scholarly journals MANAGEMENT OF SHALYAJ NADIVRAN BY MODIFIED KSHARASUTRA W.S.R. TO PILONIDAL SINUS

AYUSHDHARA ◽  
2020 ◽  
pp. 2771-2775
Author(s):  
Dwivedi Amarprakash ◽  
Archana Kumari
Keyword(s):  
Pilonidal Sinus ◽  
Hair Follicles ◽  
Natal Cleft ◽  
Incision And Drainage ◽  
Secondary Intention ◽  
Local Trauma ◽  
One Year ◽  
Minimal Scar ◽  
Reduced Time

Pilonidal sinus is a disease that most commonly arises in the hair follicles of the natal cleft of the sacrococcygeal. Incidence is more common in men as they are hairier than women. The factor which increases the risk of pilonidal sinus is continuous sitting, obesity, sedentary occupation, family history, local trauma. The surgical management commonly practiced are included incision and drainage, excision and primary closure, excision and healing by secondary intention, excision with reconstructive flap technique (Bascom’s method). However, the risk of recurrence or of developing an infection of the wound after the operation is high. In Ayurveda as clinical features, the pathology of Pilonidal sinus and Shalyaj nadivrana described in Sushruta Samhita are very much similar to each other we can correlate with Shalyaj type of Vrana with Pilonidal sinus. Sushruta has explained Shastrakarma with the intervention of ‘Ksharsutra’ procedure for the management of Nadi vran (PNS). This case study was presented on a male patient aged 39 years. He was suffering from pilonidal sinus for 9 months and treated successfully with partial sinus excision along with Ksharsutra therapy. Partial sinus excision followed by Ksharsutra ligation in the remaining intact tract was performed under local anaesthesia. The Ksharasutra was changed weekly for 3 sittings. Observation revealed that sinus track cut through and healed by 5 weeks. The patient was under observation for one year to check for recurrence. Ksharasutra treatment not only minimizes complications and recurrences, causing minimal scar but also facilitates the patient to resume early working with less discomfort as well as reduced time and cost.

scholarly journals SURGICAL TREATMENT OF CHRONIC PILONIDAL SINUS

2019 ◽  
Vol 141 (3-4) ◽  
pp. 63-67
Keyword(s):  
Wound Healing ◽  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Limberg Flap ◽  
Secondary Intention ◽  
One Year ◽  
Flap Closure

Chronic pilonidal sinus is an acquired skin disease resulting from chronic inflammation of an affected skin area. It creates a cyst with epithelized subcutaneous channels. The disease mostly affects younger men with elevated BMI and sedentary lifestyle being the main risk factors. The aim of this study was to compare wound healing times, seroma, wound infection and wound dehiscence frequency, average length of hospital stay and recurrence rate in patients undergoing first-time operation for chronic pilonidal sinus at the Surgery clinic of University hospital Mostar from June 2015 to June 2017, with recurrence rate monitoring for one one year after the operative procedure. The patients were divided into three groups by the type of operating procedure: excision with primary closure (23.0%), excision with healing by secondary intention (55.2%) and excision with Limberg flap closure (21.8%). Most of the patients included in this study had elevated BMI (72.4%). Patients who were operated using primary closure and Limberg flap closure had on average shorter wound healing times than patients operated with excision and secondary intention healing. Seroma frequency was highest in patients operated using primary closure (70.6%) and lowest in patients operated using Limberg flap closure (29.4%). Average length of hospital stay was 6.4 days (min 3, max 13; SD 1.919). There were no statistically significant differences in hospital stay between different types of operating procedures used. Patients operated using Limberg flap closure had two (10.5%) cases of recurrence in the one year period after the operation. There were seven (35.0%) recurrences of the disease in patients operated using primary closure and six (12.5%) recurrences in patients operated using healing with secondary intention. The difference in the number of recurrences between patients operated using primary closure, healing by secondary intention and Limberg flap closure was borderline statistically significant. We find that Limberg flap closure reduces postoperative complications and wound healing time which improves postoperative recovery.

scholarly journals Minor vs complete excision of pilonidal sinus: Early postoperative period

2012 ◽  
Vol 59 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Jelena Petrovic ◽  
Ivan Dimitrijevic ◽  
Zoran Krivokapic
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Healing Time ◽  
Early Postoperative Period ◽  
Surgical Approaches ◽  
Complete Excision ◽  
Surgical Incision ◽  
Natal Cleft ◽  
Incision And Drainage

