Assessment of the Efficacy of Nebulized 3% Hypertonic Saline versus Nebulized Adrenaline in Infants with Acute Bronchiolitis

Aims: The aim of the work was to assess the efficacy of nebulized 3% hypertonic saline versus nebulized adrenaline in treatment of acute bronchiolitis in infants as supportive therapy with conventional therapy. Place and Duration of Study: Pediatric Pulmonology Unit (PPU), Tanta University Hospital (TUH), was applied during the period from April 2019 to April 2020. Methodology: We included ninety infants with moderate to severe acute bronchiolitis were selected, enrolled in the study and randomized into 3 groups: Group A: thirty patients were received nebulized 3% hypertonic saline plus conventional therapy. Was started from first day of admission till RADI score became 4. Group B: thirty patients were received nebulized adrenaline plus conventional therapy. Was started from first day of admission till RADI score became 4. Group C: thirty patients were received conventional therapy. Was started from first day of admission till RADI score became 4. They were subjected to history taking, clinical assessment and investigations (CXR, ECHO, CBC and CRP). Follow up done in Chest Clinic four day after discharge. Results: There was statistically significant difference between studied groups as mean duration of O2 supplementation was significantly shorter in group B than in group A than in group C (p-value<0.05). On admission, mean RR in group B was significantly higher than those in groups A and C (p-value=0.05), On 5th day, mean RR in group B was significantly lower than those in groups A and C (p-value= 0.05). On admission, mean HR in group B was significantly higher than those in groups A and c (p-value =0.05) On 5th days, mean HR in group B was significantly lower than those in groups A and C (p-value= 0.05), with no statistically significant difference between groups A and C. length of hospitalization in studied groups group B showed significantly shorter need for hospital stay than that in groups A and C, with no statistically significant difference between group A and C. Conclusion: When comparing between inhalation of adrenaline and hypertonic saline 3% in acute bronchiolitis adrenaline improve RD, oxygenation and decrease length of hospitalization.

Download Full-text

Outcome of thyroid lobectomies undergone with and without drains

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20203438 ◽

2020 ◽

Vol 8 (8) ◽

pp. 2919

Author(s):

Sahrish Bachani ◽

Shahid N. Memon ◽

Muhammad R. Pathan ◽

Rehmat Sehrish Shah ◽

Aneeta Kumari ◽

...

Keyword(s):

Hospital Stay ◽

Wound Infection ◽

Pain Score ◽

Thyroid Nodules ◽

University Hospital ◽

P Value ◽

Thyroid Lobectomy ◽

Significant Difference ◽

Group A ◽

Group B

Background: Thyroid lobectomy is a common operative technique of management of benign solitary thyroid nodules in which drains are used routinely. Objective of this study to compare the outcome of thyroid lobectomies undergone with and without drains in patients of benign solitary thyroid nodules.Methods: A comparative cross-sectional research was completed on 98 patients of benign solitary thyroid nodules at surgery department of Liaquat University Hospital Jamshoro. Patients having age of 18-60 years underwent thyroid lobectomies were included and distributed in two groups A and B. Group A includes thyroid lobectomies with drain and Group B without drain. Postoperative outcomes including pain score assessed via visual analog score (VAS), hospital stay and complications including wound infection, seroma and hematoma.Results: Out of 98 cases, 49 underwent thyroid lobectomy with drain and 49 without a drain. Females patients were in majority in group A 42 (85.7%) and also in group B 47 (95.9%). No significant difference (p-value=0.674) was in mean age of group A 30.8±10.2 years and group B 31.8±12.2 years. Higher mean with significant difference (p-value=0.001) was in pain score of group A 5.61±1.25 as compared to group B 3.55±0.70. No significant difference was in complications; seroma 1 (2.04%) vs 5 (10.20%), hematoma 1 (2.04%) vs 1 (2.04%) and infection 3 (6.12%) vs 0 (0.0%) in group A and B respectively. Higher mean with significant difference (p-value=0.001) was in hospital stay of group A 2.40±1.57 days as compared to group B 1.42±0.54 days. No significant difference (p-value=0.748) was in overall rate of complications in group A 5 (10.20%) and B 6 (12.24%).Conclusions: Thyroid lobectomy with drain is not effective in lowering the postoperative complications whereas enhanced the risk of postoperative pain, wound infection and duration of hospital stay as compared to thyroid lobectomy without a drain.

