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Background: The practice of using the drain in thyroid surgery including hemithyroidectomy is common to avoid complications like a hematoma. The aim of this study is to evaluate the necessity of routine drainage in hemithyroidectomy.Methods: In this randomized prospective clinical study conducted in tertiary care government training hospital,60 patients who underwent hemithyroidectomy for various thyroid disorders were randomly allocated to either non-drainage (group A) or drainage (group B). The various complications including hematoma, seroma, wound infection, post-operative pain, the length of hospital stay was then compared.Results: Both groups were comparable according to age, gender, thyroid size and histopathological diagnosis. A total number of 60 patients evaluated among them 45 females (75%) and 15 males (25%) were there. No significant difference in complications was observed between two groups regarding hematoma, wound infection, but the length of hospital stay was significantly reduced in the non-drainage group compared to drainage group (p-0.004), along with the significant reduction in post-operative pain (p-0.001).Conclusions: In present study, author observed that there is a significant reduction in length of hospital stay and post-operative pain in non-drainage group compared to drainage group. So suction drainage should be done in selected patients rather than a routine procedure and it is safe without suction drain especially in hands of experienced surgeons.
BACKGROUND:Gastrointestinal functional disorders especially constipation cause morbidity in otherwise healthy children with an estimated prevalence of 1% to 30%. It is perceived as a benign, easily treatable condition however left untreated, can lead to complications (Faecal impaction, incontinence and bowel perforations). Only a small proportion of patients seek medical advice; thus, the exact prevalence of the disorder is difficult to estimate. AIMS: To estimate the prevalence of chronic functional constipation in children aged 4-14 years and the degree of psychosocial impact on children and their parents. SETTINGS AND DESIGN: This cross-sectional study was carried out at K.R and Cheluvamba Hospital, MMC &RI, MYSORE from 1st FEB 2014 to 31ST MAY, 2014. METHODS AND MATERIAL: Constipation was defined using Rome III criteria. Children with organic causes of chronic constipation were excluded. Abdominal pain, fecal mass, anorexia, fecal soiling, withholding behavior were recorded. Psychosocial impact on children and parents was assessed using Paediatric Quality Of Life Inventory (PQLI) and modified PIP Questionnaires. Scoring done according to instructions given with respective questionnaires. STATISTICAL ANALYSIS: Prevalence was calculated using rates, ratios and percentages. Tests of significance were performed wherever relevant. P value of less than 0.05 was considered significant. RESULTS:The prevalence of functional constipation was estimated to be 14.29% with higher prevalence in females as compared to males i.e. 16.19% vs. 13.42%. Perineal soiling was significantly associated with functional constipation i.e. 58.33%. Mean score of all children was 75.4 and 70.6 for physical and psychosocial impact. 88% children reported PQLI score <80 (Mean 69.4). No difference between male and female child (p=.614). 83.33% parents reported score <80(Mean 69.3). No significant difference on psychosocial impact and quality of life according to PQLI parent report (p=1). CONCLUSIONS: High prevalence of functional constipation was observed amongst the younger female children. Children with chronic constipation have a lower quality of life. This study proves that functional constipation, its associated factors and complications are frustrating to the child and their parents.
Background: There have been many attempts to find less painful surgical methods for treating haemorrhoids. Harmonic scalpel is a device that simultaneously cuts and coagulates soft tissues through ultrasonic vibrations. The aim of this study was to compare the results of Harmonic scalpel hemorrhoidectomy with conventional Milligan Morgan hemorrhoidectomy for the treatment of grade III and IV hemorrhoids.Methods: Patients with grade III or IV hemorrhoids, operated between January 2016 and December 2016, using the harmonic scalpel (n=30) or the conventional open technique (n=30) were studied. Both the groups were compared with respect to Operative time, Blood loss during surgery, early postoperative complications, postoperative pain measured on a visual analog scale (VAS), hospital stay, and return to normal work.Results: Harmonic scalpel and conventional open haemorrhoidectomy patients differ significantly in terms of VAS score of postoperative pain, blood loss during surgery, early post-operative complications, return to normal work. However, there is no significant difference in terms of duration of surgery and hospital stay in both the groups.Conclusions: Harmonic scalpel haemorrhoidectomy has been found advantageous method when assessing the amount of bleeding intraoperatively, post-operative pain, early postoperative complications, and Return to normal work. Hence Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternate method for treating symptomatic haemorrhoids.
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