scholarly journals Immediate Post-Operative Outcomesof Stapled and Hand Sewn Techniques during Oesophagogastrostomy: A Randomized Clinical Trial

2020 ◽  
Vol 6 (1) ◽  
pp. 43-47
Author(s):  
Mohammad Zakir Hossain Bhuiyan ◽  
Syed Aminul Haque ◽  
Mohammad Ahtashamul Haque ◽  
Farhana Tarannum

Background: Oesophagogastrostomy is a very crucial surgical management. Objective:The purpose of the present study was to observe the immediate post-operative outcomes of stapled and hand sewn techniques during oesophagogastrostomy. Methodology: This single centre, parallel randomized clinical trial was conducted in the Department of Thoracic Surgery at National institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh from January 2011 to December 2011 for a period of one year. Prior to commencement of this study the study protocol was approved by the thesis committee of NIDCH. Patients were purposefully selected from different surgery ward of NIDCH irrespective of age and sex of patients for the study.Patients were divided into two groups designated as group A and B.Stapled oesophagogastric anastomosis was performed in group A and hand sewn anastomosis was done in group B.Immediate post-operative complication were recorded. Result: A total of 60 patients of oesophageal or gastric cardia carcinoma were recruited for this study. Of them 32 cases were assigned to Stapler method and 28 cases to Hand-sewn method of oesophagogastrostomy. The mean age of the patients of group A and group B were 56.1±12.7 years and 55.3±8.3 years respectively. Regarding blood loss during operation, the table shows that in group A mean + SD were 430.4±63.2 ml and in group B mean + SD were 529.6 +86.9 ml. In one stage operation in group A it was mean + SD i.e. 362.2±38.3 ml and in group B it was mean + SD 529.6±86.9 ml. In two stage operation in group A it was mean 466.2±39.7 ml and in group B it was mean±SD 585.6±62.2 ml. Respiratory complication developed in 9.4% of the patients in group A and 17.9% patients in group B. Cardiac complication developed in 3.1 % of the patients in group A and 7.1 % of patients in group B. Wound infection developed in 12.5% of the patients in group A and 10.7% of the patients in group B. Conclusion: In conclusion most of the immediate anastomotic complications are less in stapled anastomotic technique than hand sewn technique Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 43-47

2019 ◽  
Vol 4 (2) ◽  
pp. 126-134 ◽  
Author(s):  
S.S. Gao ◽  
D. Duangthip ◽  
M.C.M. Wong ◽  
E.C.M. Lo ◽  
C.H. Chu

Objectives: The aim of this noninferiority double-blind randomized clinical trial was to compare the effectiveness of the topical semiannual application of a 25% silver nitrate (AgNO3) solution followed by a 5% sodium fluoride (NaF) varnish with that of a 38% silver diamine fluoride (SDF) solution in arresting caries among preschool children. Methods: Healthy 3-y-old children with active dentine carious lesions were randomly allocated to 2 groups via computer-generated random numbers. Lesions in group A received applications of a 25% AgNO3 solution followed by a 5% NaF varnish semiannually (every 6 mo). Lesions in group B received semiannual applications of a 38% SDF solution followed by a placebo varnish. A trained examiner recorded the status of caries and oral hygiene at baseline and during follow-up examinations. The examiner, children, and their caretakers were blinded to the intervention allocation. This study adopted an intention-to-treat analysis. A noninferiority test was conducted for the data analysis. Group A’s noninferiority was accepted if the lower limit of the 95% CI for the difference in the mean number of arrested surfaces was >−0.5. Results: A total of 1,070 children were recruited at baseline, with 535 children in each group. After 18 mo, the mean ± SD number of arrested surfaces was 3.3 ± 3.4 in group A (n = 484) and 3.2 ± 3.5 in group B (n = 476; P = 0.664). The difference in the mean number of arrested surfaces between the groups was 0.092 (95% CI, −0.322 to 0.505). Apart from black staining on the arrested lesions, no other significant side effect was observed. Conclusion: A semiannual application of 25% AgNO3 followed by 5% NaF is no worse than a 38% SDF in arresting dentine caries among preschool children over 18 mo. The Hong Kong Research Grants Council (GRF 17107315) funded this trial, which was registered at ClinicalTrials.gov (NCT02019160). Knowledge Transfer Statement: This randomized clinical trial found that silver nitrate solution followed by sodium fluoride varnish is effective in arresting dentine caries among preschool children. As silver nitrate followed by sodium fluoride is a noninvasive and simple protocol, it can be an alternative strategy to manage dental caries among young children, especially in countries where silver diamine fluoride is not available.


