scholarly journals Comparison between intravenous injectable diclofenac and per rectal diclofenac suppository as analgesics in operated per anal and perianal benign pathologies

2019 ◽  
Vol 7 (1) ◽  
pp. 263
Author(s):  
Juthikaa Abhijit Deherkar
Keyword(s):  
Pain Relief ◽  
Hospital Stay ◽  
Pain Score ◽  
Pain Scale ◽  
Group A ◽  
Group B ◽  
At Home

Background: Per anal and perianal surgeries are one of the bread and butter surgeries in a surgeons life, and satisfaction of patient matters a lot. Early miraculous recovery has always been patient’s expectations hence we decided to study standard IV method of diclofenac as analgesic with diclofenac suppository and compared their effects on patients with the help of pain scale of 0 to 10.Methods: 200 common per anal surgeries were considered in the study, and were divided in two groups group A post operatively IV diclofenac was given 12 hourly and in group B cases diclofenac suppository 100 mg was started daily twice and the pain score was noted for a week.Results: Diclofenac suppositories resulted in early pain relief and thus early discharges of these patients. The pain score had decreased to a larger extent by day 3 and was almost negligible by day 5 and a few cases to day 7. The hospital stay reduced as patient could manage suppository at home by themselves. IV site complications like thrombophlebitis leading to pain and fever could be easily avoided.Conclusions: Thus diclofenac suppositories proved to be an effective way to give a pain free satisfaction compared to intravenous painful analgesics, thus decreased their hospital stay and also it was a patient friendly.

scholarly journals Outcome of thyroid lobectomies undergone with and without drains

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.

scholarly journals Single centre randomized comparative trial of lateral internal sphincterotomy versus 2% diltiazem in chronic anal fissure

2020 ◽  
Vol 7 (6) ◽  
pp. 1723
Author(s):  
Hariharan Sritharan ◽  
Naren Kumar Ashok Kumar ◽  
Mohamed Ismail Syed Ibrahim M. S.
Keyword(s):  
Pain Relief ◽  
Pain Score ◽  
Comparative Trial ◽  
Lateral Sphincterotomy ◽  
Anal Fissures ◽  
Standard Management ◽  
Flatus Incontinence ◽  
Group A ◽  
Group B ◽  
Pharmacologic Agents

Background: Anal fissures are often encountered in surgical practice with surgery the gold standard management for chronic anal fissures. Recently the widespread use of pharmacologic agents for chronic fissures has increased. In our study we compare topical 2% diltiazem with lateral sphincterotomy with respect to symptoms such as relief of pain, ulcer healing, and side effects of treatments.Methods: A prospective comparative study, a total of 80 patients were randomized into 2 groups 40 each. Group A patients were subjected to open internal lateral sphincterotomy and group B to 2% topical diltiazem. The patients in both groups were followed up at 1st, 4th, 14th weeks and 6 months in OPD and were assessed for pain, sphincter tone and complications.Results: In group A (lateral anal sphincterotomy), patients achieved a good pain relief with a mean pain score of 1.98 by one week post procedure whereas group B (2% diltiazem) had taken 14 weeks to achieve similar pain relief (pain score of 1.5). At the end of 6 months, healing of fissure was noted in 100% of group A and in 90% of group B. 4 patients (10%) had recurrences in group B. Flatus incontinence was reported in 2 patients (5%) in group A although transient.Conclusions: Lateral anal sphincterotomy is superior to 2% diltiazem especially in healing of fissure, pain relief, quality of life and recurrence. Pharmacologic agents should be reserved for patients who are unfit or unwilling for surgery or can be used as a bridge therapy till sphincterotomy can be planned.

scholarly journals Efficacy of Tamsulosin as Compared to Placebo, in Reducing Post Operative Flank Pain during Voiding, in Patients with Ureteric Stent