Download Full-text

Comparison of Outcome of one Versus two Drains Insertion for Seroma Formation Following Modified Radical Mastectomy in Breast Carcinoma

Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University ◽

10.48036/apims.v17i1.499 ◽

2021 ◽

Vol 17 (1) ◽

pp. 52-55

Author(s):

Shiraz Shaikh ◽

Ambreen Munir ◽

Shahnawaz Abro ◽

Shahida Khatoon ◽

Zameer Hussain Laghari ◽

...

Keyword(s):

Breast Carcinoma ◽

General Surgery ◽

Stable Condition ◽

Radical Mastectomy ◽

Seroma Formation ◽

University Hospital ◽

P Value ◽

Modified Radical Mastectomy ◽

Group A ◽

Group B

Objective: Comparative outcome of one versus two drains insertion for in the term of seroma formation following modified radical mastectomy in breast carcinoma. Methodology: This Prospective Interventional trial was conducted at Department of General Surgery, Liaquat University Hospital Hyderabad from February 2018 to January 2019. Females with breast carcinoma admitted for modified radical mastectomy were included. Patients were divided into two groups. Groups I underwent one drain placement and group II underwent two drains placement. All patients were observed to measure and record the volume of the fluid. Patients were discharged from Hospital in stable condition and after removal of drains, and followed up weekly for one month. Data was recorded on self-made proforma and analyzed by using SPSS-20. Results: Total of 80 patients were selected, 38 in group A and 42 in group B. Mean age of patients of group A was 49.08 ± 9.89 years and group B was 51.40 ± 13.59 years. , Excised Mass weight was lesser in group A as compared to group B. Mean volume of drain discharge was significantly higher in Group B 323.43 ± 158.88 ml, while it was in group A 230.29± 200.98, findings were statistically significant 0.013. Seroma formation was statistically insignificant among both groups as 8(21.1%) in group A and 10(23.8%) in group B, p-value 0.768. Conclusion: One-drain and two-drain insertion are equally effective to reduce the seroma formation after modified radical mastectomy; however, one drain insertion leads to more patient compliance and comfort with probably less morbidity and cost.

Download Full-text

A Comparative Study of Epidemiology, Clinicopathologic Features and Outcome of Colorectal Cancer Patients between Ain Shams University Hospitals and Luxor International Hospital

QJM ◽

10.1093/qjmed/hcab103.005 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Tarek Hussein Kamel ◽

Amr Lotfy Farag ◽

Dr/Sherif Hassanin Ahmed ◽

Chresteen Talaat Samy Hanna

Keyword(s):

Colorectal Cancer ◽

Comparative Study ◽

Disease Free Survival ◽

University Hospital ◽

Treatment Modalities ◽

Clinicopathologic Features ◽

Free Survival ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is the third most common malignancy after lung & breast and the fourth leading cause of cancer-related deaths worldwide, accounting for approximately 1,400,000 new cases and about 700,000 deaths worldwide. Objectives The aim of this retrospective study is to compare the epidemiology, clinicopathologic features, different treatment modalities and outcomes regarding disease free survival (DFS), progression free survival (PFS) & overall survival (OS) of colorectal cancer disease between cases presented to Ain shams university hospital & to Luxor international hospital in 3 consecutive years. Patients and Methods The study is retrospective comparative study. Clinical oncology department in Ain Shams University Hospital and Luxor International Hospital. The data Collected from January 2013 to December 2015. This study analyzed hospital records of patients who diagnosed with colorectal cancer (CRC) and allocated into two groups: Group A: CRC patients presented to Ain-Shams University Hospital from January 2013 to December 2015, group B: CRC patients presented to Luxor International Hospital from January 2013 to December 2015. Results There was no statistically significant difference regarding age parameter in LIH when compared to ASU, but the study was consistent with higher incidence in patients who were aged more than forty- accounted about 70.5% in all CRC cases. Cases less than 40 years old, in group A were 35.2%, while in Group B were 23.5%. Even there was no statistically significant difference but it may be attributable to more westernization in Lower Egypt. Other explanation may be due to decreased low socioeconomic status and different lifestyle factors in more developing region what increase risk of colorectal cancer. Among our cases, there is no statistically significant difference regarding gender between the two hospitals. Both sexes almost were affected equally, females appeared to be at a slightly higher risk of developing CRC cancer with current prevalence 1.3:1 in ASU group, and 1.1:1 in LIH group. Conclusion The need to increase awareness about CRC in Egypt especially upper Egypt, is recommended. An awareness campaign should be performed to promote detection of CRC at its earliest and most curable stage by recognizing early symptoms and enabling early referrals for colonoscopy. Those at higher risk should be offered more intensive surveillance. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.

