scholarly journals Management of Postcaesarean Delivery Analgesia-Diclofenac Suppository, Paracetamol Infusion and a Combination

2021 ◽  
Author(s):  
Mandem Sadana Reddy ◽  
Munikrishna Munisamaiah
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Caesarean Section ◽  
Satisfaction Score ◽  
Early Recovery ◽  
Patient Satisfaction Score ◽  
Duration Of Surgery ◽  
Group A ◽  
Individual Use ◽  
Group B

Introduction: One of the most important aspect of postoperative care is pain management which plays an important role in early recovery and improves patient’s general condition. Paracetamol and diclofenac have an excellent safety profile when compared to opioids. Aim: To assess and compare the analgesic efficacy and safety of individual use of Intravenous (IV) paracetamol, diclofenac suppository and in combination. Materials and Methods: This hospital-based cross-sectional study was conducted from October 2018 to June 2020 at Department of Obstetrics and Gynaecology. A total of 90 women who underwent caesarean section were recruited for the study and were randomly allocated (lottery method) into three groups with 30 participants in each group. The patients underwent Lower Segment Caesarean Section (LSCS) under spinal anaesthesia with the same technique and medicine, (Bupivacaine 0.5%) without receiving any sedation. Group A patients received diclofenac suppository 50 mg every eight hourly, Group B received paracetamol infusion 1000 mg every eight hourly and Group C received 50 mg diclofenac suppository and 500 mg IV paracetamol every eight hourly. Pain severity (Visual Analogue Scale (VAS) score), Heart Rate (HR), Blood Pressure (BP) and side-effects were evaluated at 2,4,6,8,12 and 24 hours postoperatively. Patient satisfaction score was evaluated 24 hours after caesarean section. Results: Age range of participants was 19 to 28 years. Mean duration of surgery (minutes) in each group were- Group A-56.5±7.49, Group B-58.27±8.06 and Group C-56.97±6.78, respectively. There was a significant reduction of pain in patients receiving paracetamol and diclofenac suppository combination group. The satisfaction score was categorised as excellent by 80% patients in Group C. In Group A 30% and in Group B 16.6% categorised as excellent patient satisfaction score. The adverse effects such as nausea and epigastric discomfort was higher (7.7%) with diclofenac suppository group followed by Paracetamol (2.2% side-effects) and minimal with combination (1%). Conclusion: Paracetamol infusion is as effective as diclofenac suppository in reducing postoperative pain following caesarean section. Diclofenac suppository and IV paracetamol combination provides more effective postoperative analgesia compared with individual usage of IV paracetamol or diclofenac suppository in patients following caesarean section. The combined use of paracetamol and diclofenac suppository has fewer side-effects compared with individual use of either IV paracetamol or diclofenac suppository.

scholarly journals Fetomaternal outcome in high-risk parturients receiving epidural analgesia using fentanyl with ropivacaine versus iv tramadol: a comparative study

2017 ◽  
Vol 6 (7) ◽  
pp. 2836
Author(s):  
Ashima Taneja ◽  
Kamaldeep Arora ◽  
Isha Chopra ◽  
Anju Grewal ◽  
Sushree Samiksha Naik ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
High Risk ◽  
Epidural Analgesia ◽  
Comparative Study ◽  
Satisfaction Score ◽  
Epidural Group ◽  
Patient Satisfaction Score ◽  
Vaginal Deliveries ◽  
Group A ◽  
Group B

Background: Labour analgesia has been recommended but sufficient data on use of labour epidural analgesia with ropivacaine and fentanyl combination during labour is not available.Methods: A comparative study was conducted on 40 high risk labouring partuirents, randomly allocated to group A (iv tramadol) and group B (epidural analgesia with ropivacaine plus fentanyl). Assessments were done for fetal heart rate abnormality, mode of delivery, duration of labour, and Apgar score. The VAS score, patient satisfaction score, and complications were recorded.Results: Group A had more number of instrumental deliveries compared to group B, the later had higher number of caesarean sections. No difference was observed in vaginal deliveries in both the groups. Pain relief was significant in patients of epidural group. The neonatal outcome was same in both the groups. Significant number of patients had a higher degree of satisfaction score in group B compared to group A.Conclusions: Tramadol and epidural analgesia in labour are safe and effective. Patient satisfaction is significantly higher in epidural group as compared to the tramadol group.

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.

scholarly journals Comparison of two different techniques of uterine closure in caesarean section: Continuous single layer technique versus Babu and Magon technique

2018 ◽  
Vol 7 (6) ◽  
pp. 2197
Author(s):  
S. Vinayachandran ◽  
Vedhapriya Sudhakar
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Single Layer ◽  
Adverse Outcomes ◽  
Caesarean Scar ◽  
Duration Of Surgery ◽  
Layer Technique ◽  
Observational Prospective Cohort Study ◽  
Group A ◽  
Group B

Background: To compare size of the caesarean scar and residual myometrial thickness (RMT) between continuous single non-interlocking and Babu and Magon technique for uterine closure following primary elective caesarean section (CS).Methods: An observational prospective cohort study was conducted at 6 weeks and 4 months postpartum following primary elective CS. Group A included 25 patients who underwent continuous single layer technique and Group B included 25 patients who underwent Babu and Magon technique for uterine closure. Baseline demographic profile, obstetric score, details of the CS and associated complications were studied. Two-dimensional Transvaginal ultrasonography (TVS) measurements of the length, width and depth of the caesarean scar and RMT were compared.Results: Mean age of study population was 29.6 years. Malpresentation (44%) was the most common indication for CS. Mean Bishops score at the time of CS was <4. The duration of surgery (-2.8 min, 37.96 ±5.660min) and estimated amount of blood loss (-51.6 ml, mean 671.20 ±136.208ml) was less in Group A compared to Group B (40.76 ±4.68min, 722.80±132.083ml respectively). The caesarean scar measurements were similar in both groups at both visits. The mean RMT in Group B at 6 weeks and 4 months postpartum (8.05mm±2.06 and 7.10mm±2.04 respectively) was statistically higher than Group A (6.23mm ± 1.76 and 5.36mm ± 1.70 respectively), p=0.002.Conclusions: We conclude that Babu and Magon technique for uterine closure in caesarean section could result in better healing of the scar and probably reduce the adverse outcomes in subsequent pregnancies.

scholarly journals Total Knee Arthroplasty with and without Tourniquet: Comparative study

2020 ◽  
Author(s):  
Sherwan Hamawandi ◽  
Hazhar I. Amin ◽  
Ameer Kadhim Al-Humairi
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Knee Arthroplasty ◽  
Thigh Pain ◽  
Early Recovery ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B ◽  
Without Tourniquet

Abstract Background The use of tourniquet during complete knee arthroplasty (TKA) improves protection and reduces blood loss intraoperative. Turniquet use, however, may also have a negative impact after TKA on early recovery of muscle strength and lower extremity function. The purpose of this study was to demonstrate the effect of tourniquet use in TKA on surgery length, need for blood transfusion, and amount of postoperative blood drainage by suction drain, incidence of postoperative wound hematoma, postoperative thigh pain, and early mobilization.Methods Seventy Patients are involved in this study and were divided into two groups; Group A (35) patients were treated with TKA with pneumatic thigh tourniquet. Group B (35) patients were treated with TKA without tourniquet. All patients were suffering from severe knee osteoarthritis and they failed to respond to conservative treatment so they are candidates for primary TKA. The two groups are matched related to age and gender. Selection of patients into two groups done randomly with regard of odd number for group A and even number for group B.Results The results showed no significant difference regarding age, gender, postoperative DVT and wound hematoma between group A (when tourniquet was used) and group B (when tourniquet was not used) although we have 2 patients developed DVT and 3 patients had wound hematoma in group A but these are statistically not significant. Regarding post-operative VAS for thigh pain was significantly less in group B and this will result in early mobilization. Also there was significant difference in duration of surgery between two groups with less time in group A due to bloodless field of tourniquet while there was significantly more postoperative drainage amount of blood through the surgical drains in group A and significantly more amount of blood transfusion perioperatively in group B which explain that tourniquet can reduce the total amount of blood loss in TKA.Conclusion There is significant effect of tourniquet in TKA on thigh pain postoperatively, which will effect postoperative mobilization and rehabilitation. Also the tourniquet can result in significant reduction in time of operation, total blood loss and amount of blood transfusion.

scholarly journals A randomized open label comparative study to determine the various side effects and patient satisfaction of low dose continuous versus low dose intermittent oral isotretinoin therapy in moderate to severe acne vulgaris

2018 ◽  
Vol 7 (6) ◽  
pp. 1169
Author(s):  
Santhosh A. Shetti ◽  
Nagesh H. N. ◽  
Nagabushan Hanumanthaiah
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Low Dose ◽  
Acne Vulgaris ◽  
Once Daily ◽  
Severe Acne ◽  
Treatment Regimens ◽  
Group A ◽  
Oral Isotretinoin ◽  
Group B

Background: Acne Vulgaris is chronic inflammatory disease of pilosebaceous units. Oral isotretinoin is recommended for moderate to severe acne vulgaris who are not responding satisfactorily to conventional therapies. Recent reports indicate that acne patients have been benefiting from the low dose treatment protocols. However, long term daily use of this drug results in frequent side effects such mucocutaneous and systemic side effects. Our aim was to assess and compare the various side effects and patient satisfaction of oral isotretinoin in low dose continuous and intermittent treatment of moderate to severe acne vulgaris.Methods: This was a prospective randomized open labeled comparative study carried out at outpatient department in the Department of Dermatology in Mandya Institute of Medical sciences, Mandya. Patients with moderate to severe acne were assigned equally (50 subjects each) to one of the two treatment regimens by using block randomization technique, Group A was given low dose continuous regimen-20 mg oral isotretinoin once daily for 4 months and Group B was given low dose intermittent regimen-20 mg oral isotretinoin once daily for 1 week out of every 4 weeks. The patients were followed up every 4th week during the treatment period. The patients were examined and side effects were noted in each visit. A six month follow-up evaluation was done to analyze patient satisfaction.Results: Muco-cutaneous dryness was most common adverse effect noted in both the groups A and B. Itching (42%), Alopecia (44%), Myalgia (36%) were seen most commonly in group A and Acne flaring (47%) was most common with group B. With regard to patient satisfaction, in group A 42% were satisfied and 20% were very satisfied, in group B 36% were satisfied and 14% were very satisfied.Conclusions: Study suggests that, Muco-cutaneous dryness was most common side effect in both treatment regimens. Side effects were more frequent with low dose continuous than low dose intermittent isotretinoin regimen. Patient satisfaction was better in continuous regimen.

Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wound Infection ◽  
Port Site ◽  
Site Infection ◽  
College Hospital ◽  
Medical College ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

scholarly journals A PROSPECTIVE STUDY TO ANALYSE THE SIDE EFFECTS OF OLMESARTAN MEDOXOMIL AND ENALAPRIL IN HYPERTENSIVE SUBJECTS

2018 ◽  
Vol 11 (12) ◽  
pp. 258
Author(s):  
Parminderpal Singh ◽  
Kiranjit Kiranjit
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Postural Hypotension ◽  
Olmesartan Medoxomil ◽  
National Commission ◽  
Group A ◽  
Group B ◽  
Taste Alteration ◽  
A Prospective Study

Objective: The present study was aimed to analyze the side effects of olmesartan medoxomil and enalapril in hypertensive subjects.Methods: The study consisted of newly diagnosed hypertension categorized according to 7th report of Joint National Commission on prevention, detection, evaluation, and treatment of high blood pressure. The subjects were divided into two groups. The Group A subjects received olmesartan, and Group B subjects received enalapril. Pressure was recorded both in supine and sitting positions. The appearance of side effects was observed in the follow-up, i.e., dry cough, headache, postural hypotension, angioedema, dizziness, skin rashes, taste alterations, and urticaria. A statistical data were prepared on the basis of information obtained and analyzed thoroughly for antihypertensive effects and side effects of olmesartan and enalapril. SPSS software was used for analysis.Results: There was observed an increase in the incidence of taste alteration with drug therapy in Group B (Enalapril). There was observed an increase in the incidence of postural hypotension with drug therapy in both groups. In Group A (Olmesartan), the incidence of postural hypotension at the beginning of trial, 4 weeks, and 8 weeks was 0%, 2%, and 2%, respectively. In Group A (Olmesartan), there was no incidence of a headache at the beginning of trial, at 4 weeks and 8 weeks.Conclusion: From the study, it can be concluded that both olmesartan and enalapril are effective in Stage I and Stage II hypertension, but olmesartan is tolerated well with lesser side effects.

scholarly journals Prophylactic corneal cross-linking in LASIK surgery: effects on visual outcome and recovery time

2020 ◽  
Vol 17 (1) ◽  
pp. 61-68
Author(s):  
Dominique Clare Oh ◽  
Yiong Huak Chan ◽  
Sao Bing Lee ◽  
Jovina Li Shuen See
Keyword(s):  
Visual Acuity ◽  
Side Effects ◽  
Recovery Time ◽  
Visual Outcome ◽  
Cross Linking ◽  
Safe Procedure ◽  
Distance Visual Acuity ◽  
Visual Outcomes ◽  
Group A ◽  
Group B

Introduction: Collagen cross-linking is a useful adjunct in preventing corneal ectasia after laser-assisted in situ keratomileusis (LASIK). This study aimed to evaluate whether prophylactic cross-linking in IntraLase LASIK affects optimum visual outcome and recovery time in the immediate post-surgery period and is associated with any side effects. Methods: This was a retrospective case study on the right eyes of 100 Chinese subjects aged 18 to 40 years who underwent IntraLase LASIK. Fifty subjects who underwentcross-linking after completing LASIK (Group A) were compared with 50 subjects who did not undergo LASIK (Group B). Cases were evaluated for pre- and post-operative spherical equivalent, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), recovery time and presence of side effects. Results: At 1 week post-LASIK, mean (SD) UDVA of Group A subjects was poorer than Group B, at 1.05 (0.19) vs 1.17 (0.19) (p = 0.036); however, there was no significant difference in CDVA (p = 0.095). By 1 month post-LASIK, differences in both UDVA and CDVA were insignificant (p = 0.055, 0.106, respectively). Mean recovery time was 2.72 (95% confidence interval [CI] = 0.64-4.7) days longer in Group A (p = 0.010), although by 1 month post-LASIK, both groups were able to achieve CDVA equal to or better than that achieved pre-LASIK. Incidence of mild inflammation and dry eyes post-LASIK was similar in both groups (p = 1.00, 0.749, respectively); no other complications were observed. Conclusion: No differences in visual outcomes at and occurrence of side effects at 1 month post-LASIK were observed between subjects who underwent cross-linking prior to refractive surgery and those who did not. However, the group that underwent cross-linking had a slightly longer mean recovery time. Our study supports prophylactic cross-linking as a safe procedure that does not affect immediate visual outcomes among the Chinese population when used in adjunct with LASIK surgery.

scholarly journals Endoscopic 3-S Technique Tympanoplasty: Taking the Convention a Step Ahead

2019 ◽  
Vol 27 (3) ◽  
pp. 179-185
Author(s):  
Mridul Janweja ◽  
Sayan Hazra ◽  
Arindam Das ◽  
Arya Brata Dubey
Keyword(s):  
Endoscopic Surgery ◽  
Routine Activity ◽  
Middle Ear Surgery ◽  
Graft Material ◽  
Operating Microscope ◽  
Advantages And Disadvantages ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Introduction Endoscopic Surgery has immense potential for middle ear surgery and is currently favoured by many surgeons. The 3 (vascular) Strips/ 3 Flap Tympanoplasty with operating microscope is popular but Endoscopic 3-Flap Tympanoplasty remains less explored. Hence this study was conducted to compare advantages and disadvantages of Endoscopic and Microscopic 3-Flap Tympanoplasty. Materials and Methods Forty two patients with large/subtotal perforation of tympanic membrane were divided into two equal groups (Group A & B). Endoscope was used in Group A, whereas, operating microscope in Group B. Temporalis fascia was the graft material in all patients. Patients were followed up for six months. Pre and post-operative audiograms, post-operative pain, graft uptake, time taken for surgery and intra-operative visualization convenience were compared. Results Mean Air-Bone Gap closure at the end of six months was 9.23 dB (SD-0.88 dB) in the endoscope group and 8.95 dB (SD-0.66 dB) in microscope group whereas the graft uptake rate was 95.2% and 90.2% respectively. Post-operative pain, cosmesis, ease of doing surgery and time taken for surgery were better in ‘Endoscope’ as compared to ‘Microscope’ group. Conclusion The three flaps produce adequate exposure in very large or subtotal perforations, very thin anterior rim or with anterior bony overhang. Results in terms of mean hearing gain and graft uptake were comparable. In terms of morbidity (post-op pain), recovery (return to routine activity), mean duration of surgery and cosmesis, endoscopic surgery produced better outcome.

scholarly journals BIOBRAN MGN-3

2012 ◽  
Vol 20 (01) ◽  
pp. 13-16
Author(s):  
Ahmad Ijaz Masood ◽  
RABEETA SHEIKH ◽  
RANA ATIQUE ANWER
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Hair Loss ◽  
White Blood Cells ◽  
Food Supplement ◽  
Severe Nausea ◽  
Treatment Side Effects ◽  
Group A ◽  
Group B

Objective: The aim of study was to assess the effect of Biobran in reducing of chemotherapy induced side effects in termsof tiredness, anorexia, vomiting and hair loss and quality of life in terms of weight loss. Setting: Radiotherapy Department, NishtarHospital Multan. Material and Methods: Fifty patients of breast cancer were enrolled randomly in two groups. Group-A patients weregiven 3 gram dose of Biobran MGN-3 per day one week before and one week after chemotherapy. Group-B patient were givenchemotherapy alone. Total six cycles of chemotherapy were given. No multivitamin or food supplements were given during this study.Chemotherapy induced side effects (tiredness, anorexia, and vomiting, hair loss) were assessed by questionnaire to the patients beforestart of each cycle. Weight was checked before each cycle to assess weight gain or loss. White blood cells were checked by completeblood count just before and one week after chemotherapy. Results: Between six months, 50 patients were enrolled in RadiotherapyDepartment, Nishtar Hospital Multan. There was a significant reduction in tiredness and anorexia in group-A patients. 20 (80%) patients ofgroup-A felt increase in their diet and no tiredness without any appetizer or multivitamin. But group-B patients demanded for appetizer dueto severe anorexia after chemotherapy except 3 (12%) patients who didn’t use any appetizer or food supplement. In group-A, 15 (60%)patients didn’t need any anti-emetic as compared to group-B all patient (100%) experienced severe nausea during and afterchemotherapy. Group-A patients experienced less hair fall 7 (28%) patients as compared to other group which is 25 (100%) patients.Conclusions: The study showed that, by helping to optimize the immune system, Biobran MGN-3 can not only help maximize treatmentsuccess, but also minimize treatment side effects and improve quality of life during treatment and in recovery.

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