease was observed in 64.5% and 40.4% of Group A and Group B patients, respectively. During follow-up, 9 (21.4%) Group B patients required Hartmann’s. Group A had longer median length of stay compared to Group B (25.1 vs 9.2 days). Post-operative complications occurred in 80.6% with 40% being Clavien-Dindo grade III or higher in group A. Stoma reversal was performed in 8 patients (25.8%). Conclusions In carefully selected cases, complicated diverticulitis including CT grade 3 and 4 disease, can be managed conservatively with acceptable recurrence rates (16.7% at 30 days, 4.8% at 90 days, 19.0% at 5 years). Surgical intervention on the other hand, carries high post-operative complication rates and low stoma reversal rates.

scholarly journals INGUINAL HERNIA REPAIR;

2014 ◽  
Vol 21 (06) ◽  
pp. 1144-1146
Author(s):  
Iftikhar Ahmed Bhatti
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Prosthetic Mesh ◽  
Indirect Inguinal Hernia ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Group A ◽  
Group B

Objective: To compare the results of Inguinal Hernia repair using commonly employed methods of Bassini’s and Mesh repair. Methodology: This study included 90 cases of hernia repair ranging over a period of 18 months from October 2008 to Mar 2010 at Social Security Hospital Lahore. All the cases were done by the consultants and senior surgeons. The methods of repair included Bassini’s and Hernioplasty with Prosthetic mesh. Results: Out of 90 patients, 88 were males (97.78%) and 02 were females (2.22%). Male – female ratio 45 : 1. The peak incidence was found in 3rd and 4th decades of life. 56(62.22%) had Rt.sided Inguinal hernia, 29 (32.22%) had Lt. sided and 5(5.56%) had bilateral Inguinal hernia. 72 patients (80%) had Indirect Inguinal hernia, 17 (18.89%) had direct inguinal hernia while 1(1.11%) had both types. All the cases were done under Spinal anaesthesia. The Bassini’s repair was performed in 50% cases, using non-absorble no. 1 Prolene interrupted suturing (Group- A). In the Group – B, 50% cases underwent Hernioplasty with prosthetic prolene mesh 6x11 cms. Post-operative follow up was done for a period of 01 year. In the group- A, 3 (6.67%) patients had recurrence and 3 (6.67%) had infection of the wound. In group – B, 01 patient (2.22%) got infected and none of the cases did not get recurrence over a period of 01 year. Conclusions: Hernioplasty with prosthetic mesh is a better treatment modality for inguinal hernia repair to get a low recurrence rate.

scholarly journals Intranasal Splint in Nasal Septal Surgery: Is It Necessary?

2020 ◽  
Vol 32 (2) ◽  
pp. 126-129
Author(s):  
Jahangir Alam Mazumder ◽  
Md Golam Mustafa ◽  
AHM Delwar ◽  
Shazibur Rashid ◽  
Md Mostafizur Rahaman ◽  
...  
Keyword(s):  
Complete Healing ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Septal Surgery ◽  
Significant Difference ◽  
Group A ◽  
Medicine Today ◽  
Group B ◽  
Male To Female

Introduction: After SMR/septoplasty with or without turbinate surgery, it needs to keep apart the septum and turbinates upto their complete healing otherwise there is a chance of adhesion (synechia) formation. To prevent this there are variousprocedures. To place an intranasal splint in one or both sides of the septum is one of them. Nowadays there raised thequestion of whether the splinting is necessary or not. There is no significant difference in result with or without anintranasal splint. Weighing against the co-morbidities the routine use of an intranasal splint can no longer be justified. Materials and Methods: This is a randomized control study of 200 patients of SMR/septoplasty, done for nasal septaldeviation causing symptoms in Cumilla Medical College Hospital in the period of January 2016 to December 2019. Theywere equally divided into two groups, group-A were operated placing an intranasal splint and group-B with no intranasalsplint. They were followed up for 6 weeks to detect any synechia and co-morbidities. Result: The age of our patients wasranged from 13-49 years with a mean age of 22.45 years. The male to female ratio is 1.78:1. Synechia was found in 4% ofthe splinted group and 6 of the nonsplinted groups. Co-morbidities were detected more in the splinted group than that ofnon-splinted. In INS group these were found as follows: pain in the nose, face and head (26%), faint during removal ofnasal splint (6%), nasal obstruction (38%), the anxiety of splint removal in the postoperative period (35%) and vestibulitisdue to persistent irritation by a splint (17%). Conclusion: There is little significant advantage of using intranasal splintroutinely in septal surgery to prevent synechia formation. Medicine Today 2020 Vol.32(2): 126-129

