Research & Reviews: Journal of Surgery (RRJoS) is an International online Journal focused towards the publication of current research work carried out under surgery. This journal covers all major fields of applications in surgery. Focus and Scope Covers General surgery, Cardiothoracic surgery and Vascular surgery Plastic surgery, Paediatric surgery and Colorectal surgery Transplant surgery and Trauma surgery Endocrine surgery and Breast surgery Otolaryngology, Gynaecology, Oral & Maxillofacial surgery Orthopaedic surgery and Neurosurgery Podiatric surgery and Urology
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Role of USG Guided Percutaneous Needle Aspiration in Pyogenic Liver Abscess
Abstract Background: Liver abscess has been a condition of high mortality and morbidity in past but since there is work done over decades with use of percutaneous aspiration and percutaneous drainage along with antibiotics; percutaneous drainage is currently the treatment of choice in liver abscess. Percutaneous needle aspiration (PNA) as an alternative to continuous percutaneous catheter drainage in combination with systemic antibiotics for the treatment of PLA has never been popular.Aims and Objectives: To analyze the role of ultrasound (USG) guided percutaneous needle aspiration in the treatment of PLA.Material and Methods: A total number of 25 patients over a time period from March 2016 to February 2017 irrespective of their age. All patients with PLAs underwent PNA with ultrasound (USG) guidance and antibiotic therapy. Complete pus removal from each abscess was attempted with 18 gauge thin-walled trocar needles with USG guidance.Results: The rate of success was unrelated to the large size or number of abscess in the patient. A complete cure (normalization of clinical and laboratory parameters and resolution of hepatic lesions) was achieved in all the patients (100%). Imaging-guided percutaneous catheter drainage or open surgery was not needed in any of the patient. Neither complications nor deaths ensued. Recurrence rate was nil.Conclusions: PNA with USG-guided in treatment for PLA is a low-cost, safe and effective procedure. It should be considered as a first line alternative to catheter drainage. Our data suggest that a trial of percutaneous needle aspiration should always be undertaken before catheter drainage or surgery. Keywords: Pyogenic liver abscess, ultrasonography, percutaneous needle aspiration Cite this Article Arun Dhankhar, Ravi Mathur. Role of USG Guided Percutaneous Needle Aspiration in Pyogenic Liver Abscess. Research & Reviews: Journal of Surgery. 2017; 6(2): 22–27p.
Spontaneous Popliteal Arteriovenous Fistula Presenting as Gangrene Foot
Abstract An arteriovenous fistula (AVF) of the popliteal artery is a rare condition, mainly to be seen in relation to trauma to the knee in road traffic accidents, firearm injuries and stab wounds. In this article a case report is presented of a 50 year old female admitted with complaints of blackish discoloration of right foot and prominent veins on lower limb. Gangrenous changes of limb involved up to lower leg in next 2 days. A decision to do knee amputation was taken. Keywords: Arteriovenous fistula, color doppler, amputation Cite this Article Vijay Verma, Akhilesh Kumar, Garima Verma et al. Spontaneous Popliteal Arteriovenous Fistula Presenting as Gangrene Foot. Research & Reviews: Journal of Surgery. 2017; 6(2): 13–15p.
A Quasi-experimental Study on Effect of Sponge Bath on Reducing Discomfort among Post Operative General Surgery Patients in a Selected Hospital at Chandigarh in 2011
Abstract Background: Bathing is considered a necessary and therapeutic nursing intervention since it provides hygienic care for clients. Bathing removes sweat, oil, dirt and micro-organisms from the skin, assists in decreasing body odour and the potential for infection, stimulates circulation and provides clients with a refreshed and comforted feeling. Objective: To study the effect of sponge bath on reducing discomfort among post operative general surgery patients. Methods: Study was conducted on 100 post operative patients. Systematic random sampling technique was used draw the sample. Standardized visual analogue scale was used to assess discomfort level of the study subjects. Observation check list for discomfort among study subjects was used to assess the level of the discomfort in the three parameters: interaction, facial expression and activity. Facial expression and opinionnaire of study subjects on being sponged is recorded by the investigator. Results: Data was analyzed by using Chi test and Wilcoxon signed rank test. For visual analogue scale, Wilcoxon test was used and the findings were: Z=–9.113, p=<0.001. Hence the H0 was rejected and alternate hypothesis i.e., sponge bath will bring significant difference in the level of discomfort scores among post operative general surgery study subjects at 0.01 level of significance and observational check list was analyzed by using Chi test and the findings for facial expression were: 0.2, df-2 and p>0.05. Findings of the interaction were calculated by chi square test. It proved that sponge bath made study subjects feel better. Findings were 25.99, df-2, and p<0.001. Activity was significant by calculated chi square test. And the findings were: 92.84, df-2, and p<0.001. This study shows effect of sponge bath on reducing discomfort among post operative general surgery patients. Conclusion: This study shows effect of sponge bath on reducing discomfort among post operative general surgery patients. Keywords: Sponge bath, discomfort, post operative general surgery patients Cite this Article Jasmeet Kaur. A Quasi-experimental Study on Effect of Sponge Bath on Reducing Discomfort among Post Operative General Surgery Patients in a Selected Hospital at Chandigarh in 2011. Research & Reviews: Journal of Surgery. 2017; 6(2): 1–5p.
