ABSTRACT
Objective: To compare the efficacy of early oral feeding and conventional oral feeding in elective intestinal stoma reversal in terms of mean number of days of NG tube out and hospital stay. Study Design: Randomized Controlled Trials. Settings: Surgical Units of Allied/DHQ hospitals Faisalabad. Duration of Study: 1 year duration from February 2014 to January 2015. Sampling Technique: Non-probability consecutive sampling
Methodology: 60 patients were selected from OPD. Patients were randomly allocated to two groups. All stomas were closed in single layer extramucosal seromuscular fashion, intraperitonealy. In post-operative period, patients in group I were allowed oral feed in early post-operative period [6-8 hours] after the surgery. Initially, oral liquids [30ml/hr] was given and patients were observed for nausea and vomiting. Oral feed was increased gradually with the response of the patient with semi-solid to solid diet on 1[st] or 2[nd] post-operative day. Patients in group II were started oral sips of liquids once they pass flatus or audible bowel sounds. At least two follow up visits were advised within two weeks of discharge of patients, 1[st] on the 7[th] day and 2[nd] on the 14[th] day, for removal of skin stitches
Results: Out of 60 patients 37 [61.7%] were males and 23 [38.3%] were females. Among the variables under the study, for both groups, the minimum total number of days of nasogastric decompression was 0 days and maximum total number of days of nasogastric decompression was 5 days with mean of 1.17 days and standard deviation of 1.33. In group 1, the mean of the total number of days of nasogastric decompression was 0.13 +/- 0.35 days and in group 2, the mean of the total number of days of nasogastric decompression was 2.20 +/- 1.13 days with p-value of 0.0001 for both the groups, the minimum total number of days of hospital stay was 3 days and the maximum was 9 days, with mean of 4.82 days and Std. Deviation of 1.70 days. In group 1, the mean of the total number of days of hospital stay was 3.37 +/- 0.61 days and in group 2 the mean of the total number of days of hospital stay was 6.27 +/- 1.08 days with p-value of 0.000
Conclusion: Early oral feeding in cases of elective intestinal stoma reversal is better than conventional oral feeding in terms of number of days of nasogastric decompression and hospital stay
ABSTRACT
Objectives: To determine damage of RLN with and without exposure during thyroidectomy. Study design: Randomized control study Sampling technique: Non-probability consecutive sampling. Sample size: 150 patients. Setting: Surgical units of Allied Hospital Faisalabad
Methodology: With informed consent, study was conducted on two groups[75 in each group].Patients were distributed on alternate basis into group A and group B for thyroidectomy with and without identification of RLN respectively
Results: In group A 30[40%] patients were between 31-40 Years and 18[24%] between 41-50 Years. In group B 32[42.7%] were between 31-40 Years,13[17.3%] between 41-50 Years and 15[20%] between 50-60 Years. Mean of age was 38.5 +/- 10.9[standard deviation].In group A,28[37.3%] were male and 47[62.7%] females while in group B 25[33.3%] were males and 50 [66.7%] females. In group A 38[50.7%] patients were of MNG, 10 [13.3%] diffuse goiter, 7[9.3] solitary nodules, 13 [17.3%] suspicion of malignancy and 7[9.3%] malignanacy. In group B 33[44%] patients were having MNG, 15[20%] diffuse goiter, 10[13.3%] solitary nodule, 6[8%] suspicion of malignancy and 11[14.7%] malignant disease. In group A 39[52%] patients underwent STT, 20[26.7%] NTT, 10[13.3%] TT and 6[8%] hemi-thyroidectomy. In group B 35[46.7%] patients underwent STT, 21[28%] NTT, 12[16%] TT and 7 [9.3%] hemi-thyroidectomy. In group A 3 [4%] patients developed transient paralysis and 1[1.3%] permanent paralysis of RLN. In group B 7[9.3%] patients developed transient paralysis and 3[4%] permanent paralysis of RLN
Conclusion: Preservation of RLN is more likely with exposure and identification of RLN post-operatively
ABSTRACT
Objective: to compare the postoperative outcome of stapled haemorrhoidectomy and conventional Milligan Morgan's haemorrhoidectomy at Allied Hospital
Study Design: simple comparative study
Place of Study: Surgical Unit 1, Allied Hospital Faisalabad
Duration of Study: January 2011 to September 2012
Sample size: 50 patients
Material and Methods: fifty patients of 3rd and 4th degree hemorrhoids were selected for admission from the outpatient department. Patients with additional anal disease [e.g. fissure, abscess, fistula, ano-rectal cancer etc.] were excluded. Two groups of twenty five each were made. Group A for stapled haemorrhoidectomy and Group B for Milligan- Morgan haemorrhoidectomy [MMH]. The operative time was measured in minutes. Postoperative pain was assessed through visual analogue scale [VAS]. Bleeding was measured as mild, moderate and profuse. Other postoperative complications during hospital stay like urinary retention, anal stenosis etc. were noted. T-test, chi-square test and repeated measured analysis of variance were applied to compare the variables
Results: a majority of patients[combined in both groups] had third degree haemorrhoids. The mean length of operative time was found statistically insignificant between stapled and open groups [34 vs 36 minutes]. In Group A 23 [92%] patients were discharged in 24 hrs while 2 [8%] patients were discharged after 24 hrs. In Group B 9 [36%] patients were discharged in 24 hrs and 16 [64%] patients were discharged after 24 hrs. In group A 19 [76%] patients were having mild bleeding, 5 [20%] moderate bleeding and 1 [4%] profuse bleeding. In Group B 7 [28%] patients were having mild, 16 [64%] moderate and 2 [8%] profuse bleeding. In Group A 15 [60%] patients were having mild pain, 7 [28%] moderate and 3 [12%] severe pain on visual analogue scale. In Group B 4 [16%] patients were having mild pain, 15 [60%] moderate and 6 [24%] severe pain. The proportion of postoperative anal stenosis, prolapsed recurrence, persistent pain, recurrent bleeding and urinary retention was higher in MMH than stapled haemorrhoidectomy group
Conclusion: there was a significant difference between stapled haemorrhoidectomy and Milligan Morgan's for bleeding, pain and hospital stay. However the mean length of operative time was insignificantly different
ABSTRACT
Objectives: To compare the role of adjuvant topical oxygen therapy versus conventional methods in the management of non-healing infected wounds
Study Design: Simple comparative study
Setting: The study was carried out in one year duration from January 2010 to December 2010 in Surgical unit-1 Allied Hospital Faisalabad
Sample Size: 60 patients
Methods: Total of 60 patients was divided into two groups. In one group [A] topical oxygen therapy was given along with conventional measures for management of wound. In second group [B] only conventional methods were used for wounds
Results: 60 cases included in this study,30 in group A and 30 in group B. From patients of group A, 16[53.3%] showed clinical improvement in first week and 25[83.3%] showed clinical improvement in second week. While in group B 5[17%] and 11[36.7%] showed clinical improvement in first and second week respectively.5[17%] patients in group A developed granulation tissue in first week and 19[63%] in second week. While in group B 2 [7%] developed granulation tissue in first week and 8[27%] in second week. From group A 10[33.3%] and 24[80%] patients showed complete wound healing in second and third months respectively. In group B 3[10%] patients showed complete wound healing in two months and 12[40%] in three months.1[3.3%]patient in group A deteriorated in first week and 2[7%] in second week.8[27%]patients from group B deteriorated in first week and 4[13.3]in second week
Conclusion: Use of TOPOX along with conventional method is more safe and effective in the management of nonhealing infected wound than conventional methods alone