BACKGROUND & OBJECTIVE: Thyroidectomy is a classic surgical procedure used worldwide for thyroid gland excision. A study was conducted to compare the outcomes (mean operative time, drainage volume, ...postoperative pain and hospital stay) and postoperative complications of Harmonic scalpel and conventional homeostasis in patients who underwent total thyroidectomy
METHODOLOGY: A prospective observational study was conducted at the department of general surgery, POF hospital Wah Cantt. The study duration was six months (June 2020-Novemebr 2020). A sample size of 70 patients was calculated using the WHO calculator. Patients for total thyroidectomy were selected through a non-probability consecutive sampling. Patients whose total thyroidectomy was planned were divided into two groups using a random number table. In Group A, we used a harmonic scalpel, while in Group B, we used the conventional homeostasis method to secure homeostasis operatively. Patients were followed after 4 weeks for complications. Chi-Square test and t-test was applied.
RESULTS: A total of 70 patients were included in the study. The mean operative time was 44.5 min±1.4 in the HS group and 66.0 min±2.0 in the conventional homeostasis group (p≤0.001). Hospital stay was significantly less in the HS group as compared to the conventional homeostasis group (2.3 days ±0.4 vs 3.3 days ±0.4, p≤0.001). Postoperative drainage was significantly high in conventional homeostasis group as compared to HS group (56.4±1.5 mL vs 36.5±1.5 mL, p≤0.001).
CONCLUSION: Harmonic scalpel is an effective, reliable and safe tool for better outcomes in terms of less operative time, lower drainage volume and short duration of hospital stay as compared to conventional methods.
BACKGROUND & OBJECTIVE: Pediatric femoral diaphyseal fractures are common fractures in preschool children. The titanium elastic nailing technique is becoming prevalent in developed and developing ...countries. To compare the frequency of efficacy, safety and mean surgical fixation outcomes among patients who underwent titanium elastic nailing versus spica casting in diaphyseal femur fractures
METHODOLOGY: A prospective study was conducted at department of orthopedics, Pakistan Ordinance Factory (POF) hospital. The study duration was 2 years (March 2018-March 2020). A sample size of 42 children was calculated using WHO calculator. Children selection was made on the basis of non-probability (consecutive) sampling. Group TEN underwent titanium elastic nailing, while group SPICA underwent hip spica casting. Patients were followed for six months. We used SPSS version 24 for the analysis of data. Fisher exacts and independent T-test were applied for measuring associations and comparisons of two groups. P-value ≤0.05 was considered significant.
RESULTS: Total of 42 patients were included in the study. The mean age of patients was 3.4 years±1.4SD. The TEN group showed satisfactory results in malalignment (p=0.000) and complications (p=0.000). SPICA group showed significantly high assisted weight bearing duration (p=0.000), full weight bearing duration (p=0.000), greater operative time (p=0.000), lower range of motion (p=0.000) and less patient satisfaction (p=0.000) as compared to TEN group.
CONCLUSION: Titanium elastic nailing is safe, effective, and allows faster recovery in pediatric patients with diaphyseal femoral fractures. We recommend titanium elastic nailing as a valid treatment option for femur fractures in preschool children.
Objective: To compare frequency of intra-abdominal complications in drainage and non-drainage group among patents who underwent intra-abdominal surgeries.
Study Design: Comparative prospective study.
...Place and Duration of Study: Department of Surgery, Pakistan Ordinance Factory, Wah Cantt, from Mar 2018 to Jul 2018.
Methodology: There were 32 patients, 16 in each group. Patients were selected through the process of consecutive sampling. Patients were randomly divided into two groups (random number table method); group A patients underwent intra-abdominal drain while group B was non-drainage group. Patients were followed up for 7 days and observed for complications.
