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Article
Haemorrhoidectomy: a Comparative Study of Open & Closed Methods

Author: Hamid I. Jasim
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2009 Volume: 8 Issue: 1 Pages: 23-26
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Haemorrhoidectomy is an operation for third and fourth degree hemorrhoids Aim: To compare the closed (Ferguson) and open (Milligan-Morgan) methods. Methods: A prospective study, eighty patients admitted with hemorrhoids were randomly allocated to either open or closed methods. Results: Mean operative time was shorter in the open method. Analgesic requirement were less in the closed method. Healing time was shorter in the closed method. Conclusions: The closed technique is associated with less pain during early post- operative period and faster healing.

Keywords

Haemorrhoids --- open --- closed --- pain --- healing time.


Article
Pain after Laparoscopic Cholecystectomy
ألم بعد استئصال المرارة بالمنظار

Author: Ali A. Dabbagh
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2009 Volume: 13 Issue: 2 Pages: 37-42
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and Objectives: Although laparoscopic cholecystectomy results in less pain than open cholecystectomy, it is not a pain free procedure. A clinical trial was designed to assess pain after LC in terms of types of pain, intensity and factors that may influence it.Methods: A prospective study on pain was performed on all patients undergoing the operation over the period of 1.5 year (n = 150). Pain was measured by a five point verbal rating scale (VRS).Results: Pain was the most frequent symptom, after the operation. The main type of postoperative pain was intra-abdominal 72%, followed by incisional 60% and shoulder pain 10%.The mean level of pain was 2.12 VRS points 8 h after the operation and declined to 1.01 points next day. In 54 patients (36%) the intensity of pain was higher than 2 VRS points. Female sex was the only predictor of pain intensity.Conclusions: Laparoscopic cholecystectomy did cause significant postoperative pain in one-third of our patients only up to the first postoperative day. As predictors for high intensity of pain were not identified clearly, pain should be monitored and multimodal analgesics should be delivered accordingly.


Article
Role of Endoscopic Ultrasonography Guided Celiac Plexus Neurolysis in the Management of Pancreatic Cancer Pain

Author: Rayadh A. Z. Al-Sharifi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 1 Pages: 79-84
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Celiac plexus neurolysis (CPN), a chemical splanchnicectomy of the celiac plexus, is used to treat pain caused by pancreatic cancer. Originally performed by anesthesiologists and radiologists via a posterior approach, recent advances in endoscopic ultrasonography (EUS) have made this technique an attractive alternative. EUS guided celiac plexus neurolysis (CPN) is simple to perform and avoids serious complications such as paraplegia or pneumothorax that are associated with the posterior percutaneous approach.OBJECTIVE:To assess the efficacy and safety of EUS guided celiac plexus neurolysis in the management of pain caused by pancreatic cancer.METHODS:This study included (310) patients with painful and inoperable pancreatic cancer were submitted to EUS guided celiac plexus neurolysis (CPN) at a tertiary referral center. The following data were collected: age, gender, tumor location, vascular invasion, adjuvant therapy, and laboratory tests including prothrombin time, and complete blood counts were obtained at baseline (before EUS celiac plexus neurolysis).RESULTS:Of 310 procedures performed, 217(70%) patients develop immediate and complete pain relieves (within 24 hours of procedure) and no need for narcotic analgesia during follows up (12 weeks). Sixty-one (20%) patients had partial response to the procedure (decreasing in the need for narcotic analgesia during follow up). Thirty-two (10%) patients were lost to follow up and no outcome of procedure obtained.CONCLUSION:EUS is more safe, feasible, and more effective than other methods in performing CPN and controls pain caused by unresectable pancreatic cancer.

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