scholarly journals SURGICAL INCISION;

2018 ◽  
Vol 25 (06) ◽  
pp. 796-798
Author(s):  
Mohammad Touseef Asghar ◽  
Rizwan Ahmad Khan ◽  
Sadaf Ishaque ◽  
Danish Imtiaz ◽  
Salman Abdul Basit

Objectives: To compare the outcome variables among patients undergoinglaparoscopic cholecystectomy using horizontal and vertical incisions for epigastric port incision.Study Design: Randomized control trial. Place and Duration of Study: Department of Surgery,Shalamar Hospital, Lahore from July 2016 to December 2016. Methodology: A total of 100patients undergoing laparoscopic cholecystectomy were selected and equally divided intotwo groups. Epigastric port insertion was done using horizontal incision (group A) and verticalincision (group B). Electrocautery use, incision extension, use of secondary intervention forbleeding control, blood loss and patient satisfaction regarding scar were noted in both groupsand compared. Results: In this study, we found that 15 out of 50 required electrocautery ingroup A while only 4 patients required in group B. Incision extension was needed in 8% ofpatients in group A while only 2% patients needed it in group B. Blood loss was 4.62 ± 2.64ml in group A while in group B, it was 1.70 ±0.81 ml. Also 80 % patients were satisfied withhorizontal scar while 76 % patients in vertical group. Conclusion: Vertical incision for epigastricport insertion is better than horizontal incision in terms of blood loss, bleeding control whencompared in laparoscopic cholecystectomy.

2017 ◽  
Vol 42 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Abu Sayeed Md. Feroz Mustafa ◽  
Md. Saiful Islam ◽  
Abdullah Al Mamun ◽  
Muhammad Syeef Khalid

Urolithiasis is the third most common disease of the urinary tract. Among all urinary tract stones, majorities are ureteral stones located in the distal part of the ureters. At present, multimodalities of treatment are available to the urologists. The purpose of the present study was to observe the efficacy of Tamsulosin in conventional treatment of juxtavesical ureteric stone having size up to 8 mm. This was a single centered, parallel randomized control trial carried out in the outpatient department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from July 2007 to June 2008. The patients with unilateral, juxtavesical ureteral stone with normal functioning kidney and absence of clinical and laboratory signs of urinary tract infection and stone size up to 8 mm were included in the study. Patients were divided into two groups according to the computer generated simple random sampling. Patients of Group-A  were given conventional hydrotherapy treatment and patients of Group-B were given Tamsulosin 0.4mg/day along with the conventional hydrotherapy. Each patient was followed-up weekly until stone expulsion for 4 weeks. In Group-A and Group-B, the mean age with SD was 38.55±10.05 and 37.7±9.33 years. Expulsion occurred in 32 (53.33%) of 60 patients in Group-A and 51 (85%) of 60 patients in Group-B (p <0.05). The number of pain episodes in this study was statistically significantly lower in Group-B patients compared to Group-A (p <0.05). Urinary tract infection was encountered in 12 (20%) patients of Group-A and 2 (3.33%) patients of Group-B (p <0.05) during four weeks therapy which was treated by appropriate antibiotics. No side effects of Tamsulosin were encountered in any patients of Group-B which could require the cessation of the medication or might need for dose titration. Findings of the study revealed that the Tamsulosin supplemented conventional therapy is more effective than conventional hydrotherapy alone in management of juxtavesical ureteral stones.


2019 ◽  
Vol 5 (1) ◽  
pp. 64-68
Author(s):  
Ali Imam Ahsan ◽  
Nasimul Jamal ◽  
Ashfaq Ahmad ◽  
Syed Farhan Ali ◽  
Momenul Haque

