scholarly journals Is there any role of post operative antibiotics in reducing secondary haemorrhage after tonsillectomy

2012 ◽  
Vol 18 (2) ◽  
pp. 166-170
Author(s):  
Mohammad Shah Kamal ◽  
Rubina Farzana ◽  
Ahmed Tariq ◽  
Abu Hena Mohammad Parvez Humayun

Objective: To compare with and without the antibiotic therapy in reducing post-tonsillectomy secondary haemorrhage.Method: A prospective study was conducted at Shaheed Shamsuddin Ahmed Hospital, Sylhet from April 2010 to April 2012. 170 patients who underwent tonsillectomy divided into two groups randomly each consisting of 85 patients. In group A (intervention group) - antibiotic was given post-operatively, while in group B (control group) - no antibiotic was given. Postoperative follow-up was done till the tonsillar fossa healed.Results: Among 170 patients 61.18% were female and 38.82% were male, mean age was 21.58 years. One patient from antibiotic group had secondary haemorrhage (1.18%), while no haemorrhage was observed in non- antibiotic group. Secondary haemorrhage rate was 0.59% in total study population.Conclusion: The study showed that antibiotic did not have any significant role in reducing the post-tonsillectomy secondary haemorrhage DOI: http://dx.doi.org/10.3329/bjo.v18i2.12009 Bangladesh J Otorhinolaryngol 2012; 18(2): 166-170

2019 ◽  
Vol 6 (4) ◽  
pp. 1029
Author(s):  
Haitham Atif ◽  
Nehad Abdou Zaid ◽  
Abd El-Mieniem Fareed Mohamed ◽  
Yehia Mohamed Alkhateep

Background: Juxta-anastomotic stenosis (JAS) is one of the predominant causes of arteriovenous fistula (AVF) failure, with the reported incidence of 65%, so that technical modification to alter the outflow vein configuration using the modified technique has been applied to prevent JAS and improve AVF maturation. The aim of the study to evaluate the modified technique of end-to-side distal radiocephalic A-V fistula regarding maturation, patency rate and the resultant juxta-anastomotic stenosis.Methods: This prospective study was carried out on 80 patients with end stage renal disease (ESRD) at vascular surgery unit in general surgery department, Menoufia university hospital that prepared for dialysis. 40 patients "intervention group" underwent the modified technique to establish a functioning radiocephalic fistula; the other group (40 patients, control group) had the conventional technique of end to side radiocephalic fistula. Follow up of patients was over 6 months regarding function, patency rate and development of juxta-anastomotic stenosis.Results: There was statistically significant difference between 2 groups regarding primary failure, patency and JAS. Primary failure was detected in 2 patients in group A and in 5 patients in group B (p-value is 0.04). Considering patency rate, after 3 months the ratio between group A and group B was 37:34 with significant P value of 0.02, and after 6 months the ratio was 35:33 with P value of 0.03. Regarding JAS, by the end of follow up period, 4 patients diagnosed with JAS in group A, while group B had 8 patients, with p value of 0.01.Conclusions: Modified technique of end to side anastomosis for primary radio-cephalic fistula creation has better patency rate and low incidence of JAS than conventional method.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Iwahashi ◽  
J Kirigaya ◽  
M Horii ◽  
T Abe ◽  
E Akiyama ◽  
...  

Abstract Background The early transmitral flow velocity (E) divided by the early diastolic velocity of the mitral valve annulus (e') is referred to as the “E/e' ratio,” is useful even for ST elevation acute myocardial infarction (STEMI). However, the role of late diastolic velocity (a') which reveals the atrial function for STEMI is still unclear. Objectives We evaluated the clinical usefulness of tissue Doppler including atrial function for a first-time STEMI by long time follow up. Furthermore, we evaluated the meaning of each parameters by performing immediately after PCI or 2 weeks later. Methods We treated consecutive 571 first-time STEMI patients by immediate PCI within 12 hours after onset, and we examined 270 patients at immediately after PCI (GroupA, 65 years, 250 male) and 301 patients at 2 weeks after onset (GroupB, 64 years, 243 male). We examined trans mitral flow and TDI, then defined E/e' as LV filling pressure and A/a' as left atrial function. We followed them for a long time (>5 years). The primary end point (PE) was cardiac death or re-admission for heart failure (HF). Results We followed the patients in Group A for 10 years, Group B for 5 years. PE occurred in 64 patients in GroupA during 10 years, and 45 patients in GroupB during 5 years. We analyzed the univariate and multivariate Cox hazard analyses and we compared e' and a', E/e' and A/a' (Table). In GroupA, a' and A/a' were the independent predictors, on the other hand neither a' nor A/a' were the predictors in GroupB. E/e' was an independent predictor both in GroupA and B. Conclusion TDI parameters have different meanings by the timing of echocardiography after onset of a first-time STEMI. These results demonstrated that atrial dysfunction immediately after onset of STEMI suggests the poor prognosis after STEMI. Cox Hazard Proportional Analysis Funding Acknowledgement Type of funding source: None


