ABSTRACT
Objective: To determine the outcome of combination of low dose oral Prednisolone with oral propranolol for the treatment of infantile hemangioma
Methods: The patients fulfilling the inclusion criteria were registered through outpatient department. Diagnosis was confirmed clinically and on Color Doppler ultrasonography [CD]. All the patients were given oral prednisolone in a dose of 1mg/kg/day and propranolol in a dose of 0.5mg/kg/day twice a day and increased up to 1.5mg/kg/day BID within three days with close monitoring of heart rate, blood pressure and blood glucose as inpatient. Treatment was given for three months then titered down for two weeks before cessation of treatment. The follow-up of patients were performed at 7[th] day, at 1[st] month and finally at 3[rd] month. Treatment compliance was checked during each visit along with outcome parameters i.e. response which was excellent, good, moderate slight improvement and no effect. All the information's were collected. Data was analyzed by using SPSS version 10
Results: Out of total 73 patients, 36.99% [n=27] were one year of age, 32.88% [n=24] were two years of age and 30.13% [n=22] were three years of age, mean +/- SD: 1.96 +/- 0.54 years, 53.42% [n=39] were male and 46.58% [n=34] were females, frequency of response of the treatment was recorded as 56.16% [n=41] had excellent, 23.29% [n=17] had good, 15.07% [n=11] had moderate response, 4.11% [n=3] had slight improvement and 1.37% [n=1] had no effect while frequency of acceptable outcome revealed as acceptable in 79.45% [n=58] while 20.55% [n=15] had not acceptable outcome
Conclusion: The frequency of acceptable outcome of combination of low dose oral Prednisolone with oral propranolol for the treatment of infantile hemangioma is higher
ABSTRACT
To evaluate the out come of the different treatment modalities for omphalocele. Descriptive. At the department of paediatric surgery Bahawal Victoria hospital Bahawalpur from January 2004 to August 2007. Fifty three patients have been studied, 33 patients with a major defect, 20 patients with a minor defect and male to female ratio of 1:3. All the patients with minor defect were managed with primary closure while same was done in only 4 [12.12%] patients with major defect. Rest of the patients with major defect, 11 [33.33%], were managed conservatively followed by delayed primary closure, silo formation was done in 6 [18.18%] patients and ventral hernia was formed in 5 [15.15%] patients. 100% survival rate was found in patients who were managed conservatively with delayed primary closure. Overall mortality was found in 12 [22.6%] patients. Primary closure is the treatment of choice in exomphalos minor. Delayed primary closure after application of escharating agent is the Management of choice in patients with exomphalos major. Silo formation is considered in exomphalos major with ruptured membrane
Subject(s)
Humans , Male , Female , Hernia, Umbilical/surgery , Hernia, Umbilical/diagnosis , Treatment Outcome , Mortality , Abdominal Wall/abnormalities , Abdominal Wall/embryologyABSTRACT
Design: It was a comparative study of randomly selected sample of 50 patients
Purpose: To compare the results of lateral internal sphincterotomy with manual dilatation of anus under general anaesthesia in the management of fissure in ano in terms of [Relief of symptoms, Post operative complications]
Place and Duration of study: Patients presented to Surgical unit, Bahawal Victoria Hospital, Bahawalpur from 15-02-2002 to 14-02-2004
Material and methods: This was a prospective type of comparative study. The patients of fissure in ano were randomly divided into two groups. Group A patients were treated by lateral sphincterotomy and Group B patients were treated by manual dilatation of anus under anesthesia. Follow up protocol was also maintained. Patients were examined and evaluated according to the comparison criteria which were [Relief of symptoms, Complications developed, Recurrence and Healing of fissure]
Result: Out of these 50 patients, 32 were male and were female. In Group-A, 92% of patients were completely cured, 4% of patients developed retention of urine while 4% of patients developed post-operative bleeding. The success rate was 92%. In Group-B, success rate was 72% out of remaining 8% developed incontinence of flatus, 8% developed incontinence of faeces, 4% developed retention of urine while haematoma was observed in 4% of cases.The data was analysed with [SPSS] on computer, Standard Error of Difference Between Two Proportions was applied. Chi square test was applied and P value found to be 0.04 which is less than 0.05 [Statistically insignificant]
Conclusion: On the basis of this study, it was concluded that the results of Lateral Internal Sphincterotomy in the management of anal fissure is safer and more effective than manual dilatation of anus under anaesthesia