scholarly journals LIGATION OF INTERSPHINCTERIC FISTULA TRACT AS AN ALTERNATIVE TREATMENT FOR PERIANAL FISTULA AT TERTIARY CARE HOSPITAL

2021 ◽  
Vol 3 (3) ◽  
pp. 53-58
Author(s):  
Nawaz Ali Dal ◽  
Ishrat Raheem Katyar ◽  
Mohammad Qasim Mallah ◽  
Ahsan Laghari ◽  
Shiraz Shaikh ◽  
...  
Keyword(s):  
Fistulous Tract ◽  
Tertiary Care ◽  
Perianal Fistula ◽  
Perianal Abscess ◽  
Sampling Technique ◽  
Fistula Tract ◽  
Care Hospital ◽  
Therapeutic Success ◽  
Preoperative Symptom ◽  
Intersphincteric Fistula

This study was aimed to evaluate clinical outcome of patients with perianal fistula operated with the ligation of intersphincteric fistula tract (LIFT) technique. The study was conducted at Department of Surgery, Liaquat University of Medical & Health Sciences, Jamshoro from July 2018 and August 2019. A total of 22 patients diagnosed with perianal fistula operated with the Ligation of Intersphincteric Fistula Tract (LIFT) technique were selected using non-probability consecutive sampling technique. Physical examination and magnetic resonance imaging (MRI) and/or endosonography (ES) were performed to make a confirmed diagnosis of fistula. They were classified according to Parks classification. All patients were subjected to intersphincteric fistulous tract ligation using the technique defined by Rojanasakul modified. There were 16 males and 6 females. Mean age was 42 years (range 23-68 years of age). Out of 22 patients, 17 patients had a history of perianal abscess drainage prior to surgery and an average preoperative symptom presentation was 2.2 years (range 0-10 years). Therapeutic success with first surgery was achieved in 77% and with a second surgery in 90%. None of this patients modified their preoperative Wexner. It was concluded that LIFT technique appears to be a convenient, reproducible, and effective surgical alternative. This provides an appropriate closing rate and without continence modification, Therefore indicated for complex cryptoglandular fistulas.  

A comparative study of ligation of intersphincteric fistula tract (LIFT) and conventional fistulotomy in treatment of fistula-in-ano

2021 ◽  
Vol 19 (1) ◽  
pp. 13-17
Author(s):  
Gopi Krishna Mishra ◽  
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Complete Healing ◽  
Fistula Tract ◽  
Care Hospital ◽  
Fistula In Ano ◽  
Post Operative Pain ◽  
Intersphincteric Fistula ◽  
The Difference ◽  
Duration Of Operation

Background: A hospital randomized control study was conducted at a tertiary care Hospital, to compare outcomes between the Ligation of Intersphincteric Fistula Tract (LIFT) technique and conventional fistulotomy for the treatment of low trans-sphincteric fistula in ano, including 50 patients of low trans-sphincteric fistula in ano randomly divided into two groups. LIFT technique was used in first group while Conventional Fistulotomy was performed in another. Mean duration of operation was significantly less and mean hospital stay, post-operative pain and analgesics need was significantly less in cases operated with LIFT. Mean time for complete healing was significantly less in cases operated with LIFT technique and the difference in complication rate was statistically nonsignificant. Recurrence was reported in 3 (12%) and 1 (4%) cases operated by LIFT and fistulotomy respectively. Ligation of Intersphincteric Fistula Tract (LIFT) procedure is effective and preferred sphincter saving technique for fistula-in-ano. Despite slightly more recurrence, LIFT procedure has certain advantages over standard fistulotomy like shorter operative time, less postoperative pain, shorter hospital stay and faster wound healing and early resumption of normal duties.

scholarly journals The ligation of the intersphinetric tract procedure of the perianal fistula: Case report

2016 ◽  
Vol 69 (9-10) ◽  
pp. 298-301
Author(s):  
Momcilo Stosic ◽  
Igor Stojanovic ◽  
Svetlana Mihajlovic
Keyword(s):  
Case Report ◽  
Perianal Fistula ◽  
Perianal Abscess ◽  
Advancement Flap ◽  
Fistula Tract ◽  
Lithotomy Position ◽  
Main Challenge ◽  
Intersphincteric Fistula ◽  
Combination Of Methods ◽  
First Time