Author(s):  
Parminderpal Singh ◽  
Kiranjit Kiranjit

Objective: The present study was aimed to analyze the side effects of olmesartan medoxomil and enalapril in hypertensive subjects.Methods: The study consisted of newly diagnosed hypertension categorized according to 7th report of Joint National Commission on prevention, detection, evaluation, and treatment of high blood pressure. The subjects were divided into two groups. The Group A subjects received olmesartan, and Group B subjects received enalapril. Pressure was recorded both in supine and sitting positions. The appearance of side effects was observed in the follow-up, i.e., dry cough, headache, postural hypotension, angioedema, dizziness, skin rashes, taste alterations, and urticaria. A statistical data were prepared on the basis of information obtained and analyzed thoroughly for antihypertensive effects and side effects of olmesartan and enalapril. SPSS software was used for analysis.Results: There was observed an increase in the incidence of taste alteration with drug therapy in Group B (Enalapril). There was observed an increase in the incidence of postural hypotension with drug therapy in both groups. In Group A (Olmesartan), the incidence of postural hypotension at the beginning of trial, 4 weeks, and 8 weeks was 0%, 2%, and 2%, respectively. In Group A (Olmesartan), there was no incidence of a headache at the beginning of trial, at 4 weeks and 8 weeks.Conclusion: From the study, it can be concluded that both olmesartan and enalapril are effective in Stage I and Stage II hypertension, but olmesartan is tolerated well with lesser side effects.


Author(s):  
Akshaya Patil

Lifestyle disorders like unhealthy dietary habits, physical habits, disturbed sleep and rest patterns are the principal factors that cause many digestion related disease. Irritable bowel syndrome (IBS) is also one such disease which occurs due to the ingestion of unwholesome diet causing disturbances in Agni. According to Ayurvedic science, this disease can be considered as a Grahani roga. So we may consider IBS as Grahani roga. Various herbal medications and panchakarma (biopurification) procedures are described in the treatment of Grahani roga though there is no reliable medical treatment for IBS in modern medicine; various efforts have been made to overcome this problem by the virtue of Ayurvedic therapy. The present study was done to assess the efficacy of Panchmooladya choorna with Takra(buttermilk) as anupan in Group A(10Patients) and Group B(10Patients)with luke warm water as anupan in management of Grahani roga in total of 20patients.The results of therapy were assessed by various parameters after 1month with follow up of 15days.The result concluded that Panchmooladya choorna with Takra as anupan reduced the symptoms of Grahani rog as compared to Group B.


2021 ◽  
Vol 3 (4) ◽  
pp. 01-05
Author(s):  
Elham Atabati

Background: periodontal disease with alveoli bone degeneration and losing teeth is seen in many people, including those with arthritis rheumatoid. Objective This study aims to evaluate the effect of non-surgical periodontal treatments on the severity of arthritis rheumatoid. Methods: this randomized control clinical trial was conducted on 60 patients who concurrently had arthritis and mild to moderate periodontitis. Patients divided into three groups of 20 subjects (group C had tooth cleaning and antibiotic therapy, group B had only tooth cleaning and group A was control). DAS28 questionnaire was filled out for all three groups at the beginning of the study. After ending the treatment and improvement, patients were examined in days 45 and 90 in terms of improvement indicators for arthritis rheumatoid. Data were finally analyzed by SPSS18. Results: the highest reduction rate of ESR, DAS28, CRP and RF was in different time periods in tooth cleaning intervention +antibiotic group and then, teeth cleaning group. The lowest reduction was seen in control group. RF, CRP and DAS28 indices showed significant differences in different time periods in tooth cleaning group and tooth cleaning+ antibiotic group (P<0.05). Conclusion: non-surgery periodontal treatment and RA indices, without considering the medicines used for treatment, had positive effect on the treatment of this disease.


2021 ◽  
pp. 27-29
Author(s):  
Prashant Lavania ◽  
Ankush Gupta ◽  
Rahul Chaudhary

INTRODUCTION: Benign prostatic hyperplasia (BPH) is the most common condition affecting men those are 50 years of age and above.TURP is still the widely used technique for management of BPH. TURPwith advent of newer technologies in diathermy and visual scope, has turned into a relatively safe one. AIM:To study role of catheter traction on blood loss and complications in patients with TURP. MATERIALS AND METHODS: This study was done among patients of BPH admitted in the Department of Surgery at S.N. Medical College, Agra during the period from January 2019 to February 2020. Total 60 cases were enrolled in the study and divided into two groups. Group A(30 patients) with traction on catheter after TURPand Group B(30 patients) without traction on catheter. DISCUSSION: Blood loss and irrigation uid was signicantly less in the group with traction on foley's catheter. Duration of hospital stay and complications were also lesser in group with traction. CONCLUSION: Traction on foley's catheter post TURP is effective in managing BPH with the merits of higher safety due to less blood loss and early discharge.


