Outcome Of Manual Vacuum Aspiration Vs Surgical Evacuation

2019 ◽  
Vol 09 (04) ◽  
pp. 303-307
Author(s):  
Fozia Akmal ◽  
Sadia Suboohi ◽  
Saba Pario ◽  
Sugra Abbasi ◽  
Shahanaz Hassan Siddiqui
Keyword(s):  
Patient Satisfaction ◽  
Operating Time ◽  
P Value ◽  
Uterine Perforation ◽  
Excessive Bleeding ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration ◽  
Surgical Evacuation ◽  
Group A ◽  
Group B

Objective: To compare the safety, efficacy and complications of manual vacuum aspiration (MVA ) versus surgical evacuation in low resource set up. Study Design and Setting: This crossectional study conducted at Department of Obstetrics & Gynaecology at Kulsoom Bai Valika Social Security SITE Hospital Karachi from January to June 2017. Methodology: A total of one hundred patients with less than 12 weeks of gestation and diagnosis of missed miscarriage, incomplete miscarriage, blighted ovum or with retained products of conception (RPOCs) were recruited and randomly allocated to MVA without anesthesia (Group A) and surgical evacuation under general Anesthesia in Operation theatre (Group B).Both groups were compared in terms of demographic and obstetric data, clinical course (need of anaesthesia, operating time, approximate blood loss and stay in hospital) ,complications(excessive bleeding, uterine perforation, need for re-evacuation/ failed procedure, sepsis and maternal death ) and patient satisfaction. Results: Mean age of patients was 28.68 in Group A and 26.90 in Group B ( P value-0.136). Average gestational age in weeks at which procedure was performed in Group A found to be 8.32 and 9.546 for Group B ( P value-0.007 ). Parity was comparable in both groups (P value-0.746). Most of the patients were literate. Mean operating time and amount of blood loss comparison among groups had no statistical difference. Average hospital stay was significantly short in MVA Group ( P value-0.001). No maternal death or uterine perforation observed in both the groups,6% and 8% of patients had excessive bleeding in Group A & Group B respectively, one patient underwent re-evacuation in MVA group and one had sepsis after surgical evacuation. Post procedure satisfaction was comparable in both the groups. Conclusion: Manual Vacuum Aspiration is comparable to surgical evacuation in terms of safety, efficacy, complications, patient satisfaction and superior in shorter hospital stay, no need of anesthesia and access to operation theater

scholarly journals A comparison of manual vacuum aspiration with medical method of abortion in termination of pregnancy up to 9 weeks of gestational age

2017 ◽  
Vol 6 (9) ◽  
pp. 3813
Author(s):  
Pramod Garhwal ◽  
Lata Rajoria ◽  
Manju Sharma
Keyword(s):  
Success Rate ◽  
Gestational Age ◽  
Vaginal Bleeding ◽  
Termination Of Pregnancy ◽  
P Value ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration ◽  
Surgical Evacuation ◽  
Group A ◽  
Group B

Background: Objective of present study was to compare efficacy and complications of medical method versus manual vacuum aspiration in early pregnancy termination and to determine whether medical method of termination of pregnancy represent a reasonable alternative to surgical method (MVA) in terms of complete evacuation of products of conception and their side effects.Methods: A comparative study was carried out on 184 pregnancies in women who were willing for termination of pregnancy up to 9 weeks (63 days) of gestational age, in Group A: women who opted for medical method for termination, Group B: women who opted for manual vacuum aspiration for termination.Results: Mean age of Group A was 27.63±3.60 years and Group B was 26.87±3.83 years. Majority 169 (92%) of women were Hindu. 165 (90%) of the patients lived in urban area and 176 (96%) were married women. Majority 130 (71%) of them were para 2 and more. Average age of gestation at which termination was performed was 46.79±6.29 days in Group A and 49.13±6.67 days in Group B. Average duration of vaginal bleeding among Group A was found to be 8.9±3.5 days (p value<0.05) and in Group B was 6.837+2.928 days which was significantly longer in Group A. 72 (78.3%) patients considered vaginal bleeding to be heavier than their normal period in Group A where as in Group B 8 (8.7%)perceived it to be heavier (p value <0.001). Incidence of pain, nausea, vomiting, diarrhea and incomplete abortion (78.26%, 32.60%, 16.3%, 19.56% and 4.43%) in group A and (52%, 7.6% ,4.3%, nil and 2.17%) in group B which were found to be higher in Group A as compare to Group B. Patient satisfaction was 95.65% in medical method and 84.78% in MVA group. Success rate was 95.65% for medical and 97.82% for MVA group.Conclusions: Duration and amount of bleeding per vaginum is more in medical method as compare to surgical method. Side effects like pain, nausea, vomiting and diarrhea were more in medical group, but majority of these symptoms were self-limiting. There was high satisfaction rate (95.65%) among medical abortion group because less surgical and anaesthetic complication, offer them more privacy and treatment is taken at home. The effectiveness of medical method of abortion in present study was 95.65% and success rate in MVA was 97.82%. Medical method of abortion for first trimester termination of pregnancy upto 9 weeks of gestation can be better alternative method to surgical evacuation. Medical method of abortion proves to be more effective, safe and economical method that avoid complication associated with surgical evacuation like uterine perforation, cervical laceration and anaesthtic complication. The only disadvantage with medical method of abortion is lack of predictability and variable success rate.

Incomplete miscarriage during the first trimester: a comparison of indoor versus outdoor procedure

2020 ◽  
Vol 24 (3) ◽  
pp. 235-239
Author(s):  
Faiza Iqbal ◽  
Sadia Azmat ◽  
Rabia Jamshaid ◽  
Zunaira Arshad ◽  
Anum Saqib
Keyword(s):  
Controlled Trial ◽  
First Trimester ◽  
P Value ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration ◽  
Group A ◽  
First Trimester Of Pregnancy ◽  
The Mean ◽  
Group B ◽  
Incomplete Miscarriage

Introduction: Miscarriage is defined as the natural death of a fetus inside the uterus. To remove complete conception material after a miscarriage, vacuum aspiration or dilatation & curettage are methods to remove uterine contents. Controversies exist regarding both procedures. So we conducted this study to confirm the more successful method. Objective: To compare the effectiveness of manual vacuum aspiration versus traditional evacuation and curettage (E & C) among females presenting with incomplete miscarriage during the first trimester of pregnancy Materials and Methods: This randomized controlled trial was done at the Department of Obstetrics & Gynecology, Shalamar Hospital, Lahore for 6 months. Then the selected females were divided randomly into 2 equal groups. In group A, females had manual vacuum procedure while in group B, females had evacuation & curettage under general anesthesia. After 12 hours of the procedure, ultrasonography was done to confirm complete evacuation. Results: The mean age of the patients was 29.87 ± 6.71 years, the mean gestational age was 8.06 ± 2.82 weeks. The effectiveness was noted in 248 (91.85%) patients. Statistically, manual vacuum showed significantly more effective as compared to evacuation & curettage procedure in the management of incomplete miscarriage i.e. p-value = 0.008. Conclusion: It has been proved that manual vacuum aspiration is more effective than traditional evacuation & curettage in the management of incomplete miscarriage.

scholarly journals Manual Vacuum Aspiration (M.V.A) Versus Conventional Evacuation and Curettage in Early Pregnancy Loss

2021 ◽  
Vol 15 (8) ◽  
pp. 2213-2215
Author(s):  
Uzma Shaheen ◽  
Sumaira Yasmin ◽  
Nazia Liaqat ◽  
Sonia Rafique
Keyword(s):  
Early Pregnancy ◽  
Gestational Age ◽  
Pregnancy Loss ◽  
Cervical Ripening ◽  
Early Pregnancy Loss ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration ◽  
Group A ◽  
Randomized Control ◽  
Group B