Results: Total 32 patients were included in the study. There were 14 (43.8%) males and 18 (56.3%) females. Mean age of patients was 43.2 ± 9.5 years. Drain group showed significantly low anastomosis leakage (p=0.02), wound infection (p=0.05), mortality (p=0.04), pulmonary complications (p=0.05) and bleeding (p=0.03) as compared to the non-drain group.
Conclusion: Intra-abdominal drains are associated with several complications. Anastomosis leakage is the most common complication following pulmonary complications and bleeding. However, drains help in early detection of complications and timely management of such complications leads to better outcome of a surgical procedure.
Objective: To compare mean pain scores among knee osteoarthritis patients following or not followingpreventive measures.
Study Design: Comparative prospective study.
Place and Duration of Study: The ...study was conducted at the department of orthopedics, Pakistan OrdinanceFactory (POF) Hospital, Wah Cantt, from Jun 2018 to May 2019.
Methodology: Patients were divided into two groups (using random number table); group A was given painrelief medications only while group B was given a combination of pain relief medication and preventive measure. Patients were followed for 3 and 6 months after the intervention. Data was analyzed with SPSS software.
Results: Total 52 knee osteoarthritis patients were included in study (26 patients in each group). Mean age ofpatients was 54.3 ± 6.4 year. Significantly lower pain scores were found in group B as compared to group A after3 (5.50 ± 0.98 vs 4.84 ± 1.00 respectively, p=0.02) and 6 months (3.53 ± 0.50 vs 4.96 ± 1.11 respectively, p<0.01) ofintervention. Knee injury and osteoarthritis outcome scores were significantly lower in group B as compared togroup A (p<0.05) after 6 months.
Conclusion: Pain is most common knee osteoarthritis symptom. Combination of pain relief medicines andpreventive measures in daily life are more effective in controlling pain intensity as compared to pain reliefmedications only. Early diagnosis and management can improve disease prognosis.
Objective: To determine fear factors before total knee replacement in advanced knee osteoarthritis patients. Study Design: Mixed method study. Place and Duration of Study: Study was conducted at ...department of Orthopedics, Pakistan Ordinance Factory Hospital Wah Cantt, form May 2017 to May 2019. Methodology: A sample of 105 knees was calculated using WHO calculator. Patients of Knee osteoarthritis were selected with consecutive sampling. Interviews were taken from patients for determining fear factors related to total knee replacement. SPSS version 24 was used for analysis. Results: Total 105 knees of osteoarthritis were included in study. There were 51 (48.6%) male and 54 (51.4%) female in study. Mean age of patients was 59.8 ± 4.1 SD years. Most common fear factor according to patients priority for total knee replacement therapy was worsening of symptoms after total knee replacement 42 (40%) followed by pain persistence after total knee replacement 27 (25.7%), financial feasibility 21 (20%), and religious problems 15 (14.3%). Patients with osteoarthritis grading 4 had high pain scores, high stiffness scores and lower social function scores (p=0.000, p=0.000, p=0.001 respectively) on Western Ontario and McMaster Universities Osteoarthritis Index scale. Conclusion: Total knee replacement therapy in advanced knee osteoarthritis is associated with several fear factors. Most common fear factor is worsening of symptoms after total knee replacement followed by pain persistence. Total knee replacement efficacy related counseling and community based awareness programs could be helpful in overcoming these fears and stigmas in Pakistan.
