Pub Date : 2019-07-17DOI: 10.5958/2321-1024.2019.00026.6
R. Subramaniam
Aim To compare and find out the effectiveness of lateral internal sphincterotomy as well as glyceryl trinitrate in the treatment of anal fissure. Materials & Method A prospective study of 100 patients at the surgery department of a medical college and tertiary health care centre, over a period of 6 months that included cases of fissure in ano in the age group of 18 yrs and 70 years. They were randomly assigned to two different groups. One for surgery and the other for medical management with GTN. Each group had 50 patients in it. Results The pain relief of the patients after the surgical operation was fast and very satisfactory. On follow up at 2 weeks post operatively, pain and other symptoms were present in only 10patients (20%). Whereas the pain relief in medical management group was not fully satisfactory and it took more time.. and it was only temporary and how ever on follow up at 2 weeks, 15 patients came with recurrent pain and other symptoms.(30%). On follow up at 8 weeks, in both groups,all the 100 patients were symptoms free (100%) in this study. The complications that were observed during this study were soiling in 5 patients (10%) and incontinence to flatus in 2 patients (4%) in the surgical group and headache in 10 patients (20%) and peri anal itching in 4 patients (8%) in the medical management group.. how ever there was no recurrence of anal fissure observed in this study group. Conclusion From the above study, it is proved that lateral internal sphincterotomy is by far the best operation for pain relief and rapid cure for fissure in ano
{"title":"Comparative Study of Lateral Internal Sphincterotomy vs Glyceryl Trinitrate Ointment for Fissure in Ano","authors":"R. Subramaniam","doi":"10.5958/2321-1024.2019.00026.6","DOIUrl":"https://doi.org/10.5958/2321-1024.2019.00026.6","url":null,"abstract":"Aim \u0000To compare and find out the effectiveness of lateral internal sphincterotomy as well as glyceryl trinitrate in the treatment of anal fissure. \u0000Materials & Method \u0000A prospective study of 100 patients at the surgery department of a medical college and tertiary health care centre, over a period of 6 months that included cases of fissure in ano in the age group of 18 yrs and 70 years. They were randomly assigned to two different groups. One for surgery and the other for medical management with GTN. Each group had 50 patients in it. \u0000Results \u0000The pain relief of the patients after the surgical operation was fast and very satisfactory. On follow up at 2 weeks post operatively, pain and other symptoms were present in only 10patients (20%). Whereas the pain relief in medical management group was not fully satisfactory and it took more time.. and it was only temporary and how ever on follow up at 2 weeks, 15 patients came with recurrent pain and other symptoms.(30%). On follow up at 8 weeks, in both groups,all the 100 patients were symptoms free (100%) in this study. The complications that were observed during this study were soiling in 5 patients (10%) and incontinence to flatus in 2 patients (4%) in the surgical group and headache in 10 patients (20%) and peri anal itching in 4 patients (8%) in the medical management group.. how ever there was no recurrence of anal fissure observed in this study group. \u0000Conclusion \u0000From the above study, it is proved that lateral internal sphincterotomy is by far the best operation for pain relief and rapid cure for fissure in ano","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129861183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-17DOI: 10.5958/2321-1024.2019.00030.8
P. Raj, Abhilash, S. Suma, K. Krishnaprasad
Background Post-thyroidectomy hypocalcaemia is a serious complication. Hypocalcaemia may occur secondarily to surgical trauma, devascularisation, unintentional removal of parathyroid glands, reoperation. Surgery has been seen as a risk factor, as in total thyroidectomy there is potential blood supply involvement resulting from bilateral surgical manipulation. This study aims to prospectively study and analyse the incidence and possible causes of hypocalcaemia following thyroid surgery, and its management. Method and Mateirals Data was collected from the patients undergoing subtotal and near total thyroidectomies from November 2012 to October 2014 by evaluating and investigating meticulous and planned for surgery. They were follow-up on day one after surgery, at the time of discharge and 6 months after surgery for post-operative hypocalcaemia. Observation 6 out of 50 patients (12%) developed postoperative hypocalcaemia, there was no incidence of permanent hypocalcaemia. Near total thyroidectomy was performed in 35(70%) patients, 1 from them (2.86%) developed hypocalcaemia and the other 5 out of 14 cases (35.71%) underwent total thyroidectomy. The hypocalcaemia was 9% in multinodular goitre (3 out of 33 patients), 20% in papillary carcinoma (1 out of 5 patients) and 40% in follicular neoplasm (2 out of 5 patients). Conclusion When preservation of parathyroid glands and their blood supply is enforced during thyroidectomy, the incidence of postoperative hypocalcaemia and permanent hypoparathyroidism can be consistently deceased.
