scholarly journals A PROSPECTIVE COMPARATIVE STUDY OF OPEN VERSUS CLOSED METHOD OF CREATING PNEUMOPERITONEUM IN LAPAROSCOPIC SURGERY

2020 ◽  
pp. 1-3
Author(s):  
Akshar Patel ◽  
Shashank Desai
Keyword(s):  
Laparoscopic Surgery ◽  
Comparative Study ◽  
Tertiary Care ◽  
Needle Insertion ◽  
Care Hospital ◽  
Open Method ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Open Versus

Objective: The aim of the study was to compare open and closed method in terms of time require for creation of pneumoperitoneum and to ascertain safety in laparoscopic surgery. Methodology: This was a prospective comparative study carried out at a tertiary care hospital from January 2019 to December 2019.We selected 100 patients who were planned for laparoscopic surgery and divided them into two equal groups using the envelop method of randomization. Group A comprised of patients in whom we created pneumoperitoneum by classical veress needle insertion and in Group B by open method. Results: In our study, the mean time require for closed method was 6.92 minutes while by open method it was 4.36 minutes. Complication rate was 18% in closed and 16% in open method. Conclusion: open method is quick but comparable to closed method in terms of complications.

scholarly journals Comparing the Efficacy of 2% Diltiazem Gel with 0.2% Glyceryl Trinitrate in Anal Fissure

2021 ◽  
pp. 397-401
Author(s):  
Ehsanullah Malik ◽  
Sania Bhatti ◽  
Qararo Shah ◽  
Muharram Ali Abbasi ◽  
Khushbakhat Abro ◽  
...  
Keyword(s):  
Glyceryl Trinitrate ◽  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Tertiary Care ◽  
Care Hospital ◽  
Male And Female ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Better Than

Objective: To compare the efficacy of 2% diltiazem gel with 0.2% glyceryl trinitrate in patients presenting with chronic anal fissure at Tertiary Care Hospital, Larkana. Methodology: This prospective comparative Study was conducted at department of Surgery ward-II Chandka Medical Hospital, Larkana from 14-01-19 to 14-07-19. A total of 130 patients who were treated as OPD cases were included in this study. Each patient detailed history & clinical examination, details of symptomatology was recorded in a epically diagnosed proforma. These patients were randomly divided in two equal groups i-e group A 65 patients and group B 65 patients. Group A patients were treated with 02% glyceryl trinitrate and group B patients were treated with diltiazem gel 02%. All the patients of group A & B were followed up to 02 months after start of leadema as a OPD cases. Results: A total of 130 patients (65 each in 2% diltiazem gel with 0.2% glyceryl trinitrate group) were included. Mean age in both groups was 42.56±3.91 and 41.71±4.01. 46 (70.8%) and 19 (29.2%) were male and female in Group A and 39 (60%) and 26 (40%) were male and female in Group B. Efficacy of 2% diltiazem gel with 0.2% glyceryl trinitrate in patients presenting with chronic anal fissure was 76.9% and 50.8% respectively. Conclusion: DTZ (2%) and GTN (0.2%) are equally effective in healing anal fissures. DTZ is better than GTN as it causes less side effects, low recurrence rate, healing rate and therefore better compliance.

scholarly journals Feto-maternal outcomes following caesarean section: a prospective comparative study at tertiary care centre in North-Western Rajasthan

2018 ◽  
Vol 7 (6) ◽  
pp. 2311
Author(s):  
Neha Kuntal ◽  
Madhu Patni Bhat ◽  
Amit Nimawat ◽  
Munmun Yadav ◽  
Mahendra Kumar Verma
Keyword(s):  
Caesarean Section ◽  
Comparative Study ◽  
Tertiary Care ◽  
Maternal Outcomes ◽  
Data Types ◽  
Common Indication ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
North Western

Background: Caesarean section (CS) is employed when vaginal delivery is not feasible or hazardous to the mother and/or her baby. The procedure, however, is not without risk. We determined the fetomaternal outcomes of CS conducted at P.B.M Tertiary hospital situated in the North-Western region of Rajasthan.Methods: This is a Hospital based prospective comparative study of all CSs performed for various indications at the Dept. of Gynaecology and Obst., S.P. Medical College and P.B.M Hospital, Bikaner, India, from August 01, 2016, to July 31, 2017. All patients who had CS at any time within the 24 h period were noted and followed up until discharge. The sociodemographic data, types of CS, indications, and feto-maternal outcomes were documented in a proforma. Statistical analysis was carried out using the SPSS version 24.Results: There were 16386 deliveries out of which 4456 (27.1%) were by LSCS. The age range of the group A was 21-25 years while in group B it was 26-30 years. The mean age group A was 22.4, and group B it was 27.9 years. Total 6572 primigravida patients delivered and 32.1% had LSCS. Total 9814 multigravida patients delivered and 12.6% had primary LSCS. In group A, 119(79.3%) LSCS were elective as compared to group B where only 19(12.7%) were elective and this difference was found statistically highly significant (p<0.001). Indication of LSCS is different in both the groups. Fetal distress was most common indication in group A (53.3%) while in group B most common indication was APH (35.9%). Perinatal mortality/morbidity was significantly higher in group B (7.3%) as compared to group A (2.7%).Conclusions: The CS rate in this study was 27.1%. Although primary caesarean section in multipara constitutes only a small percentage of total deliveries and caesarean, they are associated with high maternal and perinatal morbidity. The reason for these complications is many. Beside obstetrical causes, factors like lack of antenatal care, low socioeconomic status, anaemia, malnutrition and illiteracy also play a major role obstructed labor and previous CS among Maternal and perinatal complications were more frequent with emergency CS and in the referred cases.

scholarly journals Prospective comparative study of hypospadias surgical repair with and without the use of fibrin sealant

2019 ◽  
Vol 6 (8) ◽  
pp. 2722
Author(s):  
Tamer A. Sultan ◽  
Tamer A. Faktry ◽  
Ahmad Nabil ◽  
Mohammed Z. Shenishn
Keyword(s):  
Comparative Study ◽  
Urethral Stricture ◽  
Fibrin Sealant ◽  
Tertiary Care ◽  
Hypospadias Repair ◽  
Flap Necrosis ◽  
Significant Difference ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B

Background: Hypospadias is the most common congenital malformation of the penis, affecting about 4-6 males per 1000 male births, and ranging in severity from a urethral meatus that is slightly off-center to a meatus in the perineal area, The aim of this study was to evaluate whether the application of fibrin sealant over the suture lines of neo-urethra reduces complications and improve overall outcome in children hypospadias repair.1,2 Methods: It was a prospective comparative study conducted in a tertiary care center (Department of pediatric surgery - Menoufia University), we included the patients age more than 6 months and less than 4 years presented with hypospadias to our department in this study. A total 30 patients of coronal, sub coronal, mid shaft hypospadias and distal hypospadias were studied and were divided into two groups, group (A) 15 cases and group (B) 15 cases. All patients underwent a tabularized incised plate (TIP) repair with a Dartos vascularized pedicle flap to cover the neo-urethra, In group (B) a thin layer of fibrin sealant applied over the suture line of neo-urethra but no sealant was used in group (A).Results: Postoperative surgical complications: urethra cutaneous fistula, flap dehiscence, flap necrosis and urethral stricture were recorded. Urethrocutaneous fistula flap dehiscence and flap necrosis were lower in group (B) patients. There was no significant difference in postoperative urethral stricture between two groups. Conclusions: Use of fibrin sealant in hypospadias repair is safe and can reduce complications.

scholarly journals A comparative study of the efficacy and tolerability of parenteral ceftriaxone and cefotaxime in pediatric population for acute bacillary dysentery in a tertiary care hospital

2018 ◽  
Vol 7 (6) ◽  
pp. 1109
Author(s):  
Sagar K. ◽  
Shanmukananda P. ◽  
Veena D. R. ◽  
Shwetha H.
Keyword(s):  
Comparative Study ◽  
Bacillary Dysentery ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Paediatric Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Acute Bacillary Dysentery

Background: Diarrheal disorders in childhood account for a large proportion (18%) of childhood mortality. Among diarrheal diseases, dysentery is a major cause of childhood morbidity and mortality, especially in developing countries.Methods: This is an open labelled, prospective, randomised, comparative study carried out at Dr. B. R. Ambedkar Medical College Hospital, Bangalore from November 2014 to November 2015 after Institutional Ethics Committee approval. A total of 80 Paediatric patients who met the inclusion criteria were included in the study after taking written informed consent from parents and assigned into two groups, Group A- Inj. Ceftriaxone (50-100mg/kg/day) and Group B- Inj. Cefotaxime (100 mg/kg/day) in divided doses for a period of 3-5 days based on requirement.Results: In this study, Cefotaxime was non inferior to Ceftriaxone as the Mean Duration of Hospitalisation was 3.30±0.72 days in Group A and 3.30± 0.72 days in Group B with p value of 1.000, showing no statistically significant difference. Both were well tolerated without any reports of ADR (Adverse Drug Reaction).Conclusions: In this study shows that Inj. Cefotaxime is equally efficacious and well tolerated as Inj. Ceftriaxone in the treatment of Acute Bacillary Dysentery in paediatric patients.

scholarly journals Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
P Value ◽  
Care Hospital ◽  
Intravenous Lidocaine ◽  
Operative Outcomes ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (41) ◽  
pp. 3559-3566
Author(s):  
Abdul Salam R. T. ◽  
Shahul Hameed A. ◽  
Meera Rajan
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Tertiary Care ◽  
Operation Time ◽  
Care Hospital ◽  
Adenoid Tissue ◽  
Significant Difference ◽  
Tube Function ◽  
Prospective Comparative Study ◽  
The Mean

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

Modified Lift Versus Cutting Seton for Transphincteric Fistula -Experience at Tertiary Care Hospital

2021 ◽  
Vol 15 (12) ◽  
pp. 3257-3260
Author(s):  
Muhammad Najam Iqbal ◽  
Ashfaq Nasir
Keyword(s):  
Comparative Study ◽  
Anal Incontinence ◽  
Complete Healing ◽  
Fistula Tract ◽  
Fistula Closure ◽  
Fistula In Ano ◽  
Group A ◽  
Prospective Comparative Study ◽  
Cutting Seton ◽  
Group B

Background: Fistula in ano is a common disease which has high recurrence rate and high fecal incontinence rate after surgery. We compared modified LIFT (Ligation of the intersphincteric fistula tract (LIFT) through lateral approach ) with cutting seton for transphincteric fistula. Aim: This study is aimed at which procedure is better with respect to postoperative complications Study design: It was a prospective comparative study. Methods: This was a prospective comparative study from 01-01-2019 to 30-06-2021 which was conducted on 50 patients who presented with transsphincteric fistula in ano (FIA) in surgical ward of Bahawal Victoria Hospital Bahawalpur. Patients were divided into two groups .Patients of Group A underwent modified lift procedure and patients of group B underwent cutting seton procedure. Data was collected on a proforma which included patients’ name ,age ,sex, age group, comorbid disease like diabetes mellitus ,chronic liver disease, cardiovascular disease and chronic renal failure, fistula tract involving less than 50% or more than 50% external sphincter ,procedure done, healing time of wound, complications like recurrence and incontinence. Patients were followed for 6 months for healing rate ,recurrence and incontinence. Data was analysed on spss 22 version Results: In Group A, complete healing (fistula closure without recurrence) was achieved in 20 patients (80%) out of 25. There was no case of anal incontinence after the procedure. 5 (20%) patients experienced recurrence in 6 months . In Group B, complete healing (fistula closure without recurrence) was achieved in 21 patients (84%), in 6 months follow up . 4(16%) patients were diagnosed as a case of anal incontinence. There were 4 (16%) patients with recurrence. Conclusion: Modified LIFT is better in terms of incontinence where as cutting seton is better in terms of recurrence.it is suggested that for high lying fistula modified LIFT is better procedure and for low lying fistula involving less than 50% sphincter cutting seton is better procedure.. Keywords: Modified LIFT (ligation of ineter sphincteric fistula tract) ,Cutting seton , transphincteric fistula.

scholarly journals O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY

2021 ◽  
Vol 71 (1) ◽  
pp. 347-50
Author(s):  
Qamar Zia ◽  
Asma Rizwan ◽  
Adil Khurshid ◽  
Mudassar Sajjad ◽  
Muhammad Nawaz ◽  
...  
Keyword(s):  
Comparative Study ◽  
Vesicovaginal Fistula ◽  
Armed Forces ◽  
Vaginal Fistula ◽  
Fistulous Opening ◽  
Vesicovaginal Fistulae ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Vesico Vaginal Fistula

Objective: To assess morbidity and success of transabdominal (O’Conor) repair of vesicovaginal fistula with orwithout interposition of flap between vagina and urinary bladder. Study Design: Prospective comparative study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Mar 2016 to Jan 2019. Methodology: Fifty five patients were randomized into group A & B by lottery method. An inclusion criterionwas single fistulous opening of ≤3cm. Complex and recurrent fistulae were excluded. Patients in group A underwent O’Conor repair without interpositional flap while in group B vesicovaginal fistulae were repaired with flap interposition. Results: Twenty two patients were randomized in group A while 27 in group B. Mean age of patients was 41.65± 11.93 years. Gynecological and obstetrical surgery was the main cause of fistula. Mean duration of surgerywas 162.7 ± 18.49 minutes. Per-operative ureteric catheterization was done in 9 (16.8%) patients. Seventeen(30.6%) patients had paralytic ileus. There was transient fever in 4 (7.6%) of cases and wound infection was seenin 3 (5.8%) of patients. Mean hospital stay was 3.4 ± 2.3 days. Cystogram was done in 35 (64.5%) of patients before the removal of per-urethral catheter. The overall success rate was 92.9%. Ten (18.2%) of patients developed denovo urgency which was managed conservatively. There was no statistical difference in both groups in terms of morbidity and success. Conclusion: In simple Vesico-vaginal fistulae repair, interposition of flap can be omitted and it does not affect the outcomes in terms of success and morbidity.

scholarly journals Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

2019 ◽  
Vol 8 (10) ◽  
pp. 2197
Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig
Keyword(s):  
Tertiary Care ◽  
Nausea And Vomiting ◽  
Research Centre ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
First Line Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

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