Objective: The aim of this study is to compare the efficacy of manual vacuum aspiration and conventional evacuation and curettage in early pregnancy loss Study Design: Randomized control trial Place and Duration: Study was conducted at department of obstetrics and gynecology Lady Reading Hospital Peshawar from 1st January 2019 to 31st August 2020. Methods Patients were early pregnancy loss (12 weeks or lesser gestational age) were enrolled. Patients were divided into two groups by lottery method. Group A were the patients who had conventional evacuation and curettage treatment. Group B were patient in which MVA was used. Patients’ demographics were recorded after taking written consent. Gestational age was calculated from first day of last menstrual cycle and by ultrasound. Cervical ripening was done by (misoprostol 400mcg) two hours before procedure. Procedure was carried out under aseptic measures. Complete uterine evacuation by either procedure was assessed by ultrasound after procedure and complications were noted. Data was analyzed by SPSS 24.0. Results: mean age in Group A was 29 years with SD ± 8.65 while mean age in Group B mean age was 30 years with SD ±7.62. Group B (Manual Vacuum Aspiration) was effective in 96% patients while Group A(Conventional Evacuation and Curettage) was effective in 89% patients. Complications were fewer in MVA as compared to conventional evacuation and curettage Keywords: MVA, Evacuation and curettage , Early pregnancy loss.

scholarly journals Comparison of open versus laparoscopic appendectomy in terms of post operative pain and operative duration.

2019 ◽  
Vol 26 (10) ◽  
pp. 1706-1711
Author(s):  
Saddaqat Hayat ◽  
Osman Riaz ◽  
Muhammad Usman ◽  
Muhammad Faisal Bilal Lodhi ◽  
Asrar Ahmad Khan
Keyword(s):  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Open Appendectomy ◽  
P Value ◽  
Operative Duration ◽  
Post Operative Pain ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Open Versus

Objectives: To measure the results of open appendectomy and laparoscopic appendectomy regarding mean postoperative pain and mean operative duration in the treatment of acute appendicitis. Study Design: Randomized clinical trial. Setting: Surgical unit Allied hospital Faisalabad. Period: June 2016 to December 2016. Material and Methods: 70 patients with appendicitis were included in the study through non-probability consecutive sampling. Patients with history of long standing pain, intake of analgesics (>3 times per week for >3 months) before surgery and patients in whom laparoscopic surgery was contraindicated were excluded. Patients were randomized in group A and group B. Open appendectomy was done in group A and laparoscopic appendectomy was carried in group B. Outcomes in terms of post-operative pain at visual analogue scale and operating time in minutes was measured. Results: Mean age was 28.50 years with standard deviation of 12.283. There were 32 (45.71%) patients were male and 38 (54.29%) patients were females. Post-Operative pain was 7.34±2.014 in group A and 3±1.94 in group B with p-value=0.0001. Operative time in group A was 42.33±4.25 minutes and group B had time of 34.48±3.5 minutes with p-value=0.0001. Conclusion: Laparoscopic appendectomy is superior to open appendectomy considering pain after surgery and time of surgery in patients with appendicitis.

scholarly journals Addition of Braun enteroenterostomy to standard reconstruction in pancreaticoduodenectomy: impact on early outcomes

2017 ◽  
Vol 4 (10) ◽  
pp. 3414
Author(s):  
Venkatarami Reddy Vutukuru ◽  
Sivaramakrishna Gavini ◽  
Chandramaliteeswaran Chandrakasan ◽  
Brahmeshwara Rao Musunuru ◽  
Sarala Settipalli
Keyword(s):  
Delayed Gastric Emptying ◽  
Operating Time ◽  
Controlled Study ◽  
P Value ◽  
Infection Rates ◽  
Group A ◽  
Group B ◽  
Tumour Characteristics ◽  
Reconstruction Group ◽  
Braun Enteroenterostomy