Comparison of Phenobarbital versus Magnesium Sulphate for Management of Neonate with Birth Asphyxia

2021 ◽  
Vol 15 (8) ◽  
pp. 2145-2147
Author(s):  
Lubna Riaz ◽  
Syed Muhammad Ahmed ◽  
Muhammad Ahmad Zakki ◽  
Neelam Faryad ◽  
Shazia Iram ◽  
...  
Keyword(s):  
Magnesium Sulphate ◽  
Demographic Data ◽  
Birth Asphyxia ◽  
Female Ratio ◽  
Group A ◽  
Insignificant Difference ◽  
The Difference ◽  
Group B ◽  
Breathing Effort ◽  
Male To Female

Background: Poor breathing effort results in decrease oxygen supply to brain and other organs that lead to birth asphyxia. Phenobarbital and magnesium sulphate are both neuroprotective to asphyxia! injury to brain. Objective: To compare the frequency of neonatal mortality with phenobarbital versus magnesium sulphate in the management of birth asphyxia Study Design: Randomized control trial Place and Duration of Study: Pediatrics Department, Sheikh Zayed Hospital, from 8th March 2020 to 8th September 2020. Methodology: One hundred and two neonates were enrolled. After taking informed consent from parents their demographic data was obtained. Then patients were divided in to two groups; group A treated with Phenobarbital and other group B treated with magnesium sulphate. Results: The mean age of group A neonates was 54.37+14.303 days and in group B 48.40+15.20 days with male to female ratio was 0.7:1. Adverse outcome occurred in 12 (11.54%) patients. Statistically insignificant difference (P=0.122) was found between groups. Conclusion: There is more adverse effects outcome with magnesium sulphate than phenobarbital however the difference was statistically insignificant for management of neonates with birth asphyxia. Keywords: Birth asphyxia, Neonates, Magnesium sulphate (MgS04), Phenobarbital

COMPARATIVE STUDY BETWEEN LIFT PROCEDURE VERSUS SETON PLACEMENT IN THE MANAGEMENT OF FISTULA IN ANO

2021 ◽  
pp. 61-64
Author(s):  
S. Yashwanth ◽  
T. Praneeth
Keyword(s):  
Postoperative Pain ◽  
Fistula Tract ◽  
Internal Opening ◽  
Fistula In Ano ◽  
Medical College ◽  
Group 12 ◽  
Group A ◽  
Intersphincteric Fistula ◽  
Group B ◽  
Seton Placement

INTRODUCTION: A stula-in-ano, is a chronic abnormal communication, usually lined by granulation tissue, which runs outwards from the anorectal lumen. The standards of anal stula surgery are to obliterate the stula, prevent recurrence and maintain sphincter work. Ligation of Intersphincteric Fistula Tract (LIFT) is the most promising surgical technique based on secure closure of the internal opening and removal of the infected crypto glandular tissue through intersphincteric approach. AIMS: To compare the effectiveness of LIFT over SETON procedure based on Postoperative pain on day 1 and2, Short term recurrence, Healing, Procedural visits PATIENTS AND METHODS: A prospective, single centered, interventional study in 60 patients with stula-in-ano admitted to general surgical wards in Narayana Medical College and Hospital, Nellore. From November 2018 to November 2020. Patients were divided into two groups, group A including patients undergoing LIFT procedure and group B, including patients undergoing SETON placement of Fistula-in- ano. RESULTS: Maximum patients were in 41-60 years in the LIFT Group 18(60%), 51-60 years in the SETON group 12(40%). Maximum patients were male 21 in each group (70%), and female were 9 in each group (30%). In the present study, Visual Analog Scale (0,1,2,3) in LIFT group on POD 1, were 2, 20, 6, 2 and in SETON group on POD 1 were 0, 9, 16, 5 respectively. Similarly, visual analogue scale (0,1,2,3) in LIFT group on POD 2, were 19.8.3.0 and in SETON group on POD 2 were 5, 20, 5, 0respectively. Patients who underwent LIFT procedure had a satisfactory postoperative period and the wound healed in all the cases. CONCLUSION: we conclude that LIFT gives good outcomes in terms of Postoperative pain on day 1 and 2, wound healing rate, single time procedure and recurrence during our short follow-up period of 6 months.

