scholarly journals THE EFFECT OF TOPICAL GENTAMYCIN APPLICATION AT THE URETHRAL STENT TO THE URETHRAL STENT’S BACTERIAL COLONY-FORMING-UNIT COUNTS IN HYPOSPADIAS PATIENTS PERFORMED URETHROPLASTY: A PRELIMINARY STUDY

2018 ◽  
Vol 25 (2) ◽  
Author(s):  
Harris Oetama ◽  
Jupiter Sibarani ◽  
Tjahjodjati Tjahjodjati ◽  
Ahmad Agil
Keyword(s):  
Controlled Study ◽  
Cutaneous Fistula ◽  
Bacterial Colony ◽  
Colony Forming Unit ◽  
Significant Difference ◽  
Distal Shaft ◽  
Group A ◽  
Urethral Stent ◽  
Group B

Objective: To determine the effect of topical gentamycin application at the urethral stent to the stent’s colony-forming-unit (CFU) in hypospadias patients. Material & methods: This study is a double blind prospective randomized controlled study, conducted from November 2016 - August 2017 in Urology Department Hasan Sadikin Hospital Bandung. We include patients with distal until penoscrotal hypospadias who underwent urethroplasty for the first time. The subjects were divided into 2 groups: Group A were patients performed urethroplasty with nasogastric tube (NGT) urethral stents only. Group B were patients performed urethroplasty with NGT urethral stents that were coated with topical gentamycin. Both group were operated by a single surgeon using either Tubularized Incised Plate (TIP) or Onlay Preputial Flap technique. Both group used supra pubic urinary diversion. Both group were given the same preoperative and postoperative intravenous antibiotics and given same dressing. At post operative day 7, the stents were removed and swabbed for bacterial culture and resistance test and colony-forming-unit (CFU) counts. Demographic data is described and, among others were analyzed statistically. Other adverse events and complications were also documented. Results: There were 25 hypospadias patients who were performed urethroplasty (12 patients in Group A and 13 patients in Group B). The median age in group A was 7 ± 2.995 (years old) and the mean age in group B was 6 ± 3.178  (years old). In group A, 1 patient (8.3%) were distal shaft type, 1 patient (8.3%) were middle shaft type, 8 patients (66.7%) were penoscrotal type, 1 patient (8.3%) were proximal shaft type, and 1 patient (8.3%) were subcoronal type. In group B, 3 patients (23.1.%) were distal shaft type, 3 patients (23.1%) were middle shaft type, 5 patients (38.5%) were penoscrotal type, and 2 patients (15.7%) were proximal shaft type. In group A, 6 patients (50%) using TIP, 6 patients (50%) using onlay preputial flap. In group B, 5 patients (38.5%) using TIP, 8 patients (61.5%) using onlay preputial flap. In Group A, Staphylococus haemoliticus was the most common bacterial found in urethral stent swabbed culture (50%), followed by Pseudomonas aeroginosa (16.7%), Acinetobacter baumannii (8.3%), Enterococcus faecalis (8.3%), Morganella morgagnii (8.3%) and sterile cultures (8.3%). In Group B, 38.5% were sterile urethral stents culture, followed by Staphylococus haemoliticus (30.8%), Enterobacter cloacae (7.7%), Staphylococus warneri (7.7%), Staphylococus epidermidis (7.7%), and Moraxella catarrhalis (7.7%). The most sensitive antibiotics in both group were Amikacin, Gentamycin, Meropenem, Cotrimoxazole, and Cefepime. In group A, 11 patients (91.7%) had >100.000 CFU counts, and 1 patient (8.3%) with no colony found.  In Group B, 2 patients (15.4 %) had >100.000 CFU counts, 6 patients (46.2%) had <100.000 CFU counts, and 5 patient (38.5%) with no colony found. In group A, there were 3 patients (25%) with urethra-cutaneous fistula, 4 patients (33.3%) with hematoma, and 5 patients (38.5%) without any complications. In group B, there were 2 patients (15.4%) with urethra-cutaneous fistula, 3 patients (23.1%) with hematoma and 8 patients (61.5%) without any complication. Using Mann-Whitney U-test, we found a significant difference of CFU counts formation between the two groups (p=0.001). Statistically, the lesser CFU counts found, the lesser complication were developed (p=0.001). Conclusion: Topical gentamycin application at the urethral stents in hypospadias patients performed urethroplasty significantly reduced CFU counts found at the urethral stents and thus reduced the urethra-cutaneous fistula and hematoma formation.

Role of a modified epigastric port in reducing post operative pain and causing early ambulation in a patient undergoing laparoscopic cholecystectomy as compared to a standard four port procedure, a randomized controlled study

2020 ◽  
Vol 7 (12) ◽  
pp. 3986
Author(s):  
Arijit Roy ◽  
Pramatha Nath Datta ◽  
Kushankur Guha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Recovery ◽  
Controlled Study ◽  
Post Operative Pain ◽  
Quality Life ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
To Receive ◽  
Better Than

Background: Standard four port laparoscopic cholecystectomy is the gold standard in the treatment of gall stones. Modified epigastric port laparoscopic cholecystectomy may be considered an alternative, as this procedure maintains the advantages of four ports and does not require any special set of instruments. In this study we aimed to see whether this procedure is comparable to the standard four port laparoscopic cholecystectomy based on the primary objectives of postoperative pain score, degree of ambulation, time to return to normal activities.Methods: Consecutive patients due to undergo laparoscopic cholecystectomy, meeting all the predefined criteria were recruited into the study. The group A was assigned to receive intervention in the form of modified epigastric port laparoscopic cholecystectomy. The group B was assigned to receive intervention in the form of standard four port laparoscopic cholecystectomy. Patients in group A were compared with patients in group B based on multiple pre-defined parameters.Results: Pain scores were significantly better in group A. Degree of ambulation at was significantly better in group A. In respect to the time to resumption of normal activities there was no significant difference between the two groups. When comparing the quality life at 1 month following surgery with SF-36 health survey, the patients in group A did better than patients in group B with respect to the six scales. Conclusions: Modified epigastric port laparoscopic cholecystectomy appears to be significantly better than the standard four port cholecystectomy in terms of postoperative recovery.

scholarly journals A Comparative Study of 5.5mm Temporal Sclerocorneal Manual Small Incision Cataract Surgery Versus 5.5mm Temporal Clear Corneal Extended-incision Phacoemulsification with Implantation of a 5.25mm Rigid pmma Intraocular lens in the Bag

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Cataract Surgery ◽  
Controlled Study ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Corneal Incision ◽  
Small Incision ◽  
Clear Corneal Incision ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: Aim of the study is to Compare the astigmatism induced by a reduced temporal sclerocorneal tunnel incision manual small incision cataract surgery with an extended temporal clear corneal Phacoemulsification of similar width . Methods: A Prospective, randomised controlled study was carried out in 224 selected patients who were again divided into two groups - Group A (112 patients) and Group B (112 patients). Group A patients underwent temporal manual small incision cataract surgery with a 5.5 mm sclerocorneal incision and Group B underwent phacoemulsification by a 2.8 mm clear corneal temporal incision which was extended to 5.5 mm before IOL implantation. In both groups, a 5.25 mm rigid PMMA IOL was implanted in the bag. UCVA and BCVA of both group of patients was quantified and analyzed at 1 week and at 6 weeks Observation: It was seen that the mean surgically Induced astigmatism in group A (N=112) was 0.5625D , which was slightly lesser than that in Group B (N=112) which was 0.65D, although the p-value of 0.26 indicated that there was statistically no significant difference in visual outcomes between the two groups of patients. Here, a p-value of < 0.05 was considered statistically significant. Conclusion: In Skilled and Safe hands, refractive outcomes following performing a 5.5mm temporal sclerocorneal frown-incision manual small incision cataract surgery and a phacoemulsification procedure by a 2.8mm temporal clear corneal incision extended to 5.5mm for implanting a 5.25mm rigid PMMA IOL , are comparable.

scholarly journals Comparison of the anatomical and functional success of fascia and perichondrium grafts in transcanal endoscopic type 1 tympanoplasty

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
Kadir Özdamar ◽  
Alper Sen
Keyword(s):  
Retention Rates ◽  
Success Rates ◽  
Temporal Muscle ◽  
Type 1 Tympanoplasty ◽  
Significant Difference ◽  
The Status ◽  
Group A ◽  
Group B ◽  
Age Range

Abstract Background There are no studies in the literature, comparing the functional and anatomical successes of the use of fascial and perichondrial grafts in endoscopic type 1 tympanoplasties. Objectives To compare the anatomical and functional outcomes of grafting with the fascia of the temporalis muscle and with the perichondrium of the tragal cartilage in patients undergoing primary transcanal type 1 tympanoplasty with endoscopy. Methods We enrolled a total of 151 patients (80 females and 71 males with a mean age of 26.0 ± 9.3 years in the age range between 18-57) with MERI scores ranging from 1 to 3 and who underwent a transcanal endoscopic type 1 tympanoplasty without tympanomeatal flap elevation. The patients were assigned to two groups according to the type of the graft used. The patients were assigned to either the tragal cartilage perichondrium group (Group A) or the fascia of the temporal muscle (Group B). The groups were compared according to the pre- and postoperative air-bone gaps and to the status of the tympanic membrane. Results There were no statistically significant differences in the distribution of the age, gender, localization, MERI scores, the duration of the operation, and the size of the perforation (all p values> 0.05). The pre-operative air-bone gap values of Group A and B did not show a statistically significant difference (p = 0.073). The postoperative improvement in the air-bone gap value did not demonstrate a significant difference between Group A and B (p = 0.202). The graft retention rates were 94.9 and 97.2% in Group A and in Group B respectively. There were no statistically significant differences between the two groups in terms of the graft retention success rates (p = 0.743). Conclusion Perichondrium and fascia were suitable for use in endoscopic tympanoplasties.

scholarly journals Effect of preoperative urethral dilatation on preventing urethral stricture after holmium laser enucleation of the prostate: A randomized controlled study

2018 ◽  
Vol 13 (11) ◽  
Author(s):  
Jong Kwan Park ◽  
Ji Yong Kim ◽  
Jae Hyung You ◽  
Bo Ram Choi ◽  
Sung Chul Kam ◽  
...  
Keyword(s):  
Urethral Stricture ◽  
Holmium Laser ◽  
Controlled Study ◽  
Urethral Dilatation ◽  
Significant Difference ◽  
Group A ◽  
Laser Enucleation ◽  
Group B ◽  
Transurethral Prostate Surgery ◽  
Holmium Laser Enucleation

Introduction: We aimed to evaluate the effect of preoperative urethral dilatation during holmium laser enucleation of the prostate (HoLEP) on the prevention of urethral stricture. Methods: A total of 72 patients without urethral stricture underwent HoLEP for benign prostatic hyperplasia (BPH). Recruited patients were randomly divided into two groups (groups A and B). Patients in group A (36 patients, experimental group) received preoperative urethral dilatation and patients in group B (36 patients, control group) did not. Each patient was evaluated at four weeks, 12 weeks, and 24 weeks after surgery. The effectiveness of preoperative urethral dilatation was evaluated based on the International Prostate Symptom Score (IPSS), peak urine flow rate (Qmax), voided volume, and post-void residual (PVR) volume. To diagnose urethral stricture, Qmax <10 mL/s, as assessed using uroflowmetry and findings of visualization through retrograde urethrography and urethroscopy, were used. Results: Among 72 initial participants, 33 patients in group A and 31 patients in group B completed the experiment. Preoperative characteristics were well-balanced between groups. At each postoperative visit, there was no significant difference in voiding symptoms between groups. Two patients (6.06%) in group A and five patients (15.15%) in group B showed a Qmax <10 mL/s on uroflowmetry (p=0.013). On urethroscopy, no patient in group A (0%) and two patients in group B (6.45%) (p=0.021) showed urethral stricture after HoLEP. Conclusions: Preoperative urethral dilatation during HoLEP decreased the incidence of urethral stricture. This procedure could be useful to reduce the risk of urethral stricture after transurethral prostate surgery. One limitation of the current study is the single-centre design. Also, we sought to determine the efficacy of preoperative urethral dilatation for the prevention of urethral stricture after transurethral prostate surgery within a short time period, which could be another limitation of the study. Despite these limitations, to the best of our knowledge, the present study is the first reported prospective, randomized trial analyzing the safety and efficacy of preoperative urethral dilatation for the prevention of urethral stricture after transurethral prostate surgery.

Role of Aminophylline Intravesical Instillation on Enhancing Ureteral Dilatation prior to Ureteroscopy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Mohamed Saafan ◽  
Mohamed Ismail Shabayek ◽  
Marwa Mamdouh Mohamed ◽  
Mostafa Mabrouk Bayomi Ali
Keyword(s):  
Intravesical Instillation ◽  
Controlled Study ◽  
P Value ◽  
Pressure Monitor ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Ureteral Dilatation ◽  
Group B

Abstract Background Semi-rigid uretroscopy (URS) is a common intervention approach for lower ureteric stones. Ureteral dilatation is frequently needed before URS to enable ureter accessing. Aminophylline is known by its muscle relaxant effect and has been suggested to be effective in ureteral dilation. Objectives To evaluate the effect of intravesical administration of aminophylline on ureteroscopy and to measure intraureteral pressure Methods This prospective randomized controlled study included 50 before and after aminophylline injection. patients with lower ureteral calculi. In group A, the ureter was dilated by intravesical aminophylline whereas in group B balloon dilator was used. Intraureteral pressure was measured using pressure transducer connected to invasive pressure monitor. Results No statistically significant difference was noticed between both groups in operative time, intra operative complication, need for ureteral stenting or stone free rate. However, post-operative pain and haematuria were statistically significantly higher among balloon group compared to aminophylline group. In group A, there was statistically significant decrease in intraureteral pressure after injection of aminophylline (7.80 ± 1.71) compared to before injection (12.2 ± 1.85) with p-value &lt; 0.001. Conclusion Aminophylline is effective in ureteral dilatation when intravesically injected with less frequent post-operative pain and hematuria.

scholarly journals Comparison of prophylactic versus regular use of antibiotics in elective major obstetrical and gynecological surgeries

2019 ◽  
Vol 8 (2) ◽  
pp. 580
Author(s):  
Ramya Sreevarshni Shunmugha Sundharam ◽  
Hiremath P. B. ◽  
Sankareswari R.
Keyword(s):  
Tertiary Care ◽  
Prophylactic Antibiotic ◽  
Mean Value ◽  
Controlled Study ◽  
Therapeutic Drug ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Surgical site infections better prevented by parenteral antibiotic in sufficient doses generally should be given before the operation which helps to achieve the therapeutic drug level both in the blood and related tissue during the operation. Ceftriaxone, when administered together as a prophylaxis can fulfil the above criteria of a good antibiotic. Thus, this study was planned to assess the efficacy of prophylactic antibiotic usage to that of regular antibiotics usage in patients undergoing elective surgeries.Methods: This randomized controlled study was conducted in a tertiary care teaching hospital during the study period of June 2017 to April 2018 with 140 cases. Group A received a single dose of Injection Ceftriaxone 1g. Group B, received Injection Ceftriaxone 1 gm and Injection Metronidazole 500 mg for five days. The data was entered in excel sheet and analyzed using SPSS (Version 16).Results: The mean age group in Group A and Group B was found to be 34.24±10.5 and 35.97±11.89, respectively. There was no statistical significance between group A and B for incidence of infection in the post-operative period and duration of hospital stay. The mean value in group A for duration of surgery was found to be 67.5±13.5 and in group B mean value was 72.1±14.9. (p value <0.05).Conclusions: This study demonstrated that administration of prophylactic antibiotic rather than conventional antibiotic at caesarean and gynecological surgeries are not associated with significant difference in post-operative morbidities.