Introduction. Perianal fistula is usually of cryptoglandular origin, namely it results from inflammation of the anal glands. The main challenge in its management is how to resolve a fistula but avoid its recurrence as well as incontinence, which is even a bigger problem. Several treatment methods have been described and they all focus on cutting the anal sphincter and ?opening? the fistula, placing the seton, plug technique, creating a mucosal advancement flap, injecting medical occlusive agents or using a combination of methods. In 2007 a method of managing a fistula by ligation of the intersphincteric fistula tract was described. The procedure is still getting a wider application. Case Report. A 60-year old male patient had had a fistula for 30 years. He underwent incision of perianal abscess on multiple occasions resulting in multiple scars in the gluteus area. The diagnosis revealed a high transsphincteric fistula. The inner ostium was diagnosed by injecting hydrogen-peroxide and by probing. The patient?s general condition was satisfactory. For the first time the ligation of intersphincteric fistula tract procedure was applied in our regional hospital. Under general anesthesia, in a lithotomy position, the ligation of intersphincteric fistula tract procedure was successfully performed in approximately 30 minutes. The external opening of the fistula and the scars were widely excised. The postoperative course was uneventful. After 6 months there was no recurrence. Conclusion. The ligation of intersphincteric fistula tract procedure for transsphincteric fistulae can be a treatment of choice in all hospitals treating colorectal patients because the incontinence risk is low and the disease is curable at a high percentage.

scholarly journals Effectiveness of the ligation of intersphincteric fistula tract (LIFT) in the treatment of anal fistula: initial results

2014 ◽  
Vol 27 (2) ◽  
pp. 101-103 ◽  
Author(s):  
Sergio Danilo Tanahara TOMIYOSHI ◽  
Carlos Henrique Marques DOS SANTOS
Keyword(s):  
Fecal Incontinence ◽  
Anal Fistula ◽  
Anorectal Manometry ◽  
Fistulous Tract ◽  
Complete Healing ◽  
Fistula Tract ◽  
Anal Fistulas ◽  
Intersphincteric Fistula ◽  
The Mean ◽  
Initial Results

BACKGROUND: The abscesses and anal fistulas represent about 70% of perianal suppuration, with an estimated incidence of 1/10000 inhabitants per year and representing 5% of queries in coloproctology. AIM: To evaluate the effectiveness of the interesphincteric ligation technique of the fistulous tract in the treatment of anal fistula. METHODS: The records of eight patients who underwent this technique, evaluating age, gender and presence of incontinence were studied. Was named technical first-step the passage of cotton thread to promote the correct individualization of the fistula and, as the second, the surgical procedure. RESULTS: Two patients were men and eight women. The mean age was 42.8 years. Of these, seven (87.5%) had complete healing of the fistula; six were cured only with this procedure and one required additional operation with simple fistulotomy. Only one patient developed fecal incontinence which was documented by anorectal manometry. There were no deaths in this series. CONCLUSION: The interesphincteric ligation technique of the fistulous tract proved to be effective for the treatment of anal fistula and should not be discouraged despite the occurrence of eventual fecal incontinence.

scholarly journals Commonest modes of presentation of bone and soft tissue tumors at sarcoma services of A Tertiary Care Hospital of KPK.

2020 ◽  
Vol 27 (12) ◽  
pp. 2744-2748
Author(s):  
Muhammad Ibrahim ◽  
Zeeshan Khan ◽  
Muhammad Saeed ◽  
Israr Ahmad ◽  
Salik Kashif ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Signs And Symptoms ◽  
Soft Tissue Tumors ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Mode Of Presentation ◽  
Number Of Patients ◽  
Delays In Diagnosis

