scholarly journals Ilioinguinal Neurectomy and Chronic Post-Operative Pain After Inguinal Hernia Repair

2020 ◽  
pp. 1-7
Author(s):  
Aliya Ishaq ◽  
Muhammad Shadab Khan ◽  
Mariya Ishaq ◽  
Ayesha Saba ◽  
Turab Pishori
Keyword(s):  
Inguinal Hernia ◽  
P Value ◽  
Third Wave ◽  
Brisk Walking ◽  
Healthcare Facilities ◽  
Nerve Preservation ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Objective: This study aims to determine the effect of preservation /division of ilioinguinal nerve in patients undergoing lichenstein hernioraphy on severity of chronic post operative pain as well well as presence /absence of groin numbness. Method: A randamised control trial was conducted for a period of six months on 60 patient fulfilling inclusion criteria who underwent lichenstein hernioraphy at general surgery department of Liaquat National university hospital Karachi , Pakistan. Result: A total of 60 patients undergoing elective inguinal hernia mesh repair were Included in study and divided in two groups with 30 patients each. Only male patients were included in the study as female gender was one of the exclusion criteria so gender stratification was no considered. Patients between 17 to 77 yrs of age were included in study and randomly divided in two groups. Mean age of population in group A is 42.96 +/- 17.76 an in group B is 54.23 +/- 15.0. The minimum age of the patient in Group A is 17 years and maximum age is 73 years whereas minimum age of the patient in Group B is 20 years and maximum age is 77 years. 45.9% Patients in group A (Nerve preservation group) have right inguinal hernia. 54.0%% Patients in group B (Nerve Division group) have right inguinal hernia. 56.5%% Patients in group A (Nerve Preservation group) have left inguinal hernia. 43.4% Patients in group B (Nerve Division group) have left inguinal hernia. Chronic groin pain while different physical activities and groin numbness in nerve preservation and nerve division group was assessed at three and six months follow ups in all patients of the study population. 3% of the patients from nerve preservation group had mild pain during climbing stairs at three and six months follow up and the P-Value was 0.313 which is statistically not significant. 10% of the patients from nerve division group and 50% patients from nerve preservation group had pain during brisk walking at three months follow up and the P-Value was 0.001 which is statistically significant. 23% of the patients from nerve division group and 60% patients from nerve preservation group had pain during brisk walking at six months follow up and the P-Value was 0.004 which is statistically significant. 13.3% patients from nerve preservation group had moderate pain during brisk walking at three months follow up while none of the patient from nerve division group had pain and P-Value was 0.038 which is statistically significant. 6.6% of the patients from nerve preservation group had moderate pain during brisk walking at six months follow up while none of the patient from nerve division group had pain and p-value was 0.150 which is statistically in significant. 20% of the patients from nerve division group and 30% of the patients from nerve preservation group had mild groin numbness at three months follow up with P-Value of 0.371 which is statistically in significant. 33.3% of the patients from nerve division group and 30% of the patients from nerve preservation group had groin numbness at six months follow up with a p-value of 0.781 which is statistically in significant. Conclusion: Prophylactic ilioinguinal neurectomy during Lichtenstein tension free inguinal hernia repair decreases the incidence of exertional chronic post operative pain as compare to the nerve preservation group. However the cutaneous neurosensory disturbance/groin numbness between the two groups has no difference in term of outcome. In order to prepare ourselves from a expected third wave of Covid-19, we should not repeat mistakes that we made during previos waves. We should refrain ourselves from dismantling our enhanced healthcare facilities, there should not be any sorts of shortage of oxygen , hospital beds, and drug that we have already witnessed. We must have an aggressive containment measure comprising of a really strong and pro-active surveillance system. This can be achieved by increasing the capacity of the existing surveillance system by identifying active cases early. We must ensure that we should follow “social vaccine” of proper masking, avoid indoor gatherings, and proper sanitization. Our vaccination programme needs a boost. We should vaccinate a large section of people before any third wave hits us. The more we vaccinate, the better prepared we are. As medical professionals, it must be ensured that proper scientific protocol must be implemented while handling Covid-19 cases. And last but not the least efforts must be made to fill up vacancies seen in our public health system, especially for frontline healthcare workers. As it is anticipated that the young children are more vulnerable to the forthcoming third wave, efforts are to be sought in order to start vaccination of the younger children in our country. Trials for which has already been started in India and across the world. Till the time vaccine is made available, the resources are to be mobilized to build up healthcare facilities catering the vulnerable age group in this third wave such as building up of more paediatric wards, paediatric ICU’s , training of healthcare personals in handling the emergencies for expected third wave .In addition to these efforts , more and more paediatric covid care centers must be set up at various parts of the country. Equally important is making arrangements for rehabilitation centers for the orphans. Countries like US, Singapore and UAE have already started vaccinating the children in age group between 12 to 15 years with Pfizer-BioNTech Covid vaccine. It’s a high time that the government in India must consider for allowing “expedited approval pathway” to the companies like Pfizer for their Covid-19 vaccine for children. All these combined efforts from everyone may ensure that the country and world may remain well equipped against these subsequent waves of this deadly virus and pave the path of the triumph in the near future.

scholarly journals Comparative study of preservation versus elective division of ilioinguinal nerve on chronic groin pain after lichtenstein tension free inguinal hernia repair

2020 ◽  
Vol 7 (5) ◽  
pp. 1503
Author(s):  
Renuka Chaudhary ◽  
M. Salim ◽  
M. Rafik Rao
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Chronic Groin Pain ◽  
Ilioinguinal Nerve ◽  
Nerve Preservation ◽  
Group A ◽  
Group B

Background: Post-hernioplasty chronic groin pain is one of the most important complications encountered after inguinal hernia repair. Routine ilioinguinal nerve excision has been proposed to avoid chronic post-hernioplasty neuralgia. The study aimed to evaluate the effect of routine ilioinguinal nerve excision compared to nerve preservation on chronic groin pain and other sensory symptoms in lichtenstein inguinal hernia repair.Methods: The study was conducted in the department of general surgery, at S.P. Medical College and PBM Hospital, Bikaner for duration of 15 months from august 2018 to November 2019. A total of 60 patients of uncomplicated inguinal hernia, who met the inclusion criteria, planned for lichtenstein hernioplasty were randomly divided into 2 groups with 30 cases with ilioinguinal nerve preservation (group A) and 30 cases with elective division of the nerve (group B). Follow up was done upto1 year and patients were inquired regarding pain, hypoesthesia and numbness and data was compared and analysed.Results: The incidence of post-operative neuralgia was 23.33% vs 6.67% (p=0.05) at 1 year in group A and group B respectively. The difference in pain was significant in both groups. The incidence of post-operative hypoesthesia was 10% vs 16.67% (p>0.05) at 1 year follow up in group A and group B respectively. The incidence of numbness was 11.11% vs 16.67% (p>0.05) at 1 year in group A and group B respectively. No statistically significant difference was found in both groups.Conclusions: The prophylactic exicision of ilioinguinal nerve during lichtenstein mesh repair decreases the incidence of chronic groin pain after surgery.

scholarly journals A prospective comparative study of Lichtenstein procedure with and without mesh-fixation for inguinal hernia repair

2021 ◽  
Vol 9 (2) ◽  
pp. 390
Author(s):  
Ravinder Kumar ◽  
Hilal A. Wani ◽  
Anshuman Mahesh ◽  
Irfan N. Mir
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Operative Time ◽  
Mesh Fixation ◽  
P Value ◽  
Recurrence Rates ◽  
Fixation Group ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background: Repair of inguinal hernia is one of the most common elective operations performed in general surgery worldwide. Mesh-hernioplasty became the gold standard, because of its low recurrence rate in comparison with tissue repairs. The ideal repair must be simple, safe easy to perform and require minimal dissection which provides enough space, should be cost effective with less hospital stay, less pain and less recurrence. The present study aimed at comparing the effect of mesh fixation and non-fixation in Lichtenstein technique for inguinal hernia repair.Methods: Hundred (100) patients with primary uncomplicated, unilateral inguinal hernia were treated between April 2019 and September 2020. Patients with inguinal hernia underwent Lichtenstein repair with mesh-fixation (group A) (n=50) and non-fixation (group B) (n=50). The mean operative time, post-operative pain score, average hospital study, post-operative complications and recurrence rates were compared between the two groups.Results: Mean operative time in non-fixation group- (group B) (32.24 min) was shorter as compared to fixation group-(G1) (49.36 min) with a p value of 0.002. Post-operative pain score was lower in (group B) at 12 and 24 hours (3.71±1.409 and 2.2±0.8169) as compared to G1 at 12 and 24 hours (4.77±1.196 and 2.98±1.295) with a p value of <0.0001. The analgesia required in (group B) was less as compared to (group A). The post-operative complication and recurrence rates were almost identical in both the groups, with lesser incidence of groin pain and paresthesias in group B.Conclusions: In Lichtenstein inguinal hernia repair, non-fixation of mesh is safe and preferable option, with less operative time and less postoperative pain.