scholarly journals A comparative clinical study of the effect of Upanaha Sweda by using Kottamchukkadi Churna and Grihadhumadi Churna in Janusandhigata Vata w.s.r. to Osteoarthritis of Knee Joint

2020 ◽  
Vol 5 (04) ◽  
pp. 112-117
Author(s):  
Reshmi PK ◽  
Sudarshan A ◽  
Jeejo Chandran
Keyword(s):  
Clinical Study ◽  
Knee Joint ◽  
Modern Medicine ◽  
Osteoarthritis Of Knee ◽  
Womac Index ◽  
Comparative Clinical Study ◽  
Group A ◽  
Group B ◽  
Single Blind

As per Ayurveda, Janusandhigata Vata is one among Vatavyadhi and can be compared with Osteoarthritis of Knee Joint in Modern Medicine with respect to the similarity of symptoms. Aims and Objectives: To evaluate and compare the effect of Grihadhumadi and Kottamchukkadi Upanaha in Janusandhigata Vata. Methods: Single blind randomized comparative clinical study allocated into 2 equal groups as A and B. Procedure: In Group A, Grihadhumadi Upanaha Sweda done for 7 days and in Group B, Kottamchukkadi Upanaha Sweda done for 7 days. Patients were examined as per the assessment criteria on 1st day before treatment, 8th day after completion of the treatment and 15th day as part of follow up. Observations and Results: Group A showed statistically highly significant effect in most of the criteria’s like Swelling, Stiffness, Tenderness, Visual Analogue Scale (VAS), Range Of Movements (ROM) and WOMAC INDEX. Group B showed statistically highly significant effect in Pain and Crepitation.

Success of Ponseti Method in Idiopathic Club Feet of <2 Years and 2-5 years of age – A Comparative Study

2021 ◽  
Vol 15 (11) ◽  
pp. 3022-3025
Author(s):  
Usman Ahmed ◽  
Ayesha Saeed ◽  
Mian Maqbool Hussain ◽  
Mumtaz Hussain ◽  
Abdul Latif Sami ◽  
...  
Keyword(s):  
Success Rate ◽  
Study Groups ◽  
Ponseti Method ◽  
P Value ◽  
Congenital Talipes Equinovarus ◽  
Female Ratio ◽  
Talipes Equinovarus ◽  
Group A ◽  
Group B ◽  
Male To Female

Background: The Ponseti technique is the gold standard for treatment of clubfoot. However, the data in walking children is still limited and results are ill defined. Aim: We prospectively compared Ponseti method in clubfoot patients aged <2 and between 2 to 5 years in our local scenario. Methods: A total of 40 patients were included in the study through non-probability purposive sampling. The patients were examined, classified (Goldner and Fitch classification) and demographic information was recorded. They were explained about the risk and informed consent was taken. In group A, patients were below 2 years of age while in group B, patients were between 2-5 years of age. Ponseti casting was performed by a designated team. Follow-up was done for 6 months from the correction of feet. Results: We received 27(67.5%) male and 13(32.5%) female patients .The male to female ratio was 2:1. The mean age of patients in group A and B was 0.8±0.70 years and 4.3±2.1 years respectively. There was no statistical difference of severity of deformity of clubfoot in both study groups, p-value>0.05. In group A, 17 (85%) patients had success of procedure while in group B the success was achieved in 11 (55%) patients. The success rate was statistically significantly higher in group-A as compared to group B, p-value<0.001 Conclusion: Patient aged <2 years have significantly higher success rate as compared to patients aged between 2-5 years. So we recommend the Ponseti method as standard therapy in clubfoot management for patients with age<2 years and for correction of mild and moderate deformities in patients between 2 to 5 years. Keywords: Clubfoot, Congenital talipes equinovarus, Ponseti method

scholarly journals Effects of lumbar corset on the patients with lumbar spondylosis

2014 ◽  
Vol 42 (2) ◽  
pp. 55-59
Author(s):  
MT Islam ◽  
MA Shakoor ◽  
MA Emran ◽  
KMT Islam ◽  
MG Nobi ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Female Ratio ◽  
Lumbar Spondylosis ◽  
End Of Treatment ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Medical University ◽  
Male To Female

This experimental study was done in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University to find out the effects of lumbar corset on the patients with lumbar spondylosis. Ninety seven patients were selected in the study. Out of them 40(41.24%) were male and 57(58.76%) were female. The male to female ratio was 1:1.42. The mean age was 41.22 ± 8.52 years. The patients were divided into two groups, 50 patients in group A ( Treated with NSAID, activities of daily living instructions and lumbar corset) and another 47 patients in group B (Treated with NSAID and activities of daily living instructions only ). In both the groups, patients were treated for six weeks and assessed at 7 days interval. Improvement was noticed in both the groups in every visit but there was no difference in improvement between the groups till 4th week of treatment. At the end of treatment group A showed statistically significant difference in overall improvement in comparison to group B. So, from the present study, it may be concluded that lumbar corset is beneficial to the patients with lumbar spondylosis. DOI: http://dx.doi.org/10.3329/bmj.v42i2.18987 Bangladesh Med J. 2013 May; 42 (2): 55-59

scholarly journals Outcome of treatment of high fistula in ANO, with fistulectomy plus seton placement.

