scholarly journals The Impact of Preemptive Perianal Anaesthetic Block in Open Haemorrhoidectomy – a randomised controlled trial

2021 ◽  
Vol 15 (9) ◽  
pp. 2165-2167
Author(s):  
Wajeeha I. Andrabi ◽  
M Asadullah Khawaja ◽  
K. Fatima ◽  
S I. Hussain Andrabi ◽  
A. Shafique ◽  
...  
Keyword(s):  
Placebo Group ◽  
Hospital Stay ◽  
Pain Intensity ◽  
P Value ◽  
Open Hemorrhoidectomy ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Impact ◽  
Mean Time

Background: the study was conducted to analyze the efficacy of 0.75% ropicaine at perianal block for open haemrrhoidectomy with regards to pain intensity, first demand of analgesia and hospital stay. Method: 50 patients were selected for open haemrrhoidectomy under GA which were divided into two groups.it was a randomized control trial in which sealed envelope method was used for the group delegation in which Group A was designated to the patients having the perianal block with 0.75% ropivacaine while the group B was the placebo group having normal saline injected in the perianal region. The variables compared were the first demand of analgesia, pain intensity and the duration of the hospital stay. In order to make the site of injection more authentic the injections were sited under ultrasound guidance. Results: The pain intensity which was analyzed with the visual analogue score (VAS) had a median of 3.8 (high=6, low=3) in group A while 5.5 (high=8, low=4) in the Group B with the p value of < 0.05. The mean time recorded for the first demand of analgesia was 6.20 ± 1.20 hours in the Group A which had improved from 1.20 ± 1.0 hours in the Placebo Group while the p value was < 0.001, while the mean time of hospital stay got reduced from 22.5±3.30 hours to 12.4 ± 3.10 hours with the significant p value of < 0.002. Conclusion: It was observed that with preemptive analgesia with 0.75% ropivacaine administered led to a substantial reduction in pain perception, request for an analgesic and hospital stay. Therefore it is appropriate to administer it before open hemorrhoidectomy. Keywords: preemptive anaesthesia, local anesthesia, postoperative pain, ropivacaine, open hemorrhoidectomy

scholarly journals Comparison of early versus late enteral feeding following gut anastomosis.

2020 ◽  
Vol 27 (12) ◽  
pp. 2548-2552
Author(s):  
Zohra Jabeen ◽  
Ramlah Ghazanfor ◽  
Muhammad Usman Akram ◽  
Sara Malik ◽  
Maham Tariq ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Enteral Feeding ◽  
Oral Feeding ◽  
P Value ◽  
Age Group ◽  
Bowel Sounds ◽  
Early Oral Feeding ◽  
Group A ◽  
Group B ◽  
Mean Time

Objectives: To compare early feeding versus late enteral feeding following gut anastomosis in term of hospital stay. Study Design: Prospective Randomized Control study. Setting: Surgical Unit 1, Holy Family Hospital, Rawalpindi. Period: April to October 2017. Material & Methods: All patients, excluding paediatric age group (n= 60) undergoing emergency or non-emergency gut resection with primary anastomosis were incorporated. Two strata were devised. Group A (n=30) received early enteral feeding starting at 12th post-operative hours in form of 100-150ml fluid thrice daily. Group B endured being Nil per oral for 72hrs. Both groups were correlated for timing of return of bowel sounds and timespan of hospital stay. P value < 0.05 was considered noteworthy. Results: Overall 60 patients with 30 in each group were incorporated. They were predominantly males (55%) and belonged to middle age group (Group A=31.73+10.78 years; Group B= 36.00+10.53 years). Mean time for return of bowel sounds in both the groups was 24.40+5.88 hours and 35.20+10.88 hours respectively, which was striking (p value <0.05). Mean length of hospital stay in both the groups was also noteworthy i.e. 5.23+0.72 days and 6.40+1.67 days respectively. Conclusion: In the wake of gut anastomosis, early oral feeding at 12hours is superior to delayed oral feeding after 72hours, in terms of mean time for return of bowel sounds and period of hospital stay.

scholarly journals Comparative evaluation of levetiracetam and valproic acid as monotherapy on cognitive impairment in patients of epilepsy

2019 ◽  
Vol 8 (4) ◽  
pp. 674
Author(s):  
Shreshth Khanna ◽  
Suman Bala ◽  
Yashpal Singh ◽  
Taruna Sharma ◽  
Juhi Kalra ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
P Value ◽  
Cognitive Improvement ◽  
Institutional Ethics ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Impact

