STUDY THE EFFECT OF SURGICAL STRESS ON SERUM POTASSIUM AND SERUM CALCIUM LEVEL

Background: This study was randomized clinical trial carried out in 100 patients to study the effect of surgical stress on serum potassium and calcium and to relate these changes to age of the patient and duration of surgical stress. Materials and Methods: The study was done in the Department of General Surgery SMS Medical College, Jaipur from June 2015 to June 2017. Patients equally distributed in two groups A and B on the basis of timing of collection of sample. Blood was taken from the patients who were operated under spinal anaesthesia only, so that the chemical effect of anesthetic was as minimal as possible. For comparison few cases were investigated who were operated under general anaesthesia. In all the patients operated under spinal or general anaesthesia same drug and techniques were used to overcome bias. Observations and Results: In the study we observed that variation in serum electrolyte seen in period of stress. Range of hypokalemia and hypocalcemia were 2.8 to 3.7 meq/lt and 7.6 to 8.4 mg% respectively in group A and hypokalemia and hypocalcemia were 3.0 to 3.4 meq/lt and 7.6 to 8.4 mg% respectively in group B. Maximum incidence of hypokalemia and hypocalcemia seen during 30-60 minutes duration of operation. Conclusion: Surgical stress is main cause of fluctuation in blood calcium, and blood potassium levels in surgical ward. The variation consists of increase or decrease of both electrolytes because of activation of the pituitary adrenocortical systems and maximally seen in immediate post operative period. Keywords: Calcium (Ca+2), Potassium (k+), Serum electrolytes, Surgical stress

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Comparative evaluation of sublay versus onlay meshplasty in incisional and ventral hernias

International Surgery Journal ◽

10.18203/2349-2902.isj20175892 ◽

2017 ◽

Vol 5 (1) ◽

pp. 187

Author(s):

B. D. Dhaigude ◽

Aneesh Sugunan ◽

S. V. Pancbhai ◽

Merry Francis ◽

Keyur Patel ◽

...

Keyword(s):

Hospital Stay ◽

Operative Time ◽

Wound Dehiscence ◽

Good Alternative ◽

Related Complication ◽

Average Hospital ◽

Medical College ◽

Group A ◽

Group B ◽

Duration Of Operation

Background: Hernia derived from the Latin word, is a protrusion of a viscus or part of a viscus through an abnormal opening in the walls of its containing cavity. Objectives of present study were to evaluate sublay Vs onlay meshplasty in incisional and ventral hernia and to compare and determine duration of operation and hospital stay, post-operative complications and recurrences.Methods: The study was conducted at Dr. D. Y. Patil Medical College and Hospital, DPU University, for a period of 2 years (from July 2015 - September 2017) and is a prospective and comparative randomized type of study using 100 cases (Group A Onlay and Group B Sublay - 50 each). The study was approved by the Institute’s Ethics Committee.Results: 100 patients were operated in our study. In group B, the mean operative time [70.72±18.56], and in group A mean operative time (50.96±12.61). The duration of hospital stay was an of average 7.62±1.78 days in group B, and an average hospital stay of 8.84±1.89 in group A. Suture site infection was18%. group A (26%) and group B (12%). Seroma was seen in 5 patients, group A (8 %) and in group B (2%). Flap necrosis was 8% in group A and in 6% in group B. 10 patients had wound dehiscence, group A (14%) and group B (6%). 4 patients were reported with mesh infection (6%) in group A and (2%) in group B. Recurrence was 1% group A.Conclusions: Sublay meshplasty is good alternative to onlay meshplasty that may be applicable to all forms of ventral and incisional hernias. The mesh related complication rate and recurrence was found to be minimal.

