Patients In Group-B Research Articles

Efficacy of Topical 0.05% Isotretinoin Gel Versus 0.1% Adapalene Gel in The Treatment of Mild to Moderate Acne Vulgaris

Objective: To compare the efficacy of topical 0.05% Isotretinoin gel versus 0.1% Adapalene gel in treating mild to moderate acne vulgaris.
 Study Design: Quasi-Experimental study.
 Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital (PEMH), Rawalpindi Pakistan, From Feb to Jul 2018.
 Methodology: A total of ninety-two patients aged 12 to 25 years with mild to moderate facial acne vulgaris were enrolled and divided into two treatment Groups, Group-A (0.05% Isotretinoin Gel) and Group-B (0.1% Adapalene Gel). Efficacy was measured at 12 weeks post-treatment.
 Results: Treatment was found efficacious in 84.8% (n=39/46) of patients in Group-A and 50.0% (n=23/46) of patients in Group-B (p= 0.001). There were similar results when treatment efficacy in both Groups was disease severity. In all cases,efficacy was better in Group-A (p<0.05).
 Conclusions: The efficacy of topical 0.05% Isotretinoin gel was better than topical 0.1% Adapalene gel for treating mild to moderate acne vulgaris.

Comparison of Single Versus Multiple Doses of Fluoroquinolone (Levofloxacin) for Prophylaxis in Prostate Biopsy

Objective: To assess the efficacy of Levofloxacin 500 mg orally for prophylaxis in transrectal prostate biopsy guided by ultrasonography compared to three dosages. Study design: A comparative study Place and Duration: this study was done in Murshid Hospital and Health Care Centre Karachi from September 2021 to September 2022 Methodology: A total of 615 patients having the typical indications for prostate biopsy performed under transrectal ultrasonography guidance (increased PSA, abnormal digital rectal examination) were included in this study. Overall 425 patients were considered qualified for participation; using Graph Pad Prism 6.0, patients were assigned to one of two groups using random assignment, 205 individuals in Group A were given one oral dosage of 500 mg of levofloxacin 60 to 120 minutes before the procedure, Likewise, 220 patients in Group B received Levofloxacin (500 mg) once per 24 hours for two days before to the procedure as well as the day of it. Results: Patients in Group A were given orally a single dose of levofloxacin 500 mg there were 205 patients in this group. These individuals were diagnosed with diabetes mellitus (DM) at a rate of 43.9%, febrile urinary tract infections at a rate of 4.3%, and sepsis at a rate of 0.97%.In this group, 65.80cc,was the average prostate volume, and 90.17% were overweight.A total of 220 patients in groupB who received orally three doses of levofloxacin 500 mg, with an average age of 67.45 years and a PSA mean of 21.26 ng/mL; 31.8% of patients had diabetes mellitus, & 4.45% had a febrile urinary tract infection (FUTI). In this group, no patients had sepsis, 75.61 cc was the mean prostate volume, and 72.74% of the patients were overweight, as in Group A. Conclusion: Because of how effective it is, a single dose of levofloxacin containing 500 milligrams is an excellent option for prophylaxis in patients who are going to have a transrectal prostate biopsy. Keywords: transrectal biopsy, flroquinolone, prophylaxis

A Study on the Effects of Pregabalin and Amitriptyline in Treatment of Patients with Painful Diabetic Neuropathy