2021 ◽  
Author(s):  
Heidar Safarpour ◽  
Mohammad Hadi Imanieh ◽  
naser honar ◽  
sajad hekmati ◽  
Naeimehossadat Asmarian

Abstract BackgroundThis study aimed to compare different regimens of Polyethylene Glycol (PEG, single dose vs. divided dose) in the treatment of functional constipation among children aged 4-15 years.Materials and MethodsThis double-blind randomized clinical trial was conducted on the children (4-15 years old) with functional constipation who were visited in an outpatient pediatric clinic affiliated to Shiraz University of Medical Sciences between February and July 2021. Among the120 eligible patients, 80 ones who met the inclusion criteria were recruited. The patients were divided into two parallel groups; the children who received single-dose PEG (group A) and those who received PEG in divided doses (group B). The study was performed during 12 weeks and follow-up visits were scheduled at 1, 3, 6, and 12 weeks after enrollment. The outcomes were measured using the Bristol Stool Form Scale (BSFS).ResultsThe study was performed on 78 cases including 45 boys (57.7%) and 33 girls (42.3%) with the mean age of 5.52±1.79 years. After 12 weeks, a significant difference was observed between groups A and B regarding the mean of BSFS (4.94±0.52 vs. 4.50±0.88, p=0.008). However, no significant difference was observed between the two groups regarding the number of defecation times during the study. The detected complications included mild abdominal pain in eight children in group A (5.3%), fecal incontinency in six children in group B (3.8%), and painful defecation in six children in group B (3.8%).ConclusionThis study confirmed that the administration of the single dose (0.4 g/kg) of PEG early in the morning was more effective, well tolerated, and accompanied by fewer complications compared to the divided dose.


2020 ◽  
Author(s):  
Aya Sedky Adly ◽  
Mahmoud Sedky Adly ◽  
Afnan Sedky Adly

BACKGROUND With the growing stress on hospitals caused by the COVID-19 pandemic, the need for home-based solutions has become a necessity to support these overwhelmed hospitals. OBJECTIVE The goal of this study was to compare two nonpharmacological respiratory treatment methods for home-isolated COVID-19 patients using a newly developed telemanagement health care system. METHODS In this single-blinded randomized clinical trial, 60 patients with stage 1 pneumonia caused by SARS-CoV-2 infection were treated. Group A (n=30) received oxygen therapy with bilevel positive airway pressure (BiPAP) ventilation, and Group B (n=30) received osteopathic manipulative respiratory and physical therapy techniques. Arterial blood gases of PaO<sub>2</sub> and PaCO<sub>2</sub>, pH, vital signs (ie, temperature, respiratory rate, oxygen saturation, heart rate, and blood pressure), and chest computed tomography scans were used for follow-up and for assessment of the course and duration of recovery. RESULTS Analysis of the results showed a significant difference between the two groups (<i>P</i>&lt;.05), with Group A showing shorter recovery periods than Group B (mean 14.9, SD 1.7 days, and mean 23.9, SD 2.3 days, respectively). Significant differences were also observed between baseline and final readings in all of the outcome measures in both groups (<i>P</i>&lt;.05). Regarding posttreatment satisfaction with our proposed telemanagement health care system, positive responses were given by most of the patients in both groups. CONCLUSIONS It was found that home-based oxygen therapy with BiPAP can be a more effective prophylactic treatment approach than osteopathic manipulative respiratory and physical therapy techniques, as it can impede exacerbation of early-stage COVID-19 pneumonia. Telemanagement health care systems are promising methods to help in the pandemic-related shortage of hospital beds, as they showed reasonable effectiveness and reliability in the monitoring and management of patients with early-stage COVID-19 pneumonia. CLINICALTRIAL ClinicalTrials.gov NCT04368923; https://clinicaltrials.gov/ct2/show/NCT04368923


2020 ◽  
Vol 12 (2) ◽  
pp. 51-57
Author(s):  
Javad Yazdani ◽  
Saeed Nezafati ◽  
Ali Mortazavi ◽  
Farrokh Farhadi ◽  
Milad Ghanizadeh

