RESUMO
Objective: To see the status of EBM among general surgeons of Faisalabad and Gujranwala
Settings and methods: A survey was conducted among the general surgeons in December 2010 through a questionnaire comprising of 10 questions for which level 1evidence is available
Results: Out of 110 general surgeons who were distributed the questionnaire 96 responded. The correct response rate was only 31.25% [300/960]. Only two questions [Q4 and Q5] were answered correctly by a majority of the participants. There was no significant difference of correct response rate between teaching hospital based and non teaching hospital based general surgeons [31.59% vs. 30.61%]
Conclusion: The status of EBM among general surgeons seems to be disappointing and a great effort is required to develop its culture
RESUMO
To demonstrate advantages of stapler haemorrhoidectomy and its applicability to all patients who require surgical treatment of haemorrhoids. Case Descriptive Study. Allied/DHQ Hospitals, Faisalabad. [February 2004 - July 2005]. A total of 20 patients having grade III or IV hemorrhoids were included in the study. After a detailed GIT history, patients were subjected to standard stapler hemorrhoidectomy under regional anesthesia. Patients were asked to record the postoperative pain intensity according to visual analogue score ranging from [0-10] on daily basis and the drugs required for pain control noticed. Patients were followed at weekly intervals for one month. Main outcome measures were postoperative pain, bleeding, sepsis, urinary retention, continence, relief of preoperative symptoms, operation time, hospital stay and recovery time. Pain was the most common postoperative complication affecting 18 patients [90%age].There was significant reduction in postoperative pain except for one patient in which pain was severe [VAS=8] due to technical error. Two patients developed urinary retention on the day of surgery. Postoperative bleeding was not observed in any of the patients. Pelvic sepsis and incontinence was not found in any patient. Preoperative symptoms were resolved in majority of the cases [80%age] with marked improvement in the rest[20%age]. The mean operative time was 17 minutes and mean hospital stay 1.3 days. Most patients were back to their work after 11th post operative day. Stapler Haemorrhoidectomy is a simple, quick and safe procedure that gives benefit in terms of reducing the postoperative complications namely pain and its sequelae with early return to activity. The vast majority of patients currently undergoing conventional surgical haemorrhoidectomy would be suitable for stapler approach, however the long term benefits need to be evaluated