Background: Warts are common cutaneous viral infections due to human papilloma virus (HPV) mostly affecting school age children and adults.1 Various therapeutic modalities are available including ...topical, physical, and systemic therapies. Physical therapies are considered to be effective in the management of viral warts. This study aims to compare the efficacy of electrocautery with cryotherapy in the treatment of viral warts.Patients and methods: This randomized trial was conducted in Dermatology Department of GHAQ / DHQ Teaching Hospital/SLMC, Sahiwal from October 2020 to March 2021.A total of 50 patients with clinical diagnosis of warts either sex with age ranging from 5-60 years were enrolled in the study and were divided into two equal groups. Patients excluded were those with evidence of any superadded infection and number of warts >6, having documented hypersensitivity to lignocaine or taking any treatment for warts in last month. After obtaining an informed written consent group A was treated with electrocautery and group B with liquid nitrogen cryotherapy. The patients were treated until the complete clearance of warts or maximum of eight sessions on weekly basis. Demographic and clinical data as efficacy (cleared if not palpable or visible to naked eye) was recorded on predesigned proforma and was analyzed by using chi-square test through SPSS version 25. Results: Out of total 50 patients, there were 27 (54%) male and 23 (46%) female patients, with an overall male to female ratio was 1:0.7. Most commonly observed clinical type of wart were plantar warts in 28 (56%) followed by palmar in 6 (12%). Electrocautery was found to be effective therapy in treatment of wart as indicated by complete clearance noticed in 19 (76%) patients as compared to cryotherapy in 11 (44%) participants.Conclusion: Electrocautery is more effective as compared to cryotherapy in the treatment of warts especially plantar and deep-seated. However, promising effects of cryotherapy is seen in common and multiple warts as compared to electrocautery.
Carcinoid tumors are slow-growing tumors noticed in the tracheobronchial tree and pulmonary parenchyma. Generally, these tumors are slow growing with minimum risk of distant metastasis, but the ...atypical type of carcinoids has greater malignant potential with lower survival rates. The primary and most effective treatment for all pulmonary carcinoid tumors is surgical resection if no contraindications to surgery exist. Compared to surgical resection, bronchoscopic management is minimally invasive and parenchyma sparing. The present case series describes six patients, all young males, diagnosed with typical (n = 4) and atypical (n = 2) carcinoids, and managed with electrocautery fulguration carried out through video bronchoscope. Three cases were suggested pneumonectomy, while the other three cases were suggested for lobectomy by the Hospital Tumour Board. After the electrocautery fulguration procedure, the procedures of lobectomy or pneumonectomy were successfully prevented in all the cases, thereby saving these young males from life-threatening surgeries and permanent disabilities that would have affected their health and career. This is one of its kind case series that shows the importance of bronchoscopic management in carcinoid cases, from developing countries that can help in preserving the lungs.
Cerebellar tonsillar reduction or resection can be performed as part of the surgical management of Chiari type 1 malformation when it is accompanied by symptomatic brainstem compression or ...syringomyelia. The purpose of this study is to characterize the early postoperative magnetic resonance imaging (MRI) findings in patients with Chiari type 1 malformations who undergo cerebellar tonsillar reduction via electrocautery.
The extent of cytotoxic edema and microhemorrhages demonstrated on MRI scans obtained within 9 days following surgery was assessed and correlated with neurological symptoms.
Cytotoxic edema was found on all postoperative MRI examinations included in this series, with superimposed hemorrhage in 12 of 16 patients (75%) and was primarily located along the margins of the cauterized inferior cerebellum. Cytotoxic edema was present beyond the margins of the cauterized cerebellar tonsils in 5 of 16 patients (31%) and was associated with new focal neurological deficits in 4 of 5 patients (80%).
Cytotoxic edema and hemorrhages along the cerebellar tonsil cautery margins can be expected findings in early postoperative MRI in patients who undergo Chiari decompression accompanied by tonsillar reduction. However, the presence of cytotoxic edema beyond these regions can be associated with new focal neurological symptoms.
