scholarly journals Efficacy of Local use of Metronidazole Solution among Acute Appendicitis Patients for the Prevention of Wound Infection after Appendectomy: A Randomized Control Trial

2020 ◽  
Vol 6 (1) ◽  
pp. 54-58
Author(s):  
ABM Mir Mubinul Islam ◽  
Nasima Akhter ◽  
Md Zafar Imam ◽  
Mafiur Rahman ◽  
Jalal Uddin Mohammad Rumi

Background: Prevention of wound infection after appendectomy is very important for the post-operative management of the acute appendicitis patients. Objective: The purpose of the present study was to validate the efficacy of local application of metronidazole solution in the wound after closing of peritoneum in the prevention of appendectomy wound infection. Methodology: This randomized control trial was conducted in the Department of Surgery at Rajshahi Medical College Hospital, Rajshahi, Bangladesh from July 2009 to June 2011 for a period of two years. Patients admitted with features of uncomplicated and complicated acute appendicitis (Gangrenous or perforated) underwent emergency appendectomy by grid iron incision in all the units of surgery were selected as study population. The study population were divided into two groups into group A and group B. In group A (treatment group) after closure of peritoneum the exposed tissue was washed and was flooded with 100ml of metronidazole solution with 5 gm/ml concentration and was waited for one minute and in group B (control group) with the same amount of sterile saline solution. All patients were evaluated daily for evidence of wound infection such as fever, unusual wound pain with recording of pulse, temperature. Suspected wounds were checked on 3rd, 5th and 7th POD routinely after removal of dressing. Result: A total number of 200 patients were recruited for this study and was divided into two groups in equal number. Therefore, 100 cases were in group A and the rest of 100 cases were enrolled in group B. The mean age with SD of group A and B were 25.06±9.14 years and 23.82±7.51 years respectively. Uncomplicated appendicitis was found in 66 cases and 70 cases in group A and B respectively (p>0.05). In metronidazole wound wash group only 5 patients developed wound infection, however, in saline wash group 22 patients developed infection. Among the positive cultures Staphylococcus aureus was 3 cases and Escherichia coli was in 7 cases. Conclusion: In conclusion rate of wound infection is less in the group treated with the local application of metronidazole solution after appendectomy Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 54-58

2018 ◽  
Vol 4 (1) ◽  
pp. 10-14
Author(s):  
Mahmuda Khatun ◽  
Dewan Sahida Banu ◽  
Rifat Sultana ◽  
Md Asadul Millat ◽  
Dipika Rani Mondal ◽  
...  

Background: Prophylactic medication of major gynaecological operations is very important for the reduction of bad surgical outcomes. Objective: This randomized control trial was conducted to determine whether the metronidazole prophylaxis in conventional therapy was effective in controlling postoperative wound infection in major gynaecological infection. Methodology: The study was carried out at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during .the period from August 2002 to January 2003. One hundred and fifty consecutively admitted patients for gynecological operation were randomly assigned to receive either metronidazole and ampicillin/amoxicillin (group A) or only ampicillin/amoxicillin (group B) just after operation and continued for 7 days. After operation, daily follow-up with observation of the wound was done till their discharge. All the outcome data were collected, compiled and statistically analyzed using SPSS programme with the consultation of the statistician. Result: A total number of one hundred and forty patients were referred of which 70 patients from group A and 70 from group B. Wound infection was observed in 4(5.7%) patients of group A and 6(8.6%) patients of group B. There was no significant difference (P>0.747) in only considering abdominal wound infection and also in including vaginal wound infections (P>0.747). Conclusion: The study findings show that metronidazole prophylaxis in conventional therapy is an extremely effective agent in controlling anaerobic wound infection after gynaecological surgery.Bangladesh Journal of Infectious Diseases 2017;4(1):10-14


2021 ◽  
pp. 28-31
Author(s):  
Urja S. Vaidya ◽  
Roshani S. Patel

Background: Sciatica is a radiating pain which is treated with manual accupressure and after a time electro accupressure came into introduction. Aim And Objective: Aim: To nd out the effectiveness of accupressure pen to improve the distance variable To nd out the effect of Objective: accupressure pen on pain and distance variable in sciatica patient To compare the experimental group to the control group On the basis of Method: inclusion and exclusion criteria 30 participants were selected. They were treated with electro accupressure pen for 3 alternative days / week for 3 weeks, after that re-assessment was taken with NPRS, Slump and Distance variables. The data was analyzed using SPSS Version Results: 21.Parametric test was used .In Group A improvement was seen Accupressure Conclusions: pen is effective to reduce pain and improve step length and stride length in Sciatica Patients


2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  

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.