{"title":"A Clinical Study and Management of Hypocalcemia Following Thyroid Surgery","authors":"P. Raj, Abhilash, S. Suma, K. Krishnaprasad","doi":"10.5958/2321-1024.2019.00030.8","DOIUrl":"https://doi.org/10.5958/2321-1024.2019.00030.8","url":null,"abstract":"Background \u0000Post-thyroidectomy hypocalcaemia is a serious complication. Hypocalcaemia may occur secondarily to surgical trauma, devascularisation, unintentional removal of parathyroid glands, reoperation. Surgery has been seen as a risk factor, as in total thyroidectomy there is potential blood supply involvement resulting from bilateral surgical manipulation. This study aims to prospectively study and analyse the incidence and possible causes of hypocalcaemia following thyroid surgery, and its management. \u0000Method and Mateirals \u0000Data was collected from the patients undergoing subtotal and near total thyroidectomies from November 2012 to October 2014 by evaluating and investigating meticulous and planned for surgery. They were follow-up on day one after surgery, at the time of discharge and 6 months after surgery for post-operative hypocalcaemia. \u0000Observation \u00006 out of 50 patients (12%) developed postoperative hypocalcaemia, there was no incidence of permanent hypocalcaemia. Near total thyroidectomy was performed in 35(70%) patients, 1 from them (2.86%) developed hypocalcaemia and the other 5 out of 14 cases (35.71%) underwent total thyroidectomy. The hypocalcaemia was 9% in multinodular goitre (3 out of 33 patients), 20% in papillary carcinoma (1 out of 5 patients) and 40% in follicular neoplasm (2 out of 5 patients). \u0000Conclusion \u0000When preservation of parathyroid glands and their blood supply is enforced during thyroidectomy, the incidence of postoperative hypocalcaemia and permanent hypoparathyroidism can be consistently deceased.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131146921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-17DOI: 10.5958/2321-1024.2019.00021.7
Abhayjeet Singh, P. Athwal, Harsimrat Singh, Himani Singh
Objective To study the extent of disease by DNE in case of sinonasal diseases as compared to patients’ symptoms and CT finding as well as surgical findings. Method Study was conducted at Saraswathi institute of medical sciences, Hapur from may 2017 to October 2018. Study consists of hundred patients who underwent DNE and CT scan. DNE findings were scored using Lanza and Kennedy scoring and patients were also staged using CT. We used the current definition of CRS. Observation and Results In our study 16 patients had paradoxical middle turbinate (16%), Septal deviation in 70 patients (70%), 50 had polys (50%), 68 patients had the nasal discharge (68%), 24 patients had mucosal abnormality (24%), 26 with inferior turbinate hypertrophy (26%), 18 patients had concha bullosa (18%). Conclusion Nasal endoscopy can diagnose sinonasal diseases accurately regardless of CT scan.
