scholarly journals Early Repair of Anterior and Distal Hypospadias is less Cmplicable than Delayed Repair

2017 ◽  
Vol 7 (2) ◽  
pp. 69-72
Author(s):  
Golam Kibria ◽  
Md Ansar Ali ◽  
Kaniz Hasina ◽  
Sharifuzzaman ◽  
Imdadul Hoque Raju ◽  
...  

Background: Evaluation of the result of early and delayed repair of anterior and distal penile hypospadias. A total number of 144 patients of anterior and distal penile hypospadias with/without chordee were evaluated by follow up study in our hospital and private hospital from January 2010 to July 2013. Redo cases, complex hypospadias and proximal hypospadias were excluded. Simple Random sampling technique was followed to the patients were grouped into Group-A (72 patients) and Group-B(72 patients) on the basis of age of the patients. Both Group-A, age between 6 to 18 months and Group-B, more than 18 month to 14 years were operated by Snodgrass procedure. We did follow up 12- 24 months postoperatvely. It can be recommended for repair of anterior and distal penile hypospadias within 6 to 18 months whenever the question of post urethroplasty cosmosis, wound disruption and formation of urethra cutaneous fistula.J Shaheed Suhrawardy Med Coll, December 2015, Vol.7(2); 69-72

2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.


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


Author(s):  
Gopal Sharma ◽  
Nivedita Prasher

Background: Every surgeon wants cosmetically acceptable scars along with optimal healing. Good tissue union and cosmetically acceptable scars are vital for ideal surgical practice. A basic need for skin closure is a good approximation. Apart from cosmetically good scars, it is also necessary that the skin closure technique should be technically easy, speedy, economical and acceptable.Methods: The study was conducted on 100 patients on whom elective abdominal surgeries were performed. Patients were divided into two groups with 50 patients in each group after matching the parameters like age, co morbid conditions, using simple random sampling technique. All operations were performed by one consultant. In group A, Skin was approximated with vertical mattress sutures while in group B, staplers were used to close the wound.Results: The age of the patients varied from 16 to 85 years. The average time taken for skin closure for suture group (A) was found to be 300sec (±20.78) and for stapler group was found to be 120sec (±16.50) respectively. Wound infection was found in 10 patients (20%). In stapler group 4 (8%) and in suture group 6 Patients (12%) had post-operative wound infection.Conclusions: Cosmesis is essential and necessary in modern surgical practice. It also reflects surgical expertise.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Fioravanti ◽  
R Fenici ◽  
A R Sorbo ◽  
D Brisinda

Abstract Background The Wolff-Parkinson-White (WPW) syndrome can be associated with sudden cardiac death, therefore risk assessment (RA) with electrophysiological (EP) testing (EPT) is mandatory to identify patients (pts) requiring catheter ablation (CAb). Our retrospective cohort study aimed to evaluate the variability of EP parameters during follow-up of WPW pts and the reliability of trans-esophageal EPT (TEEPT) for RA, evaluation of treatment efficacy, and EP follow-up of untreated athletes/pts. Method Data of 335 WPW pts, studied with TEEPT between 1985 and 2018, were retrospectively analyzed. Anterograde effective refractory period (ERP) of accessory pathways (AP) and of the atrioventricular node, Wenckebach point, shortest preexcited RR intervals (SPERRI) during atrial fibrillation (AF) and/or atrial pacing (At-P) and inducibility of supraventricular arrhythmias were assessed, at rest (supine and standing) and during effort. An AP was defined at high arrhythmogenic risk (HAR) if the anterograde AP-ERP and/or SPERRI (in AF or At-P) were ≤240 ms at rest or ≤200 ms during effort test. All patients were followed-up as outpatients or telephonically, as clinically required. 195 pts (17% female) were included, having exhaustive clinical information, two or more TEEPT and exhaustive clinical follow-up until late 2018. Time-evolution of EP parameters was evaluated, using parametric and non-parametric tests, as appropriate. Results and discussion Median age at first TEEPT was 20 years (IQR 16–29 years). Median follow- up was 44.3 months (IQR 16.4–122.9 months). Two pts (both identified at HAR and scheduled for surgery when ablation was unavailable) died suddenly, at rest. No other serious arrhythmic complication occurred, during the FU. Out of 19 pts (9.7% - Group A) showing enhanced AP conductivity at follow-up (mean ERP/SPERRI shortening: 30.8 ms, range 10–80 ms), 4 pts were found at HAR and underwent CAb. 176 pts (90.3% – Group B) showed a stable or impaired (25% under pharmacological treatment) AP conductivity during the follow-up. Their mean ERP/SPERRI increase was 39.7 ms (range 0–130 ms). Group A pts were significantly younger (20 vs 28 years old; 88% of Group A pts were <30 years old) and more frequently male (94.1% vs 80.6%). A non-significant trend toward Group A was found for antero-septal APs (35% Group A vs 15.4% Group B). Conclusions TEEPT is a safe, non-invasive tool to stratify arrhythmogenic risk of WPW pts. Our data suggest that a watchful waiting is safe for low to moderate risk pts. Younger males with an antero-septal Kent bundle may deserve a more intensive EP follow-up. Aggressive therapy should be considered as mandatory only for symptomatic HAR pts, taking into account complications, risk/benefit ratio and pts' preferences. In other cases, medical therapy and watchful observation could be applied safely under periodical TEEPT, as appropriate.