Objectives: The aim of this study is to assess the commonest mode of presentation at our sarcoma unit and the duration from onset of symptoms till presentation. Study Design: Retrospectively study. Setting: Sarcoma Unit of Hayatabad Medical Complex, Peshawar. Period: June 2016 to December 2019. Material & Methods: Two hundred and eighty two patients were included in this study of which 172 patients were male and 110 were female. Sample size was calculated through non-probability consecutive sampling technique. Results: Average age of patients presenting to us was 30.2years (±18.5) ranging from 3years to 83years. Highest numbers of patients fell into the age group category of 11-20years i.e. 94 (33.33%). The average duration of symptoms among our patients was 19.6 months (±26.09) ranging from 0.1months (3 days) to 168 months (14years). Highest number of patients fell into the 7months-12months category i.e. 86 patients (30.5%). The commonest mode of presentation among our patients was painful lump i.e. 128(45.3%) while patients presenting with painless lump were 57(20.2%) and those presenting with only pain were 28(9.9%). Conclusion: The study concluded that there is a need of greater awareness amount general population and health care professionals regarding red flag signs and symptoms in order to avoid the delays in diagnosis which may leads to poor prognosis.

scholarly journals Assessment of Factors Associated with Dropout for Pentavalent Vaccine in Tertiary Care Hospital of Kathmandu, Nepal

2020 ◽  
Vol 22 (3) ◽  
pp. 106-110
Author(s):  
Supri Raj Shrestha ◽  
B Shakya ◽  
R Oli
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
Sampling Technique ◽  
Cost Effective ◽  
Dropout Rate ◽  
Care Hospital ◽  
Vaccine Preventable Diseases ◽  
Factors Associated ◽  
Pentavalent Vaccine

Immunization is one of the most cost-effective public health measures as it has helped in huge reduction of disease, disability and death from different infectious diseases in children by protecting them from vaccine preventable diseases. The current study aimed to study factors associated with dropout for pentavalent vaccine in tertiary care hospital of Kathmandu. A longitudinal observational study using purposive sampling technique was conducted among 196 infants. The information was obtained using self-constructed structured questionnaire from parents visiting Community Medicine OPD of Nepal Medical College Teaching Hospital. The information regarding socioeconomic characteristics of mother, gender of the infant, place of delivery of child, birth order and reasons for dropout of pentavalent third dose were taken. The dropout of third dose pentavalent vaccine was mainly seen in infant of parents living in rented house and according to gender wise, dropout was high among male infants. The different reasons for dropout of vaccine were busy parents, forgotten date, visit to other immunization centres and sick infants. Among these, the main reason for dropout of vaccine was due to infants getting sick during the time of immunization. The dropout rates between first and third dose of pentavalent vaccine were 26.3% and 30.4% respectively for two consecutive months and the overall dropout rate was 28.35%. Also, literacy level of the mother was directly associated with the immunization visit of the infant as, maximum number of infants of illiterate mother were absent for third dose of pentavalent vaccine as opposed to no absentee among master degree holding mothers. Thus, the present study provides valuable information regarding the factors associated with dropout for pentavalent vaccine.

scholarly journals Visual Outcome of Ocular Trauma Presenting in a Tertiary Care Hospital in Sahiwal

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Ahmad Zeeshan Jamil ◽  
Muhammad Luqman Ali Bahoo
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Visual Outcome ◽  
P Value ◽  
Care Hospital ◽  
Open Globe ◽  
Patient Reported

Purpose: To find the visual outcome of ocular trauma presenting in a tertiary care hospital in Sahiwal. Study Design: Descriptive observational study. Place and Duration of Study: This study was conducted at District Headquarter Teaching Hospital affiliated with Sahiwal Medical College, Sahiwal from January 2016 to June 2019. Material and Methods:  Four hundred and thirty five patients were included in the study by convenient sampling technique. Patient’s age, gender, occupation, activity at the time of injury, nature of object causing trauma, duration of trauma, visual acuity at the time when patient reported to hospital, the time delay before coming to the hospital were recorded. Ocular injuries were classified according to Birmingham ocular trauma terminology. Detailed ocular examination was performed. Patients were managed and post-management visual acuity at three months was recorded. Results: Mean age of patients was 29.07 ± 12.53 years. There were 219 (50.3%) closed globe and 216 (49.7%) open globe injuries. In 59 (13.6%) cases, cause of injury was metal object. In 146 (33.6%) cases injury was classified as contusion. In 164 (37.7%) cases cornea was involved. Majority of the patients were male. Eighty-seven patients presented within 1 day after trauma. In 154 (35.4%) patients, visual acuity at the time of presentation was 6/12 or better while in 171 (39.3%) cases it was less than 6/60. Chi-square test was used to calculate the difference between pre and post-management visual acuity. This difference was statistically significant with p-value less than 0.05 Conclusion:  Ocular trauma cases, if properly and timely managed, have a statistically significant increase in visual acuity.