{"title":"Role of Diagnostic Nasal Endoscopy in Sinonasal Disease","authors":"Abhayjeet Singh, P. Athwal, Harsimrat Singh, Himani Singh","doi":"10.5958/2321-1024.2019.00021.7","DOIUrl":"https://doi.org/10.5958/2321-1024.2019.00021.7","url":null,"abstract":"Objective \u0000To study the extent of disease by DNE in case of sinonasal diseases as compared to patients’ symptoms and CT finding as well as surgical findings. \u0000Method \u0000Study was conducted at Saraswathi institute of medical sciences, Hapur from may 2017 to October 2018. Study consists of hundred patients who underwent DNE and CT scan. DNE findings were scored using Lanza and Kennedy scoring and patients were also staged using CT. We used the current definition of CRS. \u0000Observation and Results \u0000In our study 16 patients had paradoxical middle turbinate (16%), Septal deviation in 70 patients (70%), 50 had polys (50%), 68 patients had the nasal discharge (68%), 24 patients had mucosal abnormality (24%), 26 with inferior turbinate hypertrophy (26%), 18 patients had concha bullosa (18%). \u0000Conclusion \u0000Nasal endoscopy can diagnose sinonasal diseases accurately regardless of CT scan.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131238908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-17DOI: 10.5958/2321-1024.2019.00022.9
A. Singh, A. Mathur
Objectives This study was conducted to study the association of salmonella infection with carcinoma gall bladder. Materials and Method A total of 36 radiologically or histologically proven cases of Carcinoma Gall Bladder were included in the study and their thorough clinical history was taken and WIDAL titres were recorded using the ‘Stained Salmonella’ Antigen set. Results The ratio of male to females among salmonella positive and salmonella negative patient were 1:3 & 1:2.2 respectively.
{"title":"Study on the Incidence of Salmonella Infection in Patients with Carcinoma Gall Bladder","authors":"A. Singh, A. Mathur","doi":"10.5958/2321-1024.2019.00022.9","DOIUrl":"https://doi.org/10.5958/2321-1024.2019.00022.9","url":null,"abstract":"Objectives \u0000This study was conducted to study the association of salmonella infection with carcinoma gall bladder. \u0000Materials and Method \u0000A total of 36 radiologically or histologically proven cases of Carcinoma Gall Bladder were included in the study and their thorough clinical history was taken and WIDAL titres were recorded using the ‘Stained Salmonella’ Antigen set. \u0000Results \u0000The ratio of male to females among salmonella positive and salmonella negative patient were 1:3 & 1:2.2 respectively.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124380317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-17DOI: 10.5958/2321-1024.2019.00029.1
Pradeep Kumar, Sandeep Maliyan, S. Singh, Manjul Kumar, Nitin Chauhan, A. Tiwari
Introduction Hydatidosis, a zoonotic infection, is due to the larval stage of the tapeworm Echinococcus (E.). Two of the recognised species, E. granulosus and E. multilocularis, are of importance for humans. The disease has a world-wide distribution. Biological diagnosis relies on serological tests. CT-scan of abdomen and chest, while not usually essential for diagnosis, gives a better definition of cysts content, number, size and calcification together with relation to vessels or other organs. With this information this study aims to analyze the different clinical presentations, complications and available various management options available for hydatid cyst of liver. Method & Materials This is a prospective observational study of 30 patients with hydatid cyst of liver included the patients admitted in the Department of General Surgery, L.L.R.M. Medical College, Meerut and S.V.B.P. Hospital, Meerut between jan 2018 to august 2018. All patients of either sex, male or female admitted with the diagnosis of hepatic hydatid cyst. There were no exclusion criteria. The data was analyzed by SPSS 21.0 version. Result In our series we analysed 30 patients. M:F ratio was 1.3:1. Most commonly involved age group was 40–49 yrs. Pain abdomen was the most common presenting symptom seen in 22 patients. Hepatomegaly was seen in 22 patients, Jaundice seen in 16 patients. Right lobe of liver was involve in 20 patients while both lobes were involved in 10 patients. Isolated left lobe involvement was not seen.ELISA for Echinococcal Antibody was performed in all 30 patients. Sensitivity was 100% while specificity was 99%. Deroofing with omentoplasty and wound drainage was the most commonly performed procedure and was performed in 12 patients Concluson This study was conducted to highlight the different modes of presentations of hydatid cyst of liver and effective management techniques. For symptomatic hydatid cyst of liver, open surgical approach is the best modality of management. Although majority of patients were treated surgically, importance of antihelminthics chemotherapy pre and post operatively is immense. As there are less number of patients presented in our study this data can be meta analyzed in other higher institutions.
{"title":"Various Presentations of Hepatic Hydatid Cystic Disease and their Management","authors":"Pradeep Kumar, Sandeep Maliyan, S. Singh, Manjul Kumar, Nitin Chauhan, A. Tiwari","doi":"10.5958/2321-1024.2019.00029.1","DOIUrl":"https://doi.org/10.5958/2321-1024.2019.00029.1","url":null,"abstract":"Introduction \u0000Hydatidosis, a zoonotic infection, is due to the larval stage of the tapeworm Echinococcus (E.). Two of the recognised species, E. granulosus and E. multilocularis, are of importance for humans. The disease has a world-wide distribution. Biological diagnosis relies on serological tests. CT-scan of abdomen and chest, while not usually essential for diagnosis, gives a better definition of cysts content, number, size and calcification together with relation to vessels or other organs. With this information this study aims to analyze the different clinical presentations, complications and available various management options available for hydatid cyst of liver. \u0000Method & Materials \u0000This is a prospective observational study of 30 patients with hydatid cyst of liver included the patients admitted in the Department of General Surgery, L.L.R.M. Medical College, Meerut and S.V.B.P. Hospital, Meerut between jan 2018 to august 2018. All patients of either sex, male or female admitted with the diagnosis of hepatic hydatid cyst. There were no exclusion criteria. The data was analyzed by SPSS 21.0 version. \u0000Result \u0000In our series we analysed 30 patients. M:F ratio was 1.3:1. Most commonly involved age group was 40–49 yrs. Pain abdomen was the most common presenting symptom seen in 22 patients. Hepatomegaly was seen in 22 patients, Jaundice seen in 16 patients. Right lobe of liver was involve in 20 patients while both lobes were involved in 10 patients. Isolated left lobe involvement was not seen.ELISA for Echinococcal Antibody was performed in all 30 patients. Sensitivity was 100% while specificity was 99%. Deroofing with omentoplasty and wound drainage was the most commonly performed procedure and was performed in 12 patients \u0000Concluson \u0000This study was conducted to highlight the different modes of presentations of hydatid cyst of liver and effective management techniques. For symptomatic hydatid cyst of liver, open surgical approach is the best modality of management. Although majority of patients were treated surgically, importance of antihelminthics chemotherapy pre and post operatively is immense. As there are less number of patients presented in our study this data can be meta analyzed in other higher institutions.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130421393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-17DOI: 10.5958/2321-1024.2019.00032.1
S. Singh, D. Prakash, D. Baliyan, Virendra Kumar, V. Saxena, Prachi
Background Intestinal perforation peritonitis is a common surgical emergency in the Indian subcontinent and in tropical countries. Formation of an intestinal stoma is frequently a component of surgical intervention for diseases of the small bowel. The technique for stoma reversal has remained controversial in the use of single layer or two layers of anastomosis. Method 30 patients for stoma closure were taken for study. These patients divided in two groups A and B, 20 and 10 each. These patients were taken up for ileostomy closure in single layer group A n-20 & double layer group B n-10. Results 30 Patients of ileostomy were studied, divided in 2 groups, both groups were found to be comparatively equal in outcome with no any significant difference in complications. Conclusion Double-layer anastomosis for ileostomy closure offers no definite advantage over single layer anastomosis in terms of postoperative leak and other complications. Single layer ileostomy closure technique is safe, easy to perform and simply to taught. Considering duration of the closure procedure and cost benefits, single-layer intestinal anastomosis may prove the choice of procedure for most of the surgeons
{"title":"A Prospective Comparative Study of Intestinal Anastomosis, Single Layer Extramucosal Versus Double Layer","authors":"S. Singh, D. Prakash, D. Baliyan, Virendra Kumar, V. Saxena, Prachi","doi":"10.5958/2321-1024.2019.00032.1","DOIUrl":"https://doi.org/10.5958/2321-1024.2019.00032.1","url":null,"abstract":"Background \u0000Intestinal perforation peritonitis is a common surgical emergency in the Indian subcontinent and in tropical countries. Formation of an intestinal stoma is frequently a component of surgical intervention for diseases of the small bowel. The technique for stoma reversal has remained controversial in the use of single layer or two layers of anastomosis. \u0000Method \u000030 patients for stoma closure were taken for study. These patients divided in two groups A and B, 20 and 10 each. These patients were taken up for ileostomy closure in single layer group A n-20 & double layer group B n-10. \u0000Results \u000030 Patients of ileostomy were studied, divided in 2 groups, both groups were found to be comparatively equal in outcome with no any significant difference in complications. \u0000Conclusion \u0000Double-layer anastomosis for ileostomy closure offers no definite advantage over single layer anastomosis in terms of postoperative leak and other complications. Single layer ileostomy closure technique is safe, easy to perform and simply to taught. Considering duration of the closure procedure and cost benefits, single-layer intestinal anastomosis may prove the choice of procedure for most of the surgeons","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123187353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-17DOI: 10.5958/2321-1024.2019.00031.X
Sushil Gaur, V. R. Singh, Prince Hirdesh, Akshay S Panakkal
Objective To determine the incidence of carcinoma in patients with unilateral tonsillar enlargement. Study Design: A clinical retrospective case series based on medical records of our medical college. Results During a ten-year period, 495 patients underwent tonsillectomy at various medical colleges in western Uttar Pradesh. 29(5.9) of those patients had asymmetrical enlargement of their tonsils, three of whom had suspicious clinical findings at presentation. The latter were found to have tonsillar malignancy on histopathological testing. Malignancy was excluded in all other specimen. Conclusions Since the incidence of malignancy in asymmetrical tonsils is negligible in the absence of other associated risk factors, watchful waiting may be appropriate prior to any surgical intervention. Diagnostic tonsillectomy is indicated in patients with asymmetrical tonsillar enlargement with associated suspicious clinical findings, including cervical lymphadenopathy and rapid tonsillar enlargement.
{"title":"Incidence of Malignancy in Unilateral Tonsillar Enlargement Over a Period of 10 Years","authors":"Sushil Gaur, V. R. Singh, Prince Hirdesh, Akshay S Panakkal","doi":"10.5958/2321-1024.2019.00031.X","DOIUrl":"https://doi.org/10.5958/2321-1024.2019.00031.X","url":null,"abstract":"Objective \u0000To determine the incidence of carcinoma in patients with unilateral tonsillar enlargement. Study Design: A clinical retrospective case series based on medical records of our medical college. \u0000Results \u0000During a ten-year period, 495 patients underwent tonsillectomy at various medical colleges in western Uttar Pradesh. 29(5.9) of those patients had asymmetrical enlargement of their tonsils, three of whom had suspicious clinical findings at presentation. The latter were found to have tonsillar malignancy on histopathological testing. Malignancy was excluded in all other specimen. \u0000Conclusions \u0000Since the incidence of malignancy in asymmetrical tonsils is negligible in the absence of other associated risk factors, watchful waiting may be appropriate prior to any surgical intervention. Diagnostic tonsillectomy is indicated in patients with asymmetrical tonsillar enlargement with associated suspicious clinical findings, including cervical lymphadenopathy and rapid tonsillar enlargement.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121155060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-17DOI: 10.5958/2321-1024.2019.00025.4
Nitesh Kumar, Deepak Pankaj, Nitesh, Ashwini Kumar, M. Raj
Introduction Fissure-in-ano is a very common problem which causes considerable morbidity and affects the patient's quality of life to a great extent. This warrants prompt treatment of the condition with appropriate methods. In this study, we assess and compare the efficacy and adverse effects of topical application of 2% Diltiazem gel with that of Lateral internal sphincterotomy. Method 100 patients with chronic fissure in ano were divided into Diltiazem gel and Lateral internal sphincterotomy groups and followed up at regular intervals for symptomatic relief and healing. Results Fissure was completely healed in 42 (89.36%) out of 47 patients by 8 weeks in the Diltiazem group, 3 patients experienced mild headache, 2 local irritation, 13 patients were pain-free at the end of 4 weeks, 26 patients were 8 weeks and 3 patients by 14 weeks. 5 patients were not relieved of pain at the end of 14 weeks. Completely healed in 48 (100%) out of 48 patients by 4 weeks in the Lateral Internal Sphincterotomy group.21 patients experienced post-operative pain and incontinence for flatus in 1 patient. 32 patients were pain-free by 4 weeks and all the patients were free of pain by 8 weeks. Conclusion The current study shows results in favour of lateral internal sphincterotomy with a healing rate of 100% with a faster pain-relief and minimal complications if performed by the experienced surgeon. However topical 2% diltiazem gel is an effective agent can be safely prescribed for patients having contraindications for surgery. With a healing rate close to 90%, topical 2% Diltiazem therapy can be advised as the first line of treatment for the treatment of chronic anal fissure.