scholarly journals Comparison of Ferguson and Gross herniotomy with Mitchell Banks’ herniotomy in boys older than two years

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Hafiz Mahmood Ahmad ◽  
Fatima Naumeri ◽  
Usama Saud ◽  
Ghazala Butt
Keyword(s):  
Inguinal Hernia ◽  
Operating Time ◽  
Testicular Atrophy ◽  
P Value ◽  
Older Children ◽  
Creative Commons ◽  
Group A ◽  
Group B ◽  
Open Access Article

Background & Objective: In children younger than two years, most surgeons perform the inguinal herniotomy superficially through the external ring, a technique known as Mitchell-Banks’ Herniotomy (MBH) while in older children, commonly Ferguson and Gross Herniotomy (FGH) is performed which involves opening of inguinal canal. Our aim was to compare the FGH and MBH in terms of recurrence in boys with inguinal hernia. Methods: Boys with inguinal hernia presenting to Pediatric Surgery, Mayo Hospital Lahore from Dec 2016 to January 2018 were included in the study, if older than two years and younger than 14 years and without palpable deep ring (2 cm or more in width) or strangulation of inguinal hernia or malnutrition. They were randomly allocated in 2 groups after obtaining informed consent from parents, and underwent MBH (Group-A) and FGH (Group-B). Children were called for follow up after 1 week and at 6 months to assess for recurrence. Results: Total 260 patients with inguinal hernia were enrolled (NCT:03392636). The mean age of boys in Group-A was 5.2±3.0 years and in Group-B was 5.9±3.1 years. Mean operating time in Group-A (26.65±3.22 minutes) was longer than Group-B (15.92±4.22 minutes), and scrotal oedema was noted in 38 (29.2%) cases in Group-A, while 7 (5.4%) cases in Group-B. Testicular atrophy was noted in one patient of Group-B. Recurrence occurred in 1(0.8%) patient in Group-A, and in 8(6.2%) patients in Group-B (p-value 0.018). Conclusion: Mitchell-Banks’ herniotomy has lower recurrence rate than Ferguson and Gross Herniotomy in boys older than two years. doi: https://doi.org/10.12669/pjms.37.1.3216 How to cite this:Ahmad HM, Naumeri F, Saud U, Butt G. Comparison of Ferguson and Gross herniotomy with Mitchell Banks’ herniotomy in boys older than two years. Pak J Med Sci. 2021;37(1):40-44. doi: https://doi.org/10.12669/pjms.37.1.3216 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals 465 No Role for Postoperative Antibiotics in Uncomplicated Appendicitis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
N Ayoub ◽  
Y Tryliskyy ◽  
M K Baig
Keyword(s):  
Wound Infection ◽  
P Value ◽  
Nice Guidelines ◽  
Uncomplicated Appendicitis ◽  
Perforated Appendix ◽  
Group A ◽  
Preoperative Antibiotics ◽  
Group B ◽  
Variable Practice

Abstract Introduction Several studies have shown benefit from use of preoperative antibiotics in reducing postoperative infection after appendectomy as well as efficacy of postoperative antibiotics in complicated appendicitis (defined as perforated appendix or presence of pus in peritoneum). While for uncomplicated appendicitis, several studies showed no benefit from antibiotics postoperatively but there are no clear NICE guidelines till now and so surgeons have different practice based on their preferences. Method This study included patients who had appendectomy for uncomplicated appendicitis in Worthing hospital from 1st July 2019 till 30th June 2020. The end point was 30-day follow up postoperatively for wound infection or collection. Results 90 patients were admitted with uncomplicated appendicitis with age 6-80 years (mean of 31.3). 46 patients (51%) did not receive postoperative antibiotics (group A) and 44 (49%) received postoperative antibiotics (group B) with a variable practice from one dose to 8-day course. postoperatively, only 1 patient (2.1%) in group A developed wound infection requiring drainage while none in group B developed complications (p-value=1). Conclusions Administration of postoperative antibiotics in uncomplicated appendicitis showed no superiority over non-administration. in addition, they add extra cost on NHS. So, their routine use postoperatively is not recommended, however, larger studies are required to confirm this.

scholarly journals Comparable Efficacy of Terbinafine and Itraconazole in the Treatment of Tinea Pedis

2013 ◽  
Vol 21 (2) ◽  
pp. 74-79
Author(s):  
Md Abdul Wahab ◽  
Mohammad Jamal Uddin ◽  
Biswas Shahen Hassan ◽  
Md Zafrul Islam ◽  
Ishrat Bhuiyan ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Tinea Pedis ◽  
Comparable Efficacy ◽  
P Value ◽  
Mycological Cure ◽  
Efficacy Analysis ◽  
Group A ◽  
Group B

Background: Tinea pedis (athlet’s foot) is the most common fungal infection. Relapse is common in tinea pedis and may be result of recurrence following inadequate treatment or reinfection. Objective: To evaluate the comparable efficacy of terbinafine and itraconazole in the treatment of tinea pedis. Methods: 120 patients of tinea pedis confirmed by KOH microscopy were included in the study. The study was carried out in three different Hospitals and Private Chambers for a period of 3 years from July 2006 to June 2009. Mean age of the patients was 40.28±10.23. The patients were devided into 2 equal group:A & B. Group- A was given terbinafine 250 mg/day and group-B was given intraconazole 200 mg/day for 2 weeks. Results: Follow up 2 weeks after cessation of therapy revealed clinical and mycological cure of 93.3% in terbinafine group and 86.6% in itraconazole group. Conclusion: Efficacy analysis revealed that terbinafine is superior than itraconazole in the treatment of tinea pedis (P value 0.224). DOI: http://dx.doi.org/10.3329/bjmed.v21i2.13615 Bangladesh J Medicine 2010; 21: 74-79

scholarly journals Effect of acupuncture TENS versus conventional TENS on post cesarean section incision pain

2018 ◽  
Vol 7 (9) ◽  
pp. 3738
Author(s):  
Priti A. Mehendale ◽  
Mayur T. Revadkar
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Control Group ◽  
P Value ◽  
Random Allocation ◽  
Lower Segment Caesarean Section ◽  
Post Operative Pain ◽  
Group A ◽  
Group B ◽  
Pain Rating Scale

Background: There is evidence regarding beneficial use of Transcutaneous Electrical Nerve Stimulation (TENS) on post Lower Segment Caesarean Section (LSCS) incision pain. However, efficacy of different types of TENS following C section pain has not yet been explored adequately.Methods: 96 women who had recently undergone LSCS were included for the study. The subjects were in the age group of 20 to 40 years (25.84±3.96); having pain intensity 4 or more on Numerical Pain Rating Scale (NPRS). They were divided into three groups by random allocation method; namely Group A: Acupuncture (Low/Motor) TENS, Group B: Conventional (High/Sensory) TENS and Group C: Control group. Group A and B received specific type of TENS twice a day for 15 minutes. Control group C did not receive any TENS intervention. All subjects received standard post-operative medications and physiotherapy. Pain intensity was recorded on NPRS pre and post intervention.Results: Both Acupuncture TENS and Conventional TENS significantly decreased post-operative pain intensity as compared to control group (p value <0.0001).Conclusions: Both, acupuncture and conventional TENS are equally effective in reducing post LSCS incision pain at a strong and non-painful intensity.

scholarly journals A clinical study of the incidence and disability caused by mesh neuralgia after inguinal mesh hernioplasty and the effects of prophylactic ilioinguinal neurectomy and its role in preventing chronic groin pain after inguinal hernioplasty

2018 ◽  
Vol 5 (3) ◽  
pp. 1083
Author(s):  
Samrat Sunkar ◽  
Dick B. S. Brashier ◽  
Kiran Bhagwat ◽  
Vipin Sharma ◽  
Piyush Angrish
Keyword(s):  
Groin Pain ◽  
Sensory Loss ◽  
Chronic Groin Pain ◽  
Inguinal Hernioplasty ◽  
Nerve Preservation ◽  
Pain Disability ◽  
Group A ◽  
Group B ◽  
Mesh Hernioplasty

Background: Residual neuralgia, called as Inguinodynia, is an important complication unique to groin hernia repair. The reported incidence ranges between 9-63%. The symptoms are potentially disabling. Symptoms are often more pronounced on axial twisting of body. Methods for prevention include identification and preservation of all nerves, Ilioinguinal Neurectomy and triple Neurectomy during surgery.Methods: One hundred patients underwent elective unilateral Lichtenstein’s tension free hernioplasty. 50 patients were subjected to elective ilioinguinal neurectomy. The remaining underwent standard Liechtenstein’s mesh hernioplasty, without ilioinguinal neurectomy. Randomization was achieved by allocating alternate patients to each group - prophylactic neurectomy, or nerve preservation. All patients, during each review were asked to fill out a Pain Disability Questionnaire to assess sensory loss and pain disability objectively.Results: At completion of 6 monthly follow up pain at rest (none in group ‘A’ compared with 3 in group ‘B’), after coughing 5 times (none in group ‘A’ compared with 7 in group ‘B’), after climbing 4 flights of stairs(3 in group ‘A’ compared with 16 in group ‘B’) and after cycling for 20 minutes (11 in group ‘A’ compared with 22 in group ‘B’) were all significantly lesser in the neurectomy group as compared with the non neurectomy group. More importantly, exertional chronic pain incidence at 6 months was significantly less in group ‘A’.Conclusions: It was concluded that pain after inguinal mesh hernioplasty is a cause of morbidity, pain was complained of by a significantly larger number of non-neurectomised patients at 6 months of follow-up, prophylactic ilioinguinal neurectomy is associated with reduced exertional chronic groin pain, disability caused by pain after inguinal hernioplasty, is significantly reduced by ilioinguinal neurectomy and an extremely significant reduction in the requirement of medication is brought about by neurectomy compared with controls. 

scholarly journals INGUINAL HERNIA REPAIR;

2014 ◽  
Vol 21 (06) ◽  
pp. 1144-1146
Author(s):  
Iftikhar Ahmed Bhatti
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Prosthetic Mesh ◽  
Indirect Inguinal Hernia ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Group A ◽  
Group B

Objective: To compare the results of Inguinal Hernia repair using commonly employed methods of Bassini’s and Mesh repair. Methodology: This study included 90 cases of hernia repair ranging over a period of 18 months from October 2008 to Mar 2010 at Social Security Hospital Lahore. All the cases were done by the consultants and senior surgeons. The methods of repair included Bassini’s and Hernioplasty with Prosthetic mesh. Results: Out of 90 patients, 88 were males (97.78%) and 02 were females (2.22%). Male – female ratio 45 : 1. The peak incidence was found in 3rd and 4th decades of life. 56(62.22%) had Rt.sided Inguinal hernia, 29 (32.22%) had Lt. sided and 5(5.56%) had bilateral Inguinal hernia. 72 patients (80%) had Indirect Inguinal hernia, 17 (18.89%) had direct inguinal hernia while 1(1.11%) had both types. All the cases were done under Spinal anaesthesia. The Bassini’s repair was performed in 50% cases, using non-absorble no. 1 Prolene interrupted suturing (Group- A). In the Group – B, 50% cases underwent Hernioplasty with prosthetic prolene mesh 6x11 cms. Post-operative follow up was done for a period of 01 year. In the group- A, 3 (6.67%) patients had recurrence and 3 (6.67%) had infection of the wound. In group – B, 01 patient (2.22%) got infected and none of the cases did not get recurrence over a period of 01 year. Conclusions: Hernioplasty with prosthetic mesh is a better treatment modality for inguinal hernia repair to get a low recurrence rate.

