scholarly journals OUTCOME OF SALINE WOUND LAVAGE PRIOR TO WOUND CLOSURE IN GYNAECOLOGICAL AND OBSTETRICAL PATIENTS

2021 ◽  
Vol 71 (6) ◽  
pp. 2070-74
Author(s):  
Uzma Saleem ◽  
Tayyaba Waseem ◽  
Malik Waseem Babar

Objective: To determine the effectiveness of saline wound lavage in reducing wound infections in patients undergoing gynaecological and obstetrical abdominal surgical procedures. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Pakistan Navy Ship Shifa Hospital, Karachi Pakistan, from Oct 2018 to Sep 2019. Methodology: All the patients undergoing gynaecological or obstetrical surgical procedures were enrolled after informed consent. Participants underwent elective or emergency surgery. In Group A with 551 patients, saline wound Lavage was done before closure, whereas in 533 patients in group B saline wound irrigation was not done. Similar post-operative care was provided to both groups. All patients were observed for febrile illness and wound discharge on 2nd, 8th, 15th and 30th postoperative day. Results: Out of 1084 patients, there were 551 (50.7%) in saline wound irrigation group A, while 533 (49.3%) were in group B where no saline wound irrigation was done. The frequency of febrile illness was observed in 49 (3.8%) patients. Febrile illness was significantly higher in patients without saline wound irrigation as compared to patients with saline wound irrigation (pvalue 0.002). The frequency of wound discharge was observed in 28 (22.2%) patients. Wound discharge was significantly higher in patients without saline wound irrigation as compared to patients with saline wound irrigation (p-value=0.018). Conclusion: Saline wound irrigation prior to wound closure in obstetrical and gynaecological abdominal procedures can lead to a significant reduction in surgical site infection.

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S612-16
Author(s):  
Maryam Khan ◽  
Kamran Ashfaq Ahmed Butt ◽  
Naeem Riaz ◽  
Zaheer Ul Hassan ◽  
Attique Ahmed ◽  
...  

Objective: To compare the efficacy of steroid antibiotic wick with Ichthammol Glycerol wick in the management of Acute Otitis Externa in terms of tenderness and clearance of discharge/debris. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Out Patient department of Combined Military Hospital Peshawar and Hayatabad Medical Complex Peshawar, from May to Nov 2018. Methodology: A total of 250 patients were included and divided into two groups of 125 each. After necessary suction clearance topical Ciprofloxacin/Dexamethasone (Cipotec-D) wick was placed in auditory canal of group A patients and topical Glycerol/Ichthammol wick was placed in group B. Follow up visits were done on 3rd and 7th day of starting the treatment. Results: Group A patients responded better in terms of tenderness (88%) however both groups had similar response in terms of discharge reduction (7.2% vs 6.4%). In terms of efficacy neither of the treatment proved more efficacious compared to the other (p-value 0.058). Conclusion: While steroid antibiotic wick is significantly more efficient in terms reducing tenderness, in terms of overall efficacy and discharge reduction Ichthammol/glycerol is equally effective.


2019 ◽  
Vol 2 (2) ◽  
pp. 47-51
Author(s):  
Sania Waseem ◽  
Humera Naz Altaf ◽  
Sehrish Latif ◽  
Omar Shahzad Altaf ◽  
Fareeha Farooqui ◽  
...  

Laparoscopic cholecystectomy is now gold standard and depends on good exposure of the peritoneal cavity. It is achieved by insufflation of the abdominal cavity with CO2. Operating at lower intraabdominal pressure (<12 -15mmHg) has been associated with fewer pulmonary and hemodynamic complications and lesser postoperative pain. Objective: To ascertain the advantages of low pressure pneumoperitoneum over standard pressure pneumoperitoneum Methods: Our study was quasi experimental study conducted at  KRL Hospital, Islamabad over period of 3years from 2013 to 2016. SPSS version 20 was used to calculate p value.  Results: A total of 456 patients of gallstones were equally divided in two groups assigned to undergo low pressure (7-8mm of Hg) pneumoperitoneum or standard pressure (12-14mm of Hg) pneumoperitoneum laparoscopic cholecystectomy The average age of patients was 46.2+/-13.6yrs in group A compared to 43.5 +/- 12.9 in group B. There were 60 (26.3%) male and 168 (73.7%) female patients in group A compared to 53 (23.2% and 175 (76.85) in group B respectively. It was found that group A 14 (6.1%) had no pain, 26 (11.4%) had VAS between 1 – 7 and 188 (82.5%) had VAS of 8 – 10 where as in group B 164 (72.6%) patients reported no shoulder tip pain postoperatively, 42 (18.6%) had VAS of 1 – 7 and 20 (8.8%) had VAS OF 8 – 10. The difference was statistically significant (p-value = <0.001). Conclusions: reduced pressure of pneumoperitoneum to 7 – 8 mm of Hg produce lower incidence of postoperative shoulder tip pain.