Background: Morbidity following Pancreaticoduodenectomy still remains high. Few studies have shown decrease in morbidity with the addition of Braun Enteroenterostomy (BEE). Aim of the present study was to determine any possible benefit with addition of BE to the standard reconstruction after pancreaticoduodenectomy.Methods: In this prospective randomized controlled study, all patients who underwent Pancreaticoduodenectomy from June 2012 to July 2016 were included. They were randomized to undergo either standard reconstruction (Group A) or with addition of Braun Enteroenterostomy to standard reconstruction (Group B). Outcomes were compared between 2 groups and the results were analyzed. P value of <0.05 was considered significant.Results: 104 patients were included in the study. Group A included 56 patients who underwent standard reconstruction and Group B had 48 patients who had addition of BEE to standard reconstruction. The demographic profile, tumour characteristics, and biochemical profile were similar in 2 groups. Mean operating time and Intra operative blood loss were similar. The incidence of pancreatic fistula (POPF) did not differ significantly in 2 groups (14/56, 25% in group A versus 8/48, 16.6% in group B; p = 0.42). The incidence of Delayed Gastric Emptying (DGE) was not statistically different in 2 groups (20/56, 35.7% in group A versus 12/48, 25% in group B; p=0.77). Infection rates were similar in two groups. Mean hospital stay was similar in both groups (11.2 days versus 10.7 days; p=0.68).Conclusions: The outcomes of patients after pancreaticoduodenectomy were not altered by addition of Braun Enteroenterostomy to standard reconstruction. 

scholarly journals Comparison of Ferguson and Gross herniotomy with Mitchell Banks’ herniotomy in boys older than two years

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Hafiz Mahmood Ahmad ◽  
Fatima Naumeri ◽  
Usama Saud ◽  
Ghazala Butt
Keyword(s):  
Inguinal Hernia ◽  
Operating Time ◽  
Testicular Atrophy ◽  
P Value ◽  
Older Children ◽  
Creative Commons ◽  
Group A ◽  
Group B ◽  
Open Access Article

Background & Objective: In children younger than two years, most surgeons perform the inguinal herniotomy superficially through the external ring, a technique known as Mitchell-Banks’ Herniotomy (MBH) while in older children, commonly Ferguson and Gross Herniotomy (FGH) is performed which involves opening of inguinal canal. Our aim was to compare the FGH and MBH in terms of recurrence in boys with inguinal hernia. Methods: Boys with inguinal hernia presenting to Pediatric Surgery, Mayo Hospital Lahore from Dec 2016 to January 2018 were included in the study, if older than two years and younger than 14 years and without palpable deep ring (2 cm or more in width) or strangulation of inguinal hernia or malnutrition. They were randomly allocated in 2 groups after obtaining informed consent from parents, and underwent MBH (Group-A) and FGH (Group-B). Children were called for follow up after 1 week and at 6 months to assess for recurrence. Results: Total 260 patients with inguinal hernia were enrolled (NCT:03392636). The mean age of boys in Group-A was 5.2±3.0 years and in Group-B was 5.9±3.1 years. Mean operating time in Group-A (26.65±3.22 minutes) was longer than Group-B (15.92±4.22 minutes), and scrotal oedema was noted in 38 (29.2%) cases in Group-A, while 7 (5.4%) cases in Group-B. Testicular atrophy was noted in one patient of Group-B. Recurrence occurred in 1(0.8%) patient in Group-A, and in 8(6.2%) patients in Group-B (p-value 0.018). Conclusion: Mitchell-Banks’ herniotomy has lower recurrence rate than Ferguson and Gross Herniotomy in boys older than two years. doi: https://doi.org/10.12669/pjms.37.1.3216 How to cite this:Ahmad HM, Naumeri F, Saud U, Butt G. Comparison of Ferguson and Gross herniotomy with Mitchell Banks’ herniotomy in boys older than two years. Pak J Med Sci. 2021;37(1):40-44. doi: https://doi.org/10.12669/pjms.37.1.3216 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

COMPARISON OF EFFECTIVENESS OF MOBILIZATION AND SELF-EXERCISES IN ADHESIVE CAPSULITIS OF SHOULDER

2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad
Keyword(s):  
Pain Intensity ◽  
Adhesive Capsulitis ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
T Test ◽  
P Value ◽  
Group A ◽  
Group B

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.