Relation of Thyroid Profile in Gall Stone Disease Patients
Abstract Introduction: Gallstone disease is a very common gastro-intestinal disorder which is present world wide. They may form because of many different disorders and the basis for it is impaired metabolism of cholesterol, bilirubin and bile acid and is characterized by formation of stones in hepatic or common bile duct or gall bladder. There has been a discussion, regard to the relation of thyroid disorders and gallstone disease, there are several explanations for a possible relation between hypothyroidism and gallstone disease. Further, sphincter of Oddi expresses thyroid hormone receptors and thyroxine has a direct pro-relaxing effect on sphincter, recent studies have also demonstrated low bile flow in hypothyroid patients. Hence, the aim of our study is to study relation of thyroid profile in patients of gall stone disease. Methods: Data was collected by estimating thyroid profile in patients of gall stone disease who were admitted in department of general surgery, Dr SN Medical College, Jodhpur from January 2015 to December 2016. Statistical analysis was done on collected data and p value was determined. P value <0.05 indicates statistically significant association. Results: In our study conducted on 50 patients, only 3(6%) had hypothyroidism and all of them were females. Most common age group having hypothyroidism was 45–60 years RESULTS-In. None of the male was hypothyroid. This non-significance can be due to the fact that those patients who were already diagnosed as having thyroid disorders were not included in the study and even in those patients having hypothyroidism with gallstone disease; it could not be solely attributed to deranged thyroid profile because all patients had associated higher BMI and dyslipidaemia. Conclusion: There is no statistically significant correlation between deranged thyroid profile and gallstone disease. Keywords: Gallstone disease, thyroid profile, hypothyroidism, BMI, dyslipidaemia Cite this Article Latika Sharma, Poojan Purohit, Rohit Dhawan et al. Relation of Thyroid Profile in Gall Stone Disease Patients. Research and Reviews: Journal of Surgery. 2017; 6(2): 8–12p.
A Case study of Parapharyngeal Space Tumor with Unusual Presentation
Abstract Aim: To study and treat the parapharyngeal space tumors presenting with swelling on left side of neck. Result: presenting a case of 25 year old male with swelling on left side of neck, FNAC revealed the diagnosis of a pleomorphic adenoma of parapharyngeal space. Tumor was intraorally excised. HPR revealed pleomorphic adenoma which concluded the diagnosis of benign parapharyngeal tumor from deep lobe of parotid gland. Conclusion: Tumor of parapharyngeal space tumors are rare tumors comprising less than 1% of head and neck neoplasm. They are mainly salivary gland neoplasm or neurogenic tumors. Clinical presentation is very variable. Surgical resection by different approach remains to be the best possible treatment option. Keywords: Parapharyngeal space tumor, pleomorphic adenoma Cite this Article Raj Nagarkar, Roy S, Sachin Bansod et al. A Case Study of Parapharyngeal Space Tumor with Unusual Presentation. Research & Reviews: Journal of Surgery. 2017; 6(2): 16–21p.
Adenoid Cystic Carcinoma of Anterior Nasal Fossa: A Rare Case Report
Abstract A 50 year old female patient came with complaint of right nasal obstruction with mass since 1 year, followed by nasal bleed since 5 months. On lifting the tip of nose, mass was seen in right nasal cavity near the anterior septum. On anterior rhinoscopy, mass was found to be present at right anterior nasal septum obstructing half of the nasal cavity. Lateral wall appeared normal and opposite nostrils were normal. CT-24×14 mm mass was found in right nasal fossa, anteriorly towards septum. Biopsy was done suggestive of adenoid cystic carcinoma. Adenoid cystic carcinoma is uncommon, and that too of the nasal cavity. The cases of the adenoid cystic carcinoma involving the nasal cavity usually involve the lateral wall and the involvement of the anterior nasal fossa of nasal septum is extremely rare. Thus the presentation of this uncommon disease is discussed here. Keywords: Adenoid cystic carcinoma, nose, nasal septum Cite this Article Raj Nagarkar, Roy S, Sachin Bansod et al. Adenoid Cystic Carcinoma of Anterior Nasal Fossa: A Rare Case Report. Research & Reviews: Journal of Surgery. 2017; 6(2): 6–7p.