{"title":"Comparative Study of Chemical Sphincterotomy and Lateral Internal Sphincterotomy for Chronic Anal Fissure","authors":"Nitesh Kumar, Deepak Pankaj, Nitesh, Ashwini Kumar, M. Raj","doi":"10.5958/2321-1024.2019.00025.4","DOIUrl":"https://doi.org/10.5958/2321-1024.2019.00025.4","url":null,"abstract":"Introduction \u0000Fissure-in-ano is a very common problem which causes considerable morbidity and affects the patient's quality of life to a great extent. This warrants prompt treatment of the condition with appropriate methods. In this study, we assess and compare the efficacy and adverse effects of topical application of 2% Diltiazem gel with that of Lateral internal sphincterotomy. \u0000Method \u0000100 patients with chronic fissure in ano were divided into Diltiazem gel and Lateral internal sphincterotomy groups and followed up at regular intervals for symptomatic relief and healing. \u0000Results \u0000Fissure was completely healed in 42 (89.36%) out of 47 patients by 8 weeks in the Diltiazem group, 3 patients experienced mild headache, 2 local irritation, 13 patients were pain-free at the end of 4 weeks, 26 patients were 8 weeks and 3 patients by 14 weeks. 5 patients were not relieved of pain at the end of 14 weeks. Completely healed in 48 (100%) out of 48 patients by 4 weeks in the Lateral Internal Sphincterotomy group.21 patients experienced post-operative pain and incontinence for flatus in 1 patient. 32 patients were pain-free by 4 weeks and all the patients were free of pain by 8 weeks. \u0000Conclusion \u0000The current study shows results in favour of lateral internal sphincterotomy with a healing rate of 100% with a faster pain-relief and minimal complications if performed by the experienced surgeon. However topical 2% diltiazem gel is an effective agent can be safely prescribed for patients having contraindications for surgery. With a healing rate close to 90%, topical 2% Diltiazem therapy can be advised as the first line of treatment for the treatment of chronic anal fissure.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121783346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-17DOI: 10.5958/2321-1024.2019.00018.7
A. Chauhan, Y. Patel, P. Sharma, F. S. Mehta
Background The aim of the study was to evaluate the clinical presentation, and to investigate the effectiveness of continuous catheter drainage in comparison to needle aspiration in the treatment of liver abscesses. Method This is a comparative study of 50 patients, presented in outpatient and emergency department at the hospital,equally into two groups, percutaneous needle aspiration and pigtail catheter drainage. The effectiveness of either treatment was measured in terms of duration of hospital stay, days to achieve clinical improvement, 50% reduction in abscess cavity size and total/near total resolution of abscess cavity. Results The success rate was significantly better in catheter drainage group. The patients in pigtail catheter drainage group showed earlier clinical improvement and decrease in abscess cavity volume as compared to those who underwent percutaneous needle aspiration. Conclusions Percutaneous catheter drainage is a better modality as compared to percutaneous needle aspiration especially in larger abscesses which are partially liquefied or with thick pus.
