scholarly journals DIATHERMY INCISIONS V/S SURGICAL SCALPEL INCISIONS

2015 ◽  
Vol 22 (11) ◽  
pp. 1550-1524
Author(s):  
Khawar Saeed Jamali ◽  
Naveed Ali Khan ◽  
Muhammad Jawed ◽  
Ubedullah Shaikh

Objectives: The objective of this study was to compare the outcome of diathermyincisions v/s surgical scalpel incisions in general surgery. Study Design: Cross sectional study.Place and Duration of Study: This study was conducted at surgical unit 7, Sindh Govt. LyariGeneral Hospital and Dow University of Health Sciences between January to December 2009.Methodology: 100 consecutive patients for elective general surgery were randomly assignedto either group A incision with cutting diathermy (n=50) or group B cold steel scalpel (n=50).Data including demographic details, hospital stay, infection rate and non-infective complicationslike swelling, bleeding, dehiscence and seroma formation were recorded in both groups tocompare the final surgical outcome compared. Results: A total of 80 patients were included inthe study, placed alternatively into two groups of 40 patients each with majority being male (n =61, 76.3%). The mean age was 22.46 years. The positive predictive value for patients of Group Awas 92.5% while for Group B was 77.5%. When diagnostic accuracy was compared on the basisof Gender for the two groups, the positive predictive value for male patients of Group A and Bwas 90.09% and 89.28% respectively, but for females the positive predictive value of Group Aand B was 100% and 50% respectively. In Diathermy (Group A) total 20% patients developedcomplications and these were seroma formation (n=4, 8%), wound dehiscence (n=3, 6%) andwound infection (n=3, 6%). In Scalpel (Group B) total 26% patients developed complications(P-value=0.370) in which seromas was noted (n=5, 10%) then wound infection (n=4, 8%), thenwound bleeding (n=3, 6%) and lastly seroma formation (n=1, 2%). Hospital stays were alsoalmost similar with mean value 8.24 days in diathermy group and 10.54 days in scalpel group.No remarkable difference in demographics, characteristics and in other variables of patientswas noted. Conclusion: We conclude that no significant difference in surgical outcome ofboth groups (cutting diathermy Vs. steel scalpel). Therefore, use of either technique to createsurgical wound merely depends upon preference of surgeon.

2021 ◽  
Vol 17 (1) ◽  
pp. 52-55
Author(s):  
Shiraz Shaikh ◽  
Ambreen Munir ◽  
Shahnawaz Abro ◽  
Shahida Khatoon ◽  
Zameer Hussain Laghari ◽  
...  

Objective: Comparative outcome of one versus two drains insertion for in the term of seroma formation following modified radical mastectomy in breast carcinoma. Methodology: This Prospective Interventional trial was conducted at Department of General Surgery, Liaquat University Hospital Hyderabad from February 2018 to January 2019.  Females with breast carcinoma admitted for modified radical mastectomy were included. Patients were divided into two groups.  Groups I underwent one drain placement and group II underwent two drains placement. All patients were observed to measure and record the volume of the fluid. Patients were discharged from Hospital in stable condition and after removal of drains, and followed up weekly for one month. Data was recorded on self-made proforma and analyzed by using SPSS-20. Results: Total of 80 patients were selected, 38 in group A and 42 in group B. Mean age of patients of group A was 49.08 ± 9.89 years and group B was 51.40 ± 13.59 years. , Excised Mass weight was lesser in group A as compared to group B. Mean volume of drain discharge was significantly higher in Group B 323.43 ± 158.88 ml, while it was in group A 230.29± 200.98, findings were statistically significant 0.013. Seroma formation was statistically insignificant among both groups as 8(21.1%) in group A and   10(23.8%) in group B, p-value 0.768. Conclusion: One-drain and two-drain insertion are equally effective to reduce the seroma formation after modified radical mastectomy; however, one drain insertion leads to more patient compliance and comfort with probably less morbidity and cost.


2019 ◽  
Vol 26 (03) ◽  
Author(s):  
Marium Shoukat ◽  
Hijab Batool ◽  
Faiza Javaid

Objectives: Role of niacin in decreasing cardiovascular accidents by lowering the levels of Apo-B in hyperlipidemic patients. Background: In hyperlipidemia, there are high levels of atherogenic lipoproteins leading to higher risk of atherosclerotic cardiovascular events. Patients with dyslipidemia use statins as a mainstay of therapy over last many decades. Recent studies show that apolipoproteins play a major role in formation of atheromatous plaque, thus there is an urgent need to study the effects of lipid lowering medication on apolipoprotiens levels. Study Design: Cross sectional analytical study. Setting: Sheikh Zayed Hospital Lahore (Department of Biochemistry and Chemical Pathology). Period: 12 weeks from July to Sep 2014. Materials and Methods: Recently diagnosed hyperlipidemic patients (n=44) were selected for the study purpose and divided into two equal groups; A and B. Each group was given different medication. Group A took only statin while group B took a combination of statin and niacin. Blood samples were taken at the start of medication and then after completion of 12 week time period. Results: At the start of the treatment there was no significant difference in the Apo B cholesterol level between the two groups (p value 0.972). However, after the end of 12 week duration, there was a significant reduction in the Apo level of group B taking statin and niacin as compared to group A taking statin alone (p value 0.003). Conclusions: Niacin has cardio-protective role when used in combination with niacin.