Download Full-text

Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20211817 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1507

Author(s):

Amit Yadav ◽

Lakshman Agarwal ◽

Sumit A. Jain ◽

Sanjay Kumawat ◽

Sandeep Sharma

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Abdominal Surgery ◽

Wound Infection ◽

Skin Incision ◽

P Value ◽

Wound Area ◽

Significant Difference ◽

Group A ◽

Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

Download Full-text

Comparison of Recovery Time of Propofol and Midazolam with Propofol Alone for Sedation in Endoscopic Retrograde Cholangiopancreatography

10.53350/pjmhs211551024 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1024-1027

Author(s):

Asma Samreen ◽

Aamir Waseem ◽

Muhammad Azam ◽

Itrat Hussain Kazmi ◽

Aamir Bashir ◽

...

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Recovery Time ◽

Controlled Trial ◽

P Value ◽

Time Data ◽

Endoscopic Retrograde ◽

Intravenous Anesthetic ◽

Significant Difference ◽

Group A ◽

Group B

Background: Procedural sedation is required for multiple short duration procedures outside of the operating rooms especially in radiology and endoscopy suites. Intravenous anesthetic agent with rapid recovery profile is desirable in such circumstances. This study aims to compare two regimens of intravenous anesthetic agents. Aim: To compare the mean recovery time of propofol and midazolam with propofol alone for sedation in endoscopic retrograde cholangiopancreatography. Study Design: Randomized controlled trial. Settings: Department of Anesthesia, Shalamar Hospital, Lahore. Study Duration: June 2017 to December 2017. Methods: A total of 70 adult patients aged 20-60 years undergoing ERCP under sedation were included. Patients were given a combination of propofol and midazolam in group A while propofol alone was given in group B. After procedure, pts were transferred to recovery room and were followed for assessment of recovery time. Data were analyzed in SPSS vr 21, Independent t-test was applied & p-value ≤0.05 was considered statistically significant. Results: Significant difference was found in mean recovery time amongst both the groups. Mean recovery time in Group A (propofol and midazolam) was 19.29±4.50 minutes while in Group B (propofol alone) was 26.66±3.70 minutes showing statistically significant result with p-value = 0.0001. Conclusion: We conclude that mean recovery time with propofol plus midazolam is shorter as compared to propofol alone for sedation in ERCP. Keywords: Propofol, midazolam, sedation outside operation theatre.

Download Full-text

Combination Therapy Of Tadalafil And Pentoxifylline In Severe Erectile Dysfunction; A Prospective Randomized Trial

Polish Journal of Surgery ◽

10.1515/pjs-2015-0075 ◽

2015 ◽

Vol 87 (8) ◽

Cited By ~ 2

Author(s):

Santosh Kumar ◽

Rajesh Roat ◽

Swati Agrawal ◽

Kumar Jayant ◽

Ravimohan S. Mavuduru ◽

...

Keyword(s):

Erectile Dysfunction ◽

Combination Therapy ◽

Erectile Function ◽

T Test ◽

P Value ◽

Chi Square ◽

Significant Difference ◽

Chi Square Test ◽

Group A ◽

Group B

Abstractwas to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire.Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student’s unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant.Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value – 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value – 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects.Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.