2016 ◽  
Vol 15 (1) ◽  
pp. 17-21
Author(s):  
Sakhawat Mahmud Khan ◽  
Md Matiar Rahaman Khan ◽  
Shahin Akhter ◽  
Md Mizanur Rahman

Background: Lower urinary tract symptoms suggestive of symptomatic Benign Prostatic Hyperplasia (BPH) are a very common disease in elderly men .The incidence of benign prostatic hyperplasia is age related.Objectives: To compare the efficacy and safety of Tamsulosin and Terazosin in the treatment of symptomatic Benign Prostatic Hyperplasia.Methods: This was a prospective study carried out in the Department of Urology, Chittagong Medial College Hospital, Chittagong, Bangladesh during the period of July to December 2014. Total 40 patients of 45-80 years of age were consequently selected according to inclusion criteria. After completion of baseline clinical evaluation and investigations, participants were divided into two groups, group A and group B. Group A (n=20) was given Terazosin 1mg daily for 3 days at bed time and then 2 mg daily at bed time for 2 months. Group B (n=20) was given Tamsulosin, 0.4 mg per day for 2 months. Efficacy was evaluated of each group after 2 month follow up and lastly a comparison was made between them. The parameters monitored were International Prostate Symptoms Score (IPSS) Maximum urine flow rate (Qmax) and Post Voidal Residual Volume (PVR). Tamsulosin 0.4 mg and Terazosin 2 mg once daily for 8 weeks both are effective in relieving symptoms of BPH but Tamsulosin is superior to Terazosin in improvement of total IPSS (p<0.001) and Qmax (p<0.01) PVR (p<0.01) at the end point.Results: Outcome of parameters at follow up after 2 months. Tamsulosin group showed significant improvement of IPSS (p<0.05) PVR (p<0.001) and Qmax (p<0.001) than Terazosin. The incidence of adverse events by administration of Tamsulosin was less than that by Terazosin.Conclusion: Tamsulosin appears to have more efficacy and safety than Terazosin in symptomatic BPH.Chatt  Shi Hosp Med Coll J; Vol.15 (1); Jan 2016; Page 17-21


1970 ◽  
pp. 16-20
Author(s):  
Abu Saleh Md Waliullah ◽  
Shoheli Alam ◽  
MA Aziz ◽  
AR Khan

Introduction: Popular Swenson's pull through (1948) is still the most commonly practiced 'Gold Standard' of operative treatment for rectosigmoid hirschsprung's disease (HD). But minimally invasive transanal endorectal pull through (TERPT) is now being increasingly practiced worldwide for its treatment in many centers. Here we are describing our comparative experience between TERPT and Swenson's pull through, at Dhaka Shishu Hospital to show the per-operative advantages of the former over the latter. Materials and methods: It is a prospective study at Dhaka Shishu Hospital during January 2000 to December 2001 in 32 (age, body weight and resected Rectosigmoid length matched) biopsy confirmed patients of HD divided into two Groups: Gr. A (na = 16) and Gr. B (nb = 16) patients who underwent TERPT and Swenson's pull through respectively. Unpaired 't' and χ2 (with Yate's correction) tests were used for statistical analysis whereas operative duration, volume of blood loss and transfusion requirements were used as parameters of the study. Results: For study Group A (TERPT) - operative time, volume of blood loss and transfusion requirement were significantly lesser (P < 0.01, P < 0.001 and P < 0.001 respectively) than the control Group B (Swenson's procedure). Conclusions: Through this small comparative study, TERPT was found to be more advantageous than the Swenson's pull through procedure in terms of operative duration, blood loss and transfusion requirement. Key words: TERPT; Swenson's; Compare. DOI: 10.3329/bjch.v31i1.6068 Bangladesh Journal of Child Health 2007; Vol.31(1-3): 12-15