2013 ◽  
Vol 38 (3) ◽  
pp. 74-78
Author(s):  
MMH Talukder ◽  
KMT Islam ◽  
M Hossain ◽  
MU Jahan ◽  
F Mahmood ◽  
...  

This prospective study was conducted to compare the outcome between medical and surgical treatment of primary intracerebral haemorrhage at the department of Neurosurgery, Dhaka Medical College Hospital from January 2006 to October 2007. All patients with primary intracerebral haematoma with Glasgow Coma Scale (GCS) 5-15 (on admission) and heamatoma volume 30 cc or above admitted at Neurosurgery department managed conservatively or surgically were included in this study. Total 60 patients were selected, of them 30 patients managed conservatively and 30 patients managed surgically. Conservatively managed patients regarded as control group (Group-A) and surgically managed patients regarded as experimental group (Group-B). Patients or attendants refused to operate were included in the conservative group. All the selected patients were evaluated on the basis of detailed history, clinical examination (general and neurological examination) and CT scan findings. Outcome was evaluated in term of Glasgow Outcome Scale (GOS). Best medical treatment was given for conservative group and operations were done for surgical group and followed up after surgery till discharge by observing GCS and GOS at discharge. Number of death were 15 (50%) patients in group- A and 13 (43%) patients in group-B. There was no significant difference in mortality rate between two groups but outcome was relatively better in group-B. According to Glasgow Outcome Scale, dependency in group-A and group-B was 26.6% and 23.4% respectively. So dependency were more in group-A. But there was no significant difference statistically. Seven (23.4%) patients were independent in group-A but 10(43.3%) patients were independent in group-B. However in relative terms of outcome of group-B was better than that of group-A. In our study we found no statistically significant difference in outcome between medical and surgical management of primary intracerebral haemorrhage. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14328 Bangladesh Med Res Counc Bull 2012; 38(3): 74-78 (December)


2017 ◽  
Vol 42 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Abu Sayeed Md. Feroz Mustafa ◽  
Md. Saiful Islam ◽  
Abdullah Al Mamun ◽  
Muhammad Syeef Khalid

Urolithiasis is the third most common disease of the urinary tract. Among all urinary tract stones, majorities are ureteral stones located in the distal part of the ureters. At present, multimodalities of treatment are available to the urologists. The purpose of the present study was to observe the efficacy of Tamsulosin in conventional treatment of juxtavesical ureteric stone having size up to 8 mm. This was a single centered, parallel randomized control trial carried out in the outpatient department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from July 2007 to June 2008. The patients with unilateral, juxtavesical ureteral stone with normal functioning kidney and absence of clinical and laboratory signs of urinary tract infection and stone size up to 8 mm were included in the study. Patients were divided into two groups according to the computer generated simple random sampling. Patients of Group-A  were given conventional hydrotherapy treatment and patients of Group-B were given Tamsulosin 0.4mg/day along with the conventional hydrotherapy. Each patient was followed-up weekly until stone expulsion for 4 weeks. In Group-A and Group-B, the mean age with SD was 38.55±10.05 and 37.7±9.33 years. Expulsion occurred in 32 (53.33%) of 60 patients in Group-A and 51 (85%) of 60 patients in Group-B (p <0.05). The number of pain episodes in this study was statistically significantly lower in Group-B patients compared to Group-A (p <0.05). Urinary tract infection was encountered in 12 (20%) patients of Group-A and 2 (3.33%) patients of Group-B (p <0.05) during four weeks therapy which was treated by appropriate antibiotics. No side effects of Tamsulosin were encountered in any patients of Group-B which could require the cessation of the medication or might need for dose titration. Findings of the study revealed that the Tamsulosin supplemented conventional therapy is more effective than conventional hydrotherapy alone in management of juxtavesical ureteral stones.