Download Full-text

EFFECTIVENESS OF NEURAL MOBILIZATION AND STRETCHING EXERCISE FOR THE MANAGEMENT OF SCIATICA

Pakistan Journal of Rehabilitation ◽

10.36283/pjr.zu.3.2/003 ◽

2014 ◽

Vol 3 (2) ◽

pp. 11-15

Author(s):

Sidra Zahid ◽

Ghazala Noor Nizami

Keyword(s):

Conventional Therapy ◽

Controlled Trial ◽

Treatment Options ◽

Tertiary Care ◽

P Value ◽

Below The Knee ◽

Pain Disability ◽

Before And After ◽

Group A ◽

Group B

OBJECTIVE To find out the effectiveness of neural mobilization and stretching exercise for the management of sciatica BACKGROUND Sciatica is described as pain, radiating to the leg below the knee joint and caused by irritation of the sciatic nerve or nerve trunk. There are many treatment options for the management of sciatica, including stretching exercise and neural mobilization. MATERIAL AND METHODS This study was a Randomized Controlled Trial. 94 patients from physical therapy OPD of tertiary care hospitals, were participated in this study. Hence, 47 patients were randomly allocated into each group A and B. Before and after the nine treatment sessions, both groups were assessed with VAS, SLR ROM and Quebec back pain disability scale. In group A, neural mobilization with conventional therapy (heat and TENS) was applied, while stretching exercise with same conventional therapy was applied to group B. RESULTS It was observed that both treatments were helpful in reducing the symptoms. The analysis showed significant improvement (p-value <0.05) in the SLR to 60.851o±6.86oand Quebec score to 23.617±3.125, after the stretching exercise. Hence, both treatments were equally effective in reducing pain (p-value >0.05). CONCLUSION Stretching exercise is more effective in the improvement of SLR and disability. Furthermore, both techniques are helpful in the management of pain. KEY WORDS Sciatica, Stretching, Neural Mobilization, Straight Leg Raising, Visual Analogue Scale, TENS.

Download Full-text

HYPERLIPIDEMIC PATIENTS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.03.3241 ◽

2019 ◽

Vol 26 (03) ◽

Author(s):

Marium Shoukat ◽

Hijab Batool ◽

Faiza Javaid

Keyword(s):

Protective Role ◽

Lipid Lowering ◽

Atheromatous Plaque ◽

P Value ◽

Cross Sectional ◽

Apo B ◽

Time Period ◽

Significant Difference ◽

Group A ◽

Group B

Objectives: Role of niacin in decreasing cardiovascular accidents by lowering the levels of Apo-B in hyperlipidemic patients. Background: In hyperlipidemia, there are high levels of atherogenic lipoproteins leading to higher risk of atherosclerotic cardiovascular events. Patients with dyslipidemia use statins as a mainstay of therapy over last many decades. Recent studies show that apolipoproteins play a major role in formation of atheromatous plaque, thus there is an urgent need to study the effects of lipid lowering medication on apolipoprotiens levels. Study Design: Cross sectional analytical study. Setting: Sheikh Zayed Hospital Lahore (Department of Biochemistry and Chemical Pathology). Period: 12 weeks from July to Sep 2014. Materials and Methods: Recently diagnosed hyperlipidemic patients (n=44) were selected for the study purpose and divided into two equal groups; A and B. Each group was given different medication. Group A took only statin while group B took a combination of statin and niacin. Blood samples were taken at the start of medication and then after completion of 12 week time period. Results: At the start of the treatment there was no significant difference in the Apo B cholesterol level between the two groups (p value 0.972). However, after the end of 12 week duration, there was a significant reduction in the Apo level of group B taking statin and niacin as compared to group A taking statin alone (p value 0.003). Conclusions: Niacin has cardio-protective role when used in combination with niacin.