2021 ◽  
pp. 88-93
Author(s):  
Arif Ali ◽  
Suhail Dilawar ◽  
Bilal Suria ◽  
Safiullah Sohu ◽  
Ghulam Mujtaba ◽  
...  
Keyword(s):  
Pain Score ◽  
Renal Calculi ◽  
Pain Scale ◽  
Flank Pain ◽  
P Value ◽  
Trauma Patients ◽  
Ureteric Stent ◽  
Group A ◽  
Group B ◽  
Centre Hospital

Objective: To evaluate the efficacy of tamsulosin in reducing post operative flank pain during voiding, in patients with ureteric stent. Study Design: This is a Randomized control trial (RCT) study. Place and Duration: Study carried out at Department of Urology, Jinnah Post Graduate Medical Centre, Hospital, Karachi, Pakistan, from June 2016 to November 2016. Methodology: 60 patients aged between 15 – 45years, undergone placement of ureteric stent to treat ureteric and renal calculi and have pain score >4, were included in the study. Divided into two groups ‘group A’ and ‘group B’. In group ‘A’ and group ‘B’ Tamsulosin and Placebo was given respectively in patients with ureteric stent and reduction in post-operative flank pain was measured and compared. Tamsulosin was given post operatively when NPO is broken after 2 hours – 6 hours.  Patients having uretral trauma, patients having BPH,  patient underwent TURP or TURBT, patent having urinary tract infection and  patients with pregnancy or lactating females were excluded. All patients were received intravenous antibiotic (Ceftrixone 1gr). Also all patients were receive oral analgesic (diclofenic sodium 50mg BID) and antispasmodics (Drotaverine 80mg BID). Patients were discharged after 24 hours. Postoperatively stent related flank pain during voiding was assessed via Pain Scale. Results: 60 Patients who got operated for ureteric stent. In group ‘A’ there were 21 males (70%) and 9 females (30%), the mean age of group A was 35.67±5.99 as In group ‘B’ there were of 21 males (70%) and 9 females (30%) and mean age of group B was 35.04±6.42 (Table 1). Mean Pain score in ‘Group A’ (Tamsulosin) in week 1, 2, 3, 4, 5, 6 was 4.1, 3.5, 2.9, 2.3, 1.9, 1.3 respectively as shown in Table 2. Mean Pain score in ‘group B’ (Placebo) in week1, 2, 3, 4, 5, 6 was 6.9, 6.3, 5.9, 5.6, 5, 4.2 respectively as shown in Table 2.  Average pain score in ‘group A’ and ‘group B’ came out to be 2.67 and 5.64 respectively (P value 0.005).  Conclusion: Alpha blockers reduces the post-operative flank pain and voiding complaints in patients with ureteric stent. Our study shows that the efficacy of Tamsulosin in reducing post-operatice flank pain in patients with uretercic stent is better than placebo.

EARLY OUTCOME OF LASER INTERNAL SPHINCTEROTOMY VERSUSOPEN INTERNAL SPHINCTEROTOMY IN THE TREATMENT OF ANAL FISSURES

2021 ◽  
pp. 55-59
Author(s):  
Rajkumar Verma ◽  
Satyendra Kumar ◽  
Vipin Mishra ◽  
Narendra Kumar
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Pain Score ◽  
Treatment Options ◽  
Lateral Internal Sphincterotomy ◽  
Fissure In Ano ◽  
Early Outcome ◽  
Internal Sphincterotomy ◽  
Group A ◽  
Group B