Background: Cognitive decline with AEDs (Anti-epileptic drugs) is associated with learning and memory deficits especially in the younger age group. The data regarding the impact of levetiracetam and valproic acid as monotherapy on cognition in epileptic patients is scarce. The present study was done for evaluation of cognitive decline associated with the use of AEDs.Methods: Present study was a prospective study on 60 patients on AEDs for a period of 12 weeks. Patients were enrolled from the Department of Neurology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India and divided into group A (levetiracetam) and group B (valproic acid) with 30 patients in each group. Permission from the institutional ethics committee and written informed consent was taken from all the patients. They were analyzed for cognitive impairment using MMSE and MoCA scales at baseline and 12 weeks.Results: The mean duration of disease was 2.13±1.1 years and 2.08±1.1 years and mean age of the patients was 14.67±1.9 years in group A and 16.20±1.6 years in group B. GTCS was present in 31 patients (52%) followed by partial seizures in 29 patients (48%). The mean change in the MMSE scores from baseline to 12 weeks was significant in group A 1.30±1.1 (p value <0.05) and change group B was -0.20±1.4 not statistically significant. The mean change was observed in MoCA scores from baseline to 12 weeks was significant in both groups A and B by 1.17±1.1 and -0.70±1.1 respectively (P value <0.05).Conclusions: Patients on levetiracetam showed cognitive improvement, whereas patients on valproic acid showed a decline in the MMSE and MoCA scores.

scholarly journals Is Nasogastric Tube essential in abdominal surgeries? Randomized controlled trail.

2021 ◽  
Vol 28 (10) ◽  
pp. 1397-1400
Author(s):  
Muhammad Bilal ◽  
Viqar Aslam ◽  
Zaheeruddin ◽  
Waqas Jan
Keyword(s):  
Hospital Stay ◽  
Nasogastric Tube ◽  
P Value ◽  
Randomized Controlled ◽  
Group A ◽  
Randomized Controlled Trail ◽  
The Mean ◽  
Group B ◽  
Study Setting ◽  
Tube Study

Objective: Objective was to compare mean hospital stay in patients with abdominal surgeries with and without Nasogastric tube. Study Design: Randomized Controlled Trail study. Setting: DHQ Charsadda. Period: Jan to Nov 2018. Material & Methods: One hundred and thirty two patients who underwent abdominal surgeries according to a preset inclusion criteria were in this study. These Patients were randomly assigned using sealed opaque envelopes containing computer‐generated random numbers into with and without NG tube. Mean hospital stay was noted in both groups. Student ‘t’ test was used to compare the mean hospital stay of both groups. Results: Mean age of patients in group A was 28.50 ± 9.28 years and for group B was 30.12+_9.09 years. Mean hospital stay for group A was 5.64+_2.32days and for group B was 8.73+_3.43 days with a p-value of < 0.000. Conclusion: Patient with nasogastric tube stay longer in hospital than without tube.

Outcome of Dynamic Compression Plate versus Interlock Intramedullary Nail for Management of Humeral Shaft Fractures

2021 ◽  
Vol 15 (10) ◽  
pp. 3387-3389
Author(s):  
Mudassar Nazar ◽  
Gauhar Nawaz Khan ◽  
Hassan Raza Khosa ◽  
Rizwan Anwar ◽  
Muhammad Abdul Hanan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Intramedullary Nailing ◽  
Dynamic Compression ◽  
P Value ◽  
Shoulder Impingement ◽  
Shaft Fractures ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Humerus Shaft

Objective: To compare outcomes of interlock intramedullary nails with Dynamic compression plates for the treatment of humerus shaft fractures in terms of hospital stay time and shoulder Impingement. Subjects and Methods: In this comparative study, a total number of 74 patients having age 20-60 years who presented with closed and open Gustilo type I or II in middle third of humerus were included. Study was conducted in Islam hospital Sialkot and and Rajib Tayyip Erdogan Hospital, Muzaffargarh from June-2019 to June-2020. Group A (n=37) patients underwent dynamic compression plating (DCP) for treatment of fractures and group B (n=37) underwent interlocking intramedullary nailing (ILN) for humerus shaft fractures. We noted post-operative hospital stay, shoulder impingement and bone union rate in all patients. Results: The mean of patients included in this study was 42.45 (SD 9.89) years. There were 57 (77.03%) males and 17 (22.97%) females. The mean duration of fracture at the time of surgery was 39.98±7.23 days. Mean hospital stay was 4.72±1.23 days in in group A and 4.89±1.40 days in group B (p-value 0.60). There were 4 (10.8%) patients in group B in whom shoulder impingement occurred but there was no patient in group A with shoulder impingement (p-value 0.04). Complete union occurred in 35 (94.6%) patients in DCP group and in 34 (91.8%) patients in ILN group (p-value 0.64). Conclusion: Both DCP and ILN are associated with high bone union rates. The complications rate of ILN is higher in comparison to DCP group. Keywords: Humerus shaft fractures, dynamic compression plates, interlocking intramedullary nailing.

scholarly journals HAEMORRHOIDECTOMY;