scholarly journals Comparison of marsupialization under nasal endoscopy versus lacrimal probing for treatment of congenital dacryocystoceles: a report of 40 cases

2020 ◽  
Author(s):  
Yan-Hui Cui ◽  
Peng Sun ◽  
Li-Xing Tang ◽  
Cheng-Yue Zhang ◽  
Qian Wu ◽  
...  
Keyword(s):  
Success Rate ◽  
Reoperation Rate ◽  
Nasal Endoscopy ◽  
Controlled Study ◽  
Lacrimal Duct ◽  
Nasal Endoscope ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background: This study was performed to compare the efficacy of marsupialization under nasal endoscopy versus lacrimal probing for the treatment of congenital dacryocystocele. Methods: A prospective randomized controlled study. Forty neonates (43 eyes) diagnosed with congenital dacryocystoceles were divided into Group A (nasal endoscopic marsupialization) and Group B (lacrimal probing). The patients were followed up for 1 year after surgery. The efficacy, incidence of complications, and reoperation rate were compared between the two groups. Results: The male:female ratio was 25:15 patients (27:16 eyes). In Group A, the success rate was 100%, the incidence of complications was 5%, and the reoperation rate was 0%. In Group B, the success rate was 90%, the incidence of complications was 20%, and the reoperation rate was 30%. There was no significant difference in the success rate between the two groups, but the incidence of complications and the reoperation rate in the lacrimal probing group(Group B) were significantly higher than those in the nasal endoscopic marsupialization group(Group A). Conclusion: In the treatment of congenital dacryocystoceles, nasal endoscope marsupialization has the same success rate as lacrimal duct probing, but the former is more effective and safer in clinical practice.

scholarly journals Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

2017 ◽  
Vol 4 (12) ◽  
pp. 3839 ◽  
Author(s):  
Hussein Lafta Hashim ◽  
Ahmed Al Adhami ◽  
Ali Hussain Abid
Keyword(s):  
Postoperative Complications ◽  
Wound Infection ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Meatal Stenosis ◽  
Early Removal ◽  
Significant Difference ◽  
Group A ◽  
Urethral Stent ◽  
Group B

Background: Hypospadias is a relatively common congenital defect of the male external genitalia. The objective of this study was to evaluate whether the early removal of urethral stent following TIP Snodgrass repair of hypospadias can reduces postoperative complications of this procedure.Methods: In Al-Yarmouk teaching hospital, the surgical procedure included 61 tabularized incised plate (TIP) repairs for penile hypospadias. The patients were prospectively observed over 36 months and randomized into 2 groups, group (A) was 30 patients where the urethral stent was removed after 24 hours of operation, and group (B) was 31 cases where the stent removed in the 6th postoperative day. Suprapubic urinary diversion was done for all patients. All of the operations were performed by the same surgeon. Complications and cosmetic appearance were documented at last follow-up.Results: The average age of the patients was 3.9 years, urethrocutaneous fistula was observed in 2 cases in group A (6.6 %), while 11 patients had fistula in group B (35.4 %) with a statistically significant difference (p < 0.05).  meatal stenosis was reported in 4 patients in (group A) (13.3%), while 12 patients had such complication in group B (38.7%) with a statistically Significant difference as (P< 0.05). 6.6 % of group A developed wound infection, while 32.2 % had wound infection postoperatively in group B with a statistically significant difference (P< 0.05). Complete surgical failure when wound dehiscence occurs, it was found that no significant difference between the 2 groups (P value=0.1).Conclusions: TIP repair is a versatile operation that can be performed in almost all cases of penile hypospadias. We believe that early stent removal after 1 day of surgery for hypospadias repair simplifies postoperative care, highly reduces risk of development of urethrocutaneous fistula, meatal stenosis and wound infection, so obviates the need for antibiotics.