1985 ◽  
Vol 54 (03) ◽  
pp. 665-668 ◽  
Author(s):  
F Rodeghiero ◽  
G C Castaman ◽  
T Chisesi ◽  
A De Rossi ◽  
O Dalla Gassa ◽  
...  

SummaryA 1-year follow-up study of the T-cell subset abnormalities was carried out in 16 severe haemophilia A patients, treated “on demand” with an average amount of 500 U/kg/yr of factor VIII concentrate (group A) and in 15 mild haemophiliacs or von Willebrand patients treated only sporadically with less than 3000 U of factor VIII and no longer exposed to any other blood component in the 2 years preceding the beginning of the study (group B).In group A, 50% and 70% of patients showed a reduced or inverted T 4/T 8 ratio, respectively, at the beginning and at the end of follow-up. These values were of 30% and 20% in patients of group B, suggesting a long-lasting effect of concentrate therapy on T-cell subsets. The low T 4/T 8 ratio was mainly due to an increase of suppressor cells. None of the patients was found positive for anti HTLV-I, whereas 3 patients, all belonging to the group A, showed antibodies against HTLV-III. Thus, in these patients, HTLV-III seems not to be the only cause of low T 4/T 8 ratio.


2009 ◽  
Vol 16 (04) ◽  
pp. 475-480
Author(s):  
MUHAMMAD SUHAIL AMER ◽  
MUHAMMAD ASHRAF

Introduction: Chronic pain following inguinal hernia repair is becoming a significant clinical problem, involving increased numberof patients and surgeons. Much controversy exists regarding treatment. Elective division of the nerves has been proposed to reduce the riskof chronic post operative pain. O b j e c t i v e s : To evaluate the effectiveness of elective neurectomy during open hernia mesh repair, in reducingpostoperativ pain. Materials a n d m e t h o d s : Settings: All patients admitted in SUN department of surgery, Allied Hospital Faisalabad wereincluded in study. Study was started after the approval of synopsis on with inguinal hernia 2n d Feb, 2007 to Aug, 2007.100 patients of inguinalhernias were divided into 2 groups, 50 in each group i.e. group A & group B. The last patient was registered in the first week of July,convenience nonprobability sampling was used for location of patients in two groups. Results: On day one the pain was assessed in the twogroups i.e. Group A and group B (convenience non probability sampling technique used for patient grouping).It was found to be absent in 24/50(48 %) and 18/50 (36 %), mild in 10/50 (20 %) and 12/50 (24 %), it was moderate in10/50 (20 %) and 10/50 (20 %) and was severe in 6/50(12%) and 10/50 (20%) in the two groups respectively. One week after operation, in groups A and B, respectively, pain assessed with the useof the 4-point verbal scale was absent in 45 patients (90%) and 37 patients (74%), mild in 3/50 (6%) and 4/50 (8%), moderate in 2/50 (4%) and6/50 (12%), and severe in none and 3/50 (6%). Postoperative pain was not correlated with the presence of preoperative pain, and no correlationwas evidenced in the 2 subgroups. One month after operation, follow-up visits were performed in group A patients and group B patients. Inparticular, pain was absent in 46/50 (92%) patients in group A and 41/50 (82%) patients in group B. It was mild in 2 (6%) and 6/50 (12 %),moderate in 2/50 (4%) and 2/50 (4 %) none of the patients with elective neurectomy had pain at follow up of one month and 1 (2 %)one patientwithout elective neurectomy had pain. The numbness was assessed by checking sense of touch around the operated area. The difference foundbetween the 2 groups with respect to the presence of numbness was 15/50 (30 %) and 7/50 (14%) in the two groups i.e. group A and groupB respectively at day 1 and 12/50 (24%) and 7/50 (14%) at follow up of one week and it was 5/50 (10%) and 2/50(4%) at one month in the twogroups. C o n c l u s i o n s : When performing lichtenstein inguinal hernia repair, routine ilioinguinal, iliohypogastric and genital branch ofgenitofemoral nerves neurectomy is a reasonable option.