2021 ◽  
Vol 28 (11) ◽  
pp. 1600-1603
Author(s):  
Kaleem Ullah ◽  
Shamsuddin ◽  
Muhammad Danish Yasin ◽  
Hafiz Bilal Ahmed
Keyword(s):  
Single Case ◽  
Female Ratio ◽  
Fistula In Ano ◽  
Stool Incontinence ◽  
Patient Reported ◽  
Flatus Incontinence ◽  
One Year ◽  
Male To Female ◽  
Seton Placement

Objective: To determine post procedure recurrence and incontinence rate for high fistula-in-ano cases, who underwent procedure of fistulectomy and Seton placement. Study Design: Descriptive study. Setting: Department of General Surgery, Khyber Teaching Hospital Peshawar. Period: January to December, 2018. Material & Methods: This study was conducted over 50 patients with diagnosis of high fistula-in-ano, treated with combined procedure of fistulectomy and Seton placement. Patients follow up was done for one year for recurrence and incontinence. Results: Out of 50 patients, 28(56%) were male and 22(44%) were female. Overall male to female ratio was 1.27:1. Average age of patient was 36.88 years+6.63 SD. Flatus Incontinence was observed in single case (2%), no patient reported stool Incontinence. Recurrence of disease was found in 2 patients (4%). All patients were followed for one year. Conclusion: This technique for treating high Fistula-in-ano showed overall low recurrence and incontinence rates during follow up, thus reducing morbidity and costs associated with recurrent surgery for Fistula-in-ano.

scholarly journals Effect of vitamin D and calcium alone or in combination in the treatment of nutritional rickets

2020 ◽  
Vol 11 (1) ◽  
pp. 39-46
Author(s):  
Fatema Yasmin ◽  
Farzana Yasmin ◽  
Fahmida Chowdhury ◽  
Mujibul Hoque ◽  
Minakshi Chowdhury ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Serum Alkaline Phosphatase ◽  
Female Ratio ◽  
Nutritional Rickets ◽  
Radiographic Score ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Nutritional rickets has emerged as a public health problem in Bangladesh during the past two decades, with up to 8% of children being clinically affected in some areas. Insufficiency of vitamin D and dietary calcium is thought to be the underlying cause. Vitamin D administered with or without calcium is commonly regarded as the mainstay of treatment. Calcium alone or in combination with vitamin D has also been used in the treatment of nutritional rickets. So this study was done to assess the effects of vitamin D, calcium or combination of vitamin D and calcium for the treatment of nutritional rickets in Bangladeshi children. Methods: This open labeled randomized comparative study was done in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital from July 1, 2010 to June 30, 2012 A total 48 rickets patient was enrolled in this study. After selection of cases patients were divided in to three groups by lottery method. Group A received single i/m dose of vitamin D 4,00,000 IU (2,00,000 IU in each buttock), Group B received calcium (750 mg per day) for 6 weeks and Group C received both calcium (750 mg per day) for 6 weeks and single i/m dose of vitamin D 4,00,000 IU (2,00,000 IU in each buttock). Response was evaluated by serum alkaline phosphatase level and using 10-point radiographic score developed by Thacher and colleagues at baseline, 6 weeks, and 12 weeks. Results: Mean age of the study participants was 35.83 months. Male to female ratio was 2:1. The radiographic score was significantly improved in first and second follow up (p<0.001) in all groups. But there was significant difference of improvement in Group C than Group A and Group B. In Group C, the percent reduction from base to first follow up was 80.05±7.04 and 90.65±3 in second follow up which showed quick improvement in combination therapy. Serum alkaline phosphatase also significantly reduced in all three groups. Conclusion: Combination use of vitamin D and calcium in the treatment of nutritional rickets is more effective than prescribing either vitamin D or calcium alone. Birdem Med J 2021; 11(1): 39-46

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