CONVENTIONAL VERSUS THREE-DIMENSIONAL CONFORMAL EXTERNAL RADIOTHERAPY IN CANCER CERVIX: A COMPARATIVE STUDY FOR COMPLIANCE, RESPONSE AND TOXICITY

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Richa Gupta ◽  
Piyush Kumar ◽  
D. P. Singh ◽  
Arvind Kumar Chauhan ◽  
Kamal Sahni
Keyword(s):  
Clinical Response ◽  
Three Dimensional ◽  
Common Side Effect ◽  
P Value ◽  
High Dose ◽  
Cancer Cervix ◽  
Conventional Radiotherapy ◽  
Radiation Fields ◽  
Group A ◽  
Group B

INTRODUCTION: Cervical cancer is the second most frequent cancer among Indian women. Radiotherapy is the cornerstone of treatment in all its stages. Three-dimensional conformal radiotherapy (3DCRT) combines multiple radiation fields to deliver precise dose of radiation to the affected area. Tailoring each of the radiation fields to focus on the tumor delivers a high dose of radiation to the tumor and avoids nearby healthy tissue. The present study is done to compare conventional radiotherapy versus 3DCRT in cancer cervix for compliance, clinical response and toxicity. MATERIAL AND METHODS: Fifty patients were enrolled and randomised into two radiotherapy plans with radical intent - Group A treated by conventional radiotherapy and group B treated by 3DCRT. Concurrent cisplatin was delivered on weekly (35mg/m2) or tri-weekly (75mg/m2) basis during external beam Radiotherapy and was followed by High Dose Radiotherapy Brachytherapy. Clinical response and complication assessment were evaluated.Collected data was analyzed using standard statistical methods and softwares to calculate level of significance using “p” value by chi square test. RESULTS: In this study mean age of the patients was 48 years (26-67 years). The anemia was the most common side effect seen in both groups (96% vs 88%, p=0.29). Neutropenia was more in group B (36% vs 44%, p= 0.56). Lower GI toxicity was seen only in patients in group A (20% vs 0%, p=0.018). In follow up there were no significant early rectal and bladder reactions in both groups and 2 patients in each group had late rectal reactions of grade I and II (p= 0.312). No significant skin, bladder and small intestinal toxicity were seen in both groups. CONCLUSION: Conventional radiotherapy gives equally efficacious response though accompanied by toxicities which were acceptable.

scholarly journals Integration of a Virtual Dispensing Simulator “MyDispense” in an Experiential Education Program to Prepare Students for Community Introductory Pharmacy Practice Experience

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 48
Author(s):  
Ashley E. Johnson ◽  
Jillian Barrack ◽  
Jill M. Fitzgerald ◽  
Diana M. Sobieraj ◽  
Lisa M. Holle
Keyword(s):  
Community Pharmacy ◽  
Experiential Education ◽  
Self Care ◽  
Pharmacy Practice ◽  
Pharmacy Education ◽  
P Value ◽  
Community Practice ◽  
Practice Experience ◽  
Group A ◽  
Group B

Background: Technology is increasingly used to enhance pharmacy education. We sought to evaluate student learning and preparedness for community introductory pharmacy practice experiences (IPPEs) after implementation of “MyDispense” into experiential education. Methods: Both first-year pharmacy students and assigned community IPPE preceptors were eligible. Students were stratified based on previous community pharmacy experience (< or ≥ 50 h), then randomized to complete MyDispense exercises before IPPE (group A) or after 24–32 h of IPPE (group B). We evaluated preceptors’ assessment of student readiness using a 6-item Likert scale survey and students’ readiness and opinion of MyDispense using an anonymous 9-item survey. Descriptive statistics were used to characterize data. The Mann–Whitney U test was used to compare groups and a p-value < 0.05 was considered statistically significant. Results: Of 177 eligible students, 155 were randomized and 56 completed study. Group A included 32 students; 56.3% had prior community practice experience. Group B included 24 students; 50% had prior community practice experience. Forty-eight preceptors were enrolled. Students who completed exercises before rotation received higher preceptor scores for patient counseling of self-care and of medications (p < 0.05 for both). Students self-assessed their counseling skills lower than all other skills; 30.4% and 42.9% of students felt mostly or always prepared to counsel for self-care and medications, respectively. Students found MyDispense straightforward, realistic, and appreciated the ability to practice in a safe, electronic, community pharmacy, patient-care environment. Conclusion: Simulation-based software, such as MyDispense, can enhance learner understanding of the prescription fill and counseling process in a community pharmacy practice setting.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

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