2021 ◽  
Vol 71 (5) ◽  
pp. 1582-84
Author(s):  
Hassam Anjum Mir ◽  
Mubashir Sharif ◽  
Ali Asif ◽  
Maleeha Shamim ◽  
Maaz Qureshi ◽  
...  

Objective: To determine if the traditional chewing stick Miswak was as effective in cleaning teeth as Toothbrush. Study Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi, from Aug 2020 to Jan 2021. Methodology: A total of 300 subjects were included which were divided in two groups on the basis of whether they used miswak or toothbrush as a cleaning aid. Group A was toothbrush users and group B was Miswak user. Plaque Index was used to determine the cleanliness of teeth. The scores were recorded and data analyzed using SPSS-23. Results: The means and standard deviations of Plaque Index score for group A and B were 0.96 ± 0.58 and 0.98 ± 0.56 respectively. The comparison of Plaque Index score for both groups was insignificant with the p-value of 0.083. Conclusion: Within the limitations of this study, it is concluded that, no significant difference was found in the effectiveness of traditional miswak and tooth brush. It is recommended that if the technique of teeth cleaning is good then any of the abovementioned means of teeth cleaning can be used.


2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S113-17
Author(s):  
Saira Saeed ◽  
Badar Murtaza ◽  
Zulekha Nasim ◽  
Sohail Raziq

Objective: To compare the frequency of cesarean section in elective induction of labour at 40 weeks and 41weeks of gestation. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Gynecology & Obstetrics, Sialkot, from July to Dec 2017. Methodology: The pregnant females at full-term were divided in 2 groups. All patients aged 20-35 years andparity less than 5 with singleton alive pregnancy and vertex presentation at 40+0 weeks gestation were placedin group A and all singleton alive pregnancies with vertex presentation at 41+0 weeks in group B. Group A wasinduced at 40+0 weeks and group B was induced at 41+0 weeks of gestation. Induction of labour was performed and fetal heart rate monitoring was conducted every 15 minutes. Augmentation was completed and frequency of cesarean section recorded in both groups. Results: In this study a total of 100 patients were included. The mean age of the patients was 27.33 ± 4.87 years(range 20-35 years) with mean age of 26.54 ± 4.66 and 28.12 ± 4.99 years in group A and group B respectively.The cesarean section was performed in 20 (20%) patients, with 14 (28%) in group A and 6 (12%) in group B.Statistically significant difference of cesarean section was noted in both groups (p-value=0.046). Conclusion: There was a significantly lower rate of cesarean section in elective induction of labour at 41weeks as compared to 40 weeks of gestation.


2015 ◽  
Vol 22 (12) ◽  
pp. 1601-1605
Author(s):  
Khawar Saeed Jamali ◽  
Humaid Ahmed ◽  
Muhammad Jawed ◽  
Ubedullah Shaikh

Objectives: The objective of this study was to compare the efficacy of ClinicalEvaluation and modified Alvarado scoring system in diagnosing acute appendicitis. StudyDesign: Cross sectional study. Place and Duration of Study: This study was conducted atSurgical Unit III of Civil Hospital Karachi from May 2010 to October 2010. Methodology: Thisstudy consisted of eighty patients. Patients were divided in two groups. Group A for completeclinical evaluation comprising of 40 patients and Group B for modified Alvarado scoring systemcomprising of 40 patients. Inclusion criteria were all patients presenting with RIF pain, nausea,vomiting, fever and/or anorexia, diagnosed as having acute appendicitis preoperatively andundergoing emergency appendectomy during this period, age >12 years and both gender.Exclusion criteria included not willing for surgery, General anesthesia problem, pregnant femalepatients and those who did not give written consent. Results: A total of 80 patients were includedin the study, placed alternatively into two groups of 40 patients each with majority being male(n = 61, 76.3%). The mean age was 22.46 years. The positive predictive value for patients ofGroup A was 92.5% while for Group B was 77.5%. When diagnostic accuracy was compared onthe basis of Gender for the two groups, the positive predictive value for male patients of GroupA and B was 90.09% and 89.28% respectively, but for females the positive predictive valueof Group A and B was 100% and 50% respectively. Conclusion: We conclude that modifiedAlvarado score can be used safely and effectively in diagnosing acute appendicitis in adultmales especially as the score increases from seven to nine.