Objective: To compare the effect of Amitriptyline and Pregabalin in treatment of painful diabetic neuropathy. Material and Methods: The design of this study was Randomized Controlled Trial study design. This study was conducted in the Department of Medicine in, Holy Family Hospital, Rawalpindi and the duration of this study was Six months after the approval of synopsis i.e from 1st November 2019 to 1st May 2020. Approval from ethical committee of the hospital was taken. Written informed consent was taken from patients. Consent form is attached with this. Patients were randomly allocated into two groups by lottery method. The dose of Pregabalin was used as 50mg thrice daily for a period of six weeks and label as group-A and group B received amitriptyline as 25mg once daily before bedtime for a period of six weeks as prescribed by a senior consultant who was blind to object of the study. At the start and end of treatment pain was marked by patients on Visual Analogue Scale (VAS) and numerical score. It was noted on the Performa. Results: Total 100 patients were included according to the inclusion criteria of the study. The dose of Pregabalin was given in patients in group-A and group-B received amitriptyline. Mean age (years) in the study was 55.87+6.43 whereas there were 55 (55.0) male and 45 (45.0) female patients who were included in the study according to the inclusion criteria. In our study, frequency and percentage of effect (pain relief) among Pregabalin and Amitriptyline in treatment of painful diabetic neuropathy was 27 (54.0) and 11 (22.0) respectively which was statistically significant (p-value 0.001). Practical Implication: In this study Pregabalin is more responsible for pain relief than Amitriptyline in treatment of painful diabetic neuropathy. Further studies at multiple studies must be conduct in future for determining the efficacy of amitriptyline and Pregabalin in diabetic neuropathy in order to formulate guidelines for management of diabetic peripheral neuropathy. Conclusion: The study concluded that Pregabalin is more responsible for pain relief than Amitriptyline in treatment of painful diabetic neuropathy. Further studies at multiple studies must be conduct in future for determining the efficacy of Pregabalin and amitriptyline in diabetic neuropathy in order to formulate guidelines for management of diabetic peripheral neuropathy. Keywords: Amitriptyline, Pregabalin, Neuropathy, Pain Relief, Diabetic Sensorimotor Polyneuropathy, Prevalence.

Postoperative Analgesia After Inguinal Herniotomy in Children; A Comparison of Combination of Intravenous Paracetamol and Rectal Diclofenac with Caudal Bupivacaine

Objective: To compare the efficacy of intravenous paracetamol and rectal diclofenac combination with caudal block using 1ml/kg of 0.25% bupivacaine in the management of post-operative pain following paediatric inguinal herniotomy. Methodology: This quasi-experimental study was conducted at the Department of Anesthesia, Holy Family Hospital, Rawalpindi, from February 2020 to August 2020. A total of 342 children aged 2-12 years requiring inguinal herniotomy were enrolled after satisfying the inclusion and exclusion criteria. Computer-generated random numbers were used to split the patients into two groups. Group A received intravenous paracetamol (30 mg/kg) and rectal diclofenac (1mg/kg). Group B received a caudal block using 1ml/kg of 0.25% Bupivacaine. Pain was assessed postoperatively in the PACU by modified Objective Pain Scale (OPS) every 15 minutes for the 1st hour and hourly up till 8 hours. Effective analgesia was defined as a modified OPS score of ≤ 3 for upto 8 hours after shifting to PACU. If at any time, the score was >3 and the patient required a rescue analgesic, effective anaglesia was not achieved. Results: Effective analgesia was achieved in 82.46% of the patients (n=141) in Group-A versus 87.13% patients (n=149) in Group-B (p-value: 0.23). Conclusion: There is no significant difference in the efficacy of analgesia in paracetamol/diclofenac combination group compared with caudal bupivacaine group.

Correlation analysis of systemic immune inflammatory index, Serum IL-35 and HMGB-1 with the severity and prognosis of sepsis.

To investigate the correlation between systemic immune inflammatory (SII) index, serum interleukin-35 (IL-35) and high mobility Group-Box one (HMGB-1) with the severity and prognosis of sepsis. A retrospective analysis was performed on the clinical data of 209 patients with sepsis admitted to Ganzhou City People's Hospital from October 2019 to October 2021. One hundred eighteen patients in Group-A had common sepsis, and 91 patients in Group-B had septic shock, which were subdivided into the survival Group-And the mortality Group-According to the 28d prognosis. The levels of SII, IL-35 and HMGB-1 in different groups were compared, and their correlation with the severity and prognosis of sepsis was analyzed. The levels of SII, IL-35 and HMGB-1 in Group-A were significantly lower than those in Group-B (p<0.05). The levels of SII, IL-35 and HMGB-1 in the survival group were significantly lower than those in the death group (p<0.05). Spearman correlation analysis showed that the levels of SII, IL-35, and HMGB-1 were significantly positively correlated with the severity of sepsis (p<0.05), and significantly positively correlated with the prognosis of patients with sepsis (p<0.05). SII, IL-35 and HMGB-1 are remarkably correlated with the severity and prognosis of patients with sepsis. With the increasing in SII, IL-35 and HMGB-1 levels, patients will suffer from severe disease progression and poor prognosis, which require more clinical attention.

