Sedation in a child with Klippel-Feil syndrome scheduled for magnetic resonance imaging / 대한마취과학회지

No abstract available.

Wound infection and length of hospital stay with and without placement of drain in patients with complicated appendicitis

Objective: To compare the outcome, in terms of wound infection and length of hospital stay, with and without drain placement in patients with complicated appendicitis

Study design: Randomised controlled trial

Place and Duration of study: Department of General Surgery, Jinnah Postgraduate Medical Centre Karachi, from August 2015 to February 2016

Methodology: A total of 60 patients with complicated appendicitis were included in this study. Patients were randomly allocated into two groups and had placement of drain or no drain. Final outcome was measured in terms of wound infection and hospital stay at the end of 5[th] postoperative day. Chi square test was used for analysis

Results: There were 42 [70%] male and 18 [30%] female patients. The mean age of the study subjects was 25.63 +/- 4.13 year. Rate of wound infection and hospital stay [>4] were significantly high in patients where intraoperative drain placement was done [p=0.008 and p=0.005 respectively

Conclusions: Routine placement of the drain after complicated appendicitis is not indicated. Drain placement was associated with increased morbidity

Right-sided diaphragmatic hernia in an elderly male

Diaphragmatic hernia is rarely reported in elderly. Here we present a 90-year-old male patient suffering from respiratory symptoms with no prior history of trauma. Investigations showed diaphragmatic hernia on the right-side. Defect was anteromedial in position. The contents of the hernia were small and large gut. Considering multiple co-morbid it was decided not to operate on this patient

Ileosigmoid knotting: an unusual cause of intestinal obstruction

Ileosigmoid knot is also known as compound volvulus or double volvulus. It consists of either an intertwining or a knot forming between a loop of ileum and sigmoid colon. This lead to a complex intestinal obstruction and may result in strangulation of one or both the segments of bowel loop. We report a case of pregnant woman who presented with acute abdominal pain. Following resuscitation she was operated and Ileosigmoid knotting was found. Loops of ileum and sigmoid colon were found gangrenous. Resection of ileal loop and stoma was fashioned while resection and anastomosis of sigmoid colon loop was performed. Recovery was uneventful

Incision pain: a comparison between use of diathermy versus scalpel in patients undergoing elective abdominal surgery

Objective: to compare the mean postoperative wound pain score in diathermy [cutting] versus scalpel made skin incisions in patients undergoing elective abdominal surgery

Study design: Randomized clinical trial

Place and Duration of study: department of Surgery Jinnah Postgraduate Medical Center Karachi, From February 2015 to August 2015

Methodology: patients who underwent clean elective abdominal surgery were randomly assigned into either group A [diathermy incision] or group B [scalpel incision]. Antibiotic prophylaxis was given at the time of induction of anesthesia. Postoperatively 20ml bupivacaine [0.25%] was infiltrated into the wound and regular dose of diclofenac sodium was given. Patients were assessed for pain by numerical analogue scale at the end of 48 hours after surgery

Results: a total of 60 patients were included. They were divided into group A and B with 30 patients in each group. Mean postoperative wound pain score was significantly low in group A than groups B [1.30+/-0.98 vs. 1.97+/-0.81; p=0.0006]

Conclusion: cutting diathermy is safe and effective method to make skin incision in elective abdominal surgeries and has significant advantage over scalpel skin incision in relation to postoperative pain

Utilization pattern of health delivery system at primary and secondary level and problems encountered by users in mirpur khas division

To know the current utilization status of the health facilities at primary and secondary level in Mirpur Khas Division. Information was collected on a specially designed questionnaire which was also translated in local language for easiness of the patients. Data were collected from 47.7% [84] out of 176 primary health care facilities and 81.8% [09] out of 11 secondary level health care facilities. The users and doctor's incharges were interviewed. The data were collected from the field were compiled, entered and analyzed at PMRC Research Centre, LMC Jamshoro, The questionnaire covered basic information of the health facilities. Staff strength, provision of medicines and consumable supplies from DHO, officers, operation and maintenance of equipments provided and other general problems highlighted. The project was conducted during 1998-99 under the HSR Grant received from PMRC Islamabad. The population of Mirpur Khas Division was 45, 56, 570. The total health care facilities were 176 [165 + 11] primary and secondary respectively. Data were collected from PHC facilities 47.7% and 81.8% secondary level. The study showed 23.7 users visited primary health care facilities while 251.33 visited secondary level. The primary and secondary care health facilities are under utilized due to shortage of staff, particularly WMOs in this division. Tharparkar desert is 22,000 km area and there are no ambulance services to transport serious patients and pregnant ladies to some tertiary care hospital for urgent surgeries or neonatal care. Most of the deaths are observed while transporting pregnant mothers on the back of the camel which is frequent traditional mode of transport in desert