2019 ◽  
Vol 5 (1) ◽  
pp. 64-68
Author(s):  
Ali Imam Ahsan ◽  
Nasimul Jamal ◽  
Ashfaq Ahmad ◽  
Syed Farhan Ali ◽  
Momenul Haque

Background: Treatment of granular myringitis (GM) is diverse with no definitive management. Objective: The aim of the present study was to see the effectiveness of different interventions for treating granular myringitis. Methodology: This was a single centred, parallel, randomized control trial. This study was done at the Specialized ENT Hospital of SAHIC, Dhaka from July 2010 to June 2012. Patients presenting with granular myringitis of 18 years of age or more with both sexes were included. All patients were divided into two groups by simple random sampling method of which patients of group A were treated by surgical treatment and that of group B were treated by medical treatment. Medical treatment was given in the form of topical ear drops and surgical treatment was performed by surgical debridement of granulation tissue followed by chemical cauterization. Repeated follow up was performed up to 6 months in both groups of treated patients. The primary outcome was the resolution of granulation tissue. During follow-up the secondary outcome variables were recurrence, perforation of the TM and any other complications or complain from the patients. Results: A total number of 60 patients were studied of which 30 patients were treated medically and 30 patients were treated surgically. The cure rate was higher in surgical treatment (80%) than conservative (16.7%) (p=0.011). The recurrence rate (17.24%) is also less in surgical group compared to medical treatment group (77.27%) (p=0.001). Conclusion: Surgical treatment is a more successful treatment modality for granular myringitis. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 64-68


2018 ◽  
Vol 3 (1) ◽  
pp. 15-21
Author(s):  
Ayobola A Iyanda ◽  
John I Anetor

Different gears (e.g. overall, mask, gloves) are being used for protective purposes by fuel filling station attendants (FFSA) in Nigeria. Whether they can adequately protect susceptible organs like liver and kidney remains largely undetermined.  The aim of the study is to compare the biochemical parameters of hepato-renal axis in FFSA that abstained from and that used protective gears in the course of daily duty.  Materials and Methods: The study population was grouped into three; GROUP A was made up of ten adult male FFSA who have used the protective measures consistently in the course of dispensing petroleum products. GROUP B was composed of 40 FFSA who did not use protective gears. GROUP C was the control group made up of thirty male adults not exposed to petroleum products. The minimum period of exposure for FFSA recruited for the study was 5 years. Information on worker safety was obtained through administered questionnaire concerning the use of self-protective equipment as a routine safety protocol for personal protection. Serum was utilized to assess biochemical indices of hepato-renal functions. Statistical differences were determined using Student’s t test and analysis of variance. p< 0.05 was considered significant.Results: Both GROUP A and GROUP B showed activities or levels of ALP, AST, ALT, creatinine, urea, albumin, and total protein that were significantly different compared with control (GROUP C), suggestive of hepatic damage.Conclusion: Data obtained from this study suggest that the three available protective gears used by FFSA in GROUP B did not significantly reduce exposure. 


2020 ◽  
Vol 24 (2) ◽  
pp. 134-138
Author(s):  
Fasial Wahid ◽  
Aftab Hussain ◽  
Faiz Ur Rahman ◽  
Obaid Ur Rahman