Outcome of head injury in motorbike riders.

To determine the impact of helmet wearing on traumatic brain injury. We analyzed 400 cases of traumatic brain injury (TBI) in motorbike riders with and without helmet, from July 2017 to December 2020 presenting to the neurosurgery department at Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan. The medical records were analyzed for CT scan findings, length of hospital stay, complications (mortality and disability), Glasgow Coma Scale (GCS) and Glasgow outcome score (GOS) at time of discharge. A total of 400 patients with head injury due to motorbike accidents were included and all were male patients. They were equally divided into two groups, 200 in Group-A (with helmet) and 200 in Group-B (without helmet). Majority of the unhelmeted patients i.e. 102 (51%), needed admission in the Intensive Care Unit (ICU) compared to 70 (35%) in helmeted. When comparing non-helmeted patients to helmeted patients, the total median length of hospital stay was greater among non-helmeted patients (10 vs 05 days). Mortality was higher among non-helmeted patients seen in 50 (25%) as compared to 14 (7%) in helmeted patients. Overall, the good outcome was observed in 119 (59.5%) patients in Group-A as compared to70 (35%) patients in Group-B while 81 (40.5%) showed bad outcome in Group-A and 130 (64%) in Group-B. The failure to wear a helmet was found to be strongly linked with abnormal neuroimaging more complications, poor outcome and lower GCS on discharge as compared to patients using helmet. Lack of helmet use is linked to abnormal brain imaging, more complications, and a longer stay in the hospital after a head injury.

Comparison of Infra Orbital Nerve Outcome in Zygomaticomaxillary Complex Fractures Treated Surgically and Conservatively

Introduction: Zygomaticomaxillary complex fractures are second most common facial injuries. These fracture are managed either by open reduction with rigid fixation or conservatively. Objective: To compare infra orbital nerve outcome in zygomaticomaxillary complex fractures treated surgically and conservatively. Methodology: The current randomized controlled trial study was carried out at Oral and Maxillofacial Surgery Department, Sandeman Provincial Hospital/Bolan Medical College Quetta from 23/04/2018 to 22/10/2018 after the synopsis approval. Total sample size calculated was 100. 50 patients in Group-A were treated by open reduction and internal fixation technique and 50 patients in Group-B were managed conservatively without any intervention. All the data was recorded in a specialized proforma for this study. Data analysis was done by SPSS. Results: The overall mean age (SD) of the patient’s was 36.2±7.1 years. Most of the patients (n=64, 64.0%) were 31-45 years old. The male patients in our study were 65 (65.0%) whereas female participants were 35 (35.0%). For detection of mechanical threshold, the patients proportion with sensations at 3cm filament length was significantly lower in patients who underwent surgical treatment (78.0% vs. 100.0%; p-value&lt;0.001) as compared to the participants managed conservatively. It was also lower significantly at 5cm and 7cm for Group-A in comparison to Group-B (p-value≤0.05). For detection of heat threshold, the patients proportion with sensation at 32°C was no different between Group-A and Group-B (p-value=0.529). However, proportion of patients with sensations at 35oC (64.0% vs. 100.0%; p-value&lt;0.001) and 37oc (90.0% vs. 100.0%; p-value=0.022) was lower significantly in surgically treated patients. Pain threshold detection was significantly lower in patients who underwent surgical treatment (1.26±0.44 vs. 1.58±0.49; p-value&lt;0.001) in comparison to conservative treatment. Conclusion: In patients with zygomaticomaxillary complex fractures, infra orbital nerve outcome was superior in patients managed conservatively than those treated with open reduction and internal fixation which advocates evading unnecessary intervention in such cases in future practice. Keywords: Zygomaticomaxillary Complex Fractures, Conservative Treatment, Infra Orbital Nerve

Efficacy of Topical 1% Adapalene Versus Cryotherapy in Treatment of Plantar Warts