INTRODUCTION : Fissure-in-Ano is one of the common and most painful anorectal conditions encountered in surgical practice. Inspite of several conservative treatment options, surgical treatment in the form of Lateral Internal Spincterotomy (LIS) remains the gold standard of treatment for anal ssure. However we compare Laser lateral internal sphincterotomy with Open lateral internal Sphincterotomy for better postoperative pain relief and lesser hospital stay. AIM: Early outcome of laser lateral internal Sphincterotomy versus open lateral internal sphincterotomy in the treatment of anal ssures. MATERIALS AND METHODS: The study was conducted on 50 cases of Laser lateral internal sphincterotomy compare with 50 cases of Open lateral internal sphincterotomy in Maharani Laxmi Bai Medical College, Jhansi between January 2020 to July 2021. RESULTS:In our study in Group A 6% were in 16-20 years, 52% in 21-30 years, 20% in 31-40 years, 20% in 41-50 years and 2% 51-60% years and Group B 2% in 16-20 years, 34% in 21-30 years, 32% in 31-40 years, 18% 41-50%, 10% in 51-60 and 4% in >60. Group A mean postoperative VAS pain score in 6 hours 5.12±0,328, 12 hours 4.32±0.768, 24 hours 3.74±0.777, 36 hours 2.76±1.379 and 48 hours 2.3±1.418. In Group B mean postoperative VAS pain score in 6 hours 5.2±0.452, 12 hours 2.7±1.741, 24 hours 1.76±1.451, 36 hours 0.58±0.971 and 48 hours 0.28±0.671. Group A 44% presented with Perianal swelling, 42% Prutis Ani and 40% atus incontinence. In Group B 6% presented with amount of blood loss 6%, 18% Perianal swelling, 6% infection, 18% atus incontinence. The mean postoperative pain score was signicantly less in Group B at 12 to 48 hours. Group A mean hospital stay was 5.02±1.237 days and in Group B 2.02±0.141 days. It was signicantly less in Group B. CONCLUSION: Laser lateral Internal Spincterotomy is better than open Lateral Internal Spincterotomy with respect to less postoperative pain and lesser hospital stay and also less postoperative complications in the treatment of anal ssure.

scholarly journals LAPROSCOPIC CHOLECYSTECTOMY;

2019 ◽  
Vol 26 (04) ◽  
Author(s):  
Muhammad Usman ◽  
Kaiser Saleem ◽  
Saddaqat Hayat
Keyword(s):  
Hospital Stay ◽  
Pain Score ◽  
Tertiary Care ◽  
P Value ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Surgical Unit ◽  
Trial Setting

Objectives: Compare the efficacy in terms of mean pain score and mean duration of hospital stay in patients of symptomatic cholilithiasis undergoing laproscopic cholecystectomy with and without subhepatic drain insertion. Study Design: Randomized control trial. Setting: Surgical unit –iii of Allied Hospital Faisalabad which is tertiary care unit. Duration of Study: 20-02-2013 to 20-08-2013. Results: Out of 150 cases (75 cases in two groups), mean+sd was calculated as 44.74+ 6.57 years, 80%(n=60) in Group-A and 82.66%(n=62) in Group-B were female, post- operative hospital stay was recorded which shows 3.16+0.463 in group-a and 2.32+0.569 days in group-b and it shows statistically significant difference between the two groups, similarly, on comparison of post-operative abdominal pain score at 24 hours in both groups 2.266+1.062 in Group-A and 1.8+0.90 in Group-B pain on vas was recorded at 24 hours which shows significantly lower in Group-B patients by calculating p value as 0.002348. Conclusion: No subhepatic drain insertion after laproscopic cholecystectomy is better when compared to those with subhepatic drain insertion in terms of mean pain score and mean duration of hospital stay in days post operatively.

scholarly journals Infective complications after percutaneous nephrolithotomy in relation to preoperative urine culture status

2019 ◽  
Vol 6 (1) ◽  
pp. 8-13
Author(s):  
Birendra Kumar Yadav ◽  
Robin Bahadur Basnet ◽  
Anil Shrestha ◽  
Parish Mani Shrestha
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Urine Culture ◽  
Operation Time ◽  
Group A ◽  
One Year ◽  
Group B ◽  
Stone Characteristics ◽  
Negative Urine Culture ◽  
Infective Complications