Background: Preemptive analgesia is one of the techniques to manage postoperative pain, which increases patient satisfaction and decreases the duration of hospitalization. The present study aimed to evaluate and compare the pain relief achieved by preoperative intravenous ketorolac and oral pregabalin in patients undergoing surgery for mandibular fractures. Methods: In the present clinical trial, 60 patients with unilateral fractures of the mandible were randomly assigned to two groups. In group A, intravenous injections of ketorolac 30 mg and in group B, pregabalin 150 mg capsules were administrated one hour preoperatively. The severity of pain was determined using a visual analog scale (VAS) up to 24 hours postoperatively. Finally, the total doses of an opioid analgesic (pethidine) prescribed for each patient in mg during the first 24 hours and the time for the request of the first analgesic dose in minutes were recorded for each patient. Then, their means were compared between the two groups. Results: Maximum pain severity was experienced immediately after surgery, which decreased gradually during the 24-hour postoperative period (P < 0.0001). The mean severity of pain immediately after regaining consciousness and the mean pain score during the 24-hour postoperative period were lower in the pregabalin group than in the ketorolac group (P < 0.0001). In the ketorolac group, a slightly higher dose of the opioid was administered; however, the difference was not significant (P > 0.05). Conclusions: The oral administration of pregabalin 150 mg one hour preoperatively was more effective than the intravenous administration of ketorolac 30 mg in relieving postoperative pain.


2020 ◽  
Author(s):  
Fatemeh Shabani ◽  
Katayon Vakilian ◽  
Fereshteh Narenji ◽  
Mahbubeh Bozorgi ◽  
Soodabeh Bioos ◽  
...  

Abstract Background Dysmenorrhea is one of the most common pelvic pains in women, impairing their quality of life.This study investigated the effects of chamomile sachet and mefenamic acid on primary dysmenorrhea, associated symptoms and bleeding. Methods In this randomized clinical trial, 200 female students with primary dysmenorrhea from Arak universities were randomly assigned to two groups. The group (A) received mefenamic acid (250 mg) and group (B) received chamomile (5000 mg) plus one teaspoonful of honey )as a flavoring( for two days before up to the first three days of menstruation, three times a day in two consecutive cycles. Pain severity, associated symptoms and bleeding were assessed using visual analog scale, Andersch-Milsom Verbal Scale and Higham chart, respectively. Data were analyzed by descriptive and inferential statistical tests by SPSS 21. Results Severe pain during two months after intervention was in 6 (6.3%) of group (B) and 6 (6.3%) in group (A) (p = 0.351, p = 0.332). Mean severity of associated symptoms two months after the treatment was( 4.93 ± 3.54) in group (B) and (5.62 ± 3.54 ) in group (A), indicating further reduction in group (B) but not significant (p = 0.278). Mean of bleeding was (88.71 ± 66.4 vs. 70.54 ± 53. 34) in group (B) and (A) respectively, in two months later. therefore decrease in the two groups but was not significant between groups(p = 0.567). Conclusions It seems chamomile sachet can reduce the severity of pain and bleeding similar to mefenamic acid and even further mitigate the symptoms associated with dysmenorrhea. Trial registration: This study was performed with the proposal approval code of 2611, ethics code of (ARAKMU.REC.1395.164) at Arak University of medical sciences and code of IRCT 2016100825031N5 on 2016.11.08.


2021 ◽  
Vol 10 (4) ◽  
pp. 3296-3299
Author(s):  
Waqar M. Naqvi

To compare the effect of Land based exercises and Pool based exercises for shoulder strength to reduce shoulder pain in competitive swimmers using Shoulder Pain Disability Index (SPADI) score, Hand-Held dynamometer (HHD), Randomized Clinical trial.29 competitive swimmers with age group between 8 to 18 years were evaluated for shoulder pain using Shoulder Pain Disability Index Score [SPADI] and shoulder strength was evaluated using Hand Held Dynamometer [HHD] before and after the study. Then all the subjects were divided into 2 groups, for Group A Pool based exercises were given and for Group B Land based exercises were given. Statistically there is significant difference in values of outcome measures after the study in both groups but there is more significant difference in Group A than Group B. Pool based exercises showed more significant effect on shoulder pain than land based exercises in swimmer’s shoulder.


10.2196/23446 ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. e23446
Author(s):  
Aya Sedky Adly ◽  
Mahmoud Sedky Adly ◽  
Afnan Sedky Adly

