Comparative Study of Efficacy and Safety of Diacerein versus Acelofenac in Patient with Knee Osteoarthritis

Introduction: There are different pharmacological modalities currently in practice for the treatment of osteoarthritis knee. Broadly these are divided into anti-inflammatory drugs such as NSAIDs and symptomatic slow-acting drugs in osteoarthritis (SYSADOA). Diacerein, an anthraquinone derivative inhibits IL-1b and has been shown to significantly decrease the symptoms.Methods: This is open label, prospective comparative study. Total 40 patients were divided into two groups: group A (diacerein) and group B (aceclofenac) by alternate method. In group A diacerein was given 50mg orally for 1 week followed by 50 mg orally twice a day for 3 weeks. In group B aceclofenac 200 mg sustained release tablet was given orally once a day for 4 weeks. Outcomes were measured at the end of the treatment period i.e. at four weeks and after two weeks of discontinuation of treatment i.e. at 6 weeks.Results: Improvement is observed in both treatment groups in their baseline value in terms of efficacy parameters. Results of VAS and WOMAC scores were better in group B (aceclofenac). However intra-group analysis showed VAS scores and WOMAC scores significantly decreased in patients receiving diacerein as well. (p<0.05).Conclusion: Though not superior to the control drug, diacerein showed efficacy in terms of measurement by patient self-reported WOMAC and VAS scores for the treatment of Osteoarthritis knee.

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A comparative study of efficacy and safety of glucosamine plus chondroitin sulphate versus rosehip as add on therapy to NSAIDs in patients suffering from osteoarthritis

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20184336 ◽

2018 ◽

Vol 7 (11) ◽

pp. 2254

Author(s):

Kiranpreet Kaur ◽

Anjleen Kaur ◽

Prabhsimran Singh ◽

Amandeep Singh Bakshi

Keyword(s):

Comparative Study ◽

Chondroitin Sulphate ◽

Tertiary Care ◽

Efficacy And Safety ◽

Tertiary Care Centre ◽

Open Label ◽

Significant Difference ◽

Group A ◽

Efficacy Parameters ◽

Group B

Background: Osteoarthritis is a chronic and debilitating disease. Management of disease is a big challenge. NSAIDS play an important role but have many adverse reactions. So, this study was designed to evaluate the efficacy and safety of natural compound rosehip versus glucosamine and chondroitin sulphate in patients of osteoarthritis.Methods: An open label, randomized, parallel group comparative study, conducted on patients of either sex with confirmed diagnosis of osteoarthritis on standard NSAIDs therapy, attending the outpatient department of orthopedics in a tertiary care centre. 150 patients were enrolled and divided into three groups (group A, group B and group C) of 50 each. Patients of group A were given Glucosamine plus chondroitin sulphate for 12 weeks. Group B was given rosehip for 12 weeks and group C placebo. These supplements were given as add on therapy. Patients were monitored and adverse drug reactions were noted. The data was analysed statistically using t- test for efficacy and descriptive stats for assessing the safety.Results: Efficacy was assessed by comparing mean reduction in the pain intensity between group A and B, group B gives highly significant results as compared to group A. While comparing joint tenderness, swelling around joint, mean functional capacity and improvement in the overall assessment, group B gives significant results as compared to group A. It was also observed that group A and group B were better than group C in all the efficacy parameters. All the drugs were well tolerated and systemically safe.Conclusions: There was significant difference in efficacy of rosehip compared with glaucosamine and chondroitin sulphate in patients of osteoarthritis. In comparison there was no significant difference in safety of two drugs and both were considered safe in patients.

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Modified Lift Versus Cutting Seton for Transphincteric Fistula -Experience at Tertiary Care Hospital

10.53350/pjmhs2115123257 ◽

2021 ◽

Vol 15 (12) ◽

pp. 3257-3260

Author(s):

Muhammad Najam Iqbal ◽

Ashfaq Nasir

Keyword(s):