Background: Warts are spiny, rough papules or nodules that can be found anywhere on skin. They are caused by human papilloma virus (HPV) infection. There are over 100 HPV types documented. Approximately 6% of children and 2% of adults consult the doctor for wart. The aim of the current study was To compare the efficacy of topical Adapalene gel 0.1% under occlusion with cryotherapy in the treatment of plantar wart Methodology: It was Randomized control trial carried out at the Department of Dermatology, Combined Military Hospital, Abbottabad, Pakistan, from Feb 2022 to July 2022. A total of 60 Patients coming to hospital with complaints of plantar warts were randomized into two equal groups of 30 patients. Patients reporting on odd serial number were allocated to group A, treated with application of topical 1% adapalene gel overnight on daily basis under occlusion, while patients reporting on even serial number were allocated to group B, treated with cryotherapy for two freeze thaw cycles, done with liquid nitrogen at -196°C temperature using direct application by a dipstick. The primary outcome was to measure the complete resolution of warts after 8 weeks from start of treatment. Results: Age range in this study was from 18 to 45 years with mean age of 32.366±8.61 years, while duration of disease was from 2 to 12 weeks with mean duration of 6.433±2.90 weeks. After 8 weeks of treatment, 27 patients (90%) in group-A, while 20 patients (66.66%) in group-B achieved complete resolution of warts (p-value 0.028). Practical implication: In the practical implications of this study, while comparing topical adapalene versus cryotherapy in trials, an important fact is that cryotherapy is done under supervision by the physician on fortnightly basis while adapalene is applied under occlusion by patients themselves daily at home, so, a major advantage of use of adapalene gel is also its simplicity and convenience of use. Another advantage to the patient is in shape of painless application at home compared to the cryotherapy. However, one disadvantage with adapalene gel is that it has to be used under occlusion by plastic sheet on daily basis which may feel messy to some patients Conclusion: Topical 0.1 % adapalene was more effective than cryotherapy in the treatment of plantar warts. Keyword: Human papillomavirus, Plantar warts, Adapalene, Cryotherapy.

Comparison of Intramuscular Versus Rectal Diclofenac Sodium in Post Caesarean Pain Relief

Objective: To compare the mean post-operative pain after intramuscular versus rectal Diclofenac Sodium in post-caesarean patients.&#x0D; Study Design: Quasi-experimental study.&#x0D; Place and Duration of Study: Department of Obstetrics &amp; Gynaecology, Benazir Bhutto Hospital, Rawalpindi Pakistan, from May to Nov 2017.&#x0D; Methodology: A total of 60 women, aged 18-45years, undergoing elective caesarean section were selected. Patients in Group-A were given, Diclofenac 75mg intramuscularly in the gluteal area every 8 hours, while patients in Group-B received a Diclofenac Sodium suppository every 8 hours post-operatively. All patients were followed for pain post-operatively, and final post-caesarean pain was noted at 24 hours post-operatively using a visual analogue scale.Results: The mean age of patients in the Group-A was 29.27±4.68 years, and in Group-B was 30.57±4.80years. The range of gestational age in the study was from 37 to 41 weeks, with an average age of 39.07±1.26 weeks. Mean post-operative pain in Group-A (Intramuscular Diclofenac Sodium-Group) was 1.13±0.43 minutes, whereas in Group-B (Rectal Diclofenac SodiumGroup), was 2.16±0.83 (p-value = 0.001).&#x0D; Conclusion: Mean post-operative pain after using intramuscular Diclofenac sodium is less than Diclofenac Sodium administered rectally in post-operative patients in caesarean sections.

Effect of Topical Liquid Nitrogen on Pain Reduction during Intradermal Platelet-Rich Plasma Therapy Scalp in Androgenic Alopecia

Objective: To compare the effect of topical liquid Nitrogen and normal saline on pain during intradermal Platelet-rich Plasma therapy in androgenic alopecia.&#x0D; Study Design: Prospective Comparative study.&#x0D; Place and Duration of Study: Tertiary Care Hospital, Gujranwala Pakistan, from Mar to Nov 2021.&#x0D; Methodology: Sixty-four patients with the clinical diagnosis of androgenic alopecia were enrolled after informed consent.After liquid Nitrogen contact application, Group- A patients opted to receive intradermal Platelet-rich Plasma on the scalp. In contrast, patients in Group-B opted to receive Platelet-rich Plasma after normal Saline topical application for improved pain tolerance.&#x0D; Results: Out of Sixty-four patients, there were 45(70.3%) males, 19(29.7%) females. Pain in intradermal Platelet-rich Plasma injection of the scalp in Group-A had a median (IQR) score of 4 (3-5), while Group-B had a median (IQR) of 5(3-7.5). Patient satisfaction score at the end of three sessions of PRP in group-A had a median (IQR) of 1.5(1-2), and in Group-B, a median (IQR) of 2(1-2).&#x0D; Conclusion: Topical liquid Nitrogen application improved pain tolerance during intradermal Platelet-rich Plasma therapy in androgenic alopecia compared to normal saline. Satisfaction of patients with Platelet-rich Plasma therapy between the two groups had no significant difference.

Comparison of Nebulized Ketamine with Nebulized Magnesium Sulfate for the Prevention of Postoperative Sore Throat

Objective: To compare the effects of nebulized Ketamine versus nebulized Magnesium Sulfate to prevent post-operative sore throat.&#x0D; Study Design: Quasi-Experimental Study.&#x0D; Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital, Rawalpindi Pakistan, from Sep 2020 to Feb 2021.&#x0D; Methodology: A total of 154 patients who underwent general anaesthesia for elective procedures were randomly included in the study. These patients were divided into two equal Groups, i.e., Group-A (n=77), who received Magnesium Sulphate 250mg in 5ml saline and Group-B (n=77), who received Ketamine 50mg in 5ml saline, respectively. The effects of nebulized Ketamine versus nebulized Magnesium Sulfate to prevent post-operative sore throat, were observed in both the Groups.&#x0D; Results: Both drugs were effective in the prevention of sore throat after extubation. Our study showed that Ketamine nebulization was more effective than Magnesium Sulfate nebulization in preventing sore throat. The frequency of sore throat in Group-A was 54.5% (42 out of 77 patients) as compared to 31.2% (24 out of 77 patients) in Group-B, which was statistically significant (p=0.003).&#x0D; Conclusion: Post-operative sore throat is more effectively controlled with Ketamine as compared to Magnesium Sulfate

Comparison of the Efficacy of Tazarotene 0.1% Cream Versus Clindamycin 1% Gel in the Treatment of Acne Vulgaris

Objective: To compare the efficacy of Tazarotene 0.1% cream versus Clindamycin 1% gel in treating acne vulgaris.&#x0D; Study Design: Quasi-experimental study.&#x0D; Place and Duration of the Study: Dermatology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jul 2018.&#x0D; Methodology: One hundred and fifty-four patients of both genders who had moderate acne vulgaris for more than four weeks were divided into two Groups. In both Groups, patients applied one-fourth fingertip unit of Tazarotene 0.1% cream in the evening once daily and Clindamycin 1% gel over the affected area in the morning once daily for 12 weeks. The Global Acne Grading System Score (GAGS score) was used for severity and efficacy assessment.&#x0D; Results: The majority of the patients belonged to 13-25 years of age, i.e., 61(79.2%) and 54(70.1%) in Group-A (Tazarotene 0.1% cream) and Group-B (Clindamycin 1% gel), respectively. The efficacy of topical Tazarotene cream (0.1%) was better than topical Clindamycin 1% gel, and the difference was statistically significant with a p-value less than 0.01. GAGS score &lt;10 was observed in 54.5% and 33.8% of patients in Group-A and Group-B, respectively.&#x0D; Conclusion: Topical Tazarotene cream (0.1%) was more effective than topical Clindamycin 1% gel in treating acne vulgaris.