2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Ayesha Baqar

Introduction: To study and compare the changes in the height of dermal papillae in the skin of different age groups in a segment of Pakistani population. Study Design: Cross sectional study. Period: Five months, from July 2010 to November 2010. Setting: Anatomy Department, Army Medical College, Rawalpindi. Materials & Method: Sixty volunteers of both sexes, after fulfilling the inclusion criteria, participated in this cross sectional study. They all gave written informed consent. They were divided into three equal groups according to their ages, Group A ranged in age from 18 – 29 years, Group B from 30 – 49 years, and Group C > 50 years. Punch biopsies were taken from the sun protected upper arm skin, from all volunteers, after giving local anaesthesia. Samples were stained with Hematoxylin and Eosin. They were observed under light microscope. Height of dermal papillae was measured at three random sites in each sample and mean was taken.The mean of all three groups was compared with each other and data was analyzed. Results: The mean of each sample was taken and then final mean of each group was calculated. They were then compared with each other. The mean height of dermal papillae of group A was 98.667µm, that of group B was 83.333µm and the mean height of dermal papillae in group C was 47.33µm. There was significant difference between the three groups and ‘p’-value was less than 0.5. Conclusion: At the end of this study, it was concluded that, the height of dermal papillae reduces significantly with age.


2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Jiahui Jiang ◽  
Xiaolei Wang ◽  
Tongtong Cheng ◽  
Mingyue Han ◽  
Xinxin Wu ◽  
...  

Background. Sepsis is a common complication of acute cholangitis (AC), which is associated with a high mortality rate. Our study is aimed at exploring the significance of white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells 1 (sTREM-1), and temperature (T) alone or combined together in early identification and curative effect monitoring of AC with or without sepsis. Methods. 65 consecutive cases with AC and 76 control cases were enrolled. They were divided into three groups: Group A (AC with sepsis), Group B (AC without sepsis), and Group C (inpatients without AC or other infections). The levels of WBC, CRP, PCT, sTREM-1, and temperature were measured dynamically. The study was carried out and reported according to STARD 2015 reporting guidelines. Results. CRP had the highest AUC to identify AC from individuals without AC or other infections (AUC 1.000, sensitivity 100.0%, specificity 100.0%, positive predictive value 100.0%, and negative predictive value 100.0%). Among various single indexes, PCT performed best (AUC 0.785, sensitivity 75.8%, specificity 72.2%, positive predictive value 68.7%, and negative predictive value 78.8%) to distinguish sepsis with AC, while different combinations of indexes did not perform better. From day 1 to day 5 of hospitalization, the levels of sTREM-1 in Group A were the highest, followed by Groups B and C (P<0.05); on day 8, sTREM-1 levels in Groups A and B declined back to normal. However, other index levels among three groups still had a significant difference on day 10. Both in Groups A and B, sTREM-1 levels declined fast between day 1 and day 2 (P<0.05). Conclusions. CRP is the best biomarker to suggest infection here. PCT alone is sufficient enough to diagnose sepsis with AC. sTREM-1 is the best biomarker to monitor patients’ response to antimicrobial therapy and biliary drainage.


2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.


2021 ◽  
Vol 15 (5) ◽  
pp. 1024-1027
Author(s):  
Asma Samreen ◽  
Aamir Waseem ◽  
Muhammad Azam ◽  
Itrat Hussain Kazmi ◽  
Aamir Bashir ◽  
...  

Background: Procedural sedation is required for multiple short duration procedures outside of the operating rooms especially in radiology and endoscopy suites. Intravenous anesthetic agent with rapid recovery profile is desirable in such circumstances. This study aims to compare two regimens of intravenous anesthetic agents. Aim: To compare the mean recovery time of propofol and midazolam with propofol alone for sedation in endoscopic retrograde cholangiopancreatography. Study Design: Randomized controlled trial. Settings: Department of Anesthesia, Shalamar Hospital, Lahore. Study Duration: June 2017 to December 2017. Methods: A total of 70 adult patients aged 20-60 years undergoing ERCP under sedation were included. Patients were given a combination of propofol and midazolam in group A while propofol alone was given in group B. After procedure, pts were transferred to recovery room and were followed for assessment of recovery time. Data were analyzed in SPSS vr 21, Independent t-test was applied & p-value ≤0.05 was considered statistically significant. Results: Significant difference was found in mean recovery time amongst both the groups. Mean recovery time in Group A (propofol and midazolam) was 19.29±4.50 minutes while in Group B (propofol alone) was 26.66±3.70 minutes showing statistically significant result with p-value = 0.0001. Conclusion: We conclude that mean recovery time with propofol plus midazolam is shorter as compared to propofol alone for sedation in ERCP. Keywords: Propofol, midazolam, sedation outside operation theatre.


2015 ◽  
Vol 87 (8) ◽  
Author(s):  
Santosh Kumar ◽  
Rajesh Roat ◽  
Swati Agrawal ◽  
Kumar Jayant ◽  
Ravimohan S. Mavuduru ◽  
...  

Abstractwas to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire.Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student’s unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant.Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value – 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value – 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects.Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.


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