ABSTRACT
BACKGROUND AND OBJECTIVES: A significant number of women experience perineal trauma following vaginal deliveries and they require stitches. This may result in perineal pain, dyspareunia and faulty healing. The type of suture material which is used, will influence these factors. This study was conducted to compare the impact of two absorbable suture materials which were used for episiotomy repair, namely vicryl rapide and chromic catgut in relation to a short term maternal morbidity, in terms of the perineal pain and the wound healing. METHODS: This was a prospective, randomized study which was conducted in the hospitals which were attached to JJMMC, Davangere. Four hundred women with episiotomies were randomly allocated to repair with either vicrylrapide or chromic catgut (200 each). The outcome measures which were assessed were perineal pain and wound healing at 24-48 hours, 3-5 days and 6 weeks postpartum. RESULTS: The two groups were similar at the trial entry. As compared to the chromic catgut group, the vicryl rapide group was associated with less pain (32.5% vs 57%) and a less need for analgesia (15.5% vs 0.5) at 3-5 days. There was also a signifi- cant reduction in the wound indurations, uncomfortable stitches and wound dehiscence (4% vs 13.5%) and a better wound healing (p<0.05 significant) in the vicrylrapide group. No significant difference was noted in the perineal pain at 6 weeks postpartum. Wound infections (3.5%) and wound resuturing (2%) were seen in the chromic catgut group and they were absent in the vicrylrapide group. INTERPRETATION AND CONCLUSION: So, this study concluded that vicrylrapide was the ideal suture material for episiotomy repair, which resulted in less perineal pain and a better wound healing.
ABSTRACT
INTRODUCTION: Peripheral insensate neuropathy is one of the most commonest and the earliest forms of peripheral neuropathy. It is one of the leading causes of the disability in working population who are at risk. METHODS: A study was conducted in Kasturba medical college (Manipal university) in the year 2009-12, which included examination of 818 people of more than 30yrs of age by random sampling method who were attending the outpatient clinic. A monofilament was used to determine the peripheral insensate neuropathy, which was defined by the presence of one or more insensate areas. RESULTS: In our study , the prevalence of peripheral insensate neuropathy was 16.2 % ( p-0.0001), among which 9.7% were males and 7.5% were females. The males were 1.27 times significantly at a higher risk than the females , even after a height adjustment to the gender difference in height. As the height increased, the prevalence of peripheral insensate neuropathy increased, irrespective of the diabetic and hypertensive statuses. The risk of the peripheral insensate neuropathy increases at a height of >167 cm in males and at a height of >159 cm in females. CONCLUSION: The authors conclude that body height is an important and an independent risk factor for peripheral insensate neuropathy, irrespective of co morbidities. Height as a marker, helps the health care professionals in identifying the people who are at risk for peripheral insensate neuropathy.