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Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

Bangladesh Journal of Urology ◽

10.3329/bju.v21i2.49882 ◽

2020 ◽

Vol 21 (2) ◽

pp. 105-110

Author(s):

Md Shawkat Alam ◽

Sudip Das Gupta ◽

Hadi Zia Uddin Ahmed ◽

Md Saruar Alam ◽

Sharif Muhammod Wasimuddin

Keyword(s):

Comparative Study ◽

Acute Urinary Retention ◽

Bladder Capacity ◽

Inclusion Criteria ◽

College Hospital ◽

Medical College ◽

High Incidence ◽

Group A ◽

Group B ◽

Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

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Age related volume of cadaver-prostates in Bangladesh

Ibrahim Medical College Journal ◽

10.3329/imcj.v4i2.6501 ◽

1970 ◽

Vol 4 (2) ◽

pp. 74-77

Author(s):

Rukshana Ahmed ◽

Shamim Ara

Keyword(s):

Prostate Gland ◽

Age Groups ◽

Clinical Settings ◽

Cross Sectional ◽

Medical College ◽

Age Related ◽

Group A ◽

Key Words Prostate ◽

The Mean ◽

Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

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Comparative study between two empirical antibiotic regime in the management of childhood malignancy with fever

Northern International Medical College Journal ◽

10.3329/nimcj.v5i2.23128 ◽

2015 ◽

Vol 5 (2) ◽

pp. 329-331 ◽

Cited By ~ 1

Author(s):

Laila Helaly ◽

Md Zakir Hossain Sarker ◽

MA Mannan ◽

Md Tafazzal Hossain ◽

Shafi Ahmed ◽

...

Keyword(s):

Antibiotic Therapy ◽

Study Drug ◽

Successful Outcome ◽

Medical College ◽

Pediatric Hematology ◽

Pediatric Cancer Patients ◽

Group A ◽

Study Population ◽

Group B ◽

Oncology Unit

Objective : The present prospective randomized clinical trial was carried out to assess whether combined cefepime and amikacin as empirical antibiotic therapy was more effective than combined ceftriaxone and gentamicin in the treatment of febrile neutropenic children with malignant diseases.Material & Methods : The study was conducted in the Pediatric Hematology and Oncology unit of BSMMU over a period of 2 years. (From January 2006 to December 2007) Hospitalised pediatric cancer patients who developed febrile neutropenia following chemotherapy or radiotherapy were the study population. A total 64 cases were consecutively included in the study and were randomly assigned to either cefepime & amikacin group (Group- A) or ceftriaxone & gentamicin group (Group-B). The Group-A received cefepime 1500 mg/m2/dose infused over 15 minutes in two divided doses intravenously(IV) while amikacin was administered as thrice daily dose of 200 mg/m2/dose. Patients of Group-B received ceftriaxone 1500 mg/m2/dose in two divided doses and gentamicin 60 mg/m2/dose thrice daily IV. The therapy was continued until absolute neutrophil counts reached >1000 neutrophils/mm3. The treatment outcome was considered successful if fever resolves within 4 days and does not recur within 7 days of completion of therapy. Of the 64 patients, 13 cases were excluded from the final analysis.Results : Bacteria were isolated from culture in only 16.7% of cases Group-A and 9.5% of group-B. Patients E. coli was the most common isolate found in blood specimen (37%). Following intervention, 90% of cefepime & amikacin group and 85.6% of ceftriaxone & gentamicin group improved absolute neutrophil count to >1000/mm3 of blood. Persistence of fever after start of study drug and duration of antibiotic therapy were significantly less in the former group than those in later group (p = 0.049 and p = 0.004 respectively). Only 1 patient of group B had recurrence of infection within 7 days of treatment completion. The mean duration of hospital stay was less in the former group (7.97 ± 2.61 days) than that in the latter group (11.00 ± 3.42 days) (p = 0.06). Evaluation of final outcome shows that majority (86.6%) of cefepime & amikacin group had successful outcome, while majority of ceftriaxone & gentamicin group (81%) failed to resolve infection with continuation of fever for > 4 days.Conclusion : The study concluded that combined cefepime and amikacin is a better option for empirical treatment of fever and neutropenia in children with malignancies than combined ceftriaxone and gentamicin (p<0.001).Northern International Medical College Journal Vol.5(2) 2014: 329-331

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Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

KYAMC Journal ◽

10.3329/kyamcj.v10i1.41478 ◽

2019 ◽

Vol 10 (1) ◽

pp. 21-24

Author(s):

