scholarly journals Comparing the Efficacy of 2% Diltiazem Gel with 0.2% Glyceryl Trinitrate in Anal Fissure

2021 ◽  
pp. 397-401
Author(s):  
Ehsanullah Malik ◽  
Sania Bhatti ◽  
Qararo Shah ◽  
Muharram Ali Abbasi ◽  
Khushbakhat Abro ◽  
...  
Keyword(s):  
Glyceryl Trinitrate ◽  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Tertiary Care ◽  
Care Hospital ◽  
Male And Female ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Better Than

Objective: To compare the efficacy of 2% diltiazem gel with 0.2% glyceryl trinitrate in patients presenting with chronic anal fissure at Tertiary Care Hospital, Larkana. Methodology: This prospective comparative Study was conducted at department of Surgery ward-II Chandka Medical Hospital, Larkana from 14-01-19 to 14-07-19. A total of 130 patients who were treated as OPD cases were included in this study. Each patient detailed history & clinical examination, details of symptomatology was recorded in a epically diagnosed proforma. These patients were randomly divided in two equal groups i-e group A 65 patients and group B 65 patients. Group A patients were treated with 02% glyceryl trinitrate and group B patients were treated with diltiazem gel 02%. All the patients of group A & B were followed up to 02 months after start of leadema as a OPD cases. Results: A total of 130 patients (65 each in 2% diltiazem gel with 0.2% glyceryl trinitrate group) were included. Mean age in both groups was 42.56±3.91 and 41.71±4.01. 46 (70.8%) and 19 (29.2%) were male and female in Group A and 39 (60%) and 26 (40%) were male and female in Group B. Efficacy of 2% diltiazem gel with 0.2% glyceryl trinitrate in patients presenting with chronic anal fissure was 76.9% and 50.8% respectively. Conclusion: DTZ (2%) and GTN (0.2%) are equally effective in healing anal fissures. DTZ is better than GTN as it causes less side effects, low recurrence rate, healing rate and therefore better compliance.

scholarly journals A PROSPECTIVE COMPARATIVE STUDY OF OPEN VERSUS CLOSED METHOD OF CREATING PNEUMOPERITONEUM IN LAPAROSCOPIC SURGERY

2020 ◽  
pp. 1-3
Author(s):  
Akshar Patel ◽  
Shashank Desai
Keyword(s):  
Laparoscopic Surgery ◽  
Comparative Study ◽  
Tertiary Care ◽  
Needle Insertion ◽  
Care Hospital ◽  
Open Method ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Open Versus

Objective: The aim of the study was to compare open and closed method in terms of time require for creation of pneumoperitoneum and to ascertain safety in laparoscopic surgery. Methodology: This was a prospective comparative study carried out at a tertiary care hospital from January 2019 to December 2019.We selected 100 patients who were planned for laparoscopic surgery and divided them into two equal groups using the envelop method of randomization. Group A comprised of patients in whom we created pneumoperitoneum by classical veress needle insertion and in Group B by open method. Results: In our study, the mean time require for closed method was 6.92 minutes while by open method it was 4.36 minutes. Complication rate was 18% in closed and 16% in open method. Conclusion: open method is quick but comparable to closed method in terms of complications.

scholarly journals ANAL FISSURE;

2017 ◽  
Vol 24 (09) ◽  
pp. 1354-1359
Author(s):  
Syeda Tooba Bukhari ◽  
Sheikh Atiq-ur- Rehman ◽  
Muhammad Shoaib Abdullah ◽  
Syed Talha Bukhari ◽  
Javid Iqbal
Keyword(s):  
Glyceryl Trinitrate ◽  
Anal Fissure ◽  
Anal Verge ◽  
Pain Response ◽  
Surgical Units ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Glyceryl Trinitrate Ointment ◽  
Mean Time

