Objective: Surgical site infections (SSIs) pose a continued problem to operating surgeons. It adds to the healthcare cost, increases morbidity and mortality and sometimes culminates in re-explorations. Rate of SSIs can be ameliorated by removing damaged or non-viable tissue, metabolic waste and wound exudates; this can be achieved by irrigation of surgical wound intraoperatively. Surgical wound irrigation can also be performed postoperatively. Even after giving prophylactic antibiotics and august aseptic measures, post-appendectomy wound infection remains soaring. The efficacy of povidone-io- dine on non-incised skin is well known but its application as an intraoperative irrigation solution in open surgical wounds is not a mundane practice. Likewise prophylactic irrigation with normal saline solution to prevent wound infection has also turned out to be effective in some studies. The objective of this study is to compare the percentage of superficial SSI post-appendectomy, with intraoperative irrigation of subcutaneous plane using 1% povidone-iodine solution versus normal saline. Methods: 200 cases of open appendectomy for acute appendicitis at Baqai Medical University, Kara- chi were randomly distributed into two arms. In group A, 0.9% Normal Saline was employed to irrigate subcutaneous tissue before skin closure while in group B irrigation with 1% diluted povidone-iodine solution was undertaken. The cases were assessed for infection in surgical wounds in line with Southampton wound grading system for five days after surgery and followed for thirty days. Results: Mean age of participants of this study was 18.65 years. There were 100 patients in both groups and the groups were not different statistically in terms of age, gender and operative findings. A total of 38 (19%) out of 200 patients had Southampton grade 2 and above, signifying wound infection. Out of these, 29 (29%) were from Group A and 9 (9%) from Group B (p=0.001). Conclusion: 1% diluted povidone-iodine irrigation of subcutaneous plane after appendectomy remark- ably lowers the rate of SSI when compared with normal saline irrigation.
Aim: To find out the frequency of perforated appendix among patients presenting with acute appendicitis. Study design: A cross-sectional study Place and Duration: This study was conducted at Sindh Employee Social Security Hospital Landhi Karachi, Pakistan from July 2020 to November 2021. Methodology: This study includes 205 patients. All the details like age, gender, and previous history associated with diabetes and fasting blood sugar were noted. The surgeries were performed by a single surgeon who detected the presence and absence of a perforated appendix. Results: Mean age of patients was 28 years with a standard deviation of ±13.63. A total of 64% of patients were male and 26% were female. About 11% of patients had perforated appendix after acute appendicitis. Conclusion: The frequency of perforated appendix in this study was 11% in patients undergoing appendectomy for acute appendicitis. Keywords: Appendicitis, perforated appendix, adults, prevalence
Aim: To examine the clinical characteristics of patients with acute appendicitis Study design: A cross-sectional study Place and Duration: This study was conducted at Liaquat University Hospital Jamshoro / Hyderabad from March 2021 to March 2022. Methodology: Presentstudy included 118 patients who went through emergency appendectomy for acute appendicitis. The study evaluated the patient's clinical profile who presented with acute appendicitis. A detailed history was taken, a clinical examination was performed, and tests such as a complete blood test and ultrasonography were performed. Patients of either gender, above 10 years of age, and with clinical diagnoses of acute appendicitis were incorporated in the study. Patients having an appendicular mass or right ureteric/renal colic were excluded from the study. Results: In the current study themean age of patients was 27.56 ± 9.8 years. Out of 118 patients, 71 (60.1%) were males, and 47 (39.83%) were females. We observed thepredominance of malesin the current study. Majority of the patients presented with complaints of right iliac fossa pain (98.3%) and migration of pain (67.8%). Nausea and anorexia were present in 86.4% of cases, and vomiting was present in 84.7% of cases.Tenderness was observed in right iliac fossa in all patients while Dunphy sign (59.3%), guarding (63.5%), rebound tenderness (69.4%), rigidity (5.9%), Psoas sign (45.7%), Rovsing sign (35.5%)and Obturator sign (21.1%). Conclusion: Males are more likely to have acute appendicitis than females between 10 and 30 years of age. The most common signs and symptoms were discomforts, anorexia, nausea/vomiting, and abdominal pain. Tenderness, guarding, and rebound tenderness were the most prevalent symptoms.
Objective: To analyse the effects of stretching the muscles of the shoulder before surgery on the functionality of the shoulder after the surgery of mastectomy Study design: An analytical cross-sectional study Place and Duration: This study was conducted at Bibi Asifa Bhutto Dental College SMBB Medical University CMC Teaching Hospital Larkana from January 2022 to June 2022. Methodology: All the patients included in the study had mastectomy. The participants were randomized to control groups and treatment groups. The participants in the treatment group were gone through static stretching with a range of motion. The control group did not undergo any stretching preoperatively and was given standard postoperative care. The Numeric Pain Rating Scale (NPRS), Groningen Activity Restriction Scale (GARS), and Universal Goniometer (UG) were used for the collection of the data on the first and third postoperative days. The data was analyzed in the IBM SPSS version 26. Results: A total of 20 patients were included in the study. Overall10 patients were allocated to the treatment group and 10 were allocated to the control group. The mean age of the patients was 47±11.86 years. A significant difference in the functionality, range of motion, pain, and Groningen Activity Restriction Scale scores for daily activities was seen in the treatment group (p<0.05)compared to the control group (p>0.05). However, the difference was not significant in external rotation and Groningen Activity Restriction Scale scores (p>0.05). Conclusion: Shoulder stretching before surgery is not only safe, but it is also effective in the reduction of functional restriction and pain after the mastectomy surgery. Keywords: Shoulder stretching, Pre-operative stretching, Mastectomy, Post-op shoulder function
Aim: To evaluate the quality of bowel preparations concerning the Boston Bowel Preparation Score (BBPS) and to analyze the administration, ease, palatability, and side effects of practices. Study design: Cross-sectional study Place and Duration: this study was conducted in Liaquat University of Medical and Health Sciences Jamshoro from October 2021 to March 2022 Methodology: The present study incorporated 132 patients who visited the hospital for a colonoscopy. Patients above 18 years of age were included, whereas patients with surgical procedures were excluded from the study. Participants were evaluated through pre-designed proforma for demography, dietary recommendations, side effects, procedure indications, bowel preparations, and patient ease of the bowel preparations. BBPS was used to access the bowel preparation. A score ≥ 5 was regarded as satisfactory. Results: Out of 132 patients, 73 (55.3%) were males. Seventy-one (53.8%) patients received Polyethylene glycol-based bowl preparation, and sixty-one (46.2%) patients received sodium phosphate-based preparation. Chronic constipation was the most typical cause of colonoscopy. Common side effects were vomiting (12.1%), nausea (1.5%), and bloating (3%). More than half of them responded that the preparations were palatable. A satisfaction rate of 80.3% was observed in patients with both preparations. BBPS of above five was observed in 109 (82.6%) patients. Conclusion: Polyethylene glycol and sodium phosphate preparations have been widely used in clinical practices for cleansing the colon. Sodium phosphate-based preparation was found more effective. Keywords: Bowel cleansing agents, Colonoscopy, Endoscopy, Polyethylene Glycol, Sodium phosphate.
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