Md Abdus Salam ◽

Md Mahbub Alam ◽

Rezwan Ahmed ◽

Md Sultan Mahmud

Keyword(s):

Postoperative Pain ◽

Postoperative Bleeding ◽

Throat Pain ◽

Medical College ◽

Advantages And Disadvantages ◽

Case Surgery ◽

Group A ◽

The Difference ◽

Group B ◽

Dissection Method

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24

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Fetal and maternal outcome following expectant management of severe pre-eclampsia remote from term

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175253 ◽

2017 ◽

Vol 6 (12) ◽

pp. 5420

Author(s):

Deepak A. V. ◽

Reena R. P. ◽

Deepa Anirudhan

Keyword(s):

Expectant Management ◽

Severe Preeclampsia ◽

Close Monitoring ◽

Antenatal Corticosteroids ◽

Maternal Complications ◽

Medical College ◽

Difficult Decision ◽

Group A ◽

The Mean ◽

Group B

Background: Expectant management of severe preeclampsia, remote from term is often a difficult decision. Maternal and foetal complications may occur while trying to achieve a more favourable perinatal outcome. We wanted to find out the foetal and maternal outcomes of expectant management in these women.Methods: A prospective cohort study was conducted at Government Medical College, Thrissur, India between May 2013 and April 2015. Women with severe preeclampsia remote from term, who were admitted, managed expectantly and delivered in our hospital during the study period, were recruited. The study subjects were grouped into: Group A (between 28 weeks and 31 weeks 6 days) and Group B (between 32 weeks and 33 weeks 6 days). A structured proforma was used to collect demographic and clinical details. The maternal and foetal outcomes were noted.Results: There were 4786 deliveries during the study period. Among them 76 (1.58% of total deliveries) women with severe preeclampsia between 28 weeks and 33-week 6 days gestation on expectant management were included in the study. The mean duration of expectant management was 7.92 days in group A (27 women) and 6.67 days in group B (49 women). Most women required termination of pregnancy for foetal distress (36.8%). HELLP syndrome and imminent eclampsia were the maternal complications that occurred. Perinatal loss was significantly more in Group A when compared to Group B.Conclusions: Expectant management of women with severe preeclampsia remote from term, especially between 32weeks and 33weeks 6 days, with antenatal corticosteroids and close monitoring, seems a reasonable option in developing countries.

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Association of Adverse Outcomes in Patients with Cirrhosis Presented with COVID-19

10.53350/pjmhs211551134 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1134-1135

Author(s):

M. A. Chhutto ◽

A. H. Mugheri ◽

A. H. Phulpoto ◽

I. A. Ansari ◽

A. Shaikh ◽

...

Keyword(s):

Liver Disease ◽

Chronic Liver Disease ◽

Adverse Outcomes ◽

Chronic Liver ◽

P Value ◽

College Hospital ◽

Medical College ◽

Group A ◽

Group B ◽

Disease Study

Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis presented with coronavirus disease. Study Design: Retrospective/observational study Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1st March 2019 to 31st December 2020. Methodology: Two hundred and twenty covid-19 patients of both genders with or without chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (with cirrhosis 60 patients) and group B (without cirrhosis 60 patients). Outcomes in term of mortality between both groups were examined. Results: There were 38 (63.33%) males and 22 (36.67%) were females with mean age 46.14±8.44 years in group A while in group B, 40 (66.67%) and 20 (33.33%) patients were males and females with mean age 45.26±9.34 years. Patients with cirrhosis had high mortality rate as compared to patients without cirrhosis (33.33% Vs 13.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients with coronavirus disease. Keywords: Chronic Liver Disease, Corvid-19, Mortality

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Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.03.6309 ◽

2021 ◽

Vol 28 (03) ◽

pp. 277-281

Author(s):

Bushra Shaikh ◽

Imamuddin Baloch ◽

Azhar Ali Shah ◽

Abdul Sami Mirani ◽

Parkash Lal Lund ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Wound Infection ◽

Port Site ◽

Site Infection ◽

College Hospital ◽

Medical College ◽

Duration Of Surgery ◽

Group A ◽

Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

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COMPARISON BETWEEN THE EFFECTS OF EXTRACT FROM MEDICINAL PLANT “ AMMI VISNAGA AND MYRISTICA FRAGRANS” ON THE VOLUME AND ACIDITY OF CARBACHOL INDUCED GASTRIC SECRETION IN FASTING RABBITS.