scholarly journals Effect of Atorvastatin on E.C.G Changes in Coronary Artery Disease

2018 ◽  
Vol 2 (1) ◽  
pp. 34
Author(s):  
Harmanjit Singh ◽  
Anita Gupta ◽  
Vijay Bajaj ◽  
Bakhshish Singh Gill ◽  
Jasbir Singh
Keyword(s):  
Controlled Study ◽  
Hypolipidemic Effect ◽  
Randomized Controlled ◽  
T Wave ◽  
St Segment ◽  
Significant Difference ◽  
Group A ◽  
Artery Disease ◽  
Group B ◽  
Ischemic Events

E.C.G is the most widely used test for both the diagnosing and estimating the prognosis of CAD. ST segment and T wave changes are most commonly evaluated parameters of E.C.G. Atorvastatin have found to decrease ischemic events apart from its hypolipidemic effect. The main objective of this open prospective randomized, controlled study was to evaluate the effect of addition of atorvastatin to conventional antianginal treatment on ST segment and T wave changes on E.C.G. The study was conducted for duration of 2 months in 30 patients of CAD (15 in each group). Group A was started on conventional antianginal treatment and group B was started on Atorvastatin 20 mg once a day at night in addition to conventional treatment. The ECG changes were recorded after 15, 30, 45 and 60 days using 12 lead E.C.G. At the end of the study, no significant difference was found in E.C.G changes between the group A and group B. A slight improvement in ST segment changes in group B patients was observed but the effect was statistically not significant. So, addition of atorvastatin to conventional antianginal treatment did not have a significant effect on reversal of ischemic changes on ECG in patients of CAD.

scholarly journals Effectiveness of Platelet Rich Plasma and Bone Graft in the Treatment of Intrabony Defects: A Clinico-radiographic Study

2018 ◽  
Vol 12 (1) ◽  
pp. 133-154 ◽  
Author(s):  
Mohammad Jalaluddin ◽  
Jayachandran Mahesh ◽  
Rethi Mahesh ◽  
Ipsita Jayanti ◽  
Mohamed Faizuddin ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Bone Graft ◽  
Alveolar Bone ◽  
Periodontal Regeneration ◽  
Periodontal Pocket ◽  
Controlled Study ◽  
Radiographic Evaluation ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background & Objectives: Periodontal disease is characterized by the presence of gingival inflammation, periodontal pocket formation, loss of connective tissue attachment and alveolar bone around the affected tooth. Different modalities have been employed in the treatment and regeneration of periodontal defects which include the use of bone grafts, PRP and other growth factors.The purpose of this prospective, randomized controlled study was to compare the regenerative efficacy of PRP and bonegraft in intrabony periodontal defects. Methodology: This randomized control trial was carried out in the Department of Periodontics & Oral Implantology, Kalinga Institute of Dental Sciences and Hospital, KIIT University, Bhubaneswar. The study sample included 20 periodontal infrabony defects in 20 patients, 12 males and 8 females. The patients were aged between 25 -45 years(with mean age of 35 years). The 20 sites selected for the study were was randomly divided into 2 groups of 10 sites each. Group A: PRP alone, Group B: Bone Graft. Statistical Anaysis & Results: Statistical Analysis Was Done Using SPSS (Version 18.0): Statistical analysis was done usingpaired ‘t’ tests and ANOVA that revealed a significant reduction ingingival index, plaque index, probing pocket depth and gain in clinical attachment level at various time intervalswithin both the groups. Radiographic evaluation revealed statistically significant defect fill (p<0.001) at the end of 6months within both the groups. However, there was astatistically significant difference seen in group B radiographically, when compared to group A. Conclusion: Both the groups showed promising results in enhancing periodontal regeneration; however the resultswith bonegraftwere comparatively better, although not statistically significant when compared to PRP alone.

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