scholarly journals Prevalence of PCOS with Associated Symptoms and Complications at Tertiary Care Hospital of Karachi

2019 ◽  
pp. 1-9
Author(s):  
Urooj Zafar ◽  
Zahida Memon ◽  
Kausar Moin ◽  
Shanza Agha ◽  
Jahan Ara Hassan ◽  
...  
Keyword(s):  
Psychological Health ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Premenopausal Women ◽  
Sampling Technique ◽  
Care Hospital ◽  
Late Adolescent ◽  
Cross Sectional ◽  
Gynecological Disorders ◽  
Age Related

Aim: The aim of this study is to determine the prevalence of PCOS among different gynecological disorders at tertiary care hospital of Karachi and to assess the most frequent presenting complaint with associated complications among them. Study Design: Single-centered cross-sectional study. Place and Duration of Study: Gynecological clinic of Karachi at a Tertiary care Hospital during 3rd December 2018 to 29th March 2019. Methodology: Total 335 premenopausal women approached the clinic with different gynecological disorders during the period of four months and 305 patients agreed to participate. The patients were enrolled via convenient sampling technique. After taking the informed consent they were evaluated through clinical interviews, questionnaire, and anthropometric measurements. The diagnosis of PCOS was made by using Rotterdam criteria 2003. Menstrual irregularities were assessed via history. Clinical hyperandrogenism was evaluated by using modified Ferriman–Gallwey scale and Acne Global Grading System. Obesity was calculated through BMI. The Hamilton scale was used to appraise associated psychological disturbances. Results: PCOS was the most prevalent gynecological disorder (55.41%) among women of the premenopausal age. Overall, the most frequent presenting complaint was infertility but age related variations in symptoms showed that young adolescent and adulthood had more menstruation irregularities while, in late adolescent the chief complaint was infertility. Moreover, these patients were either overweight 32% or obese 46.2%. Other associated problems such as anxiety and migraine were more frequent in young adults and juveniles respectively. Conclusion: PCOS is the most common gynecological problem in our region. These women usually presents with altered complains that influence their physiological and psychological health which in turn effects the quality of life.

scholarly journals Clinical profile and functional disability of patients with migraine

2016 ◽  
Vol 07 (02) ◽  
pp. 250-256 ◽  
Author(s):  
Vishnu Renjith ◽  
Mamatha Shivananda Pai ◽  
Flavia Castelino ◽  
Aparna Pai ◽  
Anice George
Keyword(s):  
Functional Disability ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Primary Headache ◽  
Headache Disorder ◽  
Episodic Migraine ◽  
Clinical Profile ◽  
Care Hospital ◽  
Cross Sectional Survey ◽  
Cross Sectional

ABSTRACT Background: Migraine is a common disabling primary headache disorder. Globally, migraine was ranked as the seventh highest cause of disability. Aim: The aim of the study was to explore the clinical profile and functional disability of patients with migraine. Settings and Design: A cross-sectional survey was conducted at the neurology outpatient department of a tertiary care hospital in Karnataka. Materials and Methods: Using a consecutive sampling technique, 60 patients were recruited for the study. Descriptive and inferential statistics were used to analyze the data. Results: Majority of the participants were in the age group of 18–40 years with a mean age 35.22 years. There was a female preponderance with 70% of study participants being females. The various symptoms experienced by patients include throbbing pain (90%), photophobia (93.3%), phonophobia (85%), nausea (76.7%), and vomiting (41.7%). Most of the subjects (73.3%) under the study belonged to moderate to severe levels of functional disability. About 53.3% of patients were in the category of episodic migraine and 46.7% were in the category of chronic migraine. Conclusion: Migraine is associated with moderate to severe functional disability. Frequency of migraine has a positive correlation with the levels of disability/migraine disability assessment scores of migraineurs.

