Background: Fistula-in-ano is defined as an epithelized abnormal tract connecting two surfaces; usually the rectal mucosa and perianal skin. The primary treatment for fistula is surgery for which many options are available. However, in this article, we will be discussing the comparison between LIFT and fistulectomy. Aim: To compare a conventional invasive technique of fistulectomy with a newly introduced minimally invasive LIFT procedure in terms of operative time, hospital stay, postoperative complications, and follow-up. Methods: A retrospective view of 135 patients was done who were operated on either by LIFT (n=59) (Group L) or fistulectomy (n=76) (Group F) over the period of three years and a comparison between two techniques was performed using Student’s t-test or Mann-Whitney test for continuous variables and Fisher’s exact test for categorical variables. Results: Our operative time for LIFT was greater than the fistulectomy. Post-operative pain was analyzed using the VAS pain scale, where Group L experienced less post-operative pain. Group F patients’ wounds took longer to heal as compared to Group L patients. Hence group L (LIFT) returned to work earlier. Post-operative complications such as wound discharge were reported more in Group F than in Group L. Same was observed in the case of post-operative infection rate. Two cases of wound granulation were observed in the case of LIFT (Group L) at one-month follow-up and one case of incontinence to flatus in the Group F group was documented at three-month follow-up in the patient's record. Thirty-seven patients’ complained of itching in Group F compared to 10 in Group L. Patients who had seton, complained of setons related problems. Conclusion: LIFT was a promising and sphincter-saving technique that was simple and easy to learn with faster healing rates and better patient contentment. Keywords: LIFT, fistulectomy, fistula-in-ano
Every doctor in their career must have read or written an editorial. Our field is very scientific, logical, evidence based and genuinely to write editorials for medical journals is indeed not an easy task. Need and use of editorialin medical journals is similar to that of newspapers, they provide a focus, give direction and stimulate interest1. This brings up thoughts of the tips and techniques of how to write an editorial? Reading editorials show how one writers style is different from another, same as all fingers of a hand are not equal. First what is an editorial: It is a piece of writing whereby the author is conveying facts to the readers, gives opinion on those facts with rationale to create a good balance between the written facts and opinion. To authenticate this the author provides reliable evidence for effective persuasion2,3. Secondly why write an editorial: It could be the forerunner of what to expect within the journal, get a not widely disseminated opinion across to readers or persuade readers to believe the authors opinion2. Thirdly what should be the structure format of an editorial: The title should be eye catching like an abstract of a scientific paper. The author should start with the fact to be portrayed on which opinion should be built which could be for or against. Keeping balance of fact: opinion, validate with evidence which will strengthen the foundation for persuasion, if the author wants to use persuasion.2 Format of editorial may vary depending on requirements of the journal but the fact writing editorials is a taxing feat especially when writing about unreported, underreported, controversial or innovative issues for creating awareness.4Nonetheless, it is a rewarding task one must indulge in at least once in career life.
Recent prospective studies have recommended primary repair for all colonic trauma. We evaluate the changing patterns given these recommendations and assess our results of primary repair. This prospective study was conducted on 63 patients with colonic trauma received over a year from July 2000 to June 2001. Morbidity was defined as failure of a primary repair, abscess, fistula, wound dehiscence, sepsis, and organ failure. Primary repairs were performed in 28 patients and colostomy was done in 35 patients. Prolonged mean hospital stay and more incidences of postoperative complications occurred in colostomy group. It was therefore, concluded that primary repair of colon should be adapted as a standard procedure. Colostomy should be reserved for patients with a prolonged delay to surgery, severe blood loss, and gross faecal contamination or associated with multiple organ injuries.
Background: WHO recognized COVID-19 a pandemic on March 12, 2020 and National Health Commission officially declared it as a Class-B infectious disease. The technological advancements enabled the teaching staffs to keep their students involved during this period of COVID-19 pandemic. Online classes become the efficient medium to learn by staying at home. Aim: To find out the challenges faced by mothers during online learning in order to devise a systematic plan for smooth and effective learning in case of another crises like COVID-19. Method: It was a cross sectional study carried out at CMH LMC&IOD , in which a user-defined questionnaire was introduced to the participants which were mothers of school going children from all over the city. The questionnaire got 161 responses in total, but two were incomplete so 159 were considered while doing the analysis. The results were analyzed using SPSS25. Results: In this study,46.9% mothers were of age 40 and above and 47.5% were between 31 -40 years of age. Rest were 30 and below 57.5 % children used laptops to study online, while 34.4 % used a mobile. 7% had their own tablets and only 1.1 used desktops. Only 14.4% mothers supervised their children during all this time. 58.7% however managed supervising studies with other tasks and 26.9% said their children could study online unsupervised. Only 20% mothers thought their children are taking interest in online schooling. 54.5% found their children struggling37.5% mothers thought that their children were learning much less through this online mode of education and 43.8% thought that online learning is somewhat less. Conclusion: Among the various the challenges faced by working mothers and housewives during online education of their children the most important challenge was to keep their children focused on study. We discovered that the online study had little effect on grades because most mothers had to take on the role of teacher as well as supervising. Keywords: Covid-19, online education, working mothers
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