ABSTRACT
Objective: The objective of this study was to compare the mean per operative and post operative blood loss using harmonic scalpel and monopolar electrocautry in modified radical mastectomy. Study Design: Randomized controlled trial. Place and Duration of Study: Department of surgery PNS Shifa Karachi, from 25[th] Oct 2011 to 24[th] Apr 2012
Material and Methods: A total of 64 patients, undergoing Modified Radical Mastectomy [MRM] were randomly divided into two groups of 32 patients each, using random numbers table. Dissection in group A was done using Harmonic Scalpel [HS]. Group B underwent Monopolar Electrocautry [ME] for dissection and hemostasis. Mean per and post operative blood loss was calculated in milliliters
Results: Mean per operative and post operative blood loss using harmonic scalpel [group-A] was 121.19 +/- 5.63 ml while 603.35 +/- 8.04 ml loss was recorded in monopolar electrocautry group [group B]. A p-value was calculated as <0.001 which shows a significant difference between both the groups
Conclusion: The mean per and post operative blood loss using harmonic scalpel is significantly less than using monopolar electrocautry in modified radical mastectomy
ABSTRACT
Objective: To compare antibiotic therapy and appendectomy in uncomplicated acute appendicitis in terms of efficacy
Study Design: Randomized controlled trial
Place and Duration of Study: Surgical Ward Forward Treatment Centre [FTC], 5 Mountain Medical Battalion Forward Kahuta Azad Jammu Kashmir [AJK], from Oct 2011 to Mar 2013
Material and Methods: A total of 103 patients with clinical diagnosis of acute appendicitis [AA] were admitted during the duration of study and divided into two groups by consecutive sampling. The antibiotic group consisted of 51 patients who received intravenous antibiotics for 48 hours and oral antibiotics for another 8 days. The appendectomy group comprised of 52 patients who all underwent standard appendectomy. All the patients were followed up at 1 month and 1 year for assessing efficacy and post treatment complications
Results: The efficacy of antibiotic treatment is 90.625% as compared to appendectomy which was 88.46% [p=0.759] at 1 month follow up after treatment. At one year post treatment, the comparison between the efficacy of antibiotic therapy [71.87%] and appendectomy [87.14%] remains statistically insignificant [p=0.055]
Conclusion: Antibiotic therapy is comparable to appendectomy in AA in terms of efficacy at 1 month and 1 year post treatment
ABSTRACT
Objective: Objective of this study was to evaluate diagnostic accuracy of fine needle aspiration cytology in diagnosing solitary thyroid nodule keeping histopathology as gold standard
Study Design: Cross sectional study
Place and Duration of Study: Combined Military Hospital, Multan from 27 Aug 2010 to 26 Feb 2011
Material and Methods: Three hundred and forty nine patients were included in the study through non-probability convenient sampling. In outdoor visit, after taking detailed history, general physical examination was done. Patients fulfilling the inclusion criteria were admitted in ward. The procedure of FNA was explained in detail to the patient and Informed consent was taken
Results: Out of 349 patients, all underwent FNAC whereas 321 underwent surgery. FNAC showed 113/321 [35.20%] patients to have malignancy, however after surgery 109 / 321 [32.08%] patients were found to have malignancy on histopathology. Eighteen patients were diagnosed as papillary CA on FNAC all confirmed on histopathology. Follicular carcinoma was diagnosed in 35 patients on FNAC. However, only 32 were actually found to have the disease on histopathology
Conclusion: Role of FNAC is quite conclusive for the diagnosing malignancy and proposing surgery in most of cases of cold nodules due to its potential for malignancy. FNAC can be relied upon due to good sensitivity [92.56%], specificity [95.81%], Accuracy [94.49%], Positive predictive value 93.83% and Negative predictive value of 94.93%
ABSTRACT
Objective: The objective of this study was to compare 5/0 polypropylene suture with 5/0 chromic catgut in small clean pediatric facial laceration repair in terms of cosmetic outcome