2021 ◽  
Vol 15 (10) ◽  
pp. 3406-3409
Author(s):  
Sarah Riaz ◽  
Najia Ahmed ◽  
Ayesha Anwar ◽  
Moizza Tahir ◽  
Farrah Yousaf ◽  
...  

Objective: comparison of efficacy of topical 4% hydroquinone monotherapy with combination of oral tranexamic acid and topical 4% hydroquinone in the treatment of epidermal melasma Study design: Quasi experimental study Study period and place: Dermatology OPD, Pak Emirates Military Hospital Rawalpindi from July 2018 to January 2019. Methodology: Total 80 patients presenting with epidermal melasma were selected from outdoor patient department after applying the inclusion criteria and consent was taken from selected patients. Study was started after getting permission from hospital ethical review board. Two treatment groups were made after dividing patients by using alternate method. Treatment with topical 4% hydroquinone alone was started for group A patients and combination of capsule tranexamic acid (250 mg two times a day) along with topical 4% hydroquinone were started for group B patients for the next 6 months. Evaluation of patients through detailed history, clinical and wood’s light examination before starting therapy and after of 24 weeks of treatment was done for both groups. Efficacy of treatment was assessed via Modified MASI score. Results: Hydroquinone monotherapy was effective in 21 (52.5%) patients among group A while in group B patients, combination treatment i.e. oral tranexamic acid and topical hydroquinone, was effective in 31 (77.5%) patients (p value= 0.01). Conclusion: Effectiveness of Hydroquinone 4% topical therapy combined with oral tranexamic acid for epidermal melasma is better than topical 4% hydroquinone alone. Key words: Epidermal melasma, oral tranexamic acid, topical 4% hydroquinone.


2021 ◽  
Vol 71 (3) ◽  
pp. 976-79
Author(s):  
Qamar Zia ◽  
Nighat Arif ◽  
Tahira Sadiq

Objective: To determine the effect of paired formative assessment on students’ learning. Study Design: Quasi experimental study. Place and Duration of Study: Islamic International Medical College Rawalpindi, from Jan 2018 to Jun 2018. Methodology: A total of 160 students who attended otolaryngology module were included in the study. Randomized allocation was done by computerized software programme and students were divided into 2 groups i.e. experimental (group A) and control group (group B). Later on in group A, pairing of students was done by lottery method. Group A and B were dealt with paired and individual formative assessment respectively. Effectiveness of both methods of learning was calculated on the basis of academic scores obtained in tests consisting of 20 MCQs from predefined and taught syllabus. A p-value were obtained by applying independent sample t-test and considered statistically significant at 0.05. Results: Out of 160 participants, 94 (58.7%) were females and 66 (41.3%) were males. In individual testing phase mean scores of group A was 13.36 ± 2.22 and mean scores of group B was 13.24 ± 2.5 (p 0.861). In paired formative assessment phase, mean scores of group A was 16.70 ± 1.94 (CI 95% 2.16-4.55) and mean of scores of group B was 13.40 ± 2.23 (CI 95% 2.16-4.55) p=0.001. Conclusion: The effectiveness of paired formative assessment. This method provides students a conducive environment to achieve learning objectives.