A Comparative Study of Visual Outcome with Superior, Supero Temporal and Temporal Incisions in Manual Small Incision Cataract Surgery
The purpose of the present study was to compare visual outcome in patients undergoing manual small incision cataract surgery with superior, supero-temporal and temporal incisions. The study was conducted between December 2014 and December 2015. For the prospective analysis, 102 cases meeting the inclusion and exclusion criteria were selected. The patients were randomly allocated to three groups of 34 each and surgeries were performed. In group A with superior, group B with supero temporal and group C with temporal incision by single experienced surgeon. Post operatively unaided visual acuity was recorded in each patient post operatively on first week, six weeks and twelve weeks. A total of 102 cases of MSICS were analysed. Most of the patients were between 61 and 70 years of age. After 12 weeks, 16 (47.1%) of the patients in SI group and 20 (58.8%) of the patients in supero-temporal group had visual acuity ranging 6/6–6/9 where as in temporal incision group 25 (73.5%) patients had visual acuity ranging 6/6–6/9 (x2–4.981, p<0.01). It was concluded that visual rehabilitation is better in temporal incision than superior incision. Keywords: MSICS, superior scleral incision, superotemporal scleral incision, temporal scleral incision
Knowledge of Staff Nurses Regarding Cardio Pulmonary Resuscitation
Heart disease is the world’s largest killer, claiming 17.5 million lives every year. About every 29 sec, an Indian dies of heart problem. As many as 20,000 new heart patients develop every day in India, six crore Indians suffered from heart disease and 30% more are at high risk. By 2020, India will have the largest coronary heart disease (CAD) burden in the world and will account for one third of all deaths; many of them will be young. The risk of sudden cardiac death from coronary artery disease in adults is estimated to be 1 per 1,000 adults of 35 years of age and older, per year. About 75 to 80% of all out-of-hospital cardiac arrests happen at home. Hence, being trained to perform cardiopulmonary resuscitation (CPR) can make the difference between life and death for a victim. Effective CPR provided immediately after cardiac arrest can double victim’s chances of survival. If more people know CPR, more lives can be saved [1]. Keywords: Coronary heart disease, cardiac death, cardiopulmonary resuscitation, cardiac arrests
Ayurvedic Management of Avascular Necrosis of Neck of Femur w.s.r. to Asthi Majja Gata Vata
Avascular necrosis (AVN) is a condition that occurs due to loss of blood supply to the bone which leads to cellular death of bone tissue. A 59 years old female patient, who was suffering from AVN for last 1 year, was admitted in NIA Panchakarma ward. She was diagnosed as a case of avascular necrosis of neck of femur based on MRI reports. As per Ayurveda, the patient was diagnosed as a case of Asthi Majja Gata Vata (∼Vata disorder involving bone and bone marrow). The patient was treated with Panchakarma procedure such as local massage and fomentation, Panchatikta Ksheera Basti (enema with medicated milk) with Yashtimadhu Taila Anuvasana (enema with oil) as per Karma Basti schedule (30 days regime of purification and oleation enema) and oral medication as Kaishore Guggulu 3 tab twice a day, Dashmool Kwath 40 ml twice a day, Ashwagandha Churna (Powder of Withania somnifera DUNAL) 3 gm, Chopchini Churna (Powder of Smilax glabra) 500 mg, Madhuyasthi churna (Powder of Glycyrrhiza glabra) 2 gm three times a day, Triphala churna 5 gm at bed time for 1 month. Before treatment, the patient was complaining of severe pain in both hip joints and thigh regions and difficulty in walking. After completion of treatment, the pain in both hip joints and thigh regions decreased, range of movement of both hip joints improved, difficulty in walking was much reduced and walking distance also improved. This case shows that Ayurved treatment may be helpful in the management of avascular necrosis of neck of femur. Keywords: Avascular necrosis, Ashthi Majja Gata Vata, Panchatikta Kshira Basti
Prevalence of Iron Deficiency Anaemia and Risk Factors in a Sample of Population of Bleeding Haemorrhoids (Bawaseer Khooni): An Observational Study