Background: Treatment of granular myringitis (GM) is diverse with no definitive management. Objective: The aim of the present study was to see the effectiveness of different interventions for treating granular myringitis. Methodology: This was a single centred, parallel, randomized control trial. This study was done at the Specialized ENT Hospital of SAHIC, Dhaka from July 2010 to June 2012. Patients presenting with granular myringitis of 18 years of age or more with both sexes were included. All patients were divided into two groups by simple random sampling method of which patients of group A were treated by surgical treatment and that of group B were treated by medical treatment. Medical treatment was given in the form of topical ear drops and surgical treatment was performed by surgical debridement of granulation tissue followed by chemical cauterization. Repeated follow up was performed up to 6 months in both groups of treated patients. The primary outcome was the resolution of granulation tissue. During follow-up the secondary outcome variables were recurrence, perforation of the TM and any other complications or complain from the patients. Results: A total number of 60 patients were studied of which 30 patients were treated medically and 30 patients were treated surgically. The cure rate was higher in surgical treatment (80%) than conservative (16.7%) (p=0.011). The recurrence rate (17.24%) is also less in surgical group compared to medical treatment group (77.27%) (p=0.001). Conclusion: Surgical treatment is a more successful treatment modality for granular myringitis. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 64-68


2020 ◽  
Vol 7 (12) ◽  
pp. 3986
Author(s):  
Arijit Roy ◽  
Pramatha Nath Datta ◽  
Kushankur Guha

Background: Standard four port laparoscopic cholecystectomy is the gold standard in the treatment of gall stones. Modified epigastric port laparoscopic cholecystectomy may be considered an alternative, as this procedure maintains the advantages of four ports and does not require any special set of instruments. In this study we aimed to see whether this procedure is comparable to the standard four port laparoscopic cholecystectomy based on the primary objectives of postoperative pain score, degree of ambulation, time to return to normal activities.Methods: Consecutive patients due to undergo laparoscopic cholecystectomy, meeting all the predefined criteria were recruited into the study. The group A was assigned to receive intervention in the form of modified epigastric port laparoscopic cholecystectomy. The group B was assigned to receive intervention in the form of standard four port laparoscopic cholecystectomy. Patients in group A were compared with patients in group B based on multiple pre-defined parameters.Results: Pain scores were significantly better in group A. Degree of ambulation at was significantly better in group A. In respect to the time to resumption of normal activities there was no significant difference between the two groups. When comparing the quality life at 1 month following surgery with SF-36 health survey, the patients in group A did better than patients in group B with respect to the six scales. Conclusions: Modified epigastric port laparoscopic cholecystectomy appears to be significantly better than the standard four port cholecystectomy in terms of postoperative recovery.


2020 ◽  
Vol 24 (2) ◽  
pp. 134-138
Author(s):  
Fasial Wahid ◽  
Aftab Hussain ◽  
Faiz Ur Rahman ◽  
Obaid Ur Rahman

Objectives: To compare the frequency of excellent intubation condition with Succinylcholine and rocuronium for rapid sequence induction in patients undergoing surgery under general anesthesia. Design: Randomized control trial. Place and duration of study: Department of anesthesiology and pain medicine, Combined Military Hospital Malir Cantt Karachi from 25th June to 10th August 2019. Methodology: In this randomized control trial, a non-probability consecutive sampling technique was used. Anesthesia was given through a standard approach. Then patients were randomly divided into two equal groups. In group A, succinylcholine (1mg/Kg) was given while in group B, rocuronium (1mg/Kg) was given. Laryngoscopy was attempted after 60 seconds. Intubating conditions were labeled as excellent, good, poor, and impossible. All the data was collected in two groups, the data was entered and analyzed on SPSS version 21. Results: The mean age of the patients was 40.11±9.49 years. The male to female ratio of the patients was 0.7:1. The study results showed the excellent intubation conditions were noted in 11 from group A and 9 from group B, good intubation condition was noted in 29 from group A and 25 from group B, poor conditions were noted in 17 from group A and 16 from group B and the impossible intubation conditions were noted in 13 from group A and 20 from group B. Statistically insignificant difference was found between the study groups with intubation conditions i.e. p-value=0.570. Conclusion: It has been proved in our study that both the succinylcholine and rocuronium are statically equally effective in terms of excellent intubation conditions in the management of rapid sequence induction in patients undergoing surgery under general anesthesia.


