Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Randomized Controlled Trial
Comparison of analgesic efficacy of acetaminophen monotherapy versus acetaminophen combinations with either pethidine or parecoxib in patients undergoing laparoscopic cholecystectomy: a randomized prospective study.
Aim To investigate analgesic effect of three different regimens of combination of analgesics administered to patients undergoing laparoscopic cholecystectomy. Methods Patients undergoing laparoscopic cholecystectomy were randomly allocated to one of three groups on admission, depending of a prescribed post-operative analgesic regimen. Patients allocated to the group A received a combination of intravenous (IV) acetaminophen and intramuscular (IM) pethidine, patients in the group B received a combination of IV acetaminophen and IV parecoxib, and the patients of the group C received IV acetaminophen monotherapy. ⋯ The analgesic regimens of groups A and B (combination regimens consisting of IV acetaminophen and intramuscular pethidine and IV acetaminophen and IV parecoxib, respectively) were found to be of equivalent efficacy (p=1.000). In contrast, patients in group C (acetaminophen monotherapy) had higher NRS scores, compared to both patients in groups A (p<0.01) and B (p<0.01). Conclusion This study confirms the notion of a significant opioid-sparing effect of parecoxib in postoperative pain management after laparoscopic cholecystectomy.
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Aim To propose a new prognostic classification system for pelvic injuries based on a new detailed and all-encompassing evaluation of the injury pelvic outcome score and to check the prognostic value of this classification and evaluate its reliability and reproducibility. Methods From January 2017 to June 2020 from 156 pelvic fractures treated at our hospitals, 98 patients with pelvic fractures were recruited according to inclusion and exclusion criteria. All patients compiled three scores (New Score System, Majeed Score, SF-12) sessions two times during the hospital stay to evaluate the endpoint before the trauma and two years after the trauma. ⋯ Tau B Kendall value was 0.827 for the new score system, 0.673 for the Majeed score, 0.746 for SF-12, there was p<0.05 for the new score system. Conclusion The new score system is prognostic, reliable, reproducible and can become a useful instrument to adequately correlate the long-term outcomes of pelvic injury fractures. Also, it provides a better evaluation of pain, work, sexual possibilities and satisfaction, balance-sitting-walking and psychological status.
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Randomized Controlled Trial
Does low intensity direct current affect open fracture wound healing?
Aim To explore the effects of a molecular pathway from the application of low-intensity direct current (LIDC) for wound healing through the pathway signalling growth factor and initiation of fibroblast activation. Methods This randomized clinical trial included 32 patients with open fracture wounds who came to Hasan Sadikin Hospital in Bandung, Indonesia. The patients were divided in the control and the treatment group. ⋯ Results This study showed a better wound area repair in the treatment group than the standard group, 3.17±0.11 and 0.78±0.07, respectively. The increase of FGF-2 level (42.69±3.5 and 15.09±1.8, respectively), FGF-7 level (42.99±3.55 and 14.67±1.9, respectively), and fibroblast group expression (7.62±0.79 and 3.54±0.6, respectively) were found to be higher in the treatment group (p <0.05). Conclusion Low-intensity direct current accelerates wound healing through the increase of growth factor and fibroblast activation.
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Aim To evaluate the case series of the patients operated with percutaneous fixation by the navigation system based on 3D fluoroscopic images, to assess the precision of a surgical implant and functional outcome of patients. Methods A retrospective study of pelvic ring fractures in a 2-year period included those treated with the use of the O-Arm 2 in combination with the Stealth Station 8. Pelvic fractures were classified according to the Tile and the Young-Burgess classification. ⋯ The median follow-up was 17.5 months. The patients were satisfied with their health condition on SF-36. Conclusion The use of the O-arm guarantees great precision in the positioning of the screws and reduced surgical times with excellent clinical results in patients.
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Aim To investigate the prevalence of Cryptosporidium sp. and B. hominis among human immunodeficiency virus (HIV) positive patients in two different outpatient clinics, Haji Adam Malik General Hospital and Primary Care Centre of Padang Bulan, Medan, Indonesia, between two interval periods. Method Cryptosporidium spp. microscopic examination, as well as Jones' medium for B. hominis, were conducted in the Parasitology Laