scholarly journals Comparison of Early versus Interval Tonsillectomy in Cases of Peritonsillar Abscess

2020 ◽  
Vol 1 (1) ◽  
pp. 5
Author(s):  
Muhammad Ahmed Khan ◽  
Attique Ahmed ◽  
Muhammad Khan
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Operation Time ◽  
Peritonsillar Abscess ◽  
Military Hospital ◽  
Secondary Hemorrhage ◽  
Perioperative Blood Loss ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare early versus interval tonsillectomy in cases of peritonsillar abscess.Study Design: Comparative study.Place and Duration of Study: The study was carried out at ENT Department of Combined Military Hospital, Mardan from January 2017 to January 2018.Materials and Methods: A total 50 patients were selected from ENT outpatient department. All the cases were randomly divided into two groups of 25 each. Group A underwent early tonsillectomy after initial incision and drainage, Group B underwent interval tonsillectomy after 6 weeks. Both the groups were compared in terms of perioperative blood loss, operation time, ease of dissection and postoperative complications including pain and hemorrhage. Tonsillectomy was done with bipolar cautery in all the cases.Results: The mean age was 30.22 + 8.25. Out of 50 patients, 42 (84%) were males and 8 (16%) were females. The mean operative time of surgery in group A (early tonsillectomy) was 45.04+5.78 minutes compared to 32.72+4.37 minutes for group B (interval tonsillectomy (p=0.00). Mean post-operative pain in group A was 3.68+2.12 compared to group B where mean score was 3.36+1.93 (p=0.579). There were 3 cases of mild perioperative blood loss, 19 cases of moderate and 3 of severe perioperative blood loss in group A. There were 18 cases of mild perioperative blood loss, 7 cases of moderate and no case of severe perioperative blood loss in group B (p=0.00). Dissection was found to be significantly easier in group B (interval tonsillectomy). There were 7 cases of post-op secondary hemorrhage in group A compared to 3 in group B (p=0.289). All these cases of secondary hemorrhage were managed conservatively.Conclusion: Interval tonsillectomy is a safer procedure as compared to early tonsillectomy in terms of perioperative blood loss, operative time, dissection with almost similar post-op pain and similar risk of post tonsillectomy hemorrhage. How to cite this: Khan MA, Ahmed A, Khan M.  Comparison of Early versus Interval Tonsillectomy in Cases of Peritonsillar Abscess. Life and Science. 2020; 1(1): 24-28.  doi: https://doi.org/10.37185/L&S.1.1.13

scholarly journals Surgery for thoracolumbar junction (T12-L1) tuberculosis a multicentre, retrospective study

2019 ◽  
Author(s):  
Yanping Zeng ◽  
Peng Cheng ◽  
Jiulin Tan ◽  
Zhilin Li ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Posterior Approach ◽  
Spinal Tuberculosis ◽  
Surgical Techniques ◽  
Operation Time ◽  
Thoracolumbar Junction ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Approach Group

Abstract Purpose A multicentre, retrospective study was conducted to evaluate the safety and efficacy of different surgical techniques for thoracolumbar junction (T12-L1) tuberculosis. Methods The medical records of thoracolumbar junction tuberculosis patients (n = 257) from January 2005 to January 2015 were collected and reviewed. A total of 45 patients were operated on by an anterior approach (Group A), 52 by a combined anterior and posterior approach (Group B) and 160 by a posterior approach (Group C). Anti-tuberculosis therapy was performed both before and after surgery. Clinical outcomes, laboratory indexes and radiological results of the three groups were compared. Results All three surgical approaches achieved bone fusion, pain relief and neurological recovery. The mean loss of correction in group A at last follow-up was higher than in groups B and C (P < 0.05), and the difference between groups B and C was not significant (P > 0.05). The mean operation time and blood loss in group B were greater than in groups A and C. Conclusions For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only approach is superior to the anterior-only approach in the correction of kyphosis and maintenance of spinal stability. The posterior-only approach is recommended because it achieves the same efficacy as the anterior-only or combined approach but with shorter operation times, less trauma and less blood loss. Keywords Spinal tuberculosis; Thoracolumbar junction; Three approaches.

scholarly journals A comparative study of two operative procedures in anterior hypospadias repair: limited urethral mobilization and tubularized incised plate urethroplasty.