Author(s):  
Parama Sengupta ◽  
Tania Sur

Introduction: Instant Messaging Applications (IMAs) like Whatsapp has changed our lives including medical education in many ways. Aim: To explore and compare the effectiveness and acceptability of Whatsapp as a Teaching Learning (TL) tool for Small Group Learning (SGL) sessions when compared with traditional classroom based learning SGL sessions, for a specific topic (pharmacokinetics) in Pharmacology in Problem Based Learning (PBL) sessions. Materials and Methods: This quasi-experimental study was conducted in a tertiary care government medical college in Eastern India on second phase Bachelors of Medicine and Bachelor of Surgery (MBBS) students in the year 2021 over a period of five weeks (from March to April 2021). After Didactic Lecture (DL) on the topic, the willing students were randomly divided into two groups, group A (n=46) and group B (n=45). Then group A and group B students attended classroom based and Whatsapp based SGL sessions, respectively, for a period of five consecutive days on "Pharmacokinetics" using PBL method. Students appeared for a Multiple Choice Question (MCQ) based examination (predecided and prevalidated) of 30 marks before and after the SGL sessions. Next, group A students attended Whatsapp based PBL session on the same topic in the same manner as group B and vice-versa. Finally the students filled in a feedback form using a 5-point Likert scale. Results: The post-test scores for both the groups were significantly better compared to the pretest scores; however, there were no significant differences in the post-test scores of both the groups. Regarding students’ feedback on the type of SGL, except for enjoyment (p-value=0.0345) and interactiveness (p-value=0.022), there were no significant differences between the two group scores. The students significantly preferred combination of both types of SGL to either of them (p-value=0.001). Conclusion: In this study, Whatsapp based SGL showed comparable effectiveness as classroom based SGL as measured in terms of MCQ based examination scores. Except for interactiveness and interest, classroom based SGL was equally acceptable to the students as Whatsapp based SGL. Interestingly, the students preferred a combination of both the type of SGL to either of them on the particular topic of Pharmacology.


2018 ◽  
Vol 21 (04) ◽  
pp. 704-716
Author(s):  
Aqdas Saqib ◽  
Saqib Ismail ◽  
Saadia Yasir

Objective: The objective of this study is to compare the effects of inhaledbeclomethasone with oral montelukast in long term management of moderate persistent asthmain children. Design: Quasi experimental study. Period: 6 months, from July 20,2007 to January20, 2008. Settings: Out patient paediatric department at Fauji Foundation hospital, Rawalpindi.Material and Methods: 8o children between 5-12yrs of age presenting with moderate persistentasthma, divided in two groups of 40 each. Group A treated with beclomethasone inhaler whileGroup B was started on oral montelukast. Drugs effect was recorded on a 2 wkly proforma for 8weeks. Results: There were 54(67.5%) male and 26(33%) female. Most common triggeringfactor seen in 54(67.5%) patients was recent history of respiratory tract infection, exposure tocarpet dust in 43(53.75%), cigarette smoke in 42(52.5%),recent psychological stress in 28(35%) ,pollen allergy in 26 (32.5%) , pets exposure in 8 (10%) and to mite was noticed in 5(6.25%)children. Marked improvement was observed in day time cough in group A with 10(25%) patientsbeing free of cough with inhaler, while 20(50%) showed mild intermittent symptoms. 1(2.5%)showed mild persistent symptoms. In Group B 3(7.5%) patients were symptom free,23(57.5%)with mild intermittent and 4(10%) with mild persistant symptoms while 6(15%)continued to have moderate persistent symptoms. P value was 0.01. Regarding day timebreathlessness, P value was significant of 0.258. Similarly marked improvement was observed innight symptoms of breathlessness, cough and sleeplessness in both groups. P value was lessthan 0.05 in majority of the variables showing statistically significant improvement with inhaledbeclomethasone than with oral montelukast. Conclusions: Inhaled beclom


2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Erum Shahid ◽  
Uzma Fasih ◽  
Arshad Shaikh

Purpose:  To compare between 10/0 nylon monofilament and 8/0 virgin silk for conventional trabeculectomy in terms of rate of complications and bleb morphology. Study Design:  Quasi experimental study. Place and Duration of Study:  Abbasi Shaheed Hospital, Karachi, from January 2017 to December 2018. Methods:  Thirty six patients who underwent conventional trabeculectomy with 6 months follow-up were included. Trabeculectomy for congenital, neovascular, traumatic glaucoma, revised surgery and laser trabeculoplasty were excluded. In group A, scleral flap and conjunctiva were closed with 8/0 virgin silk and in group B, 10/0 nylon monofilament was used. Main outcome measure was complications. Results:  Group A had 13 (36%) and group B had 23 (63.9%) patients. Mean age was 55.5 ± 10.69. Pre-operative Intraocular pressure (IOP) was 33.4 ± 6.3 and 33.5 ± 12 mm Hg in group A & B respectively. Postoperatively at 3rd month IOP was 16.8 in group A and 15.0 in group B (p = 0.24).Shallow Anterior chamber was in 53% (n = 7) patients with 8/0 silk and 13% (n = 3) patients with 10/0 nylon with p value of < 0.05. Seidel test was positive in 38% (n = 5) patients in group A (p < 0.01). Re-suturing was done in 38% (n = 5) patients in group A with a p-value (p < 0.01). Conclusion:  Shallow anterior chamber, wound leak with positive seidel test and additional intervention for re-suturing were more common in group A than group B. Diffuse blebs were frequently seen with both suture materials. Suture material does not affect final intra ocular pressure and success of trabeculectomy. Key Words:  Bleb, Trabeculectomy, 10/0 Nylon, 8/0 silk.