Background. As one of the most frequent procedures, breast surgery puts high healthcare costs. The significance of surgical quality and complications before and after breast surgery entailed using ...methods with the highest outcomes and the least complications. Methods. Throughout this research, postoperative complications and factors affecting the quality of surgery were evaluated in the Kowsar hospital between the 2019 and 2020.Patients undergoing breast surgeries were randomly categorized into two groups: electrocautery (A) and harmonic scalpel (B). Results. Out of the 56 people, 28 patients were in group A, and the remaining 28 patients were in group B. After matching the patients, intraoperative bleeding, drainage rate, a period of drainage, duration of hospitalization in group B were significantly lower (P<0/05). Further, the extent of pain in both groups was different (P<0/001), so that there was less postoperative pain in women who experienced harmonic breast surgery. Patients throughout Group A reported more complications than in Group B, such that 7 (25%) of patients underwent limb anesthesia and 3 (10/7%) of patients experienced seroma, however, the difference between the two groups was not significant. Conclusion. Harmonic scalpel usage in breast surgery has fewer complications, better operation quality and shorter hospital stay than other older methods, so it is suggested that the use of harmonic scalpel may substitute different surgical strategies. Practical Implications. According to the results of this study, the use of harmonic has fewer complications for patients, and suffering of patients are reduced and they pay less.
There have been numerous techniques used in laparoscopic appendectomy (LA) to divide the mesoappendix, including LigaSure, Harmonic scalpel, clips, endoloop ligatures, Endo GIA staplers, and bipolar ...coagulation. However, few studies have investigated monopolar diathermy for mesoappendix division. Therefore, this study aimed to assess both its safety and efficacy in LA.
In this prospective non-randomized study, patients (n = 87) who underwent LA for acute appendicitis were included. The bipolar electrocautery was used for mesoappendix division in the first 33 patients (BC group), while the monopolar electrocautery was used in the next 54 patients (MC group).
The median operative time was significantly shorter in the MC group (42 min. vs 47 min. in BE group, p = 0.01). One patient converted to open surgery in the MC group due to uncontrollable bleeding. There were no significant differences between both groups regarding postoperative complications and hospital stay (p = 0.91, p = 0.13, respectively).
Monopolar electrocautery is safe and effective for mesoappendix division in LP in comparison to bipolar electrocautery. However, larger and multicentric studies are required to validate our results.
We hypothesized that operating room (OR) airborne particulate matter (PM) was different in quantity and mutagenic potential than office air and cigarette smoke.
Exposure to surgical smoke has been ...equated to cigarette smoking and thought to be hazardous to health care workers despite limited data.
PM was measured during 15 operations in ORs with 24.8 ± 2.0 air changes/hour, and in controls (cigarettes, office air with 1.9-2.9 air changes/hour). Mutagenic potential was assessed by γH2AX staining of DNA damage in small airway epithelial cells co-cultured with PM.
Average PM concentration during surgery was 0.002 ± 0.002 mg/m3 with maximum values at 1.08 ± 1.30 mg/m3. Greater PM correlated with more diathermy (ρ = 0.69, p = 0.006). Values were most often near zero, resulting in OR average values similar to office air (0.002 ± 0.001 mg/m3) (p = 0.32). Cigarette smoke average PM concentration was significantly higher, 4.8 ± 5.6 mg/m3 (p < 0.001). PM collected from 14 days of OR air caused DNA damage to 1.6 ± 2.7% of cultured cells, significantly less than that from office air (27.7 ± 11.7%, p = 0.02), and cigarette smoke (61.3 ± 14.3%, p < 0.001).
The air we breathe during surgery has negligible quantities of PM and mutagenic potential, likely due to low frequency of diathermy use coupled with high airflow. This suggests that exposure to surgical smoke is associated with minimal occupational risk.
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