{"title":"Treatment of Liver Abscess: A Comparison of Catheter Drainage and Needle Aspiration","authors":"A. Chauhan, Y. Patel, P. Sharma, F. S. Mehta","doi":"10.5958/2321-1024.2019.00018.7","DOIUrl":"https://doi.org/10.5958/2321-1024.2019.00018.7","url":null,"abstract":"Background \u0000The aim of the study was to evaluate the clinical presentation, and to investigate the effectiveness of continuous catheter drainage in comparison to needle aspiration in the treatment of liver abscesses. \u0000Method \u0000This is a comparative study of 50 patients, presented in outpatient and emergency department at the hospital,equally into two groups, \u0000percutaneous needle aspiration and pigtail catheter drainage. The effectiveness of either treatment was measured in terms of duration of hospital stay, days to achieve clinical improvement, 50% reduction in abscess cavity size and total/near total resolution of abscess cavity. \u0000Results \u0000The success rate was significantly better in catheter drainage group. The patients in pigtail catheter drainage group showed earlier clinical improvement and decrease in abscess cavity volume as compared to those who underwent percutaneous needle aspiration. \u0000Conclusions \u0000Percutaneous catheter drainage is a better modality as compared to percutaneous needle aspiration especially in larger abscesses which are partially liquefied or with thick pus.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121907910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-17DOI: 10.5958/2321-1024.2019.00023.0
Nitesh Kumar, Nitesh, V. Bhushan, Ashwini Kumar, M. Raj
Background and Objectives There are many surgical procedures for treating complete rectal prolapse ranging from complex abdominal interventions to simple perineal procedures with varying results. The ideal procedure suitable in all cases is still an enigma. Many surgeons believe that abdominal rectopexy has become the operation of choice not only in the young but even in the elderly patients, resulting in a low recurrence rate and restoration of continence in significant number of patients. The present study to evaluate clinical and functional results of abdominal rectopexy using prolene mesh for complete rectal prolapse in our centre. Method Fifteen patients with complete rectal prolapse underwent abdominal rectopexy using prolene mesh. They were followed up for a mean period of 7.3 months and was analysed for postoperative complications like haemorrhage, operative mortality, wound infection, bladder and erectile dysfunction recurrence of rectal prolapse, changes in bowel frequency and restoration or deterioration in continence were noted. Results There was no mortality or recurrence in any patient and (100%) improvement in continence in a lone patient with incontinence and decrease in bowel frequency in 2 patients (13%), postoperatively but this did not result in clinical constipation in any of the patient. Conclusion Abdominal rectopexy using prolene mesh is a simple operation with satisfactory low recurrence rate, good functional out come with low morbidity and mortality. This procedure can be considered in all patients who are considered fit to undergo an abdominal procedure.
{"title":"Review of Clinical and Functional Result of Abdominal Rectopexy Using Proline Mesh for Complete Rectal Prolapse Over a Period of 1 Year at Tertiary Care Centre in Bihar","authors":"Nitesh Kumar, Nitesh, V. Bhushan, Ashwini Kumar, M. Raj","doi":"10.5958/2321-1024.2019.00023.0","DOIUrl":"https://doi.org/10.5958/2321-1024.2019.00023.0","url":null,"abstract":"Background and Objectives \u0000There are many surgical procedures for treating complete rectal prolapse ranging from complex abdominal interventions to simple perineal procedures with varying results. The ideal procedure suitable in all cases is still an enigma. Many surgeons believe that abdominal rectopexy has become the operation of choice not only in the young but even in the elderly patients, resulting in a low recurrence rate and restoration of continence in significant number of patients. The present study to evaluate clinical and functional results of abdominal rectopexy using prolene mesh for complete rectal prolapse in our centre. \u0000Method \u0000Fifteen patients with complete rectal prolapse underwent abdominal rectopexy using prolene mesh. They were followed up for a mean period of 7.3 months and was analysed for postoperative complications like haemorrhage, operative mortality, wound infection, bladder and erectile dysfunction recurrence of rectal prolapse, changes in bowel frequency and restoration or deterioration in continence were noted. \u0000Results \u0000There was no mortality or recurrence in any patient and (100%) improvement in continence in a lone patient with incontinence and decrease in bowel frequency in 2 patients (13%), postoperatively but this did not result in clinical constipation in any of the patient. \u0000Conclusion \u0000Abdominal rectopexy using prolene mesh is a simple operation with satisfactory low recurrence rate, good functional out come with low morbidity and mortality. This procedure can be considered in all patients who are considered fit to undergo an abdominal procedure.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124003790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：