Comparative Study ◽

Anal Incontinence ◽

Complete Healing ◽

Fistula Tract ◽

Fistula Closure ◽

Fistula In Ano ◽

Group A ◽

Prospective Comparative Study ◽

Cutting Seton ◽

Group B

Background: Fistula in ano is a common disease which has high recurrence rate and high fecal incontinence rate after surgery. We compared modified LIFT (Ligation of the intersphincteric fistula tract (LIFT) through lateral approach ) with cutting seton for transphincteric fistula. Aim: This study is aimed at which procedure is better with respect to postoperative complications Study design: It was a prospective comparative study. Methods: This was a prospective comparative study from 01-01-2019 to 30-06-2021 which was conducted on 50 patients who presented with transsphincteric fistula in ano (FIA) in surgical ward of Bahawal Victoria Hospital Bahawalpur. Patients were divided into two groups .Patients of Group A underwent modified lift procedure and patients of group B underwent cutting seton procedure. Data was collected on a proforma which included patients’ name ,age ,sex, age group, comorbid disease like diabetes mellitus ,chronic liver disease, cardiovascular disease and chronic renal failure, fistula tract involving less than 50% or more than 50% external sphincter ,procedure done, healing time of wound, complications like recurrence and incontinence. Patients were followed for 6 months for healing rate ,recurrence and incontinence. Data was analysed on spss 22 version Results: In Group A, complete healing (fistula closure without recurrence) was achieved in 20 patients (80%) out of 25. There was no case of anal incontinence after the procedure. 5 (20%) patients experienced recurrence in 6 months . In Group B, complete healing (fistula closure without recurrence) was achieved in 21 patients (84%), in 6 months follow up . 4(16%) patients were diagnosed as a case of anal incontinence. There were 4 (16%) patients with recurrence. Conclusion: Modified LIFT is better in terms of incontinence where as cutting seton is better in terms of recurrence.it is suggested that for high lying fistula modified LIFT is better procedure and for low lying fistula involving less than 50% sphincter cutting seton is better procedure.. Keywords: Modified LIFT (ligation of ineter sphincteric fistula tract) ,Cutting seton , transphincteric fistula.

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O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i1.3599 ◽

2021 ◽

Vol 71 (1) ◽

pp. 347-50

Author(s):

Qamar Zia ◽

Asma Rizwan ◽

Adil Khurshid ◽

Mudassar Sajjad ◽

Muhammad Nawaz ◽

...

Keyword(s):

Comparative Study ◽

Vesicovaginal Fistula ◽

Armed Forces ◽

Vaginal Fistula ◽

Fistulous Opening ◽

Vesicovaginal Fistulae ◽

Group A ◽

Prospective Comparative Study ◽

Group B ◽

Vesico Vaginal Fistula

Objective: To assess morbidity and success of transabdominal (O’Conor) repair of vesicovaginal fistula with orwithout interposition of flap between vagina and urinary bladder. Study Design: Prospective comparative study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Mar 2016 to Jan 2019. Methodology: Fifty five patients were randomized into group A & B by lottery method. An inclusion criterionwas single fistulous opening of ≤3cm. Complex and recurrent fistulae were excluded. Patients in group A underwent O’Conor repair without interpositional flap while in group B vesicovaginal fistulae were repaired with flap interposition. Results: Twenty two patients were randomized in group A while 27 in group B. Mean age of patients was 41.65± 11.93 years. Gynecological and obstetrical surgery was the main cause of fistula. Mean duration of surgerywas 162.7 ± 18.49 minutes. Per-operative ureteric catheterization was done in 9 (16.8%) patients. Seventeen(30.6%) patients had paralytic ileus. There was transient fever in 4 (7.6%) of cases and wound infection was seenin 3 (5.8%) of patients. Mean hospital stay was 3.4 ± 2.3 days. Cystogram was done in 35 (64.5%) of patients before the removal of per-urethral catheter. The overall success rate was 92.9%. Ten (18.2%) of patients developed denovo urgency which was managed conservatively. There was no statistical difference in both groups in terms of morbidity and success. Conclusion: In simple Vesico-vaginal fistulae repair, interposition of flap can be omitted and it does not affect the outcomes in terms of success and morbidity.