Study Design: Randomized controlled trial
Place and Duration of Study: Combined Military Hospital, Rawalpindi from 26[th] May 2012 to 25[th] Nov 2012
Patients and Methods: A total of 300 patients of both gender under 12 years of age, with small clean facial lacerations were selected and divided in two equal groups using random number tables. All the patients underwent suturing in minor operating theater of trauma centre CMH Rawalpindi as day care cases, under local anesthesia and aseptic measures. In group 1, polypropylene 5/0 suture was used where as in group 2 chromic catgut 5/0 was used for suturing
Aseptic dressing was applied. All patients were reviewed on 5[th] day [for stitch removal in polypropylene group] and 3 months post-operatively to establish cosmetic outcome which was determined by scar visual analog score both by parents of the child and consultant surgeon
Results: The mean VAS [visual analog score] as observed by Consultant surgeon was 79.14 and 78.63 for polypropylene and chromic catgut groups respectively
The mean VAS observed by the parents of the child for respective groups was 76.67 and 76.03. The significance value was 0.961 for parental VAS and 0.988 for surgeons VAS depicting insignificant difference in both suture groups
Conclusion: There is no long-term difference in cosmetic outcomes of both the sutures in the repair of facial lacerations in the pediatric population. No difference in complication rate of wound was observed. In addition, the parents of the children in absorbable suture group expressed satisfaction over prevention of psychological trauma of stitch removal
ABSTRACT
Objectives: To determine the accuracy of first morning void urine specimen for Albumin to Creatinine Ratio [ACR] comparing with 24-hour urinary albumin excretion in detecting trueroalburninuria in type 2 diabetics
Study Design: Cross Sectional study
Place and Duration of Study: Military Hospital Rawalpindi, from Apr 2013 to Oct 2013
Patients and Methods: One hundred and twenty patients with type 2 Diabetes Mellitus [DM] fulfilling the inclusion criteria were included in study using consecutive non-probability sampling. A standard protocol was followed for specimen collection. Urine collection was started from the next day of admission
Results: Mean random plasma glucose level was 174.54 +/- 33.06 mg/dL, mean HbAlc was 8.5 +/- 1.32%, mean urinary albumin 130.26 +/- 47.25 mg/24 hour and mean ACR was 104.30 +/- 51.56 mg/g. Area under ROC curve was 0.964 for microalbuminuria by ACR. Spearman's rank-order coefficient [rs] was 0.696 for ACR and 24 hour albumin excretion
Conclusion: ACR in first morning void urine accurately detected early microalbuminuria in type 2 diabetics
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Creatinine , Diabetes Mellitus, Type 2 , Cross-Sectional Studies , Urine Specimen CollectionABSTRACT
To compare laparoscopic and conventional open appendectomy in terms of operative time, hospital stay and frequency of surgical site infection [SSI]. Quasi-experimental study. Combined Military Hospital, Quetta from 6[th] Jun 2010 to 1[st] Sep 2011 and Combined Military Hospital, Multan, Pakistan from 2[nd] Sep 2011 to 5[th] Jun 2012 over a period of 2 years. A total of 417 patients underwent appendectomy during this period. 137 patients underwent laparoscopic appendectomy [group A] while 280 patients had open appendectomy [group B]. The sample includes all patients who were operated upon, between the time-span of June 2010 to September 2011. A chi square-test was performed to compare the data for statistical significance. Mean operative time for group A was 79.21 +/- 23.42 minutes whereas in group B, the mean operative time was 41.49 +/- 20.86 minutes. Group A patients had a shorter hospital, 1 stay [3.6 +/- 1 day] but in group B, it was [5.2 +/- 3 days]. Seven patients [5.1%] developed surgical site infection [SSI] in group A and 34 patients [12.14%] developed postoperative SSI in group B [p < 0.05]. Laparoscopic appendectomy is superior to open appendectomy because of shorter hospital stay and lesser post-operative SSI, but requires longer operative time