Bleeding per rectum, anal discharge, itching, pain and discomfort are the most common symptoms of a haemorrhoidal patient. Per rectal bleeding is the most common complaint for which a haemorrhoidal patient seeks medical advice. Anaemia is the commonest haematological problem in patients of chronic blood loss. Often it is a sign of underlying disease or associated co-morbid condition. An observational study was conducted at department of Jarahat (Surgery), NIUM, Bangalore, for period of one year. History and clinical examination was done thoroughly, and analyzed in full details regarding age, literacy, socio-economic status, diet, straining etc. Hb percentage was noted for each diagnosed case. Higher prevalence (31.11%) was observed in age range of 40–50 years, iron deficiency anaemia was prevalent in 17.77% patients having Hb level less than 11 g/dl. Further, about 50% cases were having Grade I haemorrhoids; maximum cases (55.55%) belong to lower socio economic status. On dietary basis, 78.89% were non-vegetarian. Moreover, high prevalence was noted in illiterate and the persons who strain on defecation. Keywords: Haemorrhoids, iron deficiency anaemia, Sooulquinya, Quillatuddam
A Study to Assess the Effectiveness of Practical Guideline on Maintaining Aseptic Technique While Preparing and Administering the Intravenous (IV) Transfusion by the Staff Nurses Working in Medical-Surgical Wards of Selected Government Hospitals of Gujara
Intravenous fluid administration is not only common in the hospitals; it is also increasingly common in the home for the replacement of fluids, administration of medications, and provision of nutrients when no other route is available. Intravenous therapy is indicated for the administration of drugs, nutrition, infusion solutions and blood products, for correcting metabolic problems and for life saving measures. Keywords: Intravenous (IV) transfusion, reduction of complications of IV, health
Giant Primary Hydatid Cyst of Spleen—A Rare Clinical Entity
Hydatid cyst (echinococcosis) is a zoonotic disease, caused by infestation of larval form of parasite of tapeworm, Echinococcus granulosus (eg). Humans are infected through faeco-oral route by the ingestion of food and milk, contaminated by dog faeces containing the ova of parasite or by direct contact with dog. Liver is the commonly involved organ (57.8%) followed by the lungs (26.4%). The kidneys, spleen, brain, soft tissues of neck, appendix and mesentery are less frequent sites. This case report describes the management of a huge primary hydatid cyst of spleen in a 58-year-old female by en bloc splenectomy. A 58-year-old female patient presented with complaining of pain abdomen and lump in left hypochondrium FPR 6–7 months of duration. Per abdominal examination was in favour of splenomegaly. Patient was further investigated by ultrasound (USG) abdomen and computed tomography (CECT) abdomen and finally diagnosed as a case of large primary hydatid cyst. She was treated surgically by en bloc splenectomy with preoperative and postoperative antihelminthic drugs. Complete en bloc resection of spleen is reserved for gold standard treatment for primary hydatid cyst of spleen as it results in complete removal of all parasite and parasitic tissue from the body. Hydatid cyst of spleen is a rare disease but it should be considered as a differential diagnosis in each case of splenic cyst especially in those geographical regions where the disease is endemic. Once diagnosed a splenic hydatid, surgical management by splenectomy is a gold standard treatment. Keywords: Hydatid cyst, splenectomy, Echinococcus granulosus Cite this Article Pipal DK,Kothari S et al. Giant Primary Hydatid Cyst of Spleen— A Rare Clinical Entity. Research & Reviews: Journal of Surgery. 2016; 5(3): 21–24p.
Comparison between Intravenous Injection of Iron Sucrose and Oral Administration of Iron for the Treatment of Iron Deficiency Anemia in Pregnancy
The aim of this study was to compare the therapeutic benefits of intravenous iron and oral iron administration for the treatment of iron deficiency anemia (IDA) in pregnancy. A total of 50 patients with gestational age between 25 and 35 weeks with established IDA with Hemoglobin (Hb) 7–9 g/dl were randomized to receive either oral ferrous sulphate 200 mg twice daily or required dose of intravenous iron sucrose 200 mg in 100 ml NS on alternate days. The Hb level, hematocrit, mean corpuscular volume and packed cell volume were measured at recruitment and on 1st week, 3rd week and at 37 weeks. Adverse drug reactions were also noted in both the groups. Hb values varied drastically with time between the two groups at 1st week, 3rd week and at term. Intravenous iron sucrose helped in treating IDA in pregnancy more effectively than oral iron therapy, without any side effects or reactions. Keyword: Iron deficiency anemia (IDA), iron sucrose, oral iron therapy Cite this Article Yadav V, Nagarathanama R, Prasad N. Comparison between Intravenous Injection of Iron Sucrose and Oral Administration of Iron for the Treatment of Iron Deficiency Anemia in Pregnancy. Research and Reviews: Journal of Surgery. 2016; 5(3): 25–28p.