Download Full-text

Stenting versus Pharmacological Therapy in Treatment of Single Vessel Intermediate Culprit Lesion Stenosis in Acute St-Segment Elevation Myocardial Infarction

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i2130699 ◽

2020 ◽

pp. 99-106

Author(s):

Hazem K. Shalaby ◽

Ayman Mohammed El Saied ◽

Hanan Kasem ◽

Mai Salama ◽

Seham Fahmy Badr

Keyword(s):

Myocardial Infarction ◽

Pharmacological Treatment ◽

P Value ◽

Culprit Lesion ◽

Acute Stemi ◽

Single Vessel ◽

St Segment ◽

Significant Difference ◽

Group A ◽

Group B

Background: Primary percutaneous coronary intervention (PCI) with stent implantation has been the standard therapy in acute ST-segment elevation myocardial infarction (STEMI) patients. Compared with medical treatment alone, stent implanting can achieve larger lumen gain and helps to reduce the re-occlusion risk of the infarct-related artery. Purpose: The aim of this study was to compare the effectiveness of stenting of single vessel intermediate culprit lesion stenosis to pharmacological treatment alone in acute STEMI patients. Methods: This study was prospective comparative interventional case series. It included 60 patients admitted to coronary care unit of our University hospital with acute STEMI. All patients were subjected to detailed history taking, clinical examination, 12 leads ECG, echocardiography and cardiac catheterization and angiography (TIMI flow and corrected TIMI frame count (CTFC) was reported. Patients selected were those with intermediate culprit lesion (40-70%) single vessel stenosis. Patients were divided into 2 groups: Group A: 30 patients who underwent stenting of the culprit lesion in addition to standard pharmacological treatment. Group B: 30 patients who received pharmacological treatment and no stenting (Glycoprotein II b/IIIa inhibitor in addition to the standard pharmacological treatment). Patients were followed up for 12 months and major adverse cardiac events (MACE) were reported (death, myocardial infarction, coronary re-vascularization, stroke and hospitalization because of heart failure). Results: 63.3% of group A patients reported complete ST segment resolution versus 30% of group B (P=0.034). TIMI Flow showed statistically significant difference in group A compared to group B regarding (P value=0.005) Group A reported slow fast blood flow (CTFC<60) in 1 patient (3.3%) while in group B it was reported in 5 patients (16%). There was a statistically significant difference between the 2 groups regarding CTFC (P value=0.029). At 12 months follow up, MACE were reported in one patient of group A versus 4 patients of group B (P value >0.05). Conclusion: Stent implantation reported better immediate efficacy and safety results among acute STEMI patients with single vessel intermediate culprit lesion stenosis and favourable effects in reducing MACE.

Download Full-text

Tramadol as an adjunct to bupivacaine for brachial plexus block.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.09.3382 ◽

2019 ◽

Vol 26 (09) ◽

pp. 1482-1486

Author(s):

Afifa Zahoor ◽

Ranna Mussrat ◽

Muhammad Ahmad Khan ◽

Shakeel Ahmad

Keyword(s):

Brachial Plexus ◽

Brachial Plexus Block ◽

University Hospital ◽

Orthopedic Procedures ◽

Controlled Study ◽

P Value ◽

Rescue Analgesia ◽

Group A ◽

Group B ◽

Plexus Block

Objectives: To compare the efficacy of tramadol and 0.25% bupivacaine versus 0.25% bupivacaine alone for brachial plexus block. Study Design: Randomized controlled study. Setting: Orthopedic department of Nishtar Medical University/Hospital Multan. Period: The study duration was Jan-2018 to Aug-2018. Material and Methods: 148 patients planned for with upper limb orthopedic procedures under BPB in the department of orthopedics department Nishtar Hospital Multan were included in this analysis. To Patients were randomly divided into two equal groups by lottery method. Group A patients were given solution with 38 ml 0.25% bupivacaine with 100 mg tramadol 2 ml and group B were given solution with 38 ml 0.25% bupivacaine and 2 ml 0.9 % normal saline. Time of onset of block and its duration and need for rescue analgesics were noted. Results: Time of onset of block was 14.56+1.01 minutes in group A versus 15.96+1.64 minutes in group B (p-value <0.001). Mean analgesia duration was 355.85+42.18 minutes in group A versus 310.47+38.79 minutes in group B (p-value <0.001). There were 51 (68.9%) patients in group A who required rescue analgesia and 68 (91.9%) patients in group B required rescue analgesia (p-value 0.004). Conclusion: We concluded that the addition of tramadol as adjunct to bupivacaine for BPB significantly shortens the duration of onset, prolongs the duration of analgesia and reduces the need for rescue analgesics.

Download Full-text