2021 ◽  
Vol 28 (11) ◽  
pp. 1578-1584
Author(s):  
Shafiq ur Rehman ◽  
Fareena Ishtiaq ◽  
Zarlish Fazal ◽  
Muhammad Anwar ◽  
Saad Fazal
Keyword(s):  
Hospital Stay ◽  
Functional Outcomes ◽  
Operative Time ◽  
Operation Time ◽  
Cosmetic Appearance ◽  
Tubularized Incised Plate ◽  
Group A ◽  
Tubularized Incised Plate Urethroplasty ◽  
The Mean ◽  
Group B

Objectives: This study is aimed to compare the results of limited urethral mobilization and tubularized incised plate urethroplasty in the management of anterior hypospadias, in terms of cosmetic and functional outcomes, complication rate, operative time, and hospital stay. Study Design: Prospective Randomized Controlled study. Settings: Department of Pediatric Surgery, DHQ Teaching Hospital Sahiwal. Period: January 2019 to December 2020. Material and Methods: A total of 89 patients with anterior hypospadias were included. Patients were divided randomly into two groups. In group A, limited urethral mobilization was performed and in group B, tubularized incised plate urethroplasty was carried out. A self-structured performa was used to collect the data of all patients. Both groups were compared in terms of the operation time, hospital stay, postoperative complications, cosmetic appearance, and functional outcomes. Results: Forty-five patients were included in group A, age ranged from 2.5 to 12 years (mean 4.83years). Forty-four patients were included in group B and their ages ranged from 3.5 to 11years (mean 4.76 years). The operation time was significantly less for group A than for group B. In group A, it ranged from 54 to 69 min with an average time of 60.51 min and in group B from 70 to 88 min, with an average of 79.34 min. The mean hospital stay period in group A was 7.37 days, ranged from 7 to 9 days, and in group B was 11.04 days, ranging from 10 to 13 days. The mean follow-up period in both groups was 7.45 months, ranging from 3 months to 12 months. Meatal stenosis was the most common complication in group A, which developed in 6.66% (n=3) patients. Urethrocutaneous fistula was the most common complication in group B, which developed in 6.81% (n=3) patients. Cosmetic appearance and functional outcome were good and comparable in both groups. Conclusion: Although both techniques, tubularized incised plate and limited urethral mobilization urethroplasty are acceptable modalities for the management of anterior hypospadias. But limited urethral mobilization urethroplasty seems to be a good option due to its simplicity, short hospital stay, significant shorter operative time, low fistula formation rate, and good cosmetic and functional outcomes.

scholarly journals TONSILLECTOMY IN PAEDIATRIC POPULATION

2016 ◽  
Vol 23 (04) ◽  
pp. 499-503
Author(s):  
Raheel Ahmad ◽  
Farhan Salam ◽  
Abdul Saeed Khan ◽  
Faisal Bashir ◽  
Atif Rafique
Keyword(s):  
Standard Deviation ◽  
Blood Loss ◽  
Operative Time ◽  
Controlled Trial ◽  
Operation Time ◽  
Group A ◽  
Group B ◽  
Cold Steel Dissection ◽  
Cold Dissection ◽  
Dissection Method

Objectives: To compare mean operative time and Intra operative blood lossbetween bipolar electro dissection and cold dissection tonsillectomy in paediatric population.Study Design: Randomized controlled trial. Place and Duration: Department of ENT and Headand Neck Surgery, Continental Medical College, Hospital Lahore, from 1 January 2015 to 30September 2015. Materials and Methods: This study included 164 patients of age group 4 to12 years of either gender undergoing tonsillectomy. The patients were divided into two equalgroups designated as A and B each having 82 patients using simple random sampling. Patientsin group A were operated for tonsillectomy by bipolar electrocautry while group B underwenttonsillectomy by cold steel dissection method. All patients in both groups were assessed foroperating time and intra-operative blood loss. Results: Out of 82 cases of Bipolar DissectionGroup 49(60%) patients were male and 33(40%) patients were female. Whereas in 82 casesof Cold Dissection Group 51(62%) patients were male and 31(38%) patients were female.Mean age of patients was 7.2(SD ± 1.97) years. Mean operation time was 15 minutes withstandard deviation ± 1.21 in group A as compared to group B where mean operation time was20 minutes with standard deviation ± 1.87. Mean blood loss was 7 ml with standard deviation± 2.53 in patients of group A as compared to Patients in group B who mean blood loss of 30ml with standard deviation ± 3.46. Group A had statistically significant lower operative time andblood loss than group B. Conclusion: Tonsillectomy with bipolar electro dissection method ismuch better than cold steel dissection method. It has an advantage of less blood loss duringsurgery. It significantly reduces intra operative time.