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Comparison of septoplasty with and without packing and splints.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.04.6175 ◽

2021 ◽

Vol 28 (04) ◽

pp. 459-463

Author(s):

Amrat Kumar ◽

Ashok Kumar ◽

Shabir Mehar ◽

Dileep Kumar ◽

Muhammad Wasi Ullah Khan

Keyword(s):

Comparative Study ◽

Nasal Packing ◽

Treatment Results ◽

New Techniques ◽

Before And After ◽

Group A ◽

Vas Scores ◽

The Mean ◽

Group B ◽

Study Setting

Objective: During septoplasty, nasal packing is routinely used by surgeons for hemostasis and balancing the cartilage and bony skeleton of the nose. However, these new techniques are not totally mild and therefore new ways are adopted to check their efficiency and reason their value. The study was performed to compare the use of plastic intranasal splints with or without anterior nasal packing to determine the need of nasal packing after septoplasty. Study Design: Comparative Study. Setting: ISRA University Hyderabad. Period: March 2018 to April 2019. Material & Methods: A total of 50 patients presenting with nasal septum in this period were prospectively examined. For the purpose of comparative study, we divided the patients into two groups: Group A –Patients who underwent septoplasty with packing and Group-B –Patients who underwent septoplasty without packing. We recorded the pain felt using Visual analogue scale before and after the surgery and also noted the Mean Age gender wise and recorded treatment results for statistical analysis using SPSS Version-20. Results: In our data, a total fifty (50) patients comprising 28 Males (68%) and 22 Females (32%) were listed in the study. The mean± standard deviation VAS scores of Group-A was at 5.2 ±0.9 and Group-B is 2.9±0.61 showing less pain in Group B-without splints and packing. However the complication rate in patients without Splints and packing was only 18%. Conclusion: Thus we find septoplasty without nasal splints and packing is more effective and cause lesser bleeding and pain to patients.

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A PROSPECTIVE COMPARATIVE STUDY OF OPEN VERSUS CLOSED METHOD OF CREATING PNEUMOPERITONEUM IN LAPAROSCOPIC SURGERY

10.36106/paripex/7904461 ◽

2020 ◽

pp. 1-3

Author(s):

Akshar Patel ◽

Shashank Desai

Keyword(s):

Laparoscopic Surgery ◽

Comparative Study ◽

Tertiary Care ◽

Needle Insertion ◽

Care Hospital ◽

Open Method ◽

Group A ◽

Prospective Comparative Study ◽

Group B ◽

Open Versus

Objective: The aim of the study was to compare open and closed method in terms of time require for creation of pneumoperitoneum and to ascertain safety in laparoscopic surgery. Methodology: This was a prospective comparative study carried out at a tertiary care hospital from January 2019 to December 2019.We selected 100 patients who were planned for laparoscopic surgery and divided them into two equal groups using the envelop method of randomization. Group A comprised of patients in whom we created pneumoperitoneum by classical veress needle insertion and in Group B by open method. Results: In our study, the mean time require for closed method was 6.92 minutes while by open method it was 4.36 minutes. Complication rate was 18% in closed and 16% in open method. Conclusion: open method is quick but comparable to closed method in terms of complications.

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DCP vs LCDCP in forearm fractures: a comparative study of functional outcomes

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20191783 ◽

2019 ◽

Vol 5 (3) ◽

pp. 454

Author(s):

Aaron R. D’souza ◽

Vamsi M. Krishna ◽

Kaushik S. Eswaran ◽

Shailesh Kumar

Keyword(s):

Comparative Study ◽

Functional Outcomes ◽

Forearm Fractures ◽

Group A ◽

Prospective Comparative Study ◽

Diaphyseal Fractures ◽

Both Bones ◽

Group B ◽

Limb Fractures ◽

Upper Limb Fractures

Background: Forearm fractures in general, and diaphyseal fractures in specific, are one of the most common fractures which accounts for about 31% of upper limb fractures seen in emergency. Early reduction and fixation is necessary in order to restore the function of forearm so as to be able to carry out their daily activities. The objective of this study was to compare the functional outcomes of forearm fractures fixed with DCP and LC DCP.Methods: The present study was a hospital based study, and a prospective, comparative study. A total of 40 patients with fracture of both bones forearm were taken up for the study, and randomly divided into 2 groups of 20 patients each. They were followed up for a period of 1 year.Results: The majority of patients were males (31 males and 9 females), involving age group 21-30. The left side was more common than right in both groups. The site of fracture was middle one-third of forearm in both groups (60% in group A and 65% in group B). The time for union was on average 4 weeks for LC DCP and DCP. ROM was full in 85% in DCP group and 90% in LC DCP group. Overall results were comparable in both groups. Excellent in 34 cases (18 in LC DCP, 16 in DCP), satisfactory in 5 cases (2 in LC DCP, 3 in DCP) and unsatisfactory in one case treated with DCP.Conclusions: LC DCP provides slightly better functional outcome in terms of time taken for union, early mobilisation and range of motion. However, it is more expensive than DCP.

