COMPLICATIONS OF INTRA ABDOMINAL DRAINS: A SINGLE CENTER EXPERIENCE

Objective: To compare frequency of intra-abdominal complications in drainage and non-drainage group among patents who underwent intra-abdominal surgeries. Study Design: Comparative prospective study. Place and Duration of Study: Department of Surgery, Pakistan Ordinance Factory, Wah Cantt, from Mar 2018 to Jul 2018. Methodology: There were 32 patients, 16 in each group. Patients were selected through the process of consecutive sampling. Patients were randomly divided into two groups (random number table method); group A patients underwent intra-abdominal drain while group B was non-drainage group. Patients were followed up for 7 days and observed for complications. Results: Total 32 patients were included in the study. There were 14 (43.8%) males and 18 (56.3%) females. Mean age of patients was 43.2 ± 9.5 years. Drain group showed significantly low anastomosis leakage (p=0.02), wound infection (p=0.05), mortality (p=0.04), pulmonary complications (p=0.05) and bleeding (p=0.03) as compared to the non-drain group. Conclusion: Intra-abdominal drains are associated with several complications. Anastomosis leakage is the most common complication following pulmonary complications and bleeding. However, drains help in early detection of complications and timely management of such complications leads to better outcome of a surgical procedure.

COMPARATIVE STUDY BETWEEN CONVENTIONAL INFERIOR TURBINECTOMY AND ENDOSCOPIC INFERIOR TURBINOPLASTY FOR TREATMENT OF INFERIOR TURBINATE HYPERTROPHY

Objective: To compare efficacy of endoscopic turbinoplasty versus conventional inferior turbinectomy for hypertrophy of inferior turbinate. Study Design: Comparative prospective study. Place and Duration of Study: Ear, Nose and Throat (ENT) Department Combined Military Hospital (CMH) Multan, from Jun 2019 to May 2020. Methodology: This study comprised of 50 patients of various age groups and both genders. Patients were grouped into two groups A and B, each group having 25 patients through random sampling. Patients in group A had endoscopic turbinoplasty whereas patients in group B had partial turbinectomy through conventional surgical method. Patients were followed regularly in both groups and were inspected postoperatively at 2 weeks, after 1 month and after 3 months. Results: Patients who underwent Endoscopic turbinoplasty experienced less pain (p˂0.05) postoperatively at 2 weeks compared to conventional surgical turbinectomy. In addition, these patients showed statistically significant healing and reduced crusting at 1 month postoperatively. At 3 months post operatively all patients had healed completely as opposed to only 72% with surgical turbinectomy. Conclusion: Endoscopic turbinoplasty is more effective than conventional surgical technique for inferior turbinate hypertrophy as it leads to less post-operative pain, reduced nasal crusting and earlier healing.

HYPOCALCEMIA IN TOTAL VERSUS SUBTOTAL THYROIDECTOMY

Objective: To compare the occurrence of hypocalcemia in patients undergoing subtotal and total thyroidectomy. Study Design: Comparative prospective study. Place and Duration of Study: Surgical departments of Ayub Teaching Hospital, Abbottabad and Combined Military Hospital, Rawalpindi, from Mar 2018 to Feb 2020. Methodology: A total of 171 patients were selected for this study and they were divided into 2 groups. Group 1 consisted of 95 patients undergoing Total thyroidectomy whereas group 2 had 76 patients undergoing Subtotal thyroidectomy. It was a comparative prospective study and the groups were made by convenience sampling. The data was analyzed by SPSS-23. Results: In total thyroidectomy group Hypocalcemia was detected after 48 hours in 34 patients (35%) while in subtotal thyroidectomy group hypocalcemia was detected in 20 patients (28%). Tests for hypocalcemia were also done after two months of surgery and low levels were detected in 7 patients (7.5%) who had total thyroidectomy and in 2 patients (5%) in the group undergoing subtotal thyroidectomy. There was no significant difference in hypocalcemia after 48 hour (p=0.22) and 2 months postoperatively (p=0.6) between patients of Total Thyroidectomy and Subtotal Thyroidectomy. Conclusion: Total thyroidectomy is not associated with increased risk of permanent hypocalcemia as compared to Subtotal thyroidectomy. Because of its advantages Total thyroidectomy should be the preferred surgical procedure for patients presenting with benign euthyroid multi nodular goiter.

Effect of thyroid dysfunction on hematological profiles at Menelik II Referral Hospital, Addis Ababa, Ethiopia