Objectives: To compare the frequency of excellent intubation condition with Succinylcholine and rocuronium for rapid sequence induction in patients undergoing surgery under general anesthesia. Design: Randomized control trial. Place and duration of study: Department of anesthesiology and pain medicine, Combined Military Hospital Malir Cantt Karachi from 25th June to 10th August 2019. Methodology: In this randomized control trial, a non-probability consecutive sampling technique was used. Anesthesia was given through a standard approach. Then patients were randomly divided into two equal groups. In group A, succinylcholine (1mg/Kg) was given while in group B, rocuronium (1mg/Kg) was given. Laryngoscopy was attempted after 60 seconds. Intubating conditions were labeled as excellent, good, poor, and impossible. All the data was collected in two groups, the data was entered and analyzed on SPSS version 21. Results: The mean age of the patients was 40.11±9.49 years. The male to female ratio of the patients was 0.7:1. The study results showed the excellent intubation conditions were noted in 11 from group A and 9 from group B, good intubation condition was noted in 29 from group A and 25 from group B, poor conditions were noted in 17 from group A and 16 from group B and the impossible intubation conditions were noted in 13 from group A and 20 from group B. Statistically insignificant difference was found between the study groups with intubation conditions i.e. p-value=0.570. Conclusion: It has been proved in our study that both the succinylcholine and rocuronium are statically equally effective in terms of excellent intubation conditions in the management of rapid sequence induction in patients undergoing surgery under general anesthesia.


2021 ◽  
Vol 9 (2) ◽  
pp. 3774-3779
Author(s):  
Shradha Santosh Shah ◽  
◽  
Sandhya Wasnik ◽  

Aim: To evaluate the effect of Pilates exercise on the level of fatigue, cognition and knee proprioception in elderly population (60-80 years). Study design: experimental study; randomized control trial. Method: 40 subjects both male and female of age ranging from 60-80 years (66.578 ± 4.857 in group A and 69.4 ± 5.442 in group B) were assigned in to two groups. The objective of the study was explained, and the subjects were screened based on the inclusion and exclusion criteria. Pre-interventional and post-interventional data analysis was done for FSS, 6MWT, MoCA and KJPS error angle. Group A (Experimental group) received Pilates exercise. Group B (control group) received aerobic and strengthening exercises. Both the groups underwent exercises 3 times a week on alternate days for 6 weeks. Duration of exercise for both groups was 45-60 minutes. Results: Both the groups showed clinically and statistically significant improvement in FSS (p<0.0001 in both groups) 6MWT (p<0.0001 in both groups), MoCA (p<0.001 in both groups) and KJPS scores (p<0.0002 in group A and p<0.0001 in group B) at the end of 6 weeks of treatment. There was no significant difference between the groups for FSS (p=0.7226), 6MWT (p=0.813), MoCA (p=0.416) and KJPS (p=0.6213). Conclusion: A significant improvement were observed in both the groups; which concluded that both the groups are equally effective in improvement of FSS, 6MWT, MoCA and KJPS scores. KEY WORDS: Pilates exercise, elderly population, fatigue, cognition, knee proprioception.


1970 ◽  
Vol 40 (1) ◽  
pp. 33-36 ◽  
Author(s):  
S Kishwara ◽  
S Tanira ◽  
E Omar ◽  
F Wazed ◽  
S Ara

Preeclampsia is a common pregnancy related disorder in Bangladesh that originates in the placenta and causes variable maternal and fetal problems. A prospective study was designed to see the associated maternal factors and fetal outcome in preeclampsia and to compare with that of normal pregnancy. The study was done in the Department of Obstetrics & Gynaecology, Dhaka Medical College Hospital and Mitford Hospital, Dhaka, from August 2005 to June 2006. Sixty Bangladeshi pregnant women were taken in this study, of which thirty were normal uncomplicated pregnancies (considered as control group or group A) and another thirty having pregnancies complicated by preeclampsia (considered as preeclampsia group or group B), where the patients were normotensive previously. Both the maternal and fetal outcomes were observed and recorded. The mean age of the mother was 26.53±5.26 years and 26.67±5.27 years in group A and group B respectively. The mean gestational age of the mother was 38.27±1.26 weeks and 36.90±1.03 weeks in group A and group B respectively and the difference in between two groups was statistically significant (p<0.001). The mean birth weight of the neonate was 2.80±0.27 kg. and 2.26±0.41 kg. in group A and group B respectively and the difference was significant (p<0.001). The mean APGAR score of the neonate at one minute was 9.00±1.02 and 8.40±0.93 in group A and group B respectively and the difference was significant (p<0.05). DOI: http://dx.doi.org/10.3329/bmj.v40i1.9960 BMJ 2011; 40(1): 33-36


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