Pilonidal sinus arises in the natal cleft of the sacrococcigeal region either as a cyst or as an abscess collection containing hair. It is predominantly a condition of younger people. When presenting as an abscess it usually requires surgical incision and drainage, or bursts spontaneously. In general, there are various surgical approaches to this condition, from very simple to complex ones. Each technique has its supporters and justifications. In the 3 years period, from 2009-2011, 110 treatments of the pilonidal disease were performed on our department. Midline excision was performed in 75 (68.18%) patients and the rest had marsupielisation done. The average discharge time was 1.14 days. Failure to heal occurred in 15 patients (13.63%). During that period we saw recurrence in 4 patients (3.63%). All the patients were coming to our department for postoperative care. The shortest healing time was 4 weeks and longest 21 weeks. During the period may 2011-may 2012 we performed 17 less extensive excisions. All the patients were discharged from the clinic within 23 hours and returned to their daily activities within 5 days. Healing time varied from 2 weeks to 5 weeks. In only one patient with the extensive excision healing time was 8 weeks. Although we had a short follow up period of 11.11 months, we saw no recurrence yet. Our results show that simple individual approach to every patients gives fastest and most comfortable results.

scholarly journals Evaluation of open versus closed pilonidal sinus excision in Basrah, Iraq

2018 ◽  
Vol 5 (3) ◽  
pp. 864
Author(s):  
Ahmed A. Muhsen ◽  
Alaa H. Ali ◽  
Mahmood S. Alharoon
Keyword(s):  
Pilonidal Sinus ◽  
Standard Procedure ◽  
Complete Healing ◽  
Hair Follicles ◽  
Natal Cleft ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Open Versus ◽  
A Prospective Study

Background: Pilonidal sinus is a disease that most commonly arises in the hair follicles of the natal cleft of the sacrococcygeal area. Different modalities of surgery have been employed. The aim of this study is to evaluate the outcome of open versus closed pilonidal sinus excision among a sample of patient in Basrah of Iraq.Methods: This is a prospective study conducted in two hospitals. The patients were randomly allocated into 2 groups. Group “A” consisted of 63 patients who underwent open pilonidal sinus excision and the other group (group “B”) included 68 patients who underwent closed pilonidal sinus excision. Technically, both approaches were performed according to the "standard procedure". All patients, in both groups, were seen on the 3rd, 7th and 10th days following surgery. Afterwards, they were followed up at weekly intervals until complete healing took place and three-monthly after that, for 2 years, to check for recurrence.Results: One hundred and thirty-one patients include in this study, 63 patients comprised group “A” open pilonidal sinus excision (54 males and 9 females) compared to 68 patients in group “B” closed pilonidal sinus excision (56 males and 12 females). The rate of wound infection approximately was similar (3.17% in group “A” and 2.94% in group “B”) two patients in both groups.Conclusions: This study shows significant difference in patient duration needed to retain normal life activity between open and closed method. Closed method achieved shorter duration of recovery.

scholarly journals S-Shaped Wide Excision with Primary Closure for Extensive Chronic Pilonidal Sinus Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Kerem Karaman ◽  
Safak Ozturk ◽  
Cem Tugmen ◽  
Eyup Kebapcı ◽  
Sait Murat Dogan ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Wide Excision ◽  
Pilonidal Sinus Disease ◽  
Natal Cleft ◽  
Sinus Disease ◽  
Postoperative Course ◽  
Large Patient ◽  
One Year ◽  
Disease Free

Background. The management of complex pilonidal sinus disease (PSD) with multiple pits on and beside the natal cleft is variable, contentious, and problematic. Wide excision of the sinus and reconstruction of the defect using different flap techniques have become more popular in recent years.Case Report. We report a case with a complex chronic PSD to which we applied primary closure after S-shaped wide excision. The patient’s postoperative course was uneventful, and at the end of one-year followup he is now disease-free and comes for routine checkups.Conclusion. The simplicity of the technique and the promising results support the applicability of the S-shaped wide excision in chronic bilaterally extended large PSDs. Further studies entailing large patient populations are needed to reach a definite conclusion.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

Treatment of Polydipsia Using a Contingency Management Procedure Incorporating a Self-Management Approach: A Single Case Study

1993 ◽  
Vol 21 (3) ◽  
pp. 275-279 ◽  
Author(s):  
John Turnbull
Keyword(s):  
Single Case ◽  
Contingency Management ◽  
Research Literature ◽  
Self Management ◽  
Pharmacological Intervention ◽  
Management Approach ◽  
Management Procedure ◽  
Management Techniques ◽  
One Year

Polydipsia is a disorder that has received little attention in the research literature. Treatment has been mainly confined to medical or pharmacological intervention. Few studies have reported the use of contingency management techniques and none have sought to encourage self-management. This study shows how such a procedure brought about a significant change in rates of water drinking in a thirty-one year old man with a mild learning disability.