2021 ◽  
Vol 9 (4) ◽  
pp. 702-707
Author(s):  
Pooja Gautam ◽  
Ramesh Kumar Chaturvedi ◽  
Shraddha Sharma

Hypertension is one of the major causes of cardiovascular morbidity and mortality worldwide. It is a global health problem affecting the people of different ethnicity and ages around the world. An estimated 1.13 billion people worldwide have hypertension, most (two-thirds) living in low- and middle-income countries. According to WHO (2015) the overall prevalence of hypertension in India was 24.2% and 22% among the men and women respectively. Hypertension is called a silent killer, non-communicable chronic disease because it rarely exhibits symptoms before it damages vital organs like kidney, brain or heart. In Ayurveda there is not a single disease which resemble with hypertension, but physician should understand the disease through Dosha, Dushya, Samprapti and initiate the treatment. A lot of potent modern antihypertensive drugs are available but none of them are free from untoward side-effects. So, a clinical study was done using herbal formulation containing Sarpaghandha, Sankhpushpi, Arjuna, Jatamansi and Ashwagandha in the form of Ghanvati. A comparative study was done as this Ghanvati was given with and without Gokshur kwath. For clinical study 52 (Group A- 25 and Group B- 27) clinically diagnosed patients of essential hypertension who fulfil inclusion criteria were selected irrespective of their age, sex, religion, occupation etc. and simple random sampling technique was followed for grouping the patients into 2 groups. All the patients selected for the clinical trial were divided in two groups ‘A’ and ‘B’. Patients of Group A were given 250 mg of Ghanvati two times a day with water as Anupan and patients of Group B were given 250 mg of Ghanvati with water as Anupan and Gokshur kwath both two times a day. Duration of the study for each group was 30 days. The present study showed that herbal formulation is also effective in the management of essential hypertension. Keywords: Essential hypertension, Ghanvati


1992 ◽  
Vol 26 (2) ◽  
pp. 82-87
Author(s):  
Maria de la Luz Alvarez ◽  
Fanny Wurgaft

The goal this follow-up study was to relate the mother's marital satisfaction to family health status in a low SES. The random sample was made up of 30 families with children under 7 years old: 15 considered as sick (Group A) and 15 as healthy (Group B). Both group had similar demographic characteristics (age of father and mother, persons per family group and age of children) and SES. Results showed that mothers were those mainly in charge of their family groups. Mothers of Group A were significantly less understanding and more dissatisfied than those of Group B ( p < .05 and p < .01). Mothers of Group A had significantly more arguments with their partners than those of Group B (p < .006). Health care was learned less from the child's own mother in group A than in B (p < .05). Health was considered by mothers of Group A as something that "must be taken care of" more than by those of Group B (p < .01). The behaviours of mothers in choosing one of the health systems was similar in both groups. Dissatisfied mothers were associated more with sick family members during the 6 month follow-up. It is suggested that the satisfaction of the mother is a factor that needs further investigation because health is managed by mothers is the large majority of families.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bekalu Kassie ◽  
Yibelu Bazezew ◽  
Yewbmirt Sharew ◽  
Leltework Yismaw ◽  
Melaku Desta ◽  
...  

Abstract Background Eclampsia is a tonic clonic type of seizure among pre-eclamptic mothers. Time to recovery from eclampsia is to mean that the time when the mother recovered from severity features of pre-eclampsia. As far as the mother is not free from severity features, she is in a potential to end-up with repeated seizure (eclampsia). Therefore, combating eclampsia through controlling severity features is crucial to enhance maternal health quality, reduce maternal morbidity and mortality, and improve prenatal outcomes. There was no literature that describes the recovery time of eclampsia and its determinants in Ethiopia. Therefore, this study aimed to assess the recovery time from eclampsia and its determinants in East Gojjam zone hospitals. Methods An institutional based retrospective follow up study was conducted between January 2014 and December 2017 among 608 eclamptic mothers in East Gojjam zone Hospitals. Simple random sampling technique was used. Data were coded and entered to Epidata version 3.1 and was exported to SPSS version 20 and then to Stata 14. We used the adjusted hazard ratio (AHR) with 95% confidence interval at p-value less than 0.05 to measure strength of association. Result The median recovery time of eclampsia was 12 h with inter-quartile range of (1–48 h). The rate of recovery from eclampsia among mothers aged more than 20 years was reduced by half (AHR 0.50 (0.28, 0.89)) than the teenagers. The rate of recovery from eclampsia among mothers who had prolonged labor was 1.3 times (AHR 1.26 (1.01, 1.57)) than those whose labor was less than 12 h. About 32% of mothers with multiple convulsions recoverd later than (AHR 0.68 (0.52, 0.87)) those who had single convulsion. As compared to antepartum convulsion, the rate of recovery from postpartum eclampsia was 1.8 times faster (AHR 1.81(1.17, 2.81)). Conclusion The median recovery time from severity features among eclamptic mothers in East Gojjam zone hospitals was half a day. It is affected by age, duration of labor, number of convulsions and time of occurrence of the event. Special attention for elders, prevent recurrent convulsion and faster termination for the antepartum eclamptic mothers are recommended from this follow-up study.


VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.


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