scholarly journals Current trends of consanguineous marriages and its association with socio-demographic variables in Pakistan

2018 ◽  
Vol 7 (5) ◽  
pp. 1699 ◽  
Author(s):  
Fouzia Zahid Ali Khan ◽  
Syeda Batool Mazhar
Keyword(s):  
Health Centre ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Sampling Technique ◽  
Fetal Distress ◽  
Care Hospital ◽  
Cross Sectional ◽  
Consanguineous Marriages ◽  
Cultural Preference ◽  
Questionnaire Form

Background: A high proportion of marriages in South and Middle East Asia are contracted between close biological relatives due to cultural preference as it is a deeply rooted social fashion among these societies. The aim of this study was to determine the frequency of consanguineous marriages and ascertain their relationship to relevant sociodemographic variables.  Methods: This was a cross sectional descriptive study conducted in tertiary care hospital of Islamabad. Data were collected on a specially designed questionnaire form. Age of participants, their education, socioeconomic status, castes and number of anomalous children born to these participants, degree of consanguinity and reasons of preferences were inquired.  Results: Out of 300 women chosen by convenience sampling technique, 62% had consanguineous marriages, and 38% had a non-consanguineous union. The mean age of women presenting to maternal and child health centre was 27 years. The average age of a woman having consanguineous marriage was 21 years in contrast to 24 years for non-consanguineous nuptial. About 18% of women in consanguineous marriages were illiterate as compared to 5.4% (p = 0.001) of women in non-consanguineous unions. First cousin marriages were more common among certain castes like Rajput and Awan. None in the consanguineous group had any anomalous baby in contrast to non-consanguineous who had two anomalous children (p = 0.0001). There was no significant association between type of marriage and the number of miscarriages (p=0.69).Conclusions: This study showed UA-S/D ratio and UA-RI>2SD are significant predictors of perinatal deaths and immediate neonatal resuscitation in preeclampsia. Acute fetal distress in labour or neonatal nursery admission could not be predicted.

scholarly journals KNOWLEDGE OF DENTAL PROFESSIONALS REGARDING TOOTH RESTORABILITY AT A PUBLIC SECTOR TERTIARY CARE HOSPITAL OF KARACHI, PAKISTAN

2019 ◽  
Vol 9 (2) ◽  
pp. 69-72
Author(s):  
Zulfiqar Ali Shaikh ◽  
Afifa Yaseen ◽  
Amna Yaseen ◽  
Subhana Akber
Keyword(s):  
Tertiary Care ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Adequate Knowledge ◽  
Inadequate Knowledge ◽  
Pain Symptoms ◽  
Dental Professionals

Background: Panoptic knowledge of dental professionals is required to provide care for patients with any dental problem which ranges from screening, emergency care or referral to alleviation of pain symptoms. Ideally to provide dental care, dental practice should be based on current clinical concepts originating from evidence-based dentistry which clearly demarcates a level between a tooth that is able to be restored so that intervention is done on it for esthetic and functional stability, or ready for extraction. Dental professionals' knowledge regarding tooth restorability is very crucial in restorative and preventive dentistry. The aim of this study was to assess the knowledge of dental professionals regarding tooth restorability. Methods: Knowledge regarding tooth restorability of dental professionals of Dow University of Health Sciences was assessed through a multi centered cross sectional study. A sample size of 140 participants was calculated using through open Epi version 3, and a convenient non-probability sampling technique was used. The study was conducted in May-June, 2018. An informed consent prior to the study was taken. The dental professionals were evaluated through a self- administered, structured questionnaire in English. The SPSS-23 was used to obtain results. The knowledge of the students was graded as adequate if >12 and inadequate if<12. Results: Out of 140 study participants, 113 (81%) dental professionals had significantly adequate knowledge (p-value <0.05); while 27 (19%) had inadequate knowledge. Among the respondents, 56% said that the traumatic dental injury must be treated by dentist whereas the others considered it to be treated by private doctor or by nearest hospital casualty. Conclusion: The knowledge of dental professionals working at teaching institutes is adequate; and as per their knowledge they might be taking right decisions regarding tooth restorability.

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