``Role of Imaging and Clinico-Endoscopic Assessment in the Upstaging and Management of Laryngeal Malignancies
Carcinomas of larynx are the very common primary head and neck malignancies. Cancer of larynx accounts for 30 percent of all head and neck cancers. The American Cancer Society’s most recent estimates for laryngeal cancer in the United States for 2013 are, about 12,260 new cases are laryngeal cancer, being 9680 in men and 2580 in women. Laryngeal cancer has also a strong socioeconomic association, being twice as common in more deprived groups compared to the more affluent groups. Anatomically larynx is divided three sub divisions and certain potential spaces through which cancer tends to spread outside the site of its origin. The causal relationship between alcohol and tobacco intake, genetic predisposition, diet, and socioeconomic conditions in the development of squamous cell cancers of the head and neck applies as well to laryngeal cancer. Site predilection for the origin of cancers of laryngeal cancers being, glottic carcinoma 60 to 65%, supraglottic carcinoma 30 to 35% and subglottic carcinoma less than 5%. Clinico-endoscopic evaluation can be undertaken with indirect laryngoscopy, fibre optic laryngoscopy/telescopic laryngoscopy (700hopkins) and direct laryngoscopy. Imaging (USG, CECT±CEMRI) plays a significant complementary role to clinical endoscopy in pretherapeutic staging of laryngeal malignancies. In present study, patients of laryngeal malignancy were treated by radiotherapy or concurrent chemoradiation, some by total laryngectomy with neck dissection and few by total laryngectomy with partial pharyngectomy along with neck dissection and further some patients were treated by total laryngectomy alone depending upon the best treatment options. Keywords: Laryngeal carcinoma, clinico-endoscopic assessment, radiological imaging, pretherapeutic staging Cite this Article Rashad Rafiq Mattoo., Sajad Majid Qazi, Basharat Rashid et al. Role of Imaging and Clinico-Endoscopic Assessment in the Upstaging and Management of Laryngeal Malignancies. Research & Reviews: Journal of Surgery. 2016; 5(3): 1–16p.
A Precious Stone to Surgery: Al Zahrawi—A Literary Review
Islamic medicine, also known as Arabic Medicine and Greeco-Arab medicine, refers to medicine developed during the Golden Age of the Arab practiced within the Mediterranean as well as most Islamic countries greatly. Then it is broadened from Spain to central Asia, India and Sri Lanka. There was massive enlightenment in the Arab-Islamic world, during that time Europe was very much embrace of the Dark Ages. The Renaissance of European science was very much thankful to the affluent of the sciences by Islamic Golden Age. But, in the East, the development of Muslim scholars developed botany, pharmacy, chemistry and science that the Muslim world is given credit for science and medicine. There are many scholars of Baghdad who translated and assimilated the Greek effort, while incorporating their own experiences. The most eminent scholars such as Muhammad Ibn Zakariya Al Razi, Ali Ibn Al Abbas Al Majoosi, Al Zahrawi, Al Tabbari, Abu Ali Ibn Sina, Ibn Al Haitham, and Ibn Zuhar Ibn Rushdetc mostly contributed to the medicine in that era. Various medical scientists were materialized in medieval period, but Al Zahrawi (934– 1013AD) was one of the greatest physicians at that time; especially he was the pioneers in the surgery and his contribution in surgery not to concurrent with now. Keywords: Al Zahrawi, surgery, Islamic medicine Cite this Article Farzana M.U.Z.N., Al Tharique I. A Precious Stone to Surgery: Al Zahrawi—A Literary Review. Research & Reviews: Journal of Surgery. 2016; 5(3): 17–20p.
Sociodemographic determinants of tobacco use among inpatients in a tertiary care hospital.
Backgrouond: Tobacco use is the most important contributor to morbidity and premature death among modifiable life style factors. More than five million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke and the annual death toll could rise to more than eight million by 2030. Materials and methods: A cross sectional survey was conducted. Males and Females 18–65 years of age who were admitted and gave informed consent, were included in the study. Sample size 398 was based on an estimated prevalence of tobacco use of (23% to 47%), confidence interval 95%, and precision15% in Master sample size estimation software 2.0. Males and females between 18–65 years of age, who were admitted as inpatient at least for 24 hours, able to speak and willing to participate in the study. Self-reported daily tobacco use Questionnaire was administered through face to face interview. Analysis: Bivariate analysis was done for each variable under study in relation to daily tobacco use. Unadjusted Odds ratios and 95% confidence intervals were obtained. Variables of interest such as age, gender, religion, and socioeconomic status were put in the regression model. Results: Overall 28.6% of the study population (20.8% men and 7.7% women) was using tobacco on a daily basis. Among the tobacco users, the various modes by which tobacco was consumed included cigarette Smoking (45.6%), beedies (22.8%), Kutka (18.4%) and tobacco leaves (26.3%).Conclusion: The present study suggests that preventive message needs to be modified to make the tobacco control more effective.
Solid Pseudopapillary Neoplasm: A Rare Neoplasm of the Pancreas
Cystic neoplasms of pancreas are rare condition. Solid pseudopapillary neoplasm commonly affects young females. It is a rare tumor presenting as abdominal mass. Here, we report a patient who was evaluated and successfully surgically managed for solid pseudopapillary tumor of pancreas. Keywords: Cystic tumors of pancreas, solid pseudo papillary neoplasm, distal pancreatectomy Cite this Article Narendra Hulikal, Ramana Reddy Naru, Radhika Kottu. Solid Pseudopapillary Neoplasm: A Rare Neoplasm of the Pancreas. Research and Reviews: Journal of Surgery. 2016; 5(2): 24–30p.
Patterns and Risk Factors of Gestational Diabetes Mellitus among Mothers Who Visited Antenatal Clinics in Public Health Centers of Mekelle City, Tigray, Ethiopia, 2015
Gestational diabetes mellitus is associated with significant morbidity in the short and longterm, for both mother and offspring. It is now well established that women with a history of GDM are at a significant increased risk of developing type-2 diabetes, later in life. There were limited studies conducted on pattern and risk factors of gestational diabetes mellitus in Tigray region. The aim of this study is to assess patterns and risk factors of gestational diabetes mellitus among mothers who visited antenatal clinics in public health centers of Mekelle city, Tigray, Ethiopia in 2015. An institution based unmatched case control and cross-sectional study design was employed. Case to control ratio was 1:3 and the total number of cases and controls were 40 and 119 respectively. Systematic random sampling and consecutive sampling technique was used to select study subjects for both, case control and cross-sectional studies respectively. The data first was cleaned, edited, coded and entered into computer and analyzed using SPSS version 20. Bivariate and multivariate logistic regressions was done for association, the test of odd ratio was using 95% confidence interval and P-value <0.02. In this study, the pattern of GDM was irregular among the three health centers. In Kasech health center, it varied from 27 to 10 then 23, in Mekelle, from 11 to 8 then 27 and in Semen health center, from 19 to 7 then 3, over the period of three years. The risk factors of GDM identified were rural residence (AOR=0.02, 95% CI; 0.001–0.737), having no still birth (AOR=0.03, 95% CI; 0.001–0.937), not taking sweet diet (AOR=0.06, 95% CI; 0.005–0.616), alcohol use (AOR=392.98, 95% CI; 11.514–13,410), doing regular exercise (AOR=0.02, 95% CI; 0.002–0.288) and having advised on danger sign of GDM (AOR=71.87, 95% CI; 3.890– 1,328) that all were significantly associated with the risk of gestational diabetes mellitus. It was concluded from the study that urban residence, having still birth, doing regular exercise at 18–22 weeks of pregnancy, counseling on dangers signs of GDM were the determinant factors for gestational diabetes mellitus. Therefore, this finding suggests that community mobilization, advice on danger sign and regular exercise on GDM in the antenatal clinic is the essential recommendations. Keywords: GDM, pattern, risk factors, women, Ethiopia Cite this Article :Tsegalem Hailemariam Ballo, Getachew Tesfaye Belayneh. Patterns and Risk Factors of Gestational Diabetes Mellitus among Mothers who Visited Antenatal Clinics in Public Health Centers of Mekelle City, Tigray, Ethiopia, 2015. Research and Reviews: Journal of Surgery. 2016; 5(2): 12–20p.
Plexiform Neurofibromatosis: Our Experience at Rural Setup with Review of Literature
Neurofibromatosis 1 (NF1), also known as von Recklinghausen disease, is an autosomaldominant condition caused by mutations of the NF1 gene, which is located at chromosome 17. The average life expectancy of patients with NF1 is probably reduced by 10–15 years, and malignancy is the most common cause of death [1]. We present a case of 28 year old female with NF-1 who presented to our OPD with a huge painless swelling over the lower back of four years duration. Patient later noticed multiple swellings over the abdomen and the right arm, which increased gradually in size. Histopathological diagnosis of plexiform neurofibromatosis was made and confirmed. Surgical excision with reconstruction was done. Keywords: Neurofibromatosis, NF-1 gene, plexiform, swelling, Recklinghausen disease Cite this Article Keerthi N, Sreeramulu PN, Rakesh N, et al. Plexiform Neurofibromatosis: Our Experience at Rural Setup with Review of Literature. Research and Reviews: Journals of Surgery. 2016; 5(2): 21–23p.
A Quasi-experimental Study to Assess the Effectiveness of Cold Application versus Glycerin Magnesium Sulphate Application in Relieving Phlebitis among Patients Receiving Intravenous Therapy in a Selected Hospital of Delhi
Peripheral venous cannulation (PVC) is a common procedure carried out in hospitals to allow rapid and accurate administration of medication. However, the placement of an intravenous cannula can have undesirable effects, the most common of which is phlebitis. If left untreated, it can lead to infection or thrombus formation. A quasi-experimental study with nonequivalent control group pre-test-post-test design was used for the study with objective to compare the efficacy of cold application vs. glycerin magnesium sulphate in relieving phlebitis among patients receiving intravenous therapy. Convenient sampling technique was used for selecting 30 patients having phlebitis; phlebitis was assessed using visual infusion phlebitis scale. The findings of the present study suggest that cold application and glycerin magnesium sulphate, both were effective on phlebitis. Keywords: Phlebitis, cold application, glycerin magnesium sulphate, intravenous therapy Cite this Article Rukhsana, Jahanara Rahman, Eke Lama Tamang et al. A Quasiexperimental Study to Assess the Effectiveness of Cold Application versus Glycerin Magnesium Sulphate Application in Relieving Phlebitis among Patients Receiving Intravenous Therapy in a Selected Hospital of Delhi. Research and Reviews: Journals of Surgery. 2016; 5(2): 7–11p.