Background With the growing stress on hospitals caused by the COVID-19 pandemic, the need for home-based solutions has become a necessity to support these overwhelmed hospitals. Objective The goal of this study was to compare two nonpharmacological respiratory treatment methods for home-isolated COVID-19 patients using a newly developed telemanagement health care system. Methods In this single-blinded randomized clinical trial, 60 patients with stage 1 pneumonia caused by SARS-CoV-2 infection were treated. Group A (n=30) received oxygen therapy with bilevel positive airway pressure (BiPAP) ventilation, and Group B (n=30) received osteopathic manipulative respiratory and physical therapy techniques. Arterial blood gases of PaO2 and PaCO2, pH, vital signs (ie, temperature, respiratory rate, oxygen saturation, heart rate, and blood pressure), and chest computed tomography scans were used for follow-up and for assessment of the course and duration of recovery. Results Analysis of the results showed a significant difference between the two groups (P<.05), with Group A showing shorter recovery periods than Group B (mean 14.9, SD 1.7 days, and mean 23.9, SD 2.3 days, respectively). Significant differences were also observed between baseline and final readings in all of the outcome measures in both groups (P<.05). Regarding posttreatment satisfaction with our proposed telemanagement health care system, positive responses were given by most of the patients in both groups. Conclusions It was found that home-based oxygen therapy with BiPAP can be a more effective prophylactic treatment approach than osteopathic manipulative respiratory and physical therapy techniques, as it can impede exacerbation of early-stage COVID-19 pneumonia. Telemanagement health care systems are promising methods to help in the pandemic-related shortage of hospital beds, as they showed reasonable effectiveness and reliability in the monitoring and management of patients with early-stage COVID-19 pneumonia. Trial Registration ClinicalTrials.gov NCT04368923; https://clinicaltrials.gov/ct2/show/NCT04368923


2019 ◽  
Vol 49 (1) ◽  
pp. 57
Author(s):  
Yunis Sucipta Ibnu ◽  
Dwi Reno Pawarti ◽  
Mansyur Siddiq Wiyadi

Latar belakang: Rinitis alergi (RA) adalah inflamasi mukosa hidung yang diperantarai oleh IgE. Gejala dapat dinilai dengan Skor Gejala Hidung Total (SGHT). Patofisiologi dan manifestasi klinis RA dipengaruhi oleh berbagai sitokin diantaranya interleukin 33 (IL-33). Efektivitas propolis maupun flavonoid dalam menurunkan SGHT dan kadar IL-33 sekret hidung masih kontroversi. Tujuan: Membuktikan bahwa penambahan propolis pada terapi komplementer RA lebih efektif menurunkan SGHT dan kadar IL-33 sekret hidung. Metode: Penelitian double blind randomized clinical trial (RCT), dilakukan di Unit Rawat Jalan (URJ) Divisi Alergi Imunologi, Departemen Telinga Hidung Tenggorok-Bedah Kepala Leher (THT-KL) RSUD Dr. Soetomo, dan Institute of Tropical Disease, Universitas Airlangga, Surabaya pada bulan September 2018-Januari 2019. Pasien RA yang memenuhi kriteria inklusi diperiksa SGHT dan kadar IL-33 sekret hidung. Terapi diberikan selama 14 hari, evaluasi SGHT dan kadar IL-33 dilakukan hari ke-15. Hasil: Sepuluh sampel mendapat propolis dan terapi standar (kelompok A), sepuluh sampel mendapat terapi standar (kelompok B). Perbandingan SGHT antar kelompok setelah terapi rerata kelompok A=1,6 (SD 1,7), kelompok B=5,2 (SD 1,6). Uji Mann-Whitney satu arah p=0,001 menunjukkan SGHT antar kelompok setelah terapi berbeda signifikan (p<0,005). Rerata kadar IL-33 setelah terapi kelompok A=0,051 (SD 0,005), kelompok B=0,051 (SD 0,013). Uji t nilai p=0,881 menunjukkan kadar IL-33 sekret hidung antar kelompok setelah terapi berbeda tidak signifikan (p>0,005). Kesimpulan: Penambahan propolis sebagai terapi komplementer lebih efektif dalam menurunkan SGHT dibandingkan dengan terapi standar saja, namun tidak efektif dalam menurunkan kadar IL-33 sekret hidung penderita RA. Background: Allergic rhinitis (AR) is a nasal mucosa inflammation mediated by IgE. The symptoms severity is determined by total nasal symptom score (TNSS). The pathophysiology and clinical manifestations of AR are affected by several cytokines, one of which is interleukin 33 (IL-33). Efficacy of propolis or flavonoid in reducing TNSS and IL-33 level in nasal secretion is still a controversy. Purpose: To find out whether propolis addition to standard therapy could be more effective in reducing TNSS and IL-33 level of nasal secretion. Method: Double blind randomized clinical trial (RCT). The study was conducted at Outpatient unit of Department of Allergic and Immunology, Dr. Soetomo General Hospital, Surabaya and Institute of Tropical Disease (ITD) Universitas Airlangga. Allergic rhinitis patients who met inclusion criteria were examined for TNSS and IL-33 nasal secretion level. Therapy was given for 14 days, after which TNSS and IL-33 levels were evaluated on day 15th. Ten samples received propolis and standard therapy (group A), ten samples received standard therapy only (group B). Result: The comparison of TNSS groups after treatment: mean group A=1.6 (SD 1.7), and mean group B=5.2 (SD 1.6). One way Mann-Whitney test showed p=0.001 indicating the TNSS after treatment was significantly different (p<0.005). The comparison of IL-33: mean group A=0.051(SD=0.005) and mean group B=0.051(SD=0.013), t-test p=0.0881 indicating the IL-33 level of nasal secretion after treatment was not significantly different (p>0.005). Conclusion: Propolis as a complementary therapy was more effective reducing TNSS compared to standard therapy only, but it was not effective in reducing IL-33 level of nasal secretion.


