scholarly journals Topical Lignocaine with Diltiazem or Glyceryltrinitrate for Paediatric Acute Anal Fissure: A Randomized Clinical Trial

2020 ◽  
Vol 34 (4) ◽  
pp. 70-75
Author(s):  
Mukhtiar Ahmed ◽  
Jamil Akhter Munir Ahmad ◽  
Muhammad Ali Sheikh ◽  
Tariq Latif ◽  
Abdul Qayyum
Keyword(s):  
Glyceryl Trinitrate ◽  
Anal Fissure ◽  
Symptomatic Relief ◽  
Paediatric Population ◽  
Paediatric Surgery ◽  
Exact Etiology ◽  
Group A ◽  
Bleeding Per Rectum ◽  
Group B

Introduction: Anal fissure is a common problem in children, the exact etiology of which is unknown and it mostly presents with painful defecation and bleeding per rectum. The standard treatment of anal fissure is lateral internal sphincterotomy but due to risk of fecal incontinence chemical sphincterotomy is used as alternative to surgical sphincterotomy. Aims & Objectives: To compare the effectiveness of topical diltiazem and lignocaine with glyceryl trinitrate and lignocaine in relieving of symptoms and healing of acute anal fissure in children. Place and duration of study: This study was conducted in the Department of Paediatric Surgery, Shaikh Zayed Hospital, Lahore & Department of Paediatric Surgery, Fatima Memorial Hospital, Lahore from September 2017 to September 2018. Material & Methods: Total 228 children were enrolled in the study and randomly divided in group A and B, 114 children in each group. Group A received topical 2% diltiazem cream and 2% lignocaine gel, while group B received topical 0.2% glyceryl trinitrate and 2% lignocaine gel, applied locally, twice daily. Results: There were 78(68.4%) male children in group A and 66(57.9%) in group B. All patients completed 6 week treatment course. The symptoms and condition of the anal fissure were evaluated before start of treatment and at subsequent follow up periods. In group A 55 (48.2%) cases completely healed by second week, while in group B, 33 (28.9%) cases healed. The number of completely healed cases at 4 weeks follow up in group A and group B were 91 (79.8%) and 69(60.5%) respectively, while at week 6 follow up this rate was 95 (83.3%) and 73 (64.0%) respectively. Symptomatic relief in painful defecation observed in group A and group B was 74(64.9%) and 55(48.2%) at week 2, 95(83.3%) and 74(64.9%) at week 4 while 95(83.3%) and 77(67.5%) at week 6 in two groups respectively. Conclusion: Use of combination of topical diltiazem and lignocaine for the treatment of acute anal fissure in paediatric population is preferred over combination of glyceryl trinitrate and lignocaine.

Absorbable suture material in carotid surgery

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  
Keyword(s):  
Suture Material ◽  
Absorbable Suture ◽  
Paediatric Surgery ◽  
Carotid Surgery ◽  
Suture Materials ◽  
Absorbable Suture Material ◽  
Absorbable Sutures ◽  
Group A ◽  
Group B

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.

scholarly journals Prospective Randomized Study between Open Vs Closed Lateral Anal Internal Sphincterotomy in Patients with Chronic Fissure in Ano

2020 ◽  
Vol 3 (1) ◽  
pp. 167-171
Author(s):  
Anand Shanmugaiah ◽  
Saravanan Pandian
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Randomized Study ◽  
Fissure In Ano ◽  
Internal Sphincterotomy ◽  
Post Surgery ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: One of the the most common cause of pain during defecationin young patientsis chronic fissure in ano. Surgical treatment of choice for chronic fissure in ano is internal sphincterotomy. This procedure can be performed by open or closed method. The aim of the study was to compare the closed and open anal internal sphincterotomy in patients admitted in our hospital with chronic anal fissure. Subjects and Methods: 105 patients admitted in department of general surgery with chronic fissure in ano were divided into two groups. 50 patients (Group A) who were treated by closed method and 55 patients (Group B) who were managed by open lateralanal sphincterotomy method. A 3 months follow up done in both post-surgery to observe for pain, bleeding, infection, incontinence, and recurrence. Results: Significant difference was observed in postoperative acute complications between the two methods of internal anal sphincterotomy. Conclusion: Lateral anal sphincterotomy is the treatment of choice for chronic anal fissure, either open or closed method. However, the closed method was observed to have lesserpost operative complication compared to the open method.

scholarly journals DACRYOCYSTORHINOSTOMY

2008 ◽  
Vol 15 (01) ◽  
pp. 81-86
Author(s):  
MUHAMMAD NAWAZ ◽  
MUHAMMAD SULTAN ◽  
QAISAR HANIF ◽  
Muhammad Sadiq
Keyword(s):  
Symptomatic Relief ◽  
Cost Effective ◽  
Medical College ◽  
Chronic Dacryocystitis ◽  
Department Of Ophthalmology ◽  
Silicon Tube ◽  
Group A ◽  
Group B ◽  
Study Setting

Purpose: To compare the results of standard dacryocystorhinostomy with the results ofdacryocystorhinostomy done with silicon tube stentting of the lacrimal canaliculi. Study design: This is a hospitalbased, prospective, comparative and interventional study. Setting: Department of Ophthalmology, Allied HospitalPunjab Medical College Faisalabad. Period: January 2006 to December 2006. Methods: Twenty seven patients ofchronic dacryocystitis fulfilling the inclusion criteria were selected and divided in two groups. Group A consisted of 15patients who underwent standard dacryocystorhinostomy and Group B consisted of 12 patients who underwentdacryocystorhinostomy along with intubation of the lacrimal canaliculi with silastic tubes. All the patients were followedup for at least six months post-operatively. Success of the procedure, defined as the symptomatic relief of epiphoraand infection was assessed at the end of follow-up period. Results: Of the total 27 patients of chronic dacryocystitis23 (85%) were female and 4(15%) were male. The mean age of the patients was 45 years. The success of theprocedure was recorded in 14 (93.33%) patients in group-A and in 10 (83.33%) patients in group B. Quite a few andsimple complications were recorded during the study period. Conclusions: 1. Standard externaldacryocystorhinostomy is a simple and cost effective procedure forthe management of chronic dacryocystitis. 2. Silicontube stentting of the lacrimal canaliculi does not have any extra advantage in the management of chronic dacryocystitiswithout canalicular obstruction.

scholarly journals Comparative study of lateral Internal Sphincterotomy verses Topical Glyceryl Trinitrate for treatment of fissure-in-Ano

2016 ◽  
Vol 9 (4) ◽  
Author(s):  
Ajmal Farooq ◽  
Zahid Niaz
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Symptomatic Improvement ◽  
Lateral Internal Sphincterotomy ◽  
Fissure In Ano ◽  
Internal Sphincterotomy ◽  
Group A ◽  
Topical Glyceryl Trinitrate ◽  
Group B

This prospective randomized interventional study was carried in one of surgical unit of Lahore General Hospital Lahore from 1st January 2002 to 30, December 2002 a total number of 100 patients with both acute and chronic anal fissure were taken and randomly divided in two groups. Group A was treated with 0.2% GTN for 6 weeks and Group B was treated with lateral internal closed Sphincterotomy a follow up after 0, 2nd, 61h weeks and even after 6 months carried out. Peak incidence of disease was observed between 30 and 40 years of age with 56 males and 44 females. 24% patients were with acute fissure and 76% with chronic fissure. In this study with 0.2% GTN overall healing rate of 66.66% for acute fissure and 63.15% for chronic anal fissure was observed. GTN was found less effective in healing the fissure but some what good for initial symptomatic improvement in its comparison 100% healing was observed with lateral internal sphincterotomy with only 10% transient incontinence for flatus. So it was concluded that lateral internal sphincterotomy is superior to GTN and is the procedure of choice for fissure in ano.

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 Surgical management of anal fissure versus Glyceryl Trinitrate ointment: a comparative prospective study

2018 ◽  
Vol 5 (6) ◽  
pp. 2205
Author(s):  
Sandeep Reddy ◽  
Krishnaprasad . ◽  
Sreeramulu P. N. ◽  
Amal Abraham ◽  
Praveen G. P. ◽  
...  
Keyword(s):  
Prospective Study ◽  
Anal Fissure ◽  
Symptomatic Relief ◽  
High Rate ◽  
Lateral Internal Sphincterotomy ◽  
Nitroglycerin Ointment ◽  
Internal Sphincterotomy ◽  
Skin Tag ◽  
Group A ◽  
Group B

Background: Anal fissure is common condition in general population which cause severe pain at the anal region while defecation and associated with bleeding. These symptoms cause reduction in quality of life with considerable morbidity. The objective of this study was to compare the difference in outcome between open lateral anal sphincterotomy and application of topical 0.2% nitroglycerin ointment for the treatment of chronic anal fissure and their individual efficacy.Methods: 68 cases with a clinical diagnosis of anal fissure were recruited in the study. All selected patients met with inclusion criteria. Thus, selected cases were assigned to one of the other groups by odd and even method. Group A was managed conservatively using topical 0.2% nitroglycerin ointment, whereas Group B underwent open lateral anal sphincterotomy. Both groups were followed up at 3 week, 6 weeks, and 12 weeks, after the treatment.Results: Among all the 68 patients, all patients had come with complaint of pain whereas 31 patients had bleeding per rectum along with pain. On clinical examination, hypertonic anal sphincter elicited in 47 patients, sentinel skin tag was noted in the 23 patients. Group A included 34 patients treated with topical 0.2% nitroglycerin ointment and group B included 34 patients who underwent lateral internal sphincterotomy. In group A, 25 (73.5%) patients treated successfully, 9 (26.4%) patients were uncured who underwent lateral anal sphincterotomy, with no fresh complaints during follow up. By contrast, all patients in group B were successfully treated and only one (0.03%) patient came with unexplained discomfort and one patient suffered from flatus incontinency.Conclusions: This prospective study, demonstrates that open lateral internal sphincterotomy is superior to topical nitroglycerin application in the treatment of anal fissure with good symptomatic relief, high rate of healing with very low rate of early incontinence. Patients who are not willing to undergo surgery the glycerin trinitrate ointment can be used as medical line for fissure in ano.

scholarly journals Comparison of functional outcome and complications in Gartland’s Type III fracture Supracondylar Humerus in paediatric population by different pinning technique

2021 ◽  
Vol 7 (3) ◽  
pp. 51-56
Author(s):  
Dr. Sunil Kumar Kirar ◽  
◽  
Dr. Sanjay Upadhyay ◽  
Dr. Sanat Singh ◽  
Dr. Atul Varshney ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Paediatric Population ◽  
Type Iii ◽  
Satisfactory Outcome ◽  
Significant Difference ◽  
Group A ◽  
The Cross ◽  
Ulnar Nerve Injury ◽  
Group B

Background: Fracture Supracondylar humerus is one among common fracture in children betweenage 5-7 years. Boys are frequently affected than girls. Extension variety is more common. Theconventional approach to treat fracture supracondylar humerus (Type III) is a close reduction withpercutaneous fixation. There have been controversies as to which surgical technique should be used,cross pinning or two-wire lateral pinning. This study aims to find which method of pinning is mostappropriate to fix fracture supracondylar humerus. Method and material: A Retrospectivecomparative study was designed to analyze the outcome of the cross pinning and lateral pinningmethod. A total of 60 patients were included in the study. They were divided into two groups of 30each. Group A comprised of fixation by cross pinning method. Group B comprised of fixation by two-wire lateral pinning method. Results of both groups were analysed about Flynn’s criteria andcomplications. Result: The mean age in Group A was 5.1 years and in Group B was 4.8 years. Onepatient was lost to follow up in Group A. On the final follow up, there was statistically no differencein terms of outcome according to Flynn’s criteria in both groups. According to Flynn’s criteria>95%of patients had a satisfactory outcome in both groups. Among Group A, there were 2 cases ofiatrogenic ulnar nerve praxis whereas in group B there was one case of pin loosening. Conclusion:On comparing both techniques there was no significant difference in the outcome. However, there isa slight increase in the chances of iatrogenic ulnar nerve injury in the cross pinning method.

scholarly journals Platelet-Rich Plasma versus Corticosteroid Intra-Articular Injections for the Treatment of Trapeziometacarpal Arthritis: A Prospective Randomized Controlled Clinical Trial

Cartilage ◽  
2018 ◽  
Vol 12 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Michael-Alexander Malahias ◽  
Leonidas Roumeliotis ◽  
Vasileios S. Nikolaou ◽  
Efstathios Chronopoulos ◽  
Ioannis Sourlas ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Platelet Rich Plasma ◽  
Symptomatic Relief ◽  
Controlled Clinical Trial ◽  
Dash Score ◽  
Ultrasound Guided ◽  
Radiographic Osteoarthritis ◽  
Group A ◽  
Group B

Various systematic reviews have recently shown that intra-articular platelet-rich plasma (IA-PRP) can lead to symptomatic relief of knee osteoarthritis for up to 12 months. There exist limited data on its use in small joints, such as the trapeziometacarpal joint (TMJ) or carpometacarpal joint (CMCJ) of the thumb. A prospective, randomized, blind, controlled, clinical trial of 33 patients with clinical and radiographic osteoarthritis of the TMJ (grades: I-III according to the Eaton and Littler classification) was conducted. Group A patients (16 patients) received 2 ultrasound-guided IA-PRP injections, while group B patients (17 patients) received 2 ultrasound-guided intra-articular methylprednisolone and lidocaine injections at a 2-week interval. Patients were evaluated prior to and at 3 and 12 months after the second injection using the visual analogue scale (VAS) 100/100, shortened Disabilities of the Arm, Shoulder, and Hand Questionnaire (Q-DASH), and patient’s subjective satisfaction. No significant differences between the baseline clinical and demographic characteristics of the 2 groups were identified. After 12 months’ follow-up, the IA-PRP treatment has yielded significantly better results in comparison with the corticosteroids, in terms of VAS score ( P = 0.015), Q-DASH score ( P = 0.025), and patients’ satisfaction ( P = 0.002). Corticosteroids offer short-term relief of symptoms, but IA-PRP might achieve a lasting effect of up to 12 months in the treatment of early to moderate symptomatic TMJ arthritis.

scholarly journals A COMPARATIVE STUDY ON EFFICACY OF COLLAGEN PEPTIDE ACECLOFENAC AND PARACETAMOL VERSUS ACECLOFENAC AND PARACETAMOL ALONE FOR THE TREATMENT OF KNEE OSTEOARTHRITIS.

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Mareena Raju ◽  
Blessy K Johnson ◽  
Ambarish Sharma ◽  
Bharathi D R
Keyword(s):  
Visual Analogue Scale ◽  
Knee Osteoarthritis ◽  
Analogue Scale ◽  
Symptomatic Relief ◽  
Keywords Knee ◽  
Knee Oa ◽  
Collagen Peptide ◽  
Group A ◽  
Group B

Background: The existing treatment for Osteoarthrits (OA)  is symptomatic by NSAIDS are effective for reducing pain associated with OA, they do not reverse the disease. This makes way for the emergence of nutraceuticals like collagen peptide which are chondroprotective in nature. Objectives: To assess the prevalence of knee OA, efficacy of combination of collagen peptide, aceclofenac and paracetamol against aceclofenac and paracetamol alone in the treatment of osteoarthritis, the medication adherence and drug related problems in OA. Methods: A prospective observational study was carried out in the outpatients of Department of Orthopaedics, BMCH & RC and Ambarish’s Clinic, Chitradurga. A total of 154 patients suffering from OA were identified. 60 subjects of Grade I knee OA were selected for the study from 112 cases of knee OA. The subjects were divided in two groups; Group A comprised of 30 subjects who were treated with collagen peptide, aceclofenac and paracetamol (Acetaminophen) for a period of two months, with a follow up of one month and the therapy was assessed by Visual Analogue Scale(VAS). Whereas Group B of 30 subjects who were treated with aceclofenac and paracetamol for  two months with a follow up of one month and assessed by VAS. Results:  The prevalence of knee osteoarthritis was found to be 72.72%.Among them Grade I was 77.67%. From this 60 patients were selected for further study of which 90% were females and 10% males. At the end Group A showed better results than Group B. Acetaminophen and Aceclofenac related gastrointestinal disturbances were found in both the groups. Majority of the patients also had good medication adherences. Conclusion: The study identifies and supports the use of collagen peptide to provide symptomatic relief and can be used as adjunct therapy for OA management. Keywords: Knee osteoarthritis, nutraceuticals, collagen peptide, Visual Analogue Scale.

scholarly journals A comparative study for management of fissure in ano with glycerin-trinitrate and lignocaine ointment: a randomized control trial

2018 ◽  
Vol 6 (8) ◽  
pp. 2644
Author(s):  
Kamlesh J. Galani ◽  
Ashwinkumar S. Gadhvi ◽  
Nidhi D. Shah
Keyword(s):  
Anal Fissure ◽  
Symptomatic Relief ◽  
Complete Healing ◽  
Fissure In Ano ◽  
Group A ◽  
Glycerin Trinitrate ◽  
Clinically Significant ◽  
Group B ◽  
The Cost ◽  
Pain Improvement

Background: Anal fissure is a very common benign anorectal disorder with significant morbidity among otherwise healthy individuals. Of all the patients coming to our OPD 15-20% have anal fissure. So there arises need to study the best and most compliant conservative treatment modality.Methods: Study was randomized, prospective, observational and longitudinal including 200 patients of age group 18-60 equally divided in 2 groups. Group A given 0.2% GTN ointment and group B given lignocaine ointment.Results: Better and early and sustained symptomatic relief was noted with GTN compared to lignocaine. 80% cases showed complete healing by 8 weeks with GTN compared to 52% healing with lignocaine. Headache was main side effect with GTN. Recurrence rate was high with lignocaine.Conclusions: Topical GTN has a statistically and clinically significant success rate for fissure healing and pain improvement at 8 weeks compared to lignocaine ointment (80% vs. 52%). It came at the cost of clinically acceptable level of morbidity (headache).

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