scholarly journals Comparison of Cohen and Lich-Gregoir ureteral reimplantation in the surgical management of primary unilateral vesicoureteral reflux in children

2020 ◽  
Vol 66 (4) ◽  
pp. 424-429
Author(s):  
Cemil Aydin ◽  
Ali Akkoc ◽  
Ramazan Topaktas ◽  
Aykut Bugra Senturk ◽  
Zeynep Banu Aydin ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Vesicoureteral Reflux ◽  
Operative Time ◽  
Significant Risk ◽  
Operation Time ◽  
Ureteral Reimplantation ◽  
Macroscopic Hematuria ◽  
Group A ◽  
The Mean ◽  
Group B

SUMMARY OBJECTIVE Vesicoureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Various intravesical and extravesical techniques have been described for the surgical correction of VUR. The aim of our study was to compare the results of open intravesical and extravesical procedures for unilateral primary VUR in children. METHODS Between January 2012 and August 2018, 38 children with primary VUR who underwent open ureteral reimplantation surgery were retrospectively reviewed. The Cohen (intravesical) and the Lich-Gregoir (extravesical) approach were grouped as groups A and B, respectively. The groups were compared for age, gender, preoperative reflux grade, presence of lower urinary tract symptoms, operation time, discomfort and pain, analgesic requirements, duration of hematuria, postoperative complications, and hospital stay. All the parameters were statistically compared. RESULTS There were 38 patients in this study. Group A had 18 patients, and group B had 20 patients. The mean operative time was significantly shorter in group B than in group A. The mean hospital stay was also shorter in group B. The urethral foley stay period was 4.7±0.9 days 2±0 days (p = 0.000*), respectively, for group A and B. Macroscopic hematuria was seen in group A. The objective pain scale was worse after intravesical surgery. Analgesic requirements were higher in group A (p =0.131). CONCLUSION Intravesical and extravesical ureteroneocystostomy methods are equally successful and feasible in the treatment of primary unilateral VUR. The Cohen technique is associated with a longer and more painful hospital stay, gross hematuria, and longer operative time, compared to the Lich-Gregoir technique.

scholarly journals Electrocautery versus cold steel tonsillectomy comparison study

2019 ◽  
Vol 15 (1) ◽  
pp. 26-29
Author(s):  
Firas Baheej Abdul Aema
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Operative Time ◽  
Late Onset ◽  
Recurrent Tonsillitis ◽  
Secondary Hemorrhage ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Cold Steel Dissection

Objective: the objective of this study was to compare the intraoperative blood loss, intraoperative time, postoperative pain and secondary hemorrhage between electrodissection and cold steel dissection tonsillectomy. Methods: One hundred and six patients were enrolled in this study, the patients were randomly allocated into electrodissection group A (n=51) and cold steel dissection tonsillectomy group B (n=53). All patients are above 7 years and had history of recurrent tonsillitis and/or tonsillar hypertrophy with obstructive symptoms. Intraoperative parameters and postoperative outcome were assessed. Results: In group A patients had statically significant less operative time and blood loss than group B early postoperative pain was not differ significantly between the two groups, however late onset pain (pain on the 7th day) was significantly higher in group A. There was no significant difference between the groups regarding secondary hemorrhage. Conclusion: Electrodissection tonsillectomy is rapid, safe and effective method of tonsillectomy with obvious advantage of minimum perioperative blood loss, lower operative time and without early post-operative pain difference when compared to cold steel dissection tonsillectomy. Although it has some disadvantage of late postoperative pain.

scholarly journals Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Yangjing Lin ◽  
Jin Cao ◽  
Changgui Zhang ◽  
Liu Yang ◽  
Xiaojun Duan
Keyword(s):  
Achilles Tendon ◽  
Recurrence Rate ◽  
Operative Time ◽  
Achilles Tendon Rupture ◽  
Tendon Lengthening ◽  
Group A ◽  
Achilles Tendon Lengthening ◽  
The Mean ◽  
Group B

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.

scholarly journals INTRAVENOUS REGIONAL ANESTHESIA (BIERS BLOCK);