Background and Objective: Femur fractures result in a high rate of mortality and morbidity. Objective was to compare effectiveness of percutaneous dynamic hip screw fixation technique (PC-DHS) and ...conventional open dynamic hip screw (DHS) in terms of mean operative time, wound size, pain scores, intraoperative blood loss, screening time, hospital stay at 2 weeks, mean full weight bearing mobilization at 6 weeks, mean hip Harris scores at 6 weeks and 3 months and mean radiological healing at 3 months in older patients having an intertrochanteric fracture of femur neck at tertiary care hospital. Methodology: The study design was a prospective observation study at the Department of Orthopedics, POF hospital. The study duration was 2 years (2018-2020). The sample size was 130 with 1:1 randomization in each group. Patients were selected through nonprobability sampling (lottery method) and divided into two groups; Group A underwent PC-DHS and Group B underwent conventional DHS procedure. Data was analyzed using SPSS version 24. Results: A total of 130 patients were studied. Patients who underwent PC-DHS showed significantly low operative time (p<0.00), wound size (p<0.00), intraoperative blood loss (p<0.00), pain scores (p<0.00), hospital stay length (p<0.00) at 2 weeks as compared to conventional DHS. PC-DHS patients showed high Hip scores (p<0.00) at 3 months and at 6 months (p<0.00). The frequency of chronic hip pain, non-union, implant failure, avascular necrosis, chronic osteomyelitis, and deep venous thrombosis was high in conventional open DHS. Conclusion: We found PC-DHS as a more effective and safe technique for intertrochanteric fracture fixation resulting in significant improvement in surgical outcomes at 2 weeks, 6 weeks, 3 months, and 6 months.
To compare efficacy of systemic antibiotics alone and combination of systemic antibiotics with gentamicin cream in diabetic foot infections.
Prospective Observational Study was conducted at ...Department of Surgery, Pakistan Ordinance Factories (POF) Hospital, Wah Cantt for duration of two years (January 2018-December 2019). A sample size of 140 diabetic foot infection patients (70 patients in each group) was calculated using WHO calculator. DFI patients were selected through non probability (consecutive) sampling technique. All patients signed consent forms before participation into study. Patients were randomly divided into two group (computer generated random number table); Group-A patients were given systemic antibiotics alone while Group-B was given combination of gentamicin cream and systemic antibiotics. SPSS version 24 was utilized for analysis purpose. Chi-square test was applied in our study. Results with p value ≤0.05 found significant.
Total 140 patients were included in study. There were 87(62.1%) male and 53(37.9%) females in our data. Mean age of patients was 46 years±11.3SD. Group-B (combination of gentamicin and systemic antibiotics) showed significant reduction in inflammation (p=0.03), culture negativity(p=0.001), increase clinical cure (p=0.02) and pathological eradication (p=0.03) as compared to Group-A (systemic antibiotics alone). Gender, age and duration of diabetes mellitus had insignificant association with outcomes (p>0.05).
Diabetic foot infections are significant contributors of morbidity in our country. Combination of gentamicin cream with systemic antibiotics is highly effective in inflammation reduction, increasing clinical cure rate and pathological eradication as compared to systemic antibiotics alone in diabetic foot infections. Early identification of risk factors, proper patients care and multidisciplinary approach for diabetic foot infections prevention is required.
Objective: To compare mean pain scores among knee osteoarthritis patients following or not following preventive measures. Study Design: Comparative prospective study. Place and Duration of Study: The ...study was conducted at the department of orthopedics, Pakistan Ordinance Factory (POF) Hospital, Wah Cantt, from Jun 2018 to May 2019. Methodology: Patients were divided into two groups (using random number table); group A was given pain relief medications only while group B was given a combination of pain relief medication and preventive measure. Patients were followed for 3 and 6 months after the intervention. Data was analyzed with SPSS software. Results: Total 52 knee osteoarthritis patients were included in study (26 patients in each group). Mean age of patients was 54.3 ± 6.4 year. Significantly lower pain scores were found in group B as compared to group A after 3 (5.50 ± 0.98 vs 4.84 ± 1.00 respectively, p=0.02) and 6 months (3.53 ± 0.50 vs 4.96 ± 1.11 respectively, p<0.01) of intervention. Knee injury and osteoarthritis outcome scores were significantly lower in group B as compared to group A (p<0.05) after 6 months. Conclusion: Pain is most common knee osteoarthritis symptom. Combination of pain relief medicines and preventive measures in daily life are more effective in controlling pain intensity as compared to pain relief medications only. Early diagnosis and management can improve disease prognosis.
PDF