2021 ◽  
Vol 17 (3) ◽  
pp. 222-226
Author(s):  
Anum Malik ◽  
Arshad Shahani ◽  
Jawad Zahir ◽  
Hassam Zulfiqar ◽  
Tabassum Aziz

Objective: To compare the efficacy of dexamethasone 8mg versus ondansetron 4mg in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy Methodology: This quasi-experimental study was conducted at the Department of Anaesthesia and Intensive Care, Holy Family Hospital from 29th July 2018 to 28th January 2019.  Anesthesia was induced with propofol (2mg/kg IV) and Atracurium (0.5 mg/kg IV) was given to facilitate tracheal intubation. Nalbuphine (0.2mg/kg) was used as analgesic.Patients were randomly divided into two groups. Patients in Group A received 4mg ondansetron at end of surgery and Group B received 8mg dexamethasone at induction. Results: A total of 90 patients were included according to the inclusion criteria of the study. The mean age (years) in the study was 37.11+10.60 years. Frequency and percentage of nausea (up to 24 hours) among both the groups was 28 (62.2) and 28 (62.2) respectively (p-value = 1.0) while the frequency and percentage of vomiting (within 24 hours after extubation) was 28 (62.2) and 27 (60.0) respectively (p-value = 0.829) Conclusion: The study concluded that there was no significant difference dexamethasone and ondansetron in preventing postoperative nausea and vomiting.


2015 ◽  
Vol 22 (2) ◽  
pp. 156-162
Author(s):  
Uttam Karmaker ◽  
SM Mahbub Alam ◽  
Md Shafiqul Alam Chowdhury ◽  
Mohammed Mizanur Rahman ◽  
Md Nazmul Islam ◽  
...  

Background: The ideal method of varicocele treatment is a controversial issue. The present study was designed to compare the outcome of laparoscopic palomo and open inguinal varicocelectomy. Methods: The present quasi experimental study was conducted in the Department of Urology, Dhaka Medical College Hospital, Dhaka, between July 2010 and June 2012 to compare the outcome of open inguinal and laparoscopic Palomo approach of varicocelectomy. Purposively selected 50 patients were divided into equal two groups, Group A and Group B treated with open inguinal varicocelectomy and laparoscopic Palomo varicocelectomy respectively. Statistical analyses were done by using SPSS and p value <0.05 was considered as significant. Results: In the present study, mean age of the patients of Group A and Group B were 29.1 ± 2.0 and 28.9±1.5 years respectively. Among the patients of Group A developed neither hydroeele nor testicular atrophy, where as in patients of Group B 20% and 12% developed hydrocele and testicular atrophy respectively. The recurrence rate of varicocele was lower in the Group A than that in the Group B. The findings of semen analysis at 1st and 2nd follow up visits show that there was negligible improvement in semen quality in terms of sperm count, motility and morphology. Conclusion: Open inguinal varicocelectomy is better than laparoscopic palomo varicocelectomy. Although sooner return to work is achieved by laparoscopic varicocelectomy, complications are more frequent than the open inguinal method. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21527 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 156-162


2012 ◽  
Vol 19 (02) ◽  
pp. 193-196
Author(s):  
MUZAFFAR MEHMOOD KHAN ◽  
Muhammad TAHIR ◽  
Mohsin RAZA ◽  
Muhammad Ali BHATTI ◽  
Muhammad Riaz Khokar

Objective: The objective of this study was to determine association of Interferon-Ribavarin therapy with hearing loss in patientssuffering from Hepatitis ‘C’. Study Design: Quasi-experimental study. Place and Duration: Otolaryngology Department Combined MilitaryHospital Rawalpindi from 09 June 2006 to 08 June 2007. Patients and Methods: Consenting sixty patients of Hepatitis C divided into two equalgroups of 30 each, (group A receiving Interferon-Ribavarin therapy and group B, not receiving it) during the study period fitting the inclusioncriteria were selected. Pure Tone Audiometery including both air and bone conduction performed as base line data at commencement oftherapy and then at the end of therapy (after six months) . Patients were sampled by Convenience (non-probability) technique. Results: Thenumber of patients who were found to have defined hearing loss was 06 (20%) in Group A (n=30) and 05(16.67%) in Group B (n=30). Chi Squaretest was applied which showed a p-value of 0.739 which is highly insignificant. Conclusions: Interferon-Ribavarin Therapy does not have asignificant association with hearing loss in patients of Hepatitis ‘C’.


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