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2014.4.2.533-536 ◽

1969 ◽

Vol 4 (2) ◽

pp. 533-536

Author(s):

SHAKIRULLAH JAN ◽

SUBHANULLAH JAN ◽

MUHAMMAD JAN ◽

MASUD UR REHMAN

Keyword(s):

Body Weight ◽

Peptic Ulcer ◽

Medicinal Plant ◽

Gastric Secretion ◽

Channel Blockers ◽

Medical College ◽

Ammi Visnaga ◽

Myristica Fragrans ◽

Group A ◽

Group B

BACKGROUND: Peptic ulcer is mostly produced due to the over production of gastric acid. This studywas undertaken to find out the effects of extract from the fruits of medicinal plant Ammi visnaga andseeds of Myristica fragrans (both of which contain documented natural Calcium channel blockers) onvolume and acidity of Carbachol induced gastric section. Their effects were also compared to find outany difference in their effect.DESIGN: Quasi experimental.PLACE & DURATION OF STUDY: Pharmacology Department Saidu Medical College Swat.METHODS: Thirty rabbits of local breed, weighing 1-1.5kg were used. The animals were kept onfasting for 48 hours, after which the pylorus of each animal was ligated. Carbachol 600iig/kg wasinjected to group A Extracts of Ammi visnaga and Myristica fragrans 500 mg/kg body weight each andafter 15 minutes Carbachol 600jlg/kg body weight was administered to group B & C intraperitoneally.RESULTS: It was found that both the extracts reduced the volume, free and total acidity of gastricsecretion, which were statistically highly significant when compared with Carbachol ( PcO.OOl). Whenthe differences of means for both the extracts were compared, all these were found statistically nonsignificant indicating that the extracts have similar effects on all parameters included in study.CONCLUSION: The extracts can be used effectively and safely in the treatment of hyper acidityconditions and peptic ulcer after evaluation of their effects in human.KEY WORDS: Ammi visnaga & Myristica fragrans, gastric secretion.

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Study on impact of duration of tympanic membrane perforation on hearing loss and audiological outcome after surgery

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213280 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1462

Author(s):

Raies Ahmad ◽

Gopika Kalsotra ◽

Kamal Kishore ◽

Aditiya Saraf ◽

Parmod Kalsotra

Keyword(s):

Hearing Loss ◽

Tympanic Membrane ◽

Pure Tone ◽

Tympanic Membrane Perforation ◽

Medical College ◽

Time Period ◽

Membrane Perforation ◽

Group A ◽

Duration Of Disease ◽

Group B

Background: The aim of the study was to assess impact of duration of tympanic membrane perforation on hearing loss and postoperative audiological outcome using pure tone audiogram.Methods: The present study was conducted on 100 patients in department of ENT and HNS, SMGS Hospital, Government Medical College Jammu during a time period of November 2018 to October 2019. All the patients with age 15 to 60 years who presented with tympanic membrane (pars tensa) perforation were included in the study. Results: In our study, mean preoperative hearing loss (AC threshold) of group A was 36.23±1.07 dB and of group B was 25.67±6.38 dB. Group C had mean preoperative hearing loss (AC threshold) of 28.78±6.50 dB. Mean preoperative air-bone gap (AB gap) of group A was 12.9±8.05dB and of group B was 13.86±4.19 dB. Group C had mean preoperative air-bone gap (AB gap) of 16.47±5.51 dB. Postoperatively, pure tone threshold at three months was least in group B (15.09±5.80 dB), followed by group C (15.68±4.66 dB) and group A (19.33±2.81 dB). Whereas, postoperative AB gap at 3 months was least in group C (10±3 dB), followed by group C (8.44±3.59 dB). Group B had maximum postoperative AB gap of 8.49±4.34 dB.Conclusions: This study did not show any correlation between duration of disease and degree of hearing loss.

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