Objectives: To compare the effectiveness of 2% Diltiazem ointment with 0.2%Glyceryl trinitrate ointment. Place & period: The study was conducted in surgical units,Bahawal Vicotria Hospital, Bahawalpur, Pakistan from 01-01-2016 to 31-12-2016. Material &Method: In this prospective comparative study, 160 patients with anal fissure were equally&randomly divided in two group A (received 2%diltiazem ointment) & group B (received 0.2%Glyceryl trinitrate ointment). The ointment had to be applied to anal verge twice daily for 6-8weeks. Assessment was done at 2nd, 4th & 6th weekends for fissure healing, pain relief & sideeffects. Results: Complete fissure healing was observed in 80%of patients in group A & 70% ingroup B (P<0.15). Pain response was good & was fairly similar in both the groups. Headacheoccurred in 5% in group A & 20% in group B (P<0.002). Mean time taken for healing of fissurein group A was 5.5±0.28 weeks & in group B was 5.8±0.32 weeks (P< 0.237). Recurrence ratewas 7.5% in group A & 17.5% in group B. Conclusion: Topical Diltiazem is preferred to topicalGlyceryl trinitrate in the treatment of acute & chronic fissure, because it is associated with a fewside effects.

What is the optimum treatment of chronic anal fissure?

2021 ◽  
Vol 15 (9) ◽  
pp. 2337-2339
Author(s):  
Said Zaman Khan ◽  
Anum Arif ◽  
Sabih Nofil ◽  
Bismah Riaz ◽  
Nawabzada Zeeeak Farhat Khan Sherwani ◽  
...  
Keyword(s):  
Treatment Group ◽  
Glyceryl Trinitrate ◽  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Age Group ◽  
Group A ◽  
Randomized Control ◽  
Topical Glyceryl Trinitrate ◽  
Group B ◽  
Surgery Department

Aim: To compare the efficacy of topical Glyceryl trinitrate 0.2% (GTN) with Lateral internal spincterotomy (LIS) for treating chronic anal fissure (CAF). Methodology: A randomized control trial was carried out in the general surgery department, Lady reading hospital, LRH MTI, Peshawar (January 2018 to July 2018). All consecutive patients 18 to 60 year old presenting to OPD with a clinical diagnosis of chronic anal fissure were enrolled after informed consent. A total of 60 patients were enrolled. The patients were assigned two groups, including treatment group A (lateral internal spinterotomy) or treatment group B (use of Topical GTN ointment 0.2%). Results: Out of the 60 patients, 30 were enrolled into each group. The female had majority of 57% (group A) and 60% (group B). Mean duration regarding symptoms in group A was 1 year with SD ± 3.51 vs 1 year ± 2.98 in group B. Majority of patients in both groups were in the 20 to 40 years age group (74% in group A vs 83% in group B). Complete fissure healing and resolution of symptoms was observed in 27(91%) in group A vs 20(66%) in group B. Conclusion: In conclusion, we derive that lateral internal spincterotomy is more effectual than Topical Glyceryl trinitrate 0.2% for treating chronic anal fissure. Keywords: Chronic anal fissure, lateral internal spincterotomy, Glyceryltrinitrate

scholarly journals Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
P Value ◽  
Care Hospital ◽  
Intravenous Lidocaine ◽  
Operative Outcomes ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

scholarly journals Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

2019 ◽  
Vol 8 (10) ◽  
pp. 2197
Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig
Keyword(s):  
Tertiary Care ◽  
Nausea And Vomiting ◽  
Research Centre ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
First Line Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

scholarly journals A prospective study of lornoxicam as pre-emptive analgesic in abdominal surgeries in tertiary care hospital in Salem, India

2017 ◽  
Vol 6 (7) ◽  
pp. 1778
Author(s):  
Mohammed Ziauddin Sarkhil ◽  
Hemant Kumar Dutt ◽  
Rajaram S.
Keyword(s):  
Rating Scale ◽  
Tertiary Care ◽  
Open Appendectomy ◽  
Care Hospital ◽  
Pain Rating ◽  
Pain Scores ◽  
Analgesic Regimen ◽  
Group A ◽  
Group B ◽  
Pain Rating Scale

Background: Preemptive analgesia, involves the introduction of an analgesic regimen before the onset of noxious stimuli, with the goal of preventing sensitization of the nervous system to subsequent stimuli that could amplify pain.Methods: To determine the efficacy and safety of Lornoxicam when administered preemptively by using Wong-Baker FACES Pain Rating scale. The patients undergoing abdominal surgery were randomly categorized into group A and B of 25 each. Group A- Received Lornoxicam 8mg (1ml) one hour before surgery. Group B- Not received any analgesic before surgery. Primary measurement of the efficacy was done by using Wong-Baker Faces Pain Rating Scale at 2, 4, 8, 12 and 24 hour. All parameters were analyzed by using student t test.Results: Surgeries which were included in the study are hernia repair, open appendectomy, laparoscopic (appendectomy, cholecystectomy). Reduction in pain scores at 12th hourly and 24th hourly pain scores (<0.05) was significant. Tramadol usage decreased significantly with laparoscopic surgeries.Conclusions: In this study we could demonstrate that lornoxicam when used preemptively reduces the pain score slightly and reduces the requirement of post-operative analgesics significantly.

scholarly journals Superiority of Spacer/Mask Topical Anesthetic Compared with Conventional Spray and Gargle Method for Fibreoptic Bronchoscopy

1996 ◽  
Vol 3 (3) ◽  
pp. 176-180
Author(s):  
RC Balkissoon ◽  
L Clelland ◽  
L Whitehead ◽  
MT Newhouse
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fibreoptic Bronchoscopy ◽  
Care Hospital ◽  
Topical Anaesthetic ◽  
Vocal Cords ◽  
Group A ◽  
Gag Reflex ◽  
The Mean ◽  
Group B

OBJECTIVE:To compare the safety and efficacy of a new spacer-oral nasal mask device with those of the standard needle nozzle spray method for the delivery of aerosolized lidocaine to the upper airway for pre-bronchoscopic anaesthesia in a tertiary care hospital.DESIGN:Single-blind randomized control trial.SETTING:University affiliated tertiary care hospital, ambulatory care bronchoscopy unit.SUBJECTS:Thirty consecutive consenting patients referred for fibreoptic bronchoscopy for various indications.INTERVENTION:Thirty randomized subjects received 150 mg of topical 1% aerosolized lidocaine via standard long needle nosed applicator (group A) or via a new oral/ nasal mask with spacer device (group B). Bronchoscopists, blinded as to the preprocedure topical anaesthetic method used, gave additional topical lidocaine at their discretion.MEASUREMENTS:The study nurse recorded the total dose of lidocaine (mg), timing of the procedure (s), cough frequency expressed as coughs per minute (c/min), vital signs, time for return of gag reflex and patients' subjective comments.RESULTS:Fifteen patients were randomized to each group. The lidocaine dose required for insertion through the vocal cords (mean ± SD) was 282.6±66.3 mg in group A and 203.3±70.6 mg in group B (PÃ0.005). Total lidocaine dose required for the procedure was 330.6±70.2 mg in group A and 256.6±75 mg in group B (PÃ0.01). The mean time for passage of the bronchoscope from mouth entry to through the vocal cords was 82.7±54.5 s in group A and 110.5±64.4 s in group B (P>0.1). The mean total time for the procedure was 699.7±377.5 s in group A and 697.2±409.1 s in group B (not significant). The mean cough frequency was 8.2±6.1 c/min in group A and 7.0±5.7 c/min in group B (not significant). There were no statistically significant differences in heart rate, in return of gag reflex time or in complication rate between the two groups.CONCLUSIONS:A statistically significant reduction in the dose of lidocaine is required to achieve equivalent topical anaesthetic for bronchoscopy with a new mask and spacer device compared with a more conventional method. Since no other variables related to the procedure showed a significant difference, the new method appears to be superior to the previous method.

scholarly journals EFFICACY AND TOLERABILITY OF FLUPIRTINE VERSUS TRAMADOL IN THE TREATMENT OF MODERATE CHRONIC LOW BACK PAIN

2019 ◽  
pp. 84-87
Author(s):  
VINEELA KARTHIK NAGURI ◽  
RAVI BABU KOMARAM ◽  
TAMILISETTI VIDYA SAGAR
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Adverse Drug Reactions ◽  
Tertiary Care ◽  
Care Hospital ◽  
Low Back ◽  
Drug Reactions ◽  
Study Results ◽  
Group A ◽  
Group B

Objective: The objective of the study was to assess and compare the efficacy and tolerability of flupirtine versus tramadol in patients with chronic moderate low back pain (LBP). Materials and Methods: A prospective study was conducted in the outpatient department of orthopaedics at tertiary care hospital, Rajamahendravarm. After meeting the inclusion criteria, a total of 60 patients were randomly allocated to tablet flupirtine 100 mg in Group A and tablet tramadol 50 mg in Group B. The efficacy of the study drugs was assessed at baseline and the end of treatment by numerical rating scale11, visual analog scale-100 mm, physician’s, and patient’s global assessment. Statistical analysis was done using paired and unpaired t-test and data were presented as mean±standard deviation. Adverse drug reactions were monitored during the treatment. Results: The study results showed that 90% of the patients in Group A and 78% of the patients in Group B had shown a good response to their respective drugs. 30% of flupirtine group patients reported adverse drug reactions which were mild. Conclusion: Both the drugs are effective in the treatment of moderate chronic LBP, but the advantage of flupirtine was, the incidence of adverse drug reactions was less when compared to tramadol group.

Vestibular Rehabilitation: Useful but not Universally so

2003 ◽  
Vol 128 (2) ◽  
pp. 240-250 ◽  
Author(s):  
E. Krebs David ◽  
M. Gill-Body Kathleen ◽  
W. Parker Stephen ◽  
V. Ramirez Jose ◽  
Wernick-Robinson Mara
Keyword(s):  
Tertiary Care ◽  
Vestibular Rehabilitation ◽  
Primary Outcome Measure ◽  
Gait Velocity ◽  
Care Hospital ◽  
Double Blind ◽  
Large Tertiary Care ◽  
Group A ◽  
Group B ◽  
Few Data

OBJECTIVE: Although vestibular rehabilitation (VR) is gaining popularity, few data support its utility in improving locomotor stability, and no good predictors exist of whom will benefit most. STUDY DESIGN AND SETTING: A double-blind, placebo-controlled randomized trial of vestibular rehabilitation was conducted at a large tertiary care hospital on 124 patients (59 ± 18 years old) with unilateral (n = 51) or bilateral (n = 73) vestibular hypofunction, of whom 86 completed a 12-week intervention. Of these 86, 27 returned for long-term (1-year) follow-up testing. The primary outcome measure was locomotor stability. RESULTS: Group A (6 weeks of VR) significantly ( P < 0.01) increased their gait velocity and stability compared with group B (6 weeks of strengthening exercise), but there was a smaller difference ( P = 0.05) between groups at 12 weeks, when both had had VR; there were no group differences at 1 year. Of the 86 who completed the intervention, 52 (61%) had clear locomotor gains. CONCLUSION AND SIGNIFICANCE: VR is helpful for most patients in providing locomotor stability, but further work is needed to determine the factors that prevent VR from being effective for all patients with vestibulopathy.

scholarly journals Closed versus open lateral internal anal sphincterotomy in a chronic anal fissure

2017 ◽  
Vol 4 (3) ◽  
pp. 1055 ◽  
Author(s):  
Anandaravi B. N. ◽  
Ramaswami B.
Keyword(s):  
Anal Fissure ◽  
Recurrence Rate ◽  
Chronic Anal Fissure ◽  
Randomized Study ◽  
Lateral Internal Sphincterotomy ◽  
Internal Sphincterotomy ◽  
Closed Technique ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Anal fissure is a common proctological problem, which presents with pain in the anal region during and after defecation. The aim of the study was to determine the best technique for surgical treatment of chronic anal fissure patients.Methods: The study was designed as a prospective randomized study. The study was conducted in surgical unit, K.R. Hospital, MMCRI, Mysore, India from January 2015 to June 2016. A total of 100 patients undergoing surgery were divided into two groups. In group A there were 50 patients who were treated by closed lateral internal anal sphincterotomy, and in group B there were 50 patients who were managed by open lateral internal anal sphincterotomy method. Patients were followed up for 6 months following surgery to observe for pain, bleeding, infection, incontinence, and recurrence. The exclusion criteria were patients who had in addition haemorrhoids or any other anorectal diseases.Results: There was acceptable difference in postoperative acute complications between the two methods of internal anal sphincterotomy. However, in group A, three patients (6%) versus 10 (20%) were complicated with incontinence postoperatively, whereas the recurrence rate was 4 versus 4% in group A versus group B, respectively (P = 0.015).Conclusions: There was significant difference between closed and open methods of lateral internal sphincterotomy in recurrence rate, healing rate, and other complications. Closed lateral internal sphincterotomy is treatment of choice for chronic anal fissure and can be done effectively and safely with acceptable rate of complications. Our recommendations are that closed technique should be adopted by experienced surgeons and Trainee should be initially trained by open technique then be shifted to closed technique.

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