Background: Inguinal hernia block is cost effective, but fear of intra-operative pain may hinder its widespread use. It is unknown whether hyaluronidase along with local anesthetic agent provides good analgesia for hernia block. The aim was to evaluate the effectiveness of hyaluronidase along with local anesthetic agents for inguinal hernia block in patients undergoing inguinal hernioplasty. Methods: 50 patients ASA grade I and II, age above 18 years, undergoing inguinal hernioplasty were randomized into two groups. Group A received inguinal hernia block with local anesthetic agents without hyaluronidase and Group B received inguinal hernia block with hyaluronidase and local anesthetic agents. Both groups received premedication 10 minutes before induction in the form of inj. Fentanyl, Midazolam, Ranitidine and Ondansetron Results: In Group B, out of 25 patients only 4 patients required intraoperative analgesia while in group A 16 patients required intraoperative analgesia. Post operative pain was assessed for 24 hours using the pain rating scale. The mean duration of analgesia was significantly longer in group B (16.16±6.8780 hrs) compared to group A (7.32±2.5285 hrs); pain score was compared between the two groups. Group B had lower pain scores than group A which was statistically significant (P<0.05). Conclusion: It concludes that hyaluronidase with local anesthetic agent for inguinal hernia block provides excellent intraoperative analgesia and also prolongs the post operative analgesia. [Int J Basic Clin Pharmacol 2013; 2(4.000): 466-469
Background: The reproductive and urinary tracts in women are closely related anatomically and embryologically. Knowledge of this anatomy plays an important role in the prevention of urinary tract injury during gynaecologic surgery. The primary approach to prevention is careful surgical dissection and knowledge of the position of urinary tract structures within the surgical field.Methods: Prospective interventional study consisted of 28 patients with obstetrics and gynecological surgeries was carried out at department of surgery, new civil hospital, Surat during December 15th to January 16th. Out of 28 patients 13 patients had bladder injuries which repaired and studied in detail.Results: Out of these 28 patients undergone various obstetrics and gynecological surgeries, 13 patients were having iatrogenic urinary bladder injuries. Bladder injury occurred commonly during in LSCS and in hysterectomies. Out of 13 urinary bladder injuries, 8 injuries repaired in 2 layers by Vicryl 2-0 without insertion of SPC and 5 injuries were managed by primary repair with vicryl 2-0 with insertion of SPC (SPC= suprapubic cystostomy).Conclusions: Surgery adjacent to or within urinary bladder continue to result in occasional iatrogenic injury. These injuries can be minor with no long-term sequelae, or they can result in significant morbidity and inconvenience to patients.
Background: Subtrochanteric fractures account for 10-30% of all hip fractures, affecting persons of all ages. Mostly, these fractures are seen in older osteopenic patients after a low-energy fall and younger patients involved in high-energy trauma. Extramedullary as well as intramedullary fixation techniques have been used to fix such fractures.Objective: To study the clinical outcomes in patients with subtrochanteric femur fractures treated with extramedullary or intramedullary devices for fixation.
Materials and Methods:Prospective study of traumatic subtrochanteric fractures of femur was carried out among 36 patients at department of Orthopaedics, New Civil Hospital, Surat during January 2013 to December 2014. During surgery, reduction was aimed by closed techniques but when required direct or indirect methods were applied as deemed necessary. Reduction of medial wall and calcar buttress were given prime importance. Pre designed and pre tested semi structured questionnaire was used and analysed with MS Excel and SPSS.Result: Extramedullary fixation among 17 cases and intramedullary fixation among 19 cases were carried out. Mean follow up was 23.9 months (16.5-27.6 months). Mean age was 42.4 years (19-60 years). A mean incision size was 10.3 cm in intramedullary fixation and 21.8 cm in extramedullary group. Average stay in hospital was 15 days (8-46 days) for intramedullary group and 20.41 (7-55 days) for extramedullary group.Conclusion: Intramedullary method of fixation requires smaller exposure (incision size) hence lesser blood loss, shorter operating time and shorter hospital stay than extramedullary method of fixation.
Background: Drug utilization studies are powerful exploratory tools to ascertain the role of drugs in society. They create a sound sociomedical and health economic basis for healthcare decision making. The study was aimed to find out the changing pattern of prescribing the antidiabetic agents in patients suffering from diabetes mellitus type 1 and 2. Methods: It was a cross sectional study done on 200 patients suffering from type 1 and 2diabetes. Indoor patients and diabetes mellitus due to secondary cause were excluded. Each patient was followed up over a period of 1 year and the analysis of the prescriptions was done during that period. At end of study only 129 patients could be included for analysis. Results: In this study the maximal change in medicine was with pioglitazone which was discontinued as a 1st change in 6.2% of patients followed by metformin [5.4%], insulin [4.6%], and glipizide [3.8%]. The drug most commonly added as a first change was glipizide [11.6%] followed by metformin [10.0%] and pioglitazone [7.7%]. In order of 2nd change the most common drug discontinued was insulin [4.6%] followed by pioglitazone [3.8%] whereas drug commonly added as second change was insulin [2.3%] followed by glipizide [1.5%] and pioglitazone [1.5%]. In our cross sectional study average onset of 1st change was found to be at 4.38±2.75 months for discontinuation of drug and 3.75±2.42 months in adding the drugs. Conclusions: Due to lack of certain records, it is envisaged that the change of medicine both discontinuation as well as addition was done because of blood glucose control, cost factor [in case of pioglitazone] as well as patients compliance. [Int J Basic Clin Pharmacol 2013; 2(1.000): 47-50
Purpose: Women living with human immunodeficiency virus (WLWH) have a higher risk of cervical cancer than women without HIV. In addition, women in India experience a high burden of death from cervical cancer. This qualitative study evaluated individual and interpersonal factors influencing cervical cancer screening among WLWH in Surat, India.
Methods:In-depth interviews were conducted with 25 WLWH and 15 stakeholders in Surat, India. Data were analyzed using directed content analysis to identify individual and intrapersonal barriers and facilitators.Results: WLWH lacked knowledge and reported being afraid of cervical cancer and cervical cancer screening but were interested in learning more about it. Interpersonal factors influencing cervical cancer screening included receipt or lack of instrumental and emotional family support, interactions with healthcare providers, and receipt or lack of information about cervical cancer and the Pap test from healthcare providers.
Conclusion:Widespread public education is necessary to increase awareness of cervical cancer and cervical cancer screening and to encourage family members to support women who wish to obtain screening. Patient-and provider-focused interventions may facilitate the process of
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