Objective: Circumcision is a commonly performed surgical procedure but choice of anesthesia remained an issue of research and debate. This study was conducted to find out the effectiveness of the eutectic mixture of local anesthetic (EMLA) cream with dorsal penile nerve block (DPNB) using lignocaine, for reduction of pain during circumcision. Methodology: This was comparative study carried out in Surgical Unit B of National Institute of Child Health Karachi, from May 2008 to October 2008. Patients under six month of age were randomized in to two groups (EMLA and DPNB) of fifty patients each. The effectiveness of pain control was assessed by measuring the baseline heart rate (HR), respiratory rate (RR) and Neonatal infant Pain Scale (NIPS scale) before the start of procedure and measuring of these parameters for each step of circumcision. Independent sample t -test was used to compare means and repeated ANOVA was used to compare means of HR, RR, oxygen (O2) saturations and NIPS. Results: The mean age in both the groups was 2.3 months. There was no statistically significant difference in baseline parameters in both the groups except the respiratory rate, which was significantly raised in DPNB group (33 breaths/min in EMLA and 38 in DPNB P < 0.04). During circumcision there was significant increase in heart rate in DPNB group, especially in step three and step four (p < 0.04). Oxygen saturation dropped in both the groups (baseline saturation 98% up to 91% in step 4). While assessing NIPS scores in both the groups, statistically significant difference was found between NIPS at step two and step four in two groups (p < 0.04). Conclusions: The overall pain control was equal in both the groups, although NIPS score was higher in DPNB in step two and four of circumcision. There was difference in application and cost. EMLA was easy to apply but has increased cost; while DPNB required expertise.
Jejunogastric Intussusceptions is a rare but potentially life threatening complication of a previous gastrectomy or gastrojejunostomy. A 70 years old man presented with severe epigastric pain followed by haematemesis, 8 years after truncal vagotomy and gastrojejunostomy for pyloric stenosis. Ultrasonography revealed dilated stomach with a large intragastric mass which has minimal peristaltic movement. Endoscopy of upper GIT revealed prolapsed segment of jejunal loops through the gastrojejunostomy stoma. Laparotomy disclosed a retrograde type II jejunogastric intussusception and was managed by reduction of jejunogastric intussusception, resection of gangrenous segment and end to end anastomosis. Post operative recovery was uneventful. Retrograde jejunogastric intussusceptions is a rare condition and around 200 cases has been reported since its first description in 1914. Urgent recognition and surgical treatment is mandatory to reduce the mortality rate from this complication. Key words: Retrograde Jejunogastric Intussusception; gastrojejunostomy; gastric surgery. DOI: 10.3329/fmcj.v5i1.6812Faridpur Med. Coll. J. 2010;5(1):32-34
Mesenteric cysts are not uncommon in pediatric age group but giant lymphatic cysts of mesentery are reported infrequently. This is a report of six years old female who had vague abdominal pain with distension for two years. Investigations revealed a large cystic mass in abdomen. On exploration a giant lymphatic cyst in the mesentery of transverse colon found. More than 1500 ml of milky fluid was drained. The cyst was unilocular and appeared to be the collection of lymph (chyle) between two leaves of the mesentery of the transverse colon. It is postulated that trauma to or malformation of lymphatics at the root of mesentery might have lead to this pathology.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.