An Experimental Study to Assess the Effectiveness of Valsalva Maneuver Prior to Intravenous Cannulation on Pain Perception among Patients Undergoing Venous Cannulation at HAHC Hospital in Delhi
An experimental study was done to assess the effectiveness of valsalva maneuver prior to IV cannulation on pain perception among patients undergoing venous cannulation at HAHC hospital in Delhi. The objectives of the study were to assess the level of pain during IV cannulation among the experimental group, to assess the level of pain during IV cannulation among the control group, to compare the level of pain during IV cannulation between experimental and control group and to find out the association of the level of pain during IV cannulation between experimental and control group with selected variables i.e. age, gender, previous experience of IV cannulation, on analgesics, size of cannula and site of cannulation. The conceptual framework for this study was developed by the researcher based on Polit and Beck PICO model. A quantitative experimental research using post-test only control group design was done in medical and surgical department of HAHC hospital on 60 patients undergoing intravenous cannulation. Samples were drawn using lottery method. After intravenous cannulation, post-test pain score was assessed using numerical pain rating scale and entered in the recording sheet. The data collected was analyzed using descriptive and inferential statistics. The two groups were homogenous with regard to all background variables. The findings also revealed that there was a significant decrease in the level of pain after performing valsalva maneuver (p<0.05), thus indicating that valsalva maneuver is an effective measure in decreasing the level of pain in patients undergoing intravenous cannulation. There was no significant association of post-test pain score with any of the selected associated variables in the experimental and control group. It was concluded that valsalva maneuver was effective in reducing the pain in patients undergoing intravenous cannulation. Valsalva maneuver can be incorporated by nurses as a measure of pain relief among patients receiving intravenous cannulation. Keywords: Pain, valsalva maneuver, intravenous cannulation Cite this Article Sundaran Jisha P, Fareha Khan, Priyanka Bansal. An Experimental Study to Assess the Effectiveness of Valsalva Maneuver Prior to Intravenous Cannulation on Pain Perception among Patients Undergoing Venous Cannulation at HAHC Hospital in Delhi. Research & Reviews: Journal of Surgery. 2016; 5(2): 1–6p
A quasi-experimental study to assess the effectiveness of hot fomentation versus cold compress in reducing infiltration among patients undergoing IV infusion in a selected hospital of Delhi.
A quasi-experimental study to assess the effectiveness of hot fomentation versus cold compress in reducing infiltration and associated pain among patients undergoing IV infusion in a selected hospital of Delhi. The objectives of the study were (i) to assess the degree of infiltration in both the groups (ii) to assess the level of infiltration after the intervention in both the groups (iii) to compare the level of infiltration before and after the intervention in both the groups (iv) to assess the level of infiltration associated pain before the intervention in both the groups (v) to assess the level of infiltration associated pain after the intervention (vi) to compare the level of infiltration associated pain in both the groups.. The conceptual framework of the present study is based on the P.I.C.O. model. A quantitative research approach was used for the study. A Clinical-Observation Sheet: Record Analysis and a recording sheet were prepared. The reliability of the tool was established using the inter-rater reliability which was found to be 0.80. The study was conducted at Hakeem Abdul Hameed Centenary Hospital, New Delhi from 25th October 2015 to 7th November 2015. The patients who met the study inclusion criteria were selected using convenient sampling technique. Data gathered were analysed and interpreted using both descriptive and inferential statistics. The study showed patients who were administered hot fomentation and cold compress over the site of infiltration experienced early reduction in the level of infiltration score and associated pain. Thus indicating that local application of both hot fomentation and cold compress over the infiltrated site was equally effective in resolution of intravenous infiltration and associated pain. However, there was no significant difference between the application of hot fomentation and cold compress in reducing the level of infiltration and associated pain. Keywords: Intravenous infiltration, hot fomentation, cold compress Cite this Article Jinna Mariam Babu, Priyanka Bansal, Fareha Khan. A Quasi-Experimental Study to Assess the Effectiveness of Hot Fomentation versus Cold Compress in Reducing Infiltration among Patients Undergoing IV Infusion in a Selected Hospital of Delhi. Research and Reviews: Journal of Surgery. 2016; 5(1):24–30p.