Introductions: Fever and sepsis after percutaneous nephrolithotomy (PCNL) secondary to urinary tract infection is a major determinant of overall post PCNL complications. This study aims to analyse infective complications after PCNL in relation to pre-operative urine culture status. Methods: A comparative analysis of post PCNL infective complications in pre-operative urine culture positive (Group A) and negative (Group B) was done for one year during June 2017 to May 2018 in department of urology, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal. Demographics, stone characteristics, mean operative time, post-operative hospital stay and post-operative complications as per Modified Clavien classification were compared between the two groups. Results: Out of total 136 PCNL patients, 51 were in Group A and 85 in Group B. Infective complications were significantly high, 28 (54.90%) in group A compared to 20 (23.53%) in group B, p=0.004. The most common isolate was Escherichia coli 19 (37.25%), sensitive to amikacin 37 (72.55%). The mean operation time, transfusion and hospital stay was not statically different in two groups. Morality occurred in 1 (1.96%) in group A. Conclusions: Infective complications were significantly high after PCNL in patients with preoperative positive urine culture, even when it was treated to sterile with sensitive antibiotics, compared to patients with preoperative negative urine culture.

The Outcome Comparison of two Groups of total Extraperitoneal and Mesh Repair of Inguinal Hernia

2021 ◽  
Vol 15 (10) ◽  
pp. 2712-2714
Author(s):  
Muhammad Aamir Jamil ◽  
Muhammad Asif ◽  
Imran Yousaf ◽  
Muhammad Faheem Anwer ◽  
Muhammad Waseem Anwar
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Recovery Time ◽  
Mesh Repair ◽  
Operative Procedure ◽  
Total Extraperitoneal ◽  
Outcome Comparison ◽  
Group A ◽  
The Mean ◽  
Group B

Aim: The outcome comparison of total extraperitoneal versus mesh repair for inguinal hernia. Study design: Quasi experimental study. Place and duration of study: Department of Surgery, M. Islam Teaching Hospital, Gujranwala from March 2018 to March 2019. Methodology: After the approval of hospital ethical committee, a total of 50 patients were included and randomly divided into two groups equally. Group A (Total extraperitoneal), Group B (Mesh repair). An informed consent was taken from every patient about operative procedure and the outcome. A detailed history of the patient i.e. clinical examination, routine investigations (CBC, Urine R/E, urea, creatinine) and some specific investigations (chest X-ray, ECG and ultrasound abdomen and prostate) was done for surgery. All data of patients was collected on proforma and was analyzed with the help of a computer SPSS programme 20. Results: The mean age of patients was 34.22±11.54 years in group A and 35.63±11.25 years in group B. All male and female patients included in this study in both groups. Twelve (48%) of patients were direct inguinal hernia in group A 13(22%) were in group B and 14(56%) patients were in group A and 11(44%) patients were in group B. The mean±SD postoperative hospital stay was 24.48±4.62 in group A and 34.65±12.26 hours in group B (p 0.001). The mean±SD postoperative recovery time in weeks was 2.18±0.43 in group A and 2.90±0.46 weeks in group B (p 0.001). Only 2 (4%) patient had postoperative infection on first week and 4 (8%) patients had infection respectively. No recurrence was seen in group A and only 3% recurrence was in group B. Conclusion: It is concluded that group A had shorter hospital stay, recovery time, postoperative time and less infection rate as compared to group B. In group A 13% patients had severe pain and in group B 25% patients. Keywords: Inguinal Hernia, Total extraperitoneal, Mesh repair.

scholarly journals Role of Rifaximin for the Treatment of Hepatic Encephalopathy in Chronic Liver Disease

2017 ◽  
Vol 7 (3) ◽  
pp. 205-211
Author(s):  
Ranjit Kumar Paul ◽  
Indrajit Kumar Datta ◽  
Habib Ahmed ◽  
Mohammad Reazul Karim ◽  
Md Nazmul Haque ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Hospital Stay ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Controlled Study ◽  
End Of Treatment ◽  
Group A ◽  
Group B ◽  
Ctp Score

