scholarly journals Comparison of insulin soaked dressing with the conventional dressing in diabetic ulcers.

2021 ◽  
Vol 28 (7) ◽  
pp. 951-956
Author(s):  
Hafiz Bilal Ahmed ◽  
◽  
Ramlah Ghazanfor ◽  
Usman Qureshi ◽  
Usman Akram ◽  
...  
Keyword(s):  
Wound Healing ◽  
Controlled Trial ◽  
Healing Process ◽  
P Value ◽  
Random Allocation ◽  
Diabetic Ulcers ◽  
Group A ◽  
Complete Wound Healing ◽  
Group B ◽  
Surgical Unit

Objective: This study aims at demonstrating the benefits of insulin soaked dressing for the treatment and accelerating the healing process of diabetic ulcers thus helping the faster wound healing, reducing morbidity and also decrease the cost of management in patients with diabetic ulcers. Study Design: Randomized Controlled Trial. Setting: Surgical Unit 1, Holy Family Hospital, Rawalpindi Medical University, Rawalpindi. Period: November 2016 to May 2017. Material & Methods: The study was initiated after approval from the institutional research forum of Rawalpindi medical college. Patients fulfilling the selection criteria reporting at surgical unit – I, Holy Family Hospital, Rawalpindi were included in the study. Written informed consent was taken. Random allocation of the study participants to either study group was done by using lottery method, 60 patients were randomly allocated to either group A(insulin soaked dressing) or Group B (conventional dressing), each with 30 patients. Results: In Group A, insulin soaked dressing was applied whereas patients in Group B were applied with conventional dressing. Mean age (years) of patients was 48.04+13.45 whereas there were 32 (53.3) male and 28 (46.7) female patients. In the study, mean duration (day) of complete wound healing in patients with diabetic ulcers receiving insulin soaked dressing and conventional dressing was 39.80 + 8.04 and 47.60+6.52 respectively which was statistically significant (p-value 0.000). Conclusion: The study concluded that in patients with diabetic foot ulcer, average duration of complete wound healing was significantly less in patients with insulin soaked dressing as compared to conventional dressing.

Comparison of harmonic scalpel versus Milligan Morgan technique in haemorrhoidectomy patients

2021 ◽  
Author(s):  
Muhammad Ahmad ◽  
Syed Tatheer Abbas ◽  
Amna Javaid ◽  
Naveed Arshad ◽  
Falak Shair
Keyword(s):  
Wound Healing ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Controlled Trial ◽  
P Value ◽  
Randomized Controlled ◽  
Group A ◽  
The Mean ◽  
Complete Wound Healing ◽  
Group B

Objectives: To assess the comparison of harmonic scalpel versus Milligan Morgan technique in patients undergoing haemorrhoidectomy. Methodology: This randomized controlled trial study was conducted at General Hospital, Lahore, from March 2019 to September 2019. Informed consent was obtained from eligible 60 patients. Patients were randomly divided into two equal groups. In group-A, haemorrhoidectomy was conducted according to the harmonic scalpel method. In group-B, open haemorrhoidectomy was performed by the Milligan Morgan procedure. Data was assembled through a designed questionnaire and investigated via SPSS version 25. Data were stratified for descriptive statistics, level of haemorrhoids and period of haemorrhoids. Post-stratification, independent sample t-test was used. Results: Mean age of both groups patients were 44.6±7.6 and 43.8±8.2 years, respectively. In group-A, mean operative time was 20.8±2.8 minutes, while 26.5±2.8 minutes in group-B, which was statistically significant with p-value of 0.001. In group-A, mean convalescence period was 9.7±2.9 days, while 13.4±3.7 days in group-B, which was statistically significant with p-value of 0.001. The mean convalescence period with harmonic scalpel method was 7.4 days (range 5–14, SD 3.6) versus 18.6 days (range 7–30, SD 5.4) with Milligan Morgan technique (P?0.001). This research observed that harmonic scalpel method required almost six weeks for complete wound healing, whereas in  Milligan Morgan technique, complete wound healing was achieved after three months (P<0.05). Conclusion: Harmonic scalpel haemorrhoidectomy found an advantageous method when assessing the operative time and convalescence period. Hence, Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternative method for treating symptomatic haemorrhoids. Continuous...

scholarly journals Fat Plug Myringoplasty Vs Trichloroacetic Acid Cauterization as Office Procedures for Managing Small Central Perforation

2018 ◽  
Vol 26 (3) ◽  
pp. 171-175
Author(s):  
Kanchan Sandeep Dhote ◽  
Priti Rakesh Dhoke ◽  
Vivek Vishwas Harkare ◽  
Nitin Vasant Deosthale ◽  
Sonali Prabhakar Khadakkar
Keyword(s):  
Trichloroacetic Acid ◽  
Controlled Trial ◽  
P Value ◽  
Fisher Exact Test ◽  
Random Allocation ◽  
Success Rates ◽  
Group A ◽  
Group B ◽  
Fat Plug Myringoplasty ◽  
Office Procedures

Introduction In a series of day care office procedures, techniques like fat plug myringoplasty and Trichloroacetic acid (TCA) cauterization are becoming increasingly popular for managing small central perforations now-a-days[Office1] . These are minor, cost effective procedures and have success rates that match success rates of conventional tympanoplasty[Office2] . The aim of this prospective randomized controlled trial, was to compare the effectiveness of fat plug myringoplasty and chemical cauterization in the management of small centrally located perforations of the pars tensa. Materials and Methods The study was carried out over a period of 2 years on 62 patients selected from ENT OPD in our tertiary health care setup of central India. All the selected patients were grouped into two using a random allocation software EPi Info7.1.1.14. Group A included those who underwent fat plug myringoplasty while group B were those who underwent TCA cauterization. Results At 6 months follow up there was closure of perforation in 29 out of 30(96.6%) patients of group A and 29 out of 32(91%) patients of group B. In both groups success was defined by closure of perforation. Comparison of results was done using Fisher Exact Test. The difference between the success rates of the two procedures was statistically insignificant with p value of 0.6624, indicating that both the office procedures are equally effective and can be used according to the needs of the patients. Conclusion These office procedures can revolutionize the protocol of tympanoplasty which has an obvious higher morbidity and more days of absenteeism as compared to these minor procedures.

PRECIPITATING FACTORS AND EFFICACY OF COMBINING LACTULOSE PLUS RIFAXIMIN IN THE TREATMENT OF HEPATIC ENCEPHALOPATHY DUE TO CIRRHOSIS AT CHO RAY HOSPITAL

2020 ◽  
pp. 63-68
Author(s):  
Phat Ho Tan ◽  
Tam Vu Thi Minh ◽  
Trong Huynh Nguyen Dang ◽  
Phuong Tran Nhat Thi Anh ◽  
Ngan Tran Thi Kim ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Gastrointestinal Bleeding ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
P Value ◽  
Precipitating Factors ◽  
Overt Hepatic Encephalopathy ◽  
Group A ◽  
Group B ◽  
Male To Female

Background: Hepatic encephalopathy is an important evidence that confirms impairment of liver function, may occur in about 40% of cirrhotics. Data about efficacy of rifaximin plus lactulose in the treatment of Vietnamese patients was still limited. This study aimed to determine the precipitating factors and to access the efficacy of lactulose plus rifaximin in overt hepatic encephalopathy. Patients and Methods: The prospective single-blind randomized controlled trial, 43 cirrhotics with overt hepatic encephalopathy without portal systemic shunting addmitted to gastroenterology department of Cho Ray Hospital from March 2019 to August 2019, were randomized into two groups (group A lactulose plus rifaximin 1.100 mg/day, n = 21; and group B only lactulose; n = 22). All patients were recorded for onset factors, clinical characteristics and assessing the recovery of hepatic encephalopathy. Results: The mean age of patients in this study was 54.8 ± 12.1 years (the ratio of male to female patients is 4.38 : 1). The leading cause of cirrhosis was alcohol (39.5%). The most common clinical symptoms were jaundice (83.7%), spider naevi (41.9%) and ascites (37.2%). The most common triggers were infection (51.2%), gastrointestinal bleeding (37.2%) and constipation (25.6%). The percentage of patients with complete improvement after treatment with lactulose plus rifaximin was 81% compared to 63.6% in the lactulose-treated patients only (95% CI: 0.539 - 1.147, p value = 0.206). Conclusion: Our data revealed that common triggers of hepatic encephalopathy were infections, gastrointestinal bleeding and constipation. The combination of lactulose plus rifaximin was more effective than rifaximin alone in the treatment of overt hepatic encephalopathy. Key words: hepatic encephalopathy, precipitating factor, lactulose, rifaximin

scholarly journals Effect of acupuncture TENS versus conventional TENS on post cesarean section incision pain

2018 ◽  
Vol 7 (9) ◽  
pp. 3738
Author(s):  
Priti A. Mehendale ◽  
Mayur T. Revadkar
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Control Group ◽  
P Value ◽  
Random Allocation ◽  
Lower Segment Caesarean Section ◽  
Post Operative Pain ◽  
Group A ◽  
Group B ◽  
Pain Rating Scale

Background: There is evidence regarding beneficial use of Transcutaneous Electrical Nerve Stimulation (TENS) on post Lower Segment Caesarean Section (LSCS) incision pain. However, efficacy of different types of TENS following C section pain has not yet been explored adequately.Methods: 96 women who had recently undergone LSCS were included for the study. The subjects were in the age group of 20 to 40 years (25.84±3.96); having pain intensity 4 or more on Numerical Pain Rating Scale (NPRS). They were divided into three groups by random allocation method; namely Group A: Acupuncture (Low/Motor) TENS, Group B: Conventional (High/Sensory) TENS and Group C: Control group. Group A and B received specific type of TENS twice a day for 15 minutes. Control group C did not receive any TENS intervention. All subjects received standard post-operative medications and physiotherapy. Pain intensity was recorded on NPRS pre and post intervention.Results: Both Acupuncture TENS and Conventional TENS significantly decreased post-operative pain intensity as compared to control group (p value <0.0001).Conclusions: Both, acupuncture and conventional TENS are equally effective in reducing post LSCS incision pain at a strong and non-painful intensity.

scholarly journals Comparison of efficacy of internal sphincterotomy versus topical 0.2 % glyceryl trinitrate ointment after hemorrhoidectomy.

2020 ◽  
Vol 27 (12) ◽  
pp. 2541-2547
Author(s):  
Muhammad Arif ◽  
Sabih Nofal ◽  
Ahsan Khan ◽  
Mariam Tariq Awana ◽  
Anum Arif
Keyword(s):  
Glyceryl Trinitrate ◽  
Controlled Trial ◽  
P Value ◽  
Chi Square ◽  
Male Predominance ◽  
Internal Sphincterotomy ◽  
Open Hemorrhoidectomy ◽  
Group A ◽  
Group B ◽  
Glyceryl Trinitrate Ointment

Objectives: To compare the efficacy of 0.2% glyceryl trinitrate ointment versus internal sphincterotomy after hemorrhoidectomy. Study Design: Randomized Controlled Trial. Setting: Department of Surgery Unit III, at Lahore General Hospital, Lahore. Period: 6 months (August 2017 to February 2018). Material & Methods: The OPD of the Department of Surgery included 124 patients who satisfied the inclusion criteria. There were two groups of patients, Group A and Group B. Group-A was told to use gloved finger three times daily for 0.2 percent GTN ointment topically. For Group B, lateral internal sphincterotomy was performed as day care procedure. On visit, patients were assessed for pain relief by using VAS. All data was collected using a pre-designed (attached) proforma. In SPSS v23.0 the data were input and analyzed. It was stratified for age, sex, disease duration and hemorrhoid stage. The effectiveness of both groups was compared by using a p-value of 0.05 as significant for a chi-square test. Results: Male predominance; in group-A, 41(66.1%) patients were male and 21(33.9%) were female, while in group-B, 52(83.9%) patients were male and 10(16.1%) were females. Efficacy was found in 11(17.7%) patients in group-A (0.2% GTN) while in 25(40.3%) patients in group-B (Internal sphincterotomy) with p-value of 0.006 which is statistically significant. Conclusion: Open hemorrhoidectomy internal sphincterotomy is an effective method to reduce pain after hemorrhoidectomy in contrast to Glyceryl Trinitrate (GTN) topical cream of 0.2 percent.

scholarly journals Comparison of Recovery Time of Propofol and Midazolam with Propofol Alone for Sedation in Endoscopic Retrograde Cholangiopancreatography

2021 ◽  
Vol 15 (5) ◽  
pp. 1024-1027
Author(s):  
Asma Samreen ◽  
Aamir Waseem ◽  
Muhammad Azam ◽  
Itrat Hussain Kazmi ◽  
Aamir Bashir ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Recovery Time ◽  
Controlled Trial ◽  
P Value ◽  
Time Data ◽  
Endoscopic Retrograde ◽  
Intravenous Anesthetic ◽  
Significant Difference ◽  
Group A ◽  
Group B

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.

Comparison of letrozole and clomiphene citrate efficacy in terms of ovulation induction and pregnancy rate.

2021 ◽  
Vol 28 (05) ◽  
pp. 749-754
Author(s):  
Nadia Sharif ◽  
Uzma Manzoor ◽  
Saadia Bano ◽  
Uzma Shahzaad
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Epidemiological Data ◽  
P Value ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Letrozole and clomiphene citrate in Patients of Anovulation polycystic ovarian syndrome with Infertility. Study Design: Randomized Controlled Trial Setting: Department of Obstetrics and Gynecology Independent Medical College Faisalabad. Period: 30-09-2019 to 29-6-2020. Material & Methods: This study included 100 patients with 50 patients in each group. Group A received 2.5 to 5mg letrozole in each cycle from day 3 to 7. Group B received clomiphene citrate 50 to 100 mg incremental dose depending on ovarian response. Both Drugs were given for consecutive 3 to 6 cycles to see response. Main outcome Measure included optimal follicle size (> 18mm), endometrial thickness, and pregnancy rate. Epidemiological data and efficacy outcome measures were recorded on a Performa. Statistical analysis was done using SPSS version 13. Chi-square test applied and p-value <o.o5 was considered significant. Both group included primary infertility patients. Results: The mean age of patients was 28.03+ 3.02 years. Mean age of group A patients was 29.04+3.44 and 28.47+3.90 group B patients. Mono ovulation in group A patients (88.9%) and 27 in group b patients (60.0%). The mean endometrial thickness was 9.6mm + 1.6 in letrozole group and 6.9mm + 1.2 in clomiphene citrate group A. In group A 18% got pregnant from Letrozole group and 1.1% from the group B. Conclusion: Efficacy was significantly higher in group A Patients received letrozole as compared to patients echo received clomiphene citrate. The effects of Letrozole showed better outcome in terms of Ovulation Induction Endometrial Thickness and Pregnancy rate.

scholarly journals SINONASAL POLYPOSIS

2018 ◽  
Vol 25 (10) ◽  
pp. 1581-1586
Author(s):  
Farhan Salam ◽  
Ejaz Ahmad ◽  
Muhammad Salman Haider Qureshi ◽  
Muhammad Aslam Khan
Keyword(s):  
Nasal Polyposis ◽  
Controlled Trial ◽  
Chronic Inflammatory Disease ◽  
P Value ◽  
Entire Study ◽  
Sense Of Smell ◽  
Study Duration ◽  
Group A ◽  
Group B ◽  
Sinonasal Polyposis

Introduction: Nasal polyposis (NP) is a chronic inflammatory disease involvingmucous membrane in paranasal sinuses and nose. It presents as gelatinous, semitranslucent,smooth, pedunculated pear or round shaped masses comprising of inflamed mucosa thatout-pouches into nose. The available surgical options are Functional Endoscopic SinusSurgery (FESS) and Conventional Intranasal Polypectomy (CIP). The study aims to compareFESS and CIP in sinonasal polyposis patient in term of symptomatic improvement. StudyDesign: Randomized controlled trial. Setting: Department of head n’ neck surgery andOtorhinolaryngology, Pakistan Institute of Medical Sciences, Islamabad. Period: 01-01-2015 to20-08-2015. Methodology: A total of 84 patients presenting with nasal polyposis were enrolled.Out of these 84 patients, 42 patients were randomly selected for FESS (Group-A). Rest of the42 patients were selected for CIP (Group-B). All the information recorded on the Performawas entered and analysed using SPSS version 17. The entire study duration was 31 weeks.Regarding ethical consideration, the study was approved from ethics committee of hospital.Informed consent was obtained from the study participants. Moreover, confidentiality andanonymity of subjects was assured. The patients were followed-up for 2 months duration. Theentire study duration was about 8 months. Results: On the basis of scoring of nasal obstruction,in FESS Group-A, 32 (76.19%) patients had completely patent nose after two months and only10 (23.81%) patients had partially blocked nose. On the other hand in CIP Group-B, only 16(38.10%) patients had completely patent nose while 26 (60.90%) patients had partially blockednose after two months. The comparison of sense of smell between both groups also showedthat the outcome of Group-A was significantly (p-value = 0.000) better as compared to Group-B.The complete sense of smell was found present in 37 (88.10%) patients in group A in contrastwith 19 (45.23%) patients in group B. Conclusion: FESS seems to be a better treatment optionfor sinonasal polyposis than conventional intranasal polypectomy. However study with largerpopulation size and longer follow up duration is recommended to rationalize the results.

scholarly journals A comparative study of the effect of piroxicam versus diclofenac on wound healing in clean abdominal wounds

2018 ◽  
Vol 5 (3) ◽  
pp. 1041 ◽  
Author(s):  
Chandrashekar Reddy J. Madinur ◽  
Prashant Tubachi ◽  
Prashant Tubachi ◽  
A. S. Godhi ◽  
A. S. Godhi
Keyword(s):  
Wound Healing ◽  
Controlled Trial ◽  
Research Centre ◽  
Female Ratio ◽  
Factors Affecting ◽  
Significant Difference ◽  
Group A ◽  
One Year ◽  
Group B ◽  
The Individual

Background: The primary function of the skin is to serve as a protective barrier against the environment. The process of wound healing constitutes an array of interrelated and concomitant events. Understanding these processes and various factors affecting these processes continue to expand. The present study was undertaken to compare and evaluate the effect of piroxicam versus diclofenac on wound healing in clean abdominal wounds.Methods: The present one year randomized controlled trial was conducted on all the patients undergoing appendicectomies for uncomplicated appendicitis and uncomplicated inguinal hernia repairs in the Department of Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum during the period of one year. Based on the thumb rule a total of 60 patients divided into two groups of 30 each were studied. Based on the computer-generated randomization patients were allocated to two groups that is group A (Inj. Piroxicam) and Group B (Inj. Diclofenac).Results: In the present study, males outnumbered females with male to female ratio between of 1.72 to 2:1. The mean age in group A was30.9±7.86 years and in group B it was 30.3±7.97 years. Both the groups that is Group A and B were graded under grade I (Good wound healing) from the POD 3 onwards. Overall the individual score and total scores had no influence of the final grading (outcome) of the wound.Conclusions: Overall, better results were seen on wound healing in patients who received Inj piroxicam with significantly less post-operative redness and edema. However, this did not have significant difference in the final outcome of the grading of the wound. 

scholarly journals EFFECTIVENESS OF NEURAL MOBILIZATION AND STRETCHING EXERCISE FOR THE MANAGEMENT OF SCIATICA

2014 ◽  
Vol 3 (2) ◽  
pp. 11-15
Author(s):  
Sidra Zahid ◽  
Ghazala Noor Nizami
Keyword(s):  
Conventional Therapy ◽  
Controlled Trial ◽  
Treatment Options ◽  
Tertiary Care ◽  
P Value ◽  
Below The Knee ◽  
Pain Disability ◽  
Before And After ◽  
Group A ◽  
Group B

OBJECTIVE To find out the effectiveness of neural mobilization and stretching exercise for the management of sciatica BACKGROUND Sciatica is described as pain, radiating to the leg below the knee joint and caused by irritation of the sciatic nerve or nerve trunk. There are many treatment options for the management of sciatica, including stretching exercise and neural mobilization. MATERIAL AND METHODS This study was a Randomized Controlled Trial. 94 patients from physical therapy OPD of tertiary care hospitals, were participated in this study. Hence, 47 patients were randomly allocated into each group A and B. Before and after the nine treatment sessions, both groups were assessed with VAS, SLR ROM and Quebec back pain disability scale. In group A, neural mobilization with conventional therapy (heat and TENS) was applied, while stretching exercise with same conventional therapy was applied to group B. RESULTS It was observed that both treatments were helpful in reducing the symptoms. The analysis showed significant improvement (p-value <0.05) in the SLR to 60.851o±6.86oand Quebec score to 23.617±3.125, after the stretching exercise. Hence, both treatments were equally effective in reducing pain (p-value >0.05). CONCLUSION Stretching exercise is more effective in the improvement of SLR and disability. Furthermore, both techniques are helpful in the management of pain. KEY WORDS Sciatica, Stretching, Neural Mobilization, Straight Leg Raising, Visual Analogue Scale, TENS.

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