Individualized Behavioural Treatment of Severe Stuttering

1991 ◽  
Vol 19 (4) ◽  
pp. 347-357 ◽  
Author(s):  
Willi Ecker ◽  
Victor Meyer
Keyword(s):  
Oral Reading ◽  
Reading Improvement ◽  
Behavioural Treatment ◽  
Communication Situations ◽  
Cognitive Techniques ◽  
One Year

This case study illustrates the reduction of severe stuttering by an individually tailored treatment programme. Interventions are derived from a tripartite analysis (Lang, 1971) and include EMG biofeedback, regulated breathing, exposure in vivo to stressful communication situations and cognitive techniques to reduce relapse risk. The role of dysfunctional response system interactions in stuttering is emphasized. Treatment resulted in a marked reduction of stuttering and associated facial contortions during videotaped conversations with strangers and oral reading. Improvement was maintained at one-year follow-up.

A Successful Adaptation of Systematic Desensitization in the Treatment of a Phobia of Babies

1985 ◽  
Vol 2 (1) ◽  
pp. 59-64
Author(s):  
Michael Free ◽  
Margaret Beekhuis
Keyword(s):  
Young Woman ◽  
Skin Conductance ◽  
Treatment Strategy ◽  
Physiological Measures ◽  
Systematic Desensitization ◽  
Physiological Measure ◽  
One Year

A case study is presented of a young woman with an unusual phobia, a fear of babies. Barabasz's (1977) technique of systematic desensitization using psycho-physiological measures was chosen as the main treatment strategy. Difficulties arose as the client was unable to visualise scenes involving babies. Nor could she look at photographs of babies long enough for the hierarchy to be ordered using a psycho-physiological measure (skin conductance). A set of photographs was eventually used for the hierarchy, but it was ordered in terms of the length of time the client could look at the various photographs. Systematic desensitization was carried out using the set of photographs instead of imaginary scenes, together with some in vivo exposure in the latter stages of treatment. At termination the client could approach babies without discomfort. Improvement was maintained at one year follow-up.

Evaluation of Coronavirus Anxiety in Pregnant Women on Apgar Score and Birth Weight After One Year of Coronavirus Outbreak (Case Study: Zabol, Iran)

2022 ◽  
Vol 7 (2) ◽  
pp. 89-98
Author(s):  
Fatemeh Mirzaie ◽  
Khadije Rezaie Keikhaie ◽  
Mahin Badakhsh ◽  
Bahareh Khajehpourbahareh ◽  
Samira Ghofrani ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Apgar Score ◽  
One Year ◽  
Outbreak Case

Multigenerational Patterns and Internal Structures in Families in which Grandparents Raise Grandchildren

1998 ◽  
Vol 79 (5) ◽  
pp. 477-489 ◽  
Author(s):  
Robin Goldberg-Glen ◽  
Roberta G. Sands ◽  
Ralph D. Cole ◽  
Carolyn Cristofalo
Keyword(s):  
Life Satisfaction ◽  
Service Providers ◽  
Well Being ◽  
Family Structures ◽  
Systems Perspective ◽  
Internal Structures ◽  
One Year ◽  
Interactional Processes

‘Skipped generation’ families, consisting of grandparents and grandchildren with parents absent from the home, are frequently served in social work agencies. These families have unique multigenerational patterns and family structures that are important for service providers to recognize. This paper uses a multigenerational systems perspective to highlight the diversity among grandparent-headed households. Twenty families who were previously part of a larger study of stress, well-being, and life satisfaction among caregiving grandparents constituted a follow-up case study involving videotaped family interviews one year after the first study. Three families representing the range of diversity among the twenty are described with accompanying genograms. Differences in structure, interactional processes, and links with prior generations are identified in each case. These examples reveal the strengths and vulnerabilities, as well as the diversity, of grandparent-headed families.

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