A Quasi Experimental Study to Assess the Effectiveness of Chewing Gum on the Bowel Motility among the Patients after Abdominal Surgery in Selected Hospital of New Delhi
A quasi experimental study to assess the effectiveness of chewing gum on the bowel motility was conducted on the patients after abdominal surgery in selected hospital of New Delhi. The objectives of the study were to (i) To assess the bowel motility of patients after abdominal surgery in the experimental and control group (ii) To compare the bowel motility of patients after abdominal surgery in the experimental and control group (iii) To determine the association of bowel motility of the experimental group with selected variables like personal habits, bowel habit, height, weight, etc. The conceptual framework of the present study is based on the P.I.C.O. model, a quantitative research approach was used for the study. A structured interview schedule and a recording sheet were prepared. The reliability of the tool was established using inter rater reliability which was found to be 0.80. The study was conducted at Hakeem Abdul Hameed Centenary Hospital, New Delhi from 25th October 2015–7th November 2015. The patients who met the study inclusion criteria were selected using convenient sampling techniques. Data gathered were analyzed and interpreted using both descriptive and inferential statistics. The study showed that the patients who were administered chewing gum experienced early return of bowel motility in terms of the bowel sounds, first flatus and return of appetite than those patients who were not administered chewing gum and there was no association between bowel motility and selected variables personal habits, bowel habit, height and weight among the patients who were administered chewing gum. Keywords: Chewing gum, bowel motility, patients after abdominal surgery Cite this Article Thomas T., Rahman J., Bansal P. A Quasi Experimental Study To Assess The Effectiveness Of Chewing Gum On The Bowel Motility Among The Patients After Abdominal Surgery In Selected Hospital of New Delhi. Research and Reviews: Journal of Surgery. 2016; 5(1): 1–6p.
Outcome of Circumferential Penile Skin versus Dorsal on Lay Buccal Mucosal Urethroplasty for Long Anterior Urethral Strictures: A Prospective Single Centre Experience with Five Years Follow-up
Buccal mucosa has become the most popular substitute in the management of urethral strictures. Prior to it, penile skin was the preferred tissue for transfer. In order to see which one is better, we study the outcome of penile versus buccal mucosa for long anterior urethral strictures. A total of 76 patients with long anterior urethral strictures of more than 5 cm were randomly divided into two groups in the age group of 20–45 years. Group A was subjected to circumferential penile skin urethroplasty and Group B to dorsal onlay buccal mucosal urethroplasty. Results were assessed by univariate analysis of various patient characteristics, preoperative and postoperative patient satisfaction and cystoscopic, retrograde urethrography and uroflowmetry. The median intraoperative stricture length was 6.5 cm with median operating time of 100 minutes (90–145 min) and blood loss of 100 ml. All patients had five years of follow-up. Year wise success rate was 92%, 89%, 84%, 80% and 75% in group A while group B had 95%, 92%, 90% 88% and 84%. Buccal mucosal urethroplasty had slightly better 5 year overall success rate than circumferential penile skin irrespective of age, aetiology and stricture length. Keywords: Penile skin, buccal mucosa, stricture and urethroplasty Cite this Article Syed SN, Muneer K, Showket AG et al. Outcome of Circumferential Penile Skin versus Dorsal On Lay Buccal Mucosal Urethroplasty for Long Anterior Urethral Strictures: A Prospective Single Centre Experience with Five Years Follow-Up. Research and Reviews: Journal of Surgery. 2016; 5(1): 18–22p.
A Study of Close Suction Drain Closure in Laparotomy Wound of Intestinal Perforation
The most common complication after emergency laparotomy is infection in subcutaneous portion of abdominal incision, sepsis within the peritoneal cavity or infection in both of these areas. The incidence of each is significantly multiplied wherever there has been a peritoneal contamination by bowel or inflammatory process is encountered during abdominal exploration. This prospective study was carried out at Dr. D. Y. Patil Medical Hospital, Pune for a period of 3 years from 2013–2016. A total of 100 patients undergoing emergency laparotomy for intestinal perforation aged 18–65 years were included and distributed in Group I and II consisting of 50 patients with subcutaneous closed suction drain and 50 cases without drain. Gynaecological procedures and caesarean sections, alongside other non-laparotomy abdominal incisions were excluded. In these high-risk cases, the overall incidence of surgical site infection (SSI) was 23%. The incidence of incisional SSI in these cases with and without the ROMO-VAC drainage system was 12% and 34%, respectively. Our results suggest that a subcutaneous closed suction drain is effective for preventing incisional SSI in patients who have undergone emergency operations for the intestinal perforation. Keywords: Surgical site infection (SSI), closed suction drain, emergency laparotomy, intestinal perforation Cite this Article Singh AK, Vijay T, Bhushan A, et al. A Study of Close Suction Drain Closure in Laparotomy Wound of Intestinal Perforation. Research and Reviews: Journal of Surgery. 2016; 5(1): 7–12p.