Background: Hepatic encephalopathy (HE) is a common problem in patients with chronic liver disease (CLD) and is characterized by diminished mentation and neuromuscular abnormalities. Rifaximin has been reported to be effective for the treatment of hepatic encephalopathy (HE) in Europe and other countries. It is unknown whether rifaximin is effective for the treatment of hepatic encephalopathy in Bangladeshi patients.Methods: A prospective, randomized, single blind, placebo controlled study was conducted to evaluate the efficacy of rifaximin among patients with cirrhosis of liver with hepatic encephalopathy. A total sixty patients of HE fulfilling inclusion criteria were randomly enrolled among those admitted under Gastrointestinal, Hepatobiliary and Pancreatic Disorders (GHPD) department of BIRDEM General Hospital during August 2012 to April 2013. Patients were divided into two groups: group A (receiving Tab. rifaximin with lactulose), the total number of patients were 31(51.7%) and group B (receiving placebo with lactulose), it was 29(48.3%). Enrolled patients were followed up for 10 days or up to discharge from the hospital or death. At enrollment and at the end of treatment, gradation of HE and estimation of portosystemic encephalopathy (PSE) index was done.Results: In this study between two groups, mean age difference (p=0.404), gender difference (p=0.668) and CLD duration difference (p=0.555) were not statistically significant between two groups. At enrollment, prognostic scores e.g. Child-Turcotte-Pugh (CTP) score (p=0.489) and PSE index (p=0.934) were not significantly different between two groups. At the end of treatment, group A patients showed significantly lower HE grade (P=0.045) and PSE index (P<0.05) than group B. CTP score (p=0.552) was also lower in rifaximin treated group than placebo group but no significant difference was observed. The mean duration of hospital stay was significantly lower in group A than group B (p<0.05).Conclusions: Hepatic encephalopathy patients treated with rifaximin plus lactulose have better outcome and less hospital stay than those treated with placebo plus lactulose.Birdem Med J 2017; 7(3): 205-211

scholarly journals Comparative study between laparoscopic trans-abdominal preperitoneal and open mesh hernioplasty in repair of non-complicated inguinal hernia

2019 ◽  
Vol 7 (1) ◽  
pp. 24
Author(s):  
Waleed Yusif El Sherpiny
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Group ◽  
Routine Activities ◽  
Group A ◽  
Group B ◽  
Open Hernia Repair ◽  
Mesh Hernioplasty

Background: Inguinal mesh hernioplasty is one of the common procedures performed all over the world. It can be done either through open or laparoscopic techniques. The aim of this study was to compare the outcomes of Lichtenstein tension free hernioplasty versus laparoscopic transabdominal pre-peritoneal (TAPP) mesh repair considering, duration of the surgery, hospital stay, and duration to resume normal activity, degree of postoperative pain, wound infection, recurrence and complications.Methods: Adult patients presented to the general surgical OPD, with the diagnosis of inguinal hernia underwent either Lichtenstein repair or laparoscopic repair by TAPP.Results: Patients in Group A (open-repair) had significantly greater level of local pain during rest and during routine activities than those within Group B (laparoscopic group) during the postoperative period assessed on the visual-analogue scale. Mean operative time for open hernia repair was 43.7 minutes and for laparoscopic hernia repair was 59.03 minutes and the difference were statistically significant (p=0.0001). The mean duration of hospital stay for open hernia repair was 2.16 days and that for laparoscopic hernia repair was 1.08 days with a (p=0.00001) which was statistically significant. The time to resume routine activities was much shorter among Group B patients than patients in Group A. Only one recurrence (3.3%) was seen in Group B after 6 months follow up.Conclusions: It is concluded that laparoscopic TAPP repair of inguinal hernia in adults is safe and preferred operation as compared to open inguinal hernia repair.

scholarly journals Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain

2015 ◽  
Vol 16 (12) ◽  
pp. 939-943 ◽  
Author(s):  
Leena Alsomadi ◽  
Riyad Al Habahbeh
Keyword(s):  
Pain Scale ◽  
Prophylactic Antibiotics ◽  
Post Treatment ◽  
Endodontic Treatment ◽  
Significant Difference ◽  
Group A ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Group B

ABSTRACT Aim To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. Materials and methods After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. Results Peak postoperative pain occurred at 16 hours posttreatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402). Conclusion Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. Clinical significance Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients. How to cite this article Alsomadi L, Al Habahbeh R. Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain. J Contemp Dent Pract 2015;16(12):939-943.

Sign in / Sign up

Export Citation Format

Share Document