scholarly journals HEMORRHOIDECTOMY;

2017 ◽  
Vol 24 (09) ◽  
pp. 1316-1321
Author(s):  
Shibber Ahmed ◽  
Ishtiaq Ahmad ◽  
Humayun Amjid ◽  
Aamir Furqan
Keyword(s):  
Hospital Stay ◽  
Severe Pain ◽  
Conventional Technique ◽  
Categorical Variables ◽  
P Value ◽  
Chi Square ◽  
Post Operative Pain ◽  
Group A ◽  
And Gender ◽  
Group B

Objectives: Is to compare outcomes in terms of mean post-operative pain andhospital stay between stapled versus conventional hemorrhoidectomy. Hypothesis: There isa difference in mean post-operative pain and hospital stay between stapled and conventionalhemorrhoidectomy, stapled technique is better than conventional technique. Study Design:Randomized control trial. Setting: Department of General Surgery Bakhtawar Amin MemorialHospital Multan. Period: February 2016 February 2017. Methodology: A total number of 60patients enrolled in the study, both genders. Statistical software SPSS ver.23 was used toanalyze the data. Mean and SD were calculated and presented for numerical variables likeduration of hemorrhoids, age and pain score while frequencies and percentage were calculatedand presented for categorical variables like ender and grade of hemorrhoids. Independent t-testand chi square test were applied to see effect modification. P value ≤0.05 was considered assignificant. Results: Total number of 60 (100%) patients in the study, 32 (53.3%) were maleand 28 (46.7 %) were female. Mean hospital stay in group A was 1.63 ± 0.71 and in groupB means duration of hospital stay was 1.73 ± 0.74. A P value was 0.001. On stratification ofdata it is concluded that in group A 9 patients have no pain 6 have mild and 6 have moderatepain and 5 patients have severe pain, similarly in group B, 3 patients have no pain 2 have mildpain 1 have moderate pain and no patient have severe pain. P value for male patients was2.65. Conclusion: This study confirms that stapled hemorrhoidectomy is associated with lesspostoperative pain with no effect of age and gender on outcome.

scholarly journals COMPARISON OF THE EFFICACY OF ANTIBIOTIC-STEROID AND ICHTHAMMOL GLYCERINE WICK IN TREATMENT OF ACUTE OTITIS EXTERNA

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S612-16
Author(s):  
Maryam Khan ◽  
Kamran Ashfaq Ahmed Butt ◽  
Naeem Riaz ◽  
Zaheer Ul Hassan ◽  
Attique Ahmed ◽  
...  
Keyword(s):  
Experimental Study ◽  
Otitis Externa ◽  
The Other ◽  
Military Hospital ◽  
P Value ◽  
Similar Response ◽  
Quasi Experimental ◽  
Group A ◽  
Group B

Objective: To compare the efficacy of steroid antibiotic wick with Ichthammol Glycerol wick in the management of Acute Otitis Externa in terms of tenderness and clearance of discharge/debris. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Out Patient department of Combined Military Hospital Peshawar and Hayatabad Medical Complex Peshawar, from May to Nov 2018. Methodology: A total of 250 patients were included and divided into two groups of 125 each. After necessary suction clearance topical Ciprofloxacin/Dexamethasone (Cipotec-D) wick was placed in auditory canal of group A patients and topical Glycerol/Ichthammol wick was placed in group B. Follow up visits were done on 3rd and 7th day of starting the treatment. Results: Group A patients responded better in terms of tenderness (88%) however both groups had similar response in terms of discharge reduction (7.2% vs 6.4%). In terms of efficacy neither of the treatment proved more efficacious compared to the other (p-value 0.058). Conclusion: While steroid antibiotic wick is significantly more efficient in terms reducing tenderness, in terms of overall efficacy and discharge reduction Ichthammol/glycerol is equally effective.

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