2017 ◽  
Vol 24 (01) ◽  
pp. 69-74
Author(s):  
Ahsan Nasim ◽  
Marriyum Baig ◽  
Reem Saad
Keyword(s):  
Hospital Stay ◽  
Harmonic Scalpel ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Randomized Control ◽  
Group B ◽  
Mean Time ◽  
Surgical Unit ◽  
Closed Haemorrhoidectomy

Haemorrhoids are one of the most common anorectal disorders. Internalhaemorrhoids are symptomatic anal cushions and characteristically lie in the 3, 7 and 11 o’clockposition whereas external haemorrhoids relate to venous channels of the inferior haemorrhoidalplexus. Objectives: To compare the outcome of haemorrhoidectomy using harmonic scalpelversus conventional closed haemorrhoidectomy. Study Design: Randomized control trial.Setting: Department of Surgical unit II, Jinnah Hospital, Lahore. Period: Six months from 25thDecember 2014 to 24th June 2015. Methodology: A total of 140 patients were included inthis study. Patients were divided in two groups A & B. In Group A, (70 patients) conventionalhaemorrhoidectomy was performed by the Ferguson Technique (closed technique) whereasin Group B, (70 patients) suture less closed haemorrhoidectomy was performed by using theharmonic scalpel. Results: The mean age of the patients in group A was 43.3±8.2 years andin group B was 42.3±7.3 years. The mean time for surgery in group A was 23.8±4.2 minutesand in group B was 8.5±3.6 minutes. The mean pain score in group A was 5.3±1.8 VAS andin group B was 3.9±1.9 VAS. In group A, less than 1 day postoperative hospital stay was in 62(88.6%) patients and in group B, it was in 66 (94.3%) patients. Conclusions: It is concludedfrom this study that haemorrhoidectomy by harmonic scalpel results in decrease in operationtime and less postoperative pain although there is not much significant difference in less than 1day hospital stay as compared to the conventional closed haemorrhidectomy technique.

Comparison of closed incision negative pressure wound therapy with conventional dressing for reducing wound complications in emergency laparotomy

2021 ◽  
Vol 93 (5) ◽  
pp. 1-5
Author(s):  
ARUN GARG ◽  
SNEH JAYANT ◽  
Arun Gupta ◽  
Lalit Bansal ◽  
MOHAMMAD FAISAL ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
P Value ◽  
Emergency Laparotomy ◽  
Wound Therapy ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Dressing Change

Objective: The aim of this study was to compare the post-operative effects of closed incision negative pressure wound therapy with conventional dressing in emergency laparotomy. Methods: This study was conducted from 1st November 2018 to 31st March 2020 in ABVIMS & Dr. R.M.L. Hospital, New Delhi. The potential candidates for the study were patients of 18 years and above who were admitted in surgical emergency and underwent emergency laparotomy by a midline incision. Fifty random patients were alternatively allotted to group A (25 patients) and group B (25 patients). In the patients of group A, closed incision negative pressure wound therapy (ciNPWT) was applied on midline closed wound after an exploratory laparotomy procedure. The patients in group B, standard dry gauze dressing was done. Results: The mean age of patients in group A and group B were 46.76±12.20 and 41.96±8.33 years, respectively (p-value-0.11). The wound infection was present in 12% of cases in group A and 32% in group B, but when we calculate the p-value, it was found to be statistically non-significant (p-value-0.08). Similarly, seroma formation and wound dehiscence were found less in group A as compared to group B but not reached up to a statistically significant limit (p-value 0.55 and 0.38 respectively). The frequency of dressing change was 1-2 per week in 92% of cases in group A while it was 3-4 per week in 68% of cases in group B. The mean time of the frequency of dressing change was 1.24±0.72 per week and 4.28±1.90 per week in both the groups respectively (p-value <0.001). There was no significant (p>0.05) difference in the duration of hospital stay between group A (mean hospital stay 8.20±2.34 days) and group B (mean hospital stay 8.21±3.37 days). Conclusion: Closed incision negative pressure wound therapy has no advantages over conventional dressing in terms of post-operative complications and hospital stay. However, it reduces the frequency of dressing change significantly, which reduces the mental stress of the patient and the burden of changing daily dressing.

scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY

2011 ◽  
Vol 18 (02) ◽  
pp. 237-242
Author(s):  
AWAIS SHUJA ◽  
ABID BASHIR ◽  
ABID RASHID
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Complication Rate ◽  
Conversion Rate ◽  
Gall Stone ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Impact