Background Thyroid hormones have a crucial role in the metabolism, production, and proliferation of blood cells. So the current study aimed to assess the hematological profile of patients with thyroid dysfunction. Methods A comparative prospective study was conducted from June to September 2021; on a total of 360 participants (120 health groups and 240 patients with thyroid dysfunction. 10 ml of venous blood samples were collected and separated into two test tubes (in the SST tube used for measurement of TSH, T3, and T4, and sample in the EDTA tubes was used for CBC analysis). The analysis was done by using SPPS software. Finally, the result was interpreted by using chi-square, Pearson's correlation, and multivariate logistic regression. The level of statistical significance was set at a 95% confidence and P-value is less than 0.05 was considered clinically significant. Results Out of 360 study participants (120 (33.33%) hypothyroidism, 120 (33.33%) hyperthyroidism, and 120 (33.33%) healthy controls); 195 (54.2%) were female, 150 (41.7%) were in the age range of 25-44 years. The finding indicated a statistically significant decrease in RBC, Hgb, HCT, MCV, PLT, MCH, MCHC, MPV, and a significantly increased valve in RDW, WBC, and NEU% in both types of thyroid dysfunction compared to control groups (p-value <0.05). Finding of MON%, EOS% and BAS% did not show significant differences between the groups (p-value >0.05). Conclusion The finding showed that thyroid dysfunction has a significant effect on RBCs, Hgb, HCT, MCV MCHC, MCH, WBC, neutrophils, PLT count, and MPV findings (p<0.05). But no show significant effect on monocyte, eosinophil and basophils (p-value > 0.05).

A COMPARATIVE PROSPECTIVE STUDY OF EFFICACY AND VISUAL OUTCOME OF PHACOEMULSIFICATION AND SICS IN NORTH INDIAN POPULATION IN AND AROUND LUCKNOW.

PURPOSE: To evaluate efcacy and visual outcome of manual small incision cataract surgery (SICS) and phacoemulsication. METHODS: A prospective, interventional, observational, follow up study was conducted on 120 patients with clinically signicant senile cataract undergoing cataract surgery by either SICS or phacoemulsication, at a tertiary eye care centre in Lucknow. The follow up evaluations were carried out at post-operative day st rd th 1, 1 week, 3 week and 6 week. RESULTS: On rst postoperative day, there was signicantly better visual outcome with phacoemulsication than SICS (p = 0.005) with 80% patients in SICS group and 90% patients in phacoemulsication group, th had best corrected visual acuity (BCVA) better than equal to 6/18. However at 6 week, nal visual recovery was similar in both the groups (BCVA 6/18 in 96.7% in SICS group and 100% in phacoemulsication group) with no statistically signicant difference. There was no signicant difference in overall per operative and post operative complications between SICS and phacoemulsication. SICS and phacoemulsication did not show signicant difference in surgery induced astigmatism (SIA) with SIA of 0.733D and 0.775D in SICS and phacoemulsication group respectively. CONCLUSIONS: Phacoemulsication is superior to SICS in terms of early visual rehabilitation. But there is no signicant difference in nal visual outcome and complication rates between the two techniques.

A comparative prospective study of laparoscopic guided needle assisted hernial sac ligation versus open herniotomy surgery in congenital inguinal hernia management

Background: To evaluate if significant difference exists in surgical outcome following laparoscopic guided needle assisted congenital hernial sac ligation versus conventional open Herniotomy as later is treatment of congenital hernia and laparoscopy guided emerged as newer alternative. Objective was to know whether a significant difference exists in surgical outcomes following laparoscopic guided needle assisted congenital hernial sac ligation and conventional herniotomy in terms of mean operative time, post operative pain, recurrence, local complication, cosmetic results.Methods: Patients were randomized on basis of odd and even registrations for surgery in our institute. Patients who undergone laparoscopic guided needle assisted congenital hernial sac ligation or who undergone conventional open herniotomy for congenital hernia between November 2018 to April 2020 (50 in each arm) were followed for 1, 3, 6 and 12 months to evaluate the outcomes.Results: In our study, major complication in open herniotomy group was surgical site infection (22%), hematoma (10%), intra operative bleeding (16%), seroma formation (8%) with minimum operative duration was ~60 minutes, hospital stay of 2-3 days while no such complication reported in laparoscopic guided needle assisted hernia sac ligation group being operative time of ~20 minutes, hospital stay of 1 day with better cosmetic results.Conclusions: We conclude that laparoscopic guided needle assisted hernial sac ligation is simple, safe, efficacious with its own advantage in comparison to conventional open herniotomy and should be acceptable alternative to traditional open herniotomy approach for congenital hernia.

A comparative study of graft uptake in split skin grafting between the first postoperative dressing done on day 3 versus day 5

Background: Skin grafting offers a method of regaining skin continuity. The common causes of skin graft failure are hematoma, seroma, infection. These affect the graft uptake maximally in the initial postoperative period by impairing graft adherence and subsequent revascularization. Aim of study was to compare graft uptake, rejection, seroma and infection among first postoperative dressing on day 3 versus day 5.Methods: A comparative, prospective study conducted at our institute from November 2015 to April 2021, with 100 patients who underwent SSG (split skin grafting) who were distributed into two groups. Group A underwent the first postoperative dressing on day 3 and group B on day 5. The second postoperative dressing was done 2 days following the first. The grafted site was then assessed on for the percentage of graft uptake, rejection, seroma, infection clinically and through culture and sensitivity.Results: The mean graft uptake in group A was 88.48% whereas in group B was 82.62% in the first dressing and in the second dressing, group A was 88.14% whereas group B was 78.02%, with statistically significant data and thus showing less rejection and infection rate in group A. Seroma was present in 82% of cases in group A and 74% in group B on 1st postoperative dressing which reduced to 6% and 12% respectively with the 2nd dressing.Conclusions: Thus, the first postoperative dressing done on Day 3 following skin grafting, significantly increased the final uptake of the graft, reduced seroma, infection and rejection rate.