Author(s):  
Jayendra R. Gohil ◽  
Vishal S. Rathod ◽  
Bhoomika D. Rathod

Objective: To study the effect and safety of Fenofibrate in uncomplicated hyperbilirubinemia in newborn with 6-month follow-up. Materials and Methods: This is a randomized controlled clinical trial conducted in 60 normal term neonates admitted for uncomplicated hyperbilirubinemia in NICU at Sir T G Hospital, Bhavnagar from January 2012 to December 2012. The data included: age, sex, total serum bilirubin (TSB), weight and duration of phototherapy. All neonates enrolled in the study received phototherapy. They were divided in two groups of 30 each: control group A and group B receiving Fenofibrate (100 mg/kg single dose). There was statistically insignificant difference between the parameters of age, sex, weight and TSB between the two groups at hospitalization. Data was analyzed by using appropriate statistical methods. Results: Mean values for total serum bilirubin in Fenofibrate group B at 24 and 48 hours after admission were significantly lower than those for control group A (p<0.0001,  p=0.0001). There was no significant difference in fall of TSB between 24 and 48 hours. The mean duration of phototherapy in Fenofibrate group (44.8h: 24-72h) was significantly shorter than that in control group (55.2 h: 24‐96 h) (P=0.02). There were no side effects of the drug observed during the study and during 6 months follow up period. Conclusion: Fenofibrate as a single 100 mg/kg dose in healthy full term neonates, is effective and a safe drug (till six-month follow-up) for neonatal hyperbilirubinemia, that can decrease the time needed for phototherapy and hence hospitalization. Effect of a single dose seems to wane after 24 hours.


Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3075-3075
Author(s):  
Antonia M.S. Mueller ◽  
Alex Kuehnemund ◽  
Monika Engelhardt

Abstract Small cell neuroendocrine carcinomas (SCNC) are composed of round to spindle-shaped cells with features of both neuroendocrine and epithelial neoplasms. SCNC can be found in basically all epitheloid organs; however, the vast majority arises in the lung, while extrapulmonary (EP) localization is rare. Small cell lung cancer (SCLC) and EP SCNC are considered one histological entity and are treated similarly. Despite the high initial response to chemo- and radiotherapy, most patients relapse after short remission, and overall prognosis is dismal. Clinical trials employing high-dose chemotherapy (HDCT) followed by autologous stem cell transplantation (auto-SCT) neither demonstrated a clear benefit nor clarified its significance in SCLC. The role of intensified treatment in EP SCNC has not been specifically addressed in detail. Conversely to SCLC, some subgroup analyses indicated that patients with EP SCNC might benefit from intensive treatment. We analyzed a total of 22 patients: 8 with EP SCNC (group A; m:f 3:5; median age 36 years (y) [range 22–56]) and 14 patients with SCLC (group B; m:f 10:4; median age 55 y [40–63]), all undergoing HDCT with auto-SCT at our single center from 07/90–01/05. A control group C consisted of 30 patients with EP SCNC (m:f 21:9, median age 66 years [32–81], who received different standard treatments without auto-SCT. All group A patients had stage IV disease (liver n=5, lymph nodes n=4, pancreas n=1, orbita n=1, bone n=1, kidney n=1). Two of these patients received additional local radiotherapy. In group B, 7 patients had limited and 7 patients extensive disease, (stage I (n=1), II (n=2), III (n=10), IV (n=1). HDCT with VIC (etoposide, ifosfamide, carboplatin; n=21), or CCT (carboplatin, cyclophosphamide, thiotepa; n=1) was followed by infusion of a median 3.2x10^6 CD34+ cells. Prophylactic radiotherapy was performed in 12 patients (mediastinum n=11; brain n=10). With a median follow-up (FU) of 48 months (7–152) for group A and 85 months (0–170) for group B, 5/8 (63%) of patients with EP SCNC (group A) are alive and in complete remission (CR), compared to 5/14 (36%) SCLC patients (group B). Best response ever achieved after HDCT was a CR in 5/8 (63%), a partial remission (PR) in 2/8 (25%) and stable disease (SD) in 1/8 (12%) in group A. In group B, a CR was attained in 11/14 (79%), a PR and a SD in 1/14 (7%) patients, respectively. In the conventionally treated control group C, a transient PR was achieved in 5/30 (16%), and after a median FU of 9.7 months, only 2/30 (6.7%) EP SCNC patients are alive. Our analysis suggests that selected SCNC patients may benefit from HDCT, particularly when integrated into multimodal treatment concepts. The remarkably favorable outcome in patients with EP primary site, even when HDCT was implemented as salvage treatment warrants further studies on the role of HDCT in SCNC. Careful attention will have to be paid to prognostic clinical features, such as primary site and/or histological parameters including neuroendocrine marker profiles and mitotic indices. These may help to predict which patients will benefit from intensified treatment. In addition, further histological studies should address the identification of markers specific for lung- vs. extrapulmonary primary localization. For this purpose all available tumor tissue from our study is currently under histological re-analysis, assessing the expression of the novel tumor testis antigens.


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