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Single Layer Extra-Mucosal Interrupted Anastomoses; Revalidated

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.2-1.59 ◽

2015 ◽

Vol 2 (1) ◽

pp. 22-26

Author(s):

Bilal Khattak ◽

Faiz -Ur- Rahman ◽

Irfan -Ul-Islam Nasir ◽

Muhammad Iftikhar ◽

Imtiaz Ahmad Khattak ◽

...

Keyword(s):

Comparative Study ◽

Double Layer ◽

Intestinal Anastomosis ◽

Single Layer ◽

P Value ◽

Burst Abdomen ◽

Group A ◽

Prospective Comparative Study ◽

Anastomosis Leakage ◽

Group B

Objective:To evaluate the safety regarding anastomotic failure of single layer interrupted extra mucosal intestinal anastomosis in comparison with double layer intestinal anastomosisMethodology:This prospective comparative study was conducted in surgical A unit of Lady reading Hospital Peshawar from 1st June 2007 to 1st February 2008 (8 months).Patients were divided into two groups, each comprising 60 patients. First 60 consecutive patients were included in Group A, for single layer extra mucosal anastomosis while Group B included last 60 consecutive patients for double layer inverting anastomosis (continuous inner and interrupted outer Lambert sutures). All the cases were admitted through OPD and emergency. The safety of two techniques of anastomosis was analyzed by comparing the outcome in terms of complications.Results:In this study, anastomosis leakage occurred only in 4 (3.33%) patients, one (1.67%) in group A and three (5%) in group B with a P-Value 0.138. Mean age of patient in group A was 36.15 years (+/- 6.0 years) and in group B was 33.25 years (+/- 5.5 years).Conclusion:Single layer extra-mucosal anastomosis has least anastomotic leakage and other complication like wound infection, septicemia, and collection and burst abdomen than in patients with double layer investing anastomosis.

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Laparoscopic appendectomy versus laparoscopic assisted appendectomy: a hospital based comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20202408 ◽

2020 ◽

Vol 7 (6) ◽

pp. 1935

Author(s):

Gopal Sharma ◽

Barinder Kumar

Keyword(s):

Comparative Study ◽

Laparoscopic Appendectomy ◽

Operating Time ◽

Laparoscopic Technique ◽

Average Operating ◽

Group A ◽

Prospective Comparative Study ◽

Average Operating Time ◽

Group B ◽

Laparoscopic Assisted

Background: Laparoscopic appendectomy is more expensive and time consuming as compared to open technique. On the other hand, laparoscopic assisted appendectomy has the advantages of both the open and laparoscopic methods.Methods: This was a prospective comparative study of patients that underwent appendectomy by laparoscopic or laparoscopic assisted techniques.Results: A total of 40 patients were selected for the study. Standard laparoscopic technique was performed in 20 patients and laparoscopic assisted appendectomy was performed in 20 patients. The average operating time was 25.4±15 minutes in laparoscopic assisted appendectomy while it was 46.20±10.90 minutes in standard laparoscopic appendectomy which was statistically significant. Mean hospital stay in group A was 2.70±0.70 and in group B it was 2.10±0.70 which was not statistically significant.Conclusions: The laparoscopic-assisted method of appendix removal can be performed as efficiently as laparoscopically. It is fast and easy to perform, and it is expected to decrease the overall cost of laparoscopic appendectomy.

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Feto-maternal outcomes following caesarean section: a prospective comparative study at tertiary care centre in North-Western Rajasthan

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182341 ◽

2018 ◽

Vol 7 (6) ◽

pp. 2311

Author(s):

Neha Kuntal ◽

Madhu Patni Bhat ◽

Amit Nimawat ◽

Munmun Yadav ◽

Mahendra Kumar Verma

Keyword(s):

Caesarean Section ◽

Comparative Study ◽

Tertiary Care ◽

Maternal Outcomes ◽

Data Types ◽

Common Indication ◽

Group A ◽

Prospective Comparative Study ◽

Group B ◽

North Western

Background: Caesarean section (CS) is employed when vaginal delivery is not feasible or hazardous to the mother and/or her baby. The procedure, however, is not without risk. We determined the fetomaternal outcomes of CS conducted at P.B.M Tertiary hospital situated in the North-Western region of Rajasthan.Methods: This is a Hospital based prospective comparative study of all CSs performed for various indications at the Dept. of Gynaecology and Obst., S.P. Medical College and P.B.M Hospital, Bikaner, India, from August 01, 2016, to July 31, 2017. All patients who had CS at any time within the 24 h period were noted and followed up until discharge. The sociodemographic data, types of CS, indications, and feto-maternal outcomes were documented in a proforma. Statistical analysis was carried out using the SPSS version 24.Results: There were 16386 deliveries out of which 4456 (27.1%) were by LSCS. The age range of the group A was 21-25 years while in group B it was 26-30 years. The mean age group A was 22.4, and group B it was 27.9 years. Total 6572 primigravida patients delivered and 32.1% had LSCS. Total 9814 multigravida patients delivered and 12.6% had primary LSCS. In group A, 119(79.3%) LSCS were elective as compared to group B where only 19(12.7%) were elective and this difference was found statistically highly significant (p<0.001). Indication of LSCS is different in both the groups. Fetal distress was most common indication in group A (53.3%) while in group B most common indication was APH (35.9%). Perinatal mortality/morbidity was significantly higher in group B (7.3%) as compared to group A (2.7%).Conclusions: The CS rate in this study was 27.1%. Although primary caesarean section in multipara constitutes only a small percentage of total deliveries and caesarean, they are associated with high maternal and perinatal morbidity. The reason for these complications is many. Beside obstetrical causes, factors like lack of antenatal care, low socioeconomic status, anaemia, malnutrition and illiteracy also play a major role obstructed labor and previous CS among Maternal and perinatal complications were more frequent with emergency CS and in the referred cases.

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Prospective comparative study of hypospadias surgical repair with and without the use of fibrin sealant

International Surgery Journal ◽

10.18203/2349-2902.isj20193315 ◽

2019 ◽

Vol 6 (8) ◽

pp. 2722

Author(s):

Tamer A. Sultan ◽

Tamer A. Faktry ◽

Ahmad Nabil ◽

Mohammed Z. Shenishn

Keyword(s):

Comparative Study ◽

Urethral Stricture ◽

Fibrin Sealant ◽

Tertiary Care ◽

Hypospadias Repair ◽

Flap Necrosis ◽

Significant Difference ◽

Group A ◽

Prospective Comparative Study ◽

Group B

Background: Hypospadias is the most common congenital malformation of the penis, affecting about 4-6 males per 1000 male births, and ranging in severity from a urethral meatus that is slightly off-center to a meatus in the perineal area, The aim of this study was to evaluate whether the application of fibrin sealant over the suture lines of neo-urethra reduces complications and improve overall outcome in children hypospadias repair.1,2 Methods: It was a prospective comparative study conducted in a tertiary care center (Department of pediatric surgery - Menoufia University), we included the patients age more than 6 months and less than 4 years presented with hypospadias to our department in this study. A total 30 patients of coronal, sub coronal, mid shaft hypospadias and distal hypospadias were studied and were divided into two groups, group (A) 15 cases and group (B) 15 cases. All patients underwent a tabularized incised plate (TIP) repair with a Dartos vascularized pedicle flap to cover the neo-urethra, In group (B) a thin layer of fibrin sealant applied over the suture line of neo-urethra but no sealant was used in group (A).Results: Postoperative surgical complications: urethra cutaneous fistula, flap dehiscence, flap necrosis and urethral stricture were recorded. Urethrocutaneous fistula flap dehiscence and flap necrosis were lower in group (B) patients. There was no significant difference in postoperative urethral stricture between two groups. Conclusions: Use of fibrin sealant in hypospadias repair is safe and can reduce complications.

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