Background: Breast abscess is a common cause of morbidity in women. While they are less common in developed countries as a result of improved maternal hygiene, nutrition, standard of living and early administration of antibiotics, breast abscess remain a problem among women in developing countries. Methods: Hospital based prospective randomized controlled trial conducted on 100 patients. 50 of them were randomized in the aspiration group and other 50 were treated by incision and drainage. All statistical analysis was done in Epi-info statistical software. Results: In our study, patients in the needle aspiration group had lesser pain as compared to the patients of the incision and drainage group. Average pain score (on visual analogue scale) on day three of patients in the needle aspiration group was 4.22 as compared to 5.72 in the incision and drainage group. On day seven the pain score was 1.73 in the aspiration group and 3.89 in the incision and drainage group. By day fourteen almost all patients (94.00%) of needle aspiration group were pain free and the average pain score in the incision and drainage group was 2.0.Using the chi square test, a p value of 0.0005 was obtained suggesting a statistically significant difference. Conclusion: Wherever the facility of ultrasound is available, serial percutaneous needle aspiration may be tried as a first line of therapy. Keywords: Needle aspiration, Incision and drainage, Breast abscess.
Background: Liver functions tests suggest the underlying cause, estimate the severity, assess prognosis and monitor efficacy of therapy. Severity of liver dysfunction when performed serially may predict prognosis and may be helpful in assessing response to medical therapy or a surgical intervention.Methods: The data was collected in thirty cases of surgical obstructive jaundice in terms of age, sex, etiology, clinical presentation, surgical intervention for biliary drainage and the laboratory liver biochemical and coagulation profiles on a day prior to surgical intervention and post-operatively on 1st week and 4th week were recorded.Results: Of total 30 patients 56.66% were females. Patients with 73.68% of benign disease and 100% of malignant disease were of age more than 40 years. 63.33% of patients had benign cause for biliary obstruction. Choledochoithiasis and periampullary carcinoma were two most common causes of obstructive jaundice. The commonest complaints were; yellowish discolouration of sclera and skin, high colored urine (100%) and acholic stool (70%). Hepatomegaly, palpable gallbladder and ascites were observed in only malignant conditions. Serum bilirubin and transaminases were significantly higher in patients with malignant lesions on pre-operative and postoperative assessment. After decompression the rate of fall of serum bilirubin, serum glutamic-oxaloacetic transaminase and SGPT were almost identical in both benign and malignant biliary obstructions. However, a better biochemical recovery profile was observed in patients with benign lesions, as they returned to normal by 4 weeks but remained at 2 to 3 times of the normal in malignant lesions.Conclusions: Sequential biochemical assessment of liver functions has diagnostic as well as prognostic value in surgical obstructive jaundice.
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