2012 ◽  
Vol 19 (05) ◽  
pp. 710-714
Author(s):  
Muhammad ASGHER ◽  
ASIM GHAURI ◽  
MUHAMMAD ABDULLAH ◽  
Tariq Abassi
Keyword(s):  
Regional Anaesthesia ◽  
Military Hospital ◽  
P Value ◽  
Complete Evaluation ◽  
Intravenous Regional Anesthesia ◽  
Number Of Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Intravenous Regional Anaesthesia

Objective: To compare the analgesic effects of combination of 0.5% Lidocaine plus Ketorolac in intravenous regionalanaesthesia technique with those of Lidocaine (0.5%) alone to prevent post operative pain after intravenous regional anaesthesia (Biersblock). Study design: Randomized Control Trial. Place and duration of study: The study was carried out at Department of Anaesthesiology,Intensive Care and pain management, Combined Military hospital, Rawalpindi from July 2008 to February 2009. Patients and Methods: Thestudy was conducted after complete evaluation of risk / benefit ratio to the patients. On the basis of random number method the patients weredivided into two equal groups (group A and group B). The number of patients in each group was 75. Group A was assigned Lidocaine in a dose of200mg 40ml of 0.5% solution and group B was assigned injection Ketorolac 30mg added to Lidocaine in a dose of 200mg 40ml of 0.5% solution.The patients were kept in post anaesthesia care unit for two hours and pain intensity was measured by visual analogue scale(VAS) on 15,30minutes,1hour, 1.5 and at 2 hours after the cuff deflation. The analgesic efficacy recorded on the basis of visual analog scale of two groups, wascompared using student’s t - test. p value of less than 0.05 was considered statistically significant. Results: In group A 33 males and 42 femaleswere enrolled for the study while in group B there were 38 males and 37 females. The mean age of the patients in group A was 34.31 ± 6.03years while in group B was 32.99 ± 6.08 years. Patients were also classified according to ASA classification in which 87 patients were classifiedas ASA – I and 63 patients as ASA – II. Group B which received Ketorolac in addition to Lidocaine for Bier’s block had low visual analogue scoresas compared to group A which received only Lidocaine for Bier’s block. P values obtained after the comparison of the mean VAS of two groupsat 15 minutes, 30 minutes, 1 hour, 1.5 hours and 2 hours were all less than 0.05 (0.002 for 15 minutes, 0.004 for 30 minutes, 0.001 for 1 hour,0.004 for 1.5 hours and 0.001 for 2 hours). Conclusions: Ketorolac improves the postoperative analgesia markedly when used with Lidocainein intravenous regional anaesthesia.

Comparison of harmonic scalpel versus Milligan Morgan technique in haemorrhoidectomy patients

2021 ◽  
Author(s):  
Muhammad Ahmad ◽  
Syed Tatheer Abbas ◽  
Amna Javaid ◽  
Naveed Arshad ◽  
Falak Shair
Keyword(s):  
Wound Healing ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Controlled Trial ◽  
P Value ◽  
Randomized Controlled ◽  
Group A ◽  
The Mean ◽  
Complete Wound Healing ◽  
Group B

Objectives: To assess the comparison of harmonic scalpel versus Milligan Morgan technique in patients undergoing haemorrhoidectomy. Methodology: This randomized controlled trial study was conducted at General Hospital, Lahore, from March 2019 to September 2019. Informed consent was obtained from eligible 60 patients. Patients were randomly divided into two equal groups. In group-A, haemorrhoidectomy was conducted according to the harmonic scalpel method. In group-B, open haemorrhoidectomy was performed by the Milligan Morgan procedure. Data was assembled through a designed questionnaire and investigated via SPSS version 25. Data were stratified for descriptive statistics, level of haemorrhoids and period of haemorrhoids. Post-stratification, independent sample t-test was used. Results: Mean age of both groups patients were 44.6±7.6 and 43.8±8.2 years, respectively. In group-A, mean operative time was 20.8±2.8 minutes, while 26.5±2.8 minutes in group-B, which was statistically significant with p-value of 0.001. In group-A, mean convalescence period was 9.7±2.9 days, while 13.4±3.7 days in group-B, which was statistically significant with p-value of 0.001. The mean convalescence period with harmonic scalpel method was 7.4 days (range 5–14, SD 3.6) versus 18.6 days (range 7–30, SD 5.4) with Milligan Morgan technique (P?0.001). This research observed that harmonic scalpel method required almost six weeks for complete wound healing, whereas in  Milligan Morgan technique, complete wound healing was achieved after three months (P<0.05). Conclusion: Harmonic scalpel haemorrhoidectomy found an advantageous method when assessing the operative time and convalescence period. Hence, Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternative method for treating symptomatic haemorrhoids. Continuous...