Laparoscopic cholecystectomy is the gold standard treatment for patients presenting with acute gall stone disease necessitating hospital admission. Objective: To assess the impact of timing of laparoscopic cholecystectomy on conversion rate, hospital stay and morbidity. Period: Jan 2008-2010. Setting: Department of Surgery, Independent University Hospital, Faisalabad. Study Design: Experimental study. Material & Methods: The subjects were included by consecutive sampling technique. 81 cases were divided into 3 groups. Group A (Surgery within 72 hrs of onset symptoms). Group B (surgery between 72hrs to 96 hours of onset of symptoms). Group C (surgery after 96 hours of onset of symptoms). Results: The mean age was 41-95 years. Female to male ratio was 4.5:1. The overall complication rate was 12.69%. Mean hospital stay was 2.85 days. The open conversion rate was 8.64%. In group A the complication rate was 6%, group B 11.5% and group C 12.8&. The mean hospital stay and conversion rate had no significant difference. Conclusions: The timing of laparoscopic cholecystectomy has no significant impact on the conversion rate and length of hospital stay in cases with acute cholecystitis. However the complication rate was higher when surgery performed after 72 hours of onset of symptoms.

scholarly journals A comparative study of suturing technique of intestine between extra-mucosal single layer interrupted and continuous all layers: a single center experience

2021 ◽  
Author(s):  
Manoranjan Kar ◽  
Somu Singhal ◽  
Bismoy Mondal ◽  
Arijit Roy
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
P Value ◽  
Bowel Anastomosis ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Gastrointestinal anastomosis has been excited interest in our day to day surgical practice. We have compared efficacy, advantages, disadvantages, and complications following intestinal resection-anastomosis using extra-mucosal interrupted single layer suturing or continuous all layer suturing.Methods: This comparative study included 50 cases (either in emergency or elective undergoing bowel resection and anastomosis), comprising of 2 Groups (25 cases in each Group) between January 2019 to June 2021 at Midnapore Medical College and Hospital. Patients data, operative findings, duration of anastomosis and length of hospital stay, post-operative complications of all patients were followed till discharge.Results: Our comparative study have shown that- the mean duration for intestinal anastomosis in Group A (extra-mucosal interrupted single layer) and Group B (continuous all layers) were 21.43 minutes and 14.35 respectively. Considering duration of the anastomosis continuous all layers intestinal anastomosis appears to represent in shorter duration, anastomotic leak was noted in 3 patients (6%). Anastomotic leak was observed in 1 patient extra-mucosal interrupted single layer bowel anastomosis whereas two patients in the Group of continuous all layered bowel anastomosis had leak (p value 0.5-not significant) and the mean duration of hospital stay in the Group A and Group B were 7.32 days and 7.92 days respectively. (p value -insignificant).Conclusions: Duration required to perform a continuous all layer bowl anastomosis is lesser when compared to an extra-mucosal interrupted single layer intestinal anastomosis. There is no significant difference in complications, final outcome and duration of hospital stay between two Groups.

scholarly journals Comparative study of peri-operative outcome following laparotomy versus laparoscopic technique of abdominal hysterectomy for benign gynaecological lesions

2018 ◽  
Vol 7 (6) ◽  
pp. 2270
Author(s):  
Satyajit P. Gavhane ◽  
Dhruval K. Bhavsar ◽  
Vidyadhar B. Bangal ◽  
Swati D. Gagare ◽  
Amey R. Kodlikeri
Keyword(s):  
Urinary Bladder ◽  
Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Laparoscopic Technique ◽  
Duration Of Surgery ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Impact

Background: Laparoscopic technique of hysterectomy is becoming increasingly popular in developing and developed world. Laparoscopic hysterectomy is a minimal access procedure that allows patients to recover faster. The study was undertaken to assess the impact of two abdominal techniques (laparoscopic and conventional laparotomy) on various variables like operative time, hospital stay, complications and convalescence period.Methods: An observational longitudinal study was carried out at tertiary care centre. Two hundred and ten women, as per inclusion and exclusion criteria, who had undergone abdominal hysterectomy for benign uterine pathology, either by laparotomy (Group A) or by laparoscopic technique (Group B) during study period were included. Data was analyzed and compared by using different variables between two methods of hysterectomy, using percentages and Chi square test for normal distribution. P value less than 0.05 was considered significant.Results: The mean duration of surgery was 100 minutes in group A and 175 minutes in Group B. There were two cases (1.90%) of minor injury to urinary bladder in Group A and one case (0.95%) of thermal injury to urinary bladder in Group B. The mean blood loss was around 240 ml and 70 ml in Group A and B respectively. The need for postoperative analgesia was observed in 100% cases from Group A and 38.09% from group B. The average duration required for out of bed ambulation was 25 hours and 14 hours in Group A and B respectively. The mean hospital stay in group A and B was 7.5 days and 3.5 days respectively.Conclusions: Following laparoscopic hysterectomy, women had less morbidity, less need for post-operative pain relief, had early ambulation, short hospital stay and early resumption of routine activities at home as compared to women who had undergone abdominal hysterectomy by conventional method.

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.

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