A Comparison of Efficacy of Two Brands of Enoxaparin in COVID-19 Patients: A Pilot Study

Introduction: Enoxaparin is a complex and biologically derived low-molecular-weight Heparin which is approved for a variety of clinical indications associated with thromboembolic events such as Deep Vein Thrombosis and Venous Thromboembolism. During COVID-19 it was frequently used as prophylaxis in the treatment of thromboembolic events. Nowadays, many brands have come up in the market for the same.&#x0D; Objective: In Tricolour Hospital located in Vadodara, Gujarat, the ongoing brand of Enoxaparin 0.6 i.e., Clexane (Sanofi) falls short as well as in the pharmaceutical market. Hence, the management decided to procure another brand of Enoxaparin until Clexane is available to the vendors. Therefore, the present study was planned to study efficacy of two brands of Enoxaparin –one is Coguparine, (Venus Pharmaceuticals) and another LMWX- (Abbott) in COVID-19 patients in an isolation ward of hospital. The aim of present study was to compare the efficacy of two brands of Enoxaparin (Coguparine vs LMWX) for prophylactic treatment of thromboembolism observed in COVID-19 patients.&#x0D; Methodology: Patients were randomly divided into 2 groups- A and B. Patients in group A received Coguparine while patients in group B received LMWX. Statistical analysis was carried out using paired t-test.&#x0D; Results: The laboratory reports of patients in Group-A presented few abnormal improvements in the Complete blood count but there was no concrete evidence about the same. On the other hand, patients in Group-B receiving LMWX showed improvement in CBC profile. Also, there was significant difference observed in C-Reactive Protein and D-Dimer profiles in both the brands.&#x0D; Conclusion: This showed that for the cost-effective treatment and procurement of Enoxaparin there is no harm in using generic formulation of Enoxaparin as and when required. But LMWX was proved to be of standard quality in terms of efficacy.

Primary Closure Versus Delayed Primary Closure in Perforated Appendix: A Comparative Study

Introduction: The elimination of unpleasant and time-consuming dressing changes, as well as the potential reduction in overall hospital costs, are potential benefits of primary closure. Recent studies suggest that perforated appendicitis may usually be principally closed without an increase in the wound infection rate compared to delayed primary closure, suggesting that the disagreement surrounding the best ways of wound management has died down. Objective: Studying the efficacy of primary versus delayed primary closure for appendectomy in patients with perforations Study design: Ayyub Teaching Hospital Abbottabad and Timergara Teaching Hospital Dir Lower. Study duration from January 2021 to June 2021. Material and Methods: Perforated appendix patients undergoing appendectomy between the ages of 18 and 45 were included. When an appendectomy was performed, the appendicular stump was not invaginated as is sometimes done nowadays. Interrupted 2/0 vicryl was used to stand in for muscles. Within the PC group, the external oblique was stitched shut with a continuous vicryl 0 suture. Using only regular saline, the wound washed and disinfected. For patients having delayed primary closure, dressing changes occurred daily; in the case of infection dressing changes occurred twice daily until the wound was closed. After the third postoperative day or once the infection had subsided in cases of infected wounds, the wound was closed after rejuvenating the edges. On the seventh postoperative day patients were evaluated for wound infection and length of hospital stay using the operational definition of success. Results: The patients' mean age was 37.3± 610.49 years. The average number of days someone spent in the hospital was 7.38 (1.25). Women made up 37 (or 61.70%) of the total, while men accounted for 23 (or 38.30%). Thirteen patients, or 21.70 percent, had an infected wound. Wound infections occurred in 11 patients in Group-A (the primary closure group) but only 2 patients in Group-B (the delayed closure group) (delayed primary closure). When comparing the rate of wound infection in groups B and A, a statistically significant difference was discovered (p=0.005). Hospitalization time was shorter for those in group A (6.24± 0.47 days) compared to those in group B (8.53± 0.51 days); p 0.001. Conclusion: Patients with a perforated appendix benefit more with primary closure than from delayed primary closure. Keywords: Primary closure, delayed primary closure, and a perforated appendix

Comparison of Mean Serum Calcium Levels in Pregnancy with and without Pregnancy Induced Hypertension

Aim: To compare mean serum calcium levels in pregnancy, with and without pregnancy induced hypertension. Study design: A Cohort study was done. Place and duration of study: Department of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, Lahore Unit III, from 1st January 2021 to 30th June 2021. Methodology: Two hundred patients with gestational age between 28 to 40 weeks, were included in the present study, 100 patients in group A (hypertension) and 100 in group B (normotensive). Results: The mean age of patients in group-A and group-B was 28.87 ± 4.32 years and 27.49±4.80 years respectively. The mean gestational age in group-A was 35.86±1.86 weeks and in group B was 35.90±1.36 weeks. The mean serum calcium level was 7.26±0.80mg in group A and 8.94±0.53mg in group B which is statistically significant (p &lt;0.001). Conclusion: It is concluded that serum calcium levels in women with pregnancy induced hypertension (PIH) are lower than in normal pregnant women. The calcium supplementation appears to reduce the risk of pregnancy induced hypertension. Therefore, calcium consumption in pregnancy should be encouraged, especially during the second and third trimester of pregnancy. Keywords: Hypocalcemia, pregnancy induced hypertension, Normotensive patients.

Comparison of Recurrence of High Trans-Sphinteric Anal Fistula After Vaaft and Tight Setons in Military Hospital Rawalpindi

Objective: To compare the recurrence rate in patients undergoing fistulectomy using tight setons with those using videoassisted anal fistula treatment (VAAFT).&#x0D; Study Design: Comparative prospective study.&#x0D; Place and Duration of Study: Department of General Surgery, MH Rawalpindi, Pakistan from May 2018 to Dec 2021.&#x0D; Methodology: We included 200 patients with high trans-sphincteric anal fistula (simple or complex) of age 18 to 60 years, having ASA I or II. Group- A comprised patients undergoing treatment with VAAFT, while Group- B included patients undergoing treatment with Tight Seton in conventional surgery. Patients were followed for three months after the procedure. Patients having a history of discharge around or in the vicinity of the previous external opening of the anal fistula were labelled as having a recurrence. Recurrence was confirmed on MRI Fistulogram.&#x0D; Results: The mean age of patients in Group-A was 42.10±8.26 years, and in Group-B was 42.17±7.91 years (p=0.95). There were 58 male patients in Group-A and 55 male patients in Group-B (p=0.67). The mean duration of the fistula was 5.30±1.64 months in Group-A and 5.22±1.61 months in Group-B (p=0.72). Recurrence was diagnosed in 24 patients in Group-B and only 06 patients in Group-A (p&lt;0.001).&#x0D; Conclusion: Video-assisted anal fistula treatment (VAAFT) has a lower recurrence rate than Tight Setons in conventional surgery in treating high trans-sphinteric anal fistula.

Post-Operative Infection Rate Between Single Dose Versus Multiple Dose Antibiotic Therapyin Patients Undergoing Laparoscopic Cholecystectomy

Objective: To compare the frequency of post-operative infection rate between single dose versus multiple dose antibiotic therapy in patients undergoing laparoscopic cholecystectomy.&#x0D; Study Design: Comparative prospective study.&#x0D; Place and Duration of Study: Surgical Department, Combined Military Hospital, Lahore Pakistan from Oct 2017 to Feb 2020.&#x0D; Methodology: Patients of both genders undergoing laparoscopic cholecystectomy for simple cholelithiasis were included. Group-A patients underwent laparoscopic cholecystectomy using single-dose prophylactic antibiotic therapy with 2-gram 3rd generation cephalosporin at the time of induction of anaesthesia. In contrast, Group-B patients underwent laparoscopic cholecystectomy using 2-grams of 3rd generation Cephalosporin intravenously at the time of induction of anaesthesia followed by intravenous 1-gram Ceftriaxone two doses 12 hours apart. All patients were followed up on the first postoperative day, and then 1-week and 2-week follow up were done for any surgical site infection.&#x0D; Results: Patients in Group-A had a mean age of 37.12±6.53 years, while patients in Group-B had a mean age of 37.74±6.40 years. The post-operative infection rate in Group-A (single dose antibiotic therapy) was seen in 08 (4.28%), while in Group-B (multiple dose antibiotic therapies) was seen in 18 (9.63%) patients (p-value = 0.042).&#x0D; Conclusion: This study concluded that the single-dose prophylactic antibiotic is as good as multiple-dose antibiotic therapy used as prophylaxis for the prevention of post-operative infection rate among patients with cholecystectomy done via the laparoscopic method.

Topical Betamethasone Valerate 0.1% W/V vs. Topical Ketoconazole 2% W/V: A Comparison of Efficacy in Patients of Seborrheic Dermatitis

Objective: To compare the efficacy of topical Betamethasone valerate 0.1% w/v and topical Ketoconazole 2% w/v in patients of seborrheic dermatitis.&#x0D; Study Design: Comparative prospective study.&#x0D; Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital Rawalpindi Pakistan from Feb to Aug 2019.&#x0D; Methodology: A total of 80 patients of both genders with seborrheic dermatitis were included. Patients were divided into two groups randomly, with 40 patients in each group. Group-A patients were given topical Betamethasone valerate 0.1% w/v, while patients in Group-B were given topical Ketoconazole 2% w/v for 12 weeks. Data regarding efficacy was assessed after 12 weeks per operational definition from both groups and noted.&#x0D; Results: The mean age of patients in group A was 34.45 ± 6.73 years, and in the Group-B was 32.18 ± 6.07 years. The majority of the patients, 54 (67.50%), were between 15 to 35 years of age. Efficacy of Group-A (topical Betamethasone valerate 0.1%) was seen in 35 (87.50%) patients while in Group-B (topical Ketoconazole 2%) efficacy was seen in 25 (62.50%) patients (p-value = 0.010).&#x0D; Conclusion: This study concluded that the efficacy of topical Betamethasone valerate 0.1% w/v is higher than topical Ketoconazole 2% w/v in patients with seborrheic dermatitis.

Comparative study of efficacy and safety between sublay and onlay polypropelene mesh repair for incisional hernia of abdominal wall

To compare the efficacy and safety between sublay and onlay polypropylene mesh repair for incisional hernia of abdominal wall. Department of General Surgery from January 2018 to December 2021 in BHIMA BHOI MEDICAL COLLEGE OF WESTERN ODISHA. It is a randomized controlled trial. In this study a total of 144 (72 in each group) patients were observed. The patients were randomly allocated in two groups by random method. Patients in group-A was subjected to onlay polypropylene mesh open repair procedure and patients in group-B was subjected to sublay polypropylene mesh open repair procedure for incisional hernia repair in abdominal wall. Post-operatively all patients were kept under observations for 7-10 days in surgery ward and observed for complications if any. Post-operatively all patients were followed at 20 days, 2nd months, 6th month and 9 months to confirm the efficacy and safety of the procedure. The mean age of patients in Group-A was 30 years± 2.16 and 32 years ± 3.71 in Group-B. In group-A 28 patients were male and 44patients were female where as in group-B 27 patients were male and 45 patients were female.

Association of Intrapartum CTG with Fetomaternal Outcome

Objective: To determine the association of intrapartum CTG with fetomaternal outcome Material and Methods: A total number of 120 pregnant females who presented in the department of obstetrics and gynecology with labour pain were included in this cross-sectional analysis. A written informed consent was taken from all patients. The study was conducted in the department of Obstetrics &amp; Gynaecology at Islam Teaching Hospital, Sialkot from January, 2021 to September, 2021. At presentation in the labor room, 20 minutes CTG was performed and patients were divided into two groups, those having abnormal trace including suspicious and pathological trace (Group A) and normal cardiotocography (CTG) pattern (Group B). After that the patients were followed till delivery to determine the feto-maternal outcomes e.g. APGAR score, NICU admission, perinatal mortality and caesarean section rate. Results: The mean age was 26.9±4.12 years in group A and 27. 1 ± 3.9 years in group B (p-value 0.78). On comparison of maternal outcomes, caesarean section was done in 38 (63.3%) patients in group-A and in 17 (28.3%) patients in group-B (p-value &lt;0.0001).Regarding neonatal outcomes, NICU admission was needed in 9 (15%) patients in group A, versus in 4 (6.7%) patients in group B (p-value 0.14). Perinatal mortality occurred in 03 (5.0%) patients in group A and in no patient in group B (p-value 0.07). APGAR score at 5 minutes was &gt;7 in 46 (76.7%) patients in group A versus in 52 (86.7%) patients in group B (p-value 0.18). Conclusion: The intrapartum abnormal CTG cannot be used as the only tool to identify fetal hypoxia during labor. It may lead to increased caesarean section rate because of high false positive rate of abnormal CTG. Keywords: Cardiotocography, Fetal Distress, Cesarean section