10.3823/2558 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Jousilene de Sales Tavares ◽  
Adriana Suely Oliveira Melo ◽  
Suzana Farias Leite ◽  
Alexandre Sergio Silva ◽  
João Guilherme Alves ◽  
...  

Objective:  This study aims to compare maternal and fetal responses during two physical exercise types. Design:  A randomized clinical trial compared 120 pregnant women, gestational age of 35-37 weeks, 56 exercising on a stationary bicycle (Group A) and 64 on a treadmill (Group B). Methods: Participants were monitored for three 20-minute phases: resting, exercise and recovery.  Fetal heart rate (FHR) and maternal heart rate (MHR) were monitored.  Glucose and lactate levels were evaluated at rest and during exercise. Results:  After the beginning of exercise, maximum lactate (L) levels were reached at 20 minutes and never exceeded 4 mmol/l.  FHR decreased by 22 bpm during exercise in relation to resting values, irrespective of the exercise type (p<0.001).  Comparing the exercise types, the incidence of bradycardia after 10’ was 23.2% in Group A and 35.9% in Group B (p>0.05), increasing at 20’ to 32% and 40.6%, respectively, (p>0.05).  The FHR decrease during exercise was accompanied by a simultaneous increase in its variability (p<0.001), nevertheless a rapid return to resting values was observed shortly after exercise end.  Glucose decreased in both groups irrespective of the exercise type (85 mg/dl at rest; 79 mg/dl during exercise and 81 mg/dl during recovery; p<0.001). There were no hypoglycemia cases. Conclusions: FHR variability increase and the rapid return to resting values after exercise suggests that the FHR fall and the presence of bradycardia during exercise is the fetal physiologic response to blood flow redistribution, with maintenance of fetal well-being. Key-words: Exercise; fetal heart rate; glucose; maternal heart rate; pregnancy Clinical Trial Registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT01383889.


2021 ◽  
Vol 15 (8) ◽  
pp. 2043-2045
Author(s):  
Tahir Hamid ◽  
Muhammad Rizwan Qadir ◽  
Ahmad Raza Nsar ◽  
Rizwan Saleem ◽  
Abdur Rehman ◽  
...  

Aim: To compare partial nail avulsion followed by matricectomy either with phenol (80-88%) or with electro cautery for Stage 2 & 3 ingrown toenails for early and late postoperative complications. Methods: This study was conducted at department of surgery Nawaz Sharif social security teaching hospital Lahore for one year from 01-01-2018 to 31-12-2018. One hundred patients full filling inclusion criteria were included in the study and divided into two equal groups A and B. Partial nail avulsion done in both groups followed by chemical matricectomy with phenol (80-88%) in group A and patients in group B matricectomy done with electrocautry. Results: The mean age in group A is 19.7± 8.08 years and in group B is 20.20± 6.9 years, both groups comparable p-value (0.74).In early post-operative complications in group A 17(34%) patients and 14(28%) patients in group B experienced mild pain p-value is (0.66). 6(12%) of group A patients and 6(12%) of group B patients experienced moderate pain p-value (01). 1(2%) of group A patient and 2(4%) of group B patients experienced severe pain p-value (01). 02(4%) patients of group A and 02(4%) patients of group B had serous discharge p-value(01). 1(2%) of group B patients have purulent discharge, however, no patients in group A patients have purulent discharge p-value (01). 1(2%) patients of group A and 2(4%) patients of group B had recurrence at three months follow up p-value (01). 2(4%) patients of group A and 4(8%) patients of group B had recurrence at six months follow up p-value (0.68). Conclusion: Partial nail avulsion followed by matricectomy either with Phenol 80-88% or with electrocautry are comparable in early and late complications. Keywords: Ingrown toenails, partial matricectomy


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