2009 ◽  
Vol 20 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Md Rafiqul Hasan Khan ◽  
Md Zohirul Islam ◽  
Md Sazzad Hossain ◽  
Lutful Aziz ◽  
SN Samad Choudhury

Under treatment of postoperative pain has been the topic of several recent editorials. The prevention, recognition, and management of postoperative pain in adults, as well as in children, have been receiving a great deal of interest. The poor outcome obtained with current regimens is primarily due to the inadequacies of drug administration techniques rather than the qualities of opioids themselves. In this prospective study comparison of preemptive use of diclofenac, ketorolac and tramadol was done for postoperative pain in laparoscopic cholecystectomy. 60 patients were divided into three groups. Group A received injection Diclofenac (3mg/kg) 75mg maximum at a time. Group B received injection Ketorolac (30 mg). And group C patients received injection Tramadol (100 mg). All drugs were given intravenous half an hour before induction. Analgesic efficacy was measured in VAS scale. In addition pulse, systolic blood pressure, diastolic blood pressure, mean blood pressure, total pethidine requirement and time of first pethidine requirement were recorded Patients received an increment of 10-20 mg of pethidine when pain score was 3-4. In this study, total pethidine consumption in group A is 56.5±5.14, in group B is 46.75±4.65 and in group C is 49±5.42. It shows that group B and group C have same analgesic effectiveness and which is better than group A. On the basis of present prospective clinical study postoperative pain can be managed by preemptive use of diclofenac, ketorolac and tramadol. The analgesic efficacy of ketorolac and tramadol is same and better than diclofenac. Key Words: Pre-emptive analgesia, Laparoscopic cholecystectomy. Journal of BSA, Vol. 20, No. 1, January 2007 p.24-29


2021 ◽  
Author(s):  
Medhavi Joshi ◽  
Pratik Phansopkar

Abstract BackgroundThis research aims at assessing the use of ultrasound in combination with a ayurvedic ani-inflammatory Zingiber Cassumunar gel, considering the parameters of physiotherapy on knee osteoarthritis. Zingiber cassumunar (ginger) has been used, for its anti-inflammatory properties, orally as well by it’s topical application. Improvement in pain, range of motion, balance and an overall quality of life in patients with osteoarthritis of knee has been studied through various physiotherapeutic exercises. In this study Otago exercise programme includes strengthening of lower limb and balance exercise along with walking protocol.Methodology: In this research we will include 52 subjects (n=52) having knee osteoarthritis between grade 1-3 according to Kallgren and Lawrence. In his randomized controlled single-blinded trial the subjects will be randomized into two group independent design (Group A and Group B) through envelope method of randomization. Group A will receive conventional therapy while Group B will be the experimental group. Efficacy of the intervention for both the groups is checked at the end of 2 weeks by using VAS, universal goniometer, WOMAC, star excursion balance test(SEBT) as the outcome measures.Discussion: The goal of this Randomized control trial is to examine the impact Zingiber Cassumunar phonophoresis in Knee osteoarthritis patients. This randomized control trial will help identify the rapid and long term effects of Zingiber Cassumunar phonophoresis on Knee osteoarthritis. This research findings will help develop a new prospect for the treatment of Knee osteoarthritis.The clinical trial registry-India(CTRI) registration number for this trial is CTRI/2021/05/033459.


2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Beni Indra ◽  
Untung Widodo ◽  
Yunita Widyastuti

Abstrak          Penggunaan Propofol untuk induksi pada general anestesi dapat menyebabkan  hipotensi akibat vasodilatasi arteri dan vena terutama vena kapasitan ditungkai. Manuver elevasi tungkai dapat mempertahankan stabilitas hemodinamik dengan meningkatkan aliran balik vena ke jantung dan mengurangi penumpukan darah di vena kapasitan tungkai. Penelitian ini dirancang dengan menggunakan cara Open Randomized Control Trial. Subyek penelitian adalah 184 sampel pasien dewasa ASA I-II yang menjalani operasi elektif dengan menggunakan general anestesi dengan induksi propofol. Kelompok sampel penelitian dibagi dalam dua kelompok masing-masing berjumlah 92 orang. Setelah prabeban cairan RL 10 cc/kgbb dan pemberian fentanyl 2 mcg/kgbb dan midazolam 0,05 mg/kgbb maka kelompok A dilakukan elevasi tungkai 45º satu menit sebelum induksi propofol dan dipertahankan sampai penelitian selesai. Sedangkan kelompok B tidak dilakukan elevasi tungkai. Data yang dikumpulkan dianalisa dengan uji t tes. Untuk data proporsi dilakukan analisa dengan tes chi-square. Dari data demografi tidak didapatkan perbedaan yang bermakna secara statistik (p>0,05) antara kedua kelompok penelitian kecuali untuk BMI (p<0,05). Insidensi hipotensi  menit pertama pasca induksi propofol pada kelompok A (elevasi tungkai) secara signifikan lebih rendah (12%) dibanding kelompok kontrol B  (27,2%) (p=0,016; p < 0,05). Pada menit ketiga pasca induksi juga didapatkan insidensi hipotensi kelompok A  (15,2%) signifikan lebih rendah dibanding kelompok B (23,9%) (p= 0,014; p < 0,05). Elevasi tungkai 45 derajat efektif dalam menurunkan insidensi hipotensi pasca induksi propofol.  Kata kunci: propofol, hipotensi, elevasi tungkai AbstractThe induction of general anaesthesia with propofol may induce of considerable degree of hypotension that has been atributed to decrease in systemic vascular resistance  caused by combination of venous and arterial vasodilatation. It will produce a shifting  of blood to venous reservoir, especially capacitance venule of legs. Leg elevation can provide hemodynamic stability by increases cardiac preload and recruits blood contained in the venous reservoir. This is Open Randomized Control Trial include 184 elective surgery patients with American Society of Anaesthesiologist (ASA) physical status I and II. Anesthesia  was induced with propofol. Patients were randomly allocated into two groups with 92 patients in each. All the patients received Ringer’s Lactate (10 ml/kg) and premedicated with fentanyl (2 mcg/kg) and midazolam (0,05 mg/kg) before induction of anesthesia. Group A was performed passive leg raising 45 degree 1 minute before injection of propofol until  the end of study and group B (control) did not receive any maneuver. Parametric data were analyzed with t-test and categorical data was done by using Chi-square test. A p value of less than 0,05 was consider significant. Demografic characteristics (age, sex, body weight and height) and  baseline haemodynamic parameters of the patients were similar in two groups (p > 0.05) except for BMI (p < 0.05) . The incidence of hypotension was significantly lower in group A (12 %, ) than group  B (27,2%) at the first minute after propofol  injection, p value = 0.016 (p < 0,05). In the third minute, incidence of hypotension was also significantly lower in group A (15,2%) than group B (23,9%), p value = 0,014 (p < 0,05). Leg elevation maneuver 45º significantly decrease incidence of hypotension after propofol induction. Keywords: Propofol, hypotension, leg elevation


2018 ◽  
Vol 4 (1) ◽  
pp. 3-7
Author(s):  
Mohammad Ariful Islam ◽  
Abdul Kader Shaikh ◽  
Sk Mahbub Alam ◽  
Dahlia Sultana ◽  
Md Saiful Islam ◽  
...  

Background: Combination of propranolol and amitriptyline drugs an be effective for migraine prophylaxis.Objective: The purpose of the present study was to see the safety and efficacy of propranolol and amitriptyline combination therapy in migraine prophylaxis.Methodology: This study randomized control trial was conducted in headache clinic at Banghabandhu Sheikh Medical University (BSMMU), Dhaka, Bangladesh from July 2012 to June 2014 for a period of two (02) years. Migraine patients with or without aura of 16 to 50 years of age, patients not on any prophylactic medication and patients willing to take part in the study were included for this study. Patients meeting all the criteria was randomized for two (02) treatment groups designated as the group A who were treated with Amitriptyline and the group B who were treated with the combination of amitriptyline and propranolol. Patients was followed for a three months period during which they were instructed to maintain a headache diary. The primary outcome evaluated was the proportion of patients in each group that achieved a 50% reduction in the number of days with headache. Secondary outcomes was reduction of visual analogue pain scale score, the number of days with headache per month, frequency of side effects and the proportion of patients abandoning the study before the end of medication. The causes of noncompliance and side effects was individually registered.Result: A total number of 8 0patietns were recruited for this study. During 1st visit among the patients in group A, duration of pain 1-4 hours 1 (2.5.0%), 5-8 hours 16(13.3%) and 9-12 hours 14(35.0%). In group B, duration of pain 1-4 hours 0(0.0%), 5-8 hours 18(15.0%) 9-12 were 21(52.5%), above 13 hours pain duration were 1(2.5%) (p>0.05). Duration of pain was recorded in final follow up among the patients. In group A, duration of pain 1-4 hours 24(60.0%), 5-8 hours 14(35.0%), 9-12 hours 2(5.0%). In group B, duration of pain 1-4 hours 28(70.0%), 5-8 hours 12(30.0%), 9-12 hours were not found (p>0.05). In group A, no adverse effect was found 26(65.0%), drowsiness 6(15.0%), dryness of mouth 6(15.0%), constipation 2(5.0%), fatigue and bradycardia were not found. In group B, no adverse effect was found 29(72.5%), drowsiness, dryness of mouth and constipation were not found, fatigue and bradycardia were 7(17.5%) and 4(10.0%). Number of attack and headache before treatment and subsequent follow up with medication it was found that number of attach and headache gradually decrease (p<0.05).Conclusion: In conclusion there is a significant changes of number of headache and attach in the amitriptyline and combine group.Journal of National Institute of Neurosciences Bangladesh, 2018;4(1): 3-7


2019 ◽  
Vol 26 (04) ◽  
Author(s):  
Sara Jamil ◽  
Rizwan Jouhar ◽  
Syed Abrar Ali ◽  
Muhammad Saqib

Objectives: To compare clinical retention of a low-shrinkage posterior resin composite by using incremental versus bulk placement technique in deep Class I cavities. Setting: Operative Dentistry Department, Altamash Institute of Dental Medicine, Karachi, Pakistan. Period: 6 months from 1st Oct 2017 – 30th March 2018. Study Design: Randomized control trial. Materials and Methods: This study was a randomized control trial study which consists of total of 94 teeth having class I cavity of 3mm minimum depth on occlusal surface. The restorative material evaluated in this study was Filtek Z250 (3M, ESPE) and the cavities were restored according to two different techniques. Patients in Group A were treated with bulk fill technique and patients in Group B were treated with incremental technique. The retention of the composite were clinically evaluated after 6 months (180 days) post-operatively. SPSS version 23 was used to analyze data. Results: The result of 6 months observation revealed retention of 43(91.4%) incremental fill composite and 39(85.4 %) bulk fill composite resin restorations which was statistically insignificant. Conclusion: Outcomes of incremental fill composite resin in terms of retention is equal to bulk fill composite resin with Filtek Z250 (3M, ESPE) in class I restorations of permanent molar teeth.


2019 ◽  
Vol 33 (1) ◽  
Author(s):  
Sidra Malik ◽  
Iqra Zaib ◽  
Omer Farooq ◽  
Kanwal Hanif

Objective: To Compare the efficacy of 2 different patching regimens in amblyopic children and highlight the factors affecting compliance. Materials & Methods: The randomized control trial was conducted in Eye OPD SKBZ Hospital Muzaffarabad from September 2017- March 2018. Analysis was limited to children 4 to 16 years of age with unilateral amblyopia. Personal information, visual acuity with and without correction, Cycloplegic refraction & subjective refraction was noted. Children with amblyopic eye acuity of 20/40 to 20/200 (mean 0.56 log MAR, approximately 20/63) and inter ocular acuity difference of 2 or more lines were specified to get either 2 hours (Group A) or 6 hours (Group B) of daily patching, combined with 1 hour of near visual activities per day. Follow up period was 2 weeks, 4 weeks and 3 months. Results:     Out of 72 children 44(61.1%) were males and 28(38.9%) were females. The mean age was 10.25 ± 0.67 years.  Mean visual acuity was 20/63(+0.5 log Mar) in both groups. In group A, 66.7 % and in group B 83.3% of patients showed improvement. The mean difference of BCVA was 2.77 ± 1.28 SD and 3.41±3.16 SD in group ‘A’ and group ‘B’ respectively. Group A and B showed improvement of 3.0 and 2.0 lines respectively. Both groups showed a poor compliance of 11.2 %. Conclusion: 2 hours of patching along with 1 hour of near activity is sufficient to treat amblyopia as compared to 6 hours of patching. Firstly, screening should be done to diagnose amblyopia at early stage. Secondly compliance is found to be a single most important factor to improve outcomes.


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