scholarly journals Intraarticular vs Intravenous Tranexamic Acid in Reduction of Blood Loss in Primary Total Knee Replacement

2016 ◽  
Vol 50 (2) ◽  
pp. 64-68
Author(s):  
Arunkumar Vijay ◽  
Jambu Nageswaran ◽  
Senthil Loganathan ◽  
Samuel Chittaranjan Bedford
Keyword(s):  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Primary Total Knee Replacement ◽  
Group A ◽  
Total Knee ◽  
The Mean ◽  
Group B ◽  
Primary Total Knee

ABSTRACT Aim To study the efficacy of topical intraarticular vs intravenous tranexamic acid (TXA) in reducing blood loss following primary total knee replacement (TKR). Materials and methods A phase 3, single center, double blind and randomized controlled study was conducted in the Department of Orthopedics, Sri Ramachandra University, Chennai, Tamil Nadu. A prospective study of 100 patients lasted from July 2013 to July 2015. Results Postoperative transfusion rates were zero in both the groups (intraarticular and intravenous). The mean 48-hour drain collected is 285.6 ml in group A (intraarticular), while it is 325.8 ml in group B (intravenous); the mean drop in hemoglobin is 1.7 gm/dl in group A (intraarticular) while it is 2.4 gm/dl in group B (intravenous). Conclusion This study shows that topical intraarticular administration of TXA has better efficacy than intravenous TXA in controlling postoperative blood loss following primary uncomplicated TKR with no significant complications. How to cite this article Vijay A, Nageswaran J, Loganathan S, Bedford SC. Intraarticular vs Intravenous Tranexamic Acid in Reduction of Blood Loss in Primary Total Knee Replacement. J Postgrad Med Edu Res 2016;50(2):64-68.

scholarly journals COMPARATIVE EVALUATION OF TACROLIMUS 0.03% OINTMENT VS OLOPATADINE 0.2% EYE DROPS IN THE TREATMENT OF VERNAL KERATOCONJUNCTIVITIS

2021 ◽  
Vol 71 (1) ◽  
pp. 34-39
Author(s):  
Hassan Sajjad Rathore ◽  
Shahzad Saeed ◽  
Ahsan Mukhtar ◽  
Umar Ijaz ◽  
Asad Habib ◽  
...  
Keyword(s):  
Subjective Symptom ◽  
Military Hospital ◽  
Vernal Keratoconjunctivitis ◽  
Eye Drops ◽  
Subjective Symptoms ◽  
Cross Sectional ◽  
Group A ◽  
Objective Sign ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of tacrolimus 0.03% ointment to olopatadine 0.2% eye drops in the treatment of vernal keratoconjunctivitis. Study Design: Prospective cross-sectional study. Place and Duration of Study: Eye Department Combined Military Hospital Quetta, from Feb to Jul 2019. Methodology: A total of 69 patients with active vernal keratoconjunctivitis (VKC) were included in this study.Thirty six (52.17%) patients were randomized in tacrolimus group and 33 (47.83%) in olopatadine group B.Baseline values of the subjective symptom score (SSS) and the objective sign score (OSS) were noted. Patientswere reviewed on weeks 2, 4, 8 and 12 and the scores at each visit were summed. These scores were used forcomparison between groups. Results: At the start of the study, the mean subjective symptoms score and objective sign score of group A was 9.0 ± 2.04 and 3.93 ± 1.93 respectively, while that of group B was 8.88 ± 2.18 and 4.36 ± 1.90 respectively. At the end of 12-weeks, the mean subjective symptoms score and objective sign score of group A reduced to 0.11 ± 0.32 and 0.08 ± 0.28 respectively, while that of group B reduced to 1.70 ± 0.77 and 0.64 ± 0.55 respectively. Total improvement of scores (as a percentage of baselines) among tacrolimus group was 98.3% and olopatadine group was 83%. Conclusion: Although both 0.03% tacrolimus and 0.2% olopatadine were effective in improving the signs andsymptoms of VKC, 0.03% tacrolimus was significantly superior.

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