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Introduction: Hysterectomy is a very common surgery and can be performed by abdominal, vaginal or laparoscopic method though the abdominal route is more popular. Vaginal hysterectomy has distinct health and economic benefits. We designed this study to compare the outcomes in TAH and non-descent vaginal hysterectomy and to determine which route of hysterectomy is superior, safe and effective. Aims of the study: To determine the safety and effectiveness of abdominal hysterectomy versus non descent vaginal hysterectomy and to compare both in terms of duration of surgery, blood loss, intra operative complications, postoperative complications and duration of hospital stay. Materials and methods: This was a prospective, study done on total of 100 patients were divided randomly into two groups. One group underwent total abdominal hysterectomy and the other underwent vaginal hysterectomy. Both groups were compared for patient demographics, indications for surgery, size of uterus, duration of surgery, blood loss, need for blood transfusions, complications and duration of hospital stay. Results: Fibroid was the most common indication in both the groups. Most of the patients had 6 – 8 weeks size uterus. Mean intra operative blood loss in TAH group was slightly more than NDVH group. The need for blood transfusion was similar. The mean duration of surgery was 100.2 minutes in TAH group and 83 minutes in NDVH group. Fever was the most common complication in both groups. Abdominal wound infection and secondary suturing was seen in TAH group. The mean postoperative stay was 8.1 days in TAH group and 5.8 days in NDVH group. P. Divya Daniel, D. Anupama. To determine effectiveness of abdominal hysterectomy versus non descent vaginal hysterectomy. IAIM, 2017; 4(10): 77-86. Page 78 Conclusion: NDVH is associated with less duration of surgery, less blood loss, less postoperative stay than TAH. There was no difference between the need for blood transfusion between the two groups. Therefore, vaginal hysterectomy is safe and feasible in most of the women requiring hysterectomy for benign conditions and should therefore be attempted.
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Background: The achievement of safe child birth by caesarean delivery (CD) was one of the greatest medical advances of the 20th century. Indeed, CD is now the most frequent operation performed, consulting approximately one third of all deliveries annually. Aim: To evaluate the effect of preoperative administration of Injection tranexamic acid on blood loss during and 2 hrs after elective caesarean delivery. Materials and methods: This study was a prospective observational study for a period of 15 months; randomized controlled trial was conducted among 200 women scheduled for elective Cesarean delivery. Results: A comparative study was undertaken to study the effect of inj. TXA on blood loss during and after Cesarean delivery. The mean age in tranexamic group was 23.40±3.06 while in control group was 23.59±3.56. 64% fall in age group 21-25 years. In Gravida Distribution, majority of the patients in both the groups are of Gravida 2 (Group A 65% and Group B 64%). The mean ± SD was 2.17 ± 0.65 in study group and 2.2 ± 0.56 in control group. Comparison of blood loss between two groups, intra-operative blood loss was lower in the study group than in the control group 375±69 vs 410±79.9 and is statistically significant. The mean postpartum blood loss was also in the study group than in the control group 52±30 Vs 131±42 and was statistically significant. Conclusion: Tranexamic acid injection significantly reduces the perioperative blood elective Cesarean section, if given prior to the skin incision, without significant adverse effects.
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The term malignant peripheral nerve sheath tumor (MPNST) refers to most spindle cell sarcomas arising from nerve or neurofibroma or showing nerve sheath differentiation and has been recently adopted by WHO. Malignant tumors of the peripheral nerve sheath are most commonly seen in association with the neurofibroma or at the site of irradiation and may also occur de novo. Its diagnosis has been called "one of the most difficult and elusive diagnosis in soft tissues diseases". We present a rare case of MPNST in a 12-year-old girl, who presented with a swelling of left cheek region of 2 months duration. Intraorally, the swelling extended buccally and palatally from premolar to tuberosity region. Swelling was fixed and firm to hard in consistency. A clinical diagnosis of odontogenic sarcoma was made. It was surgically excised and the histological features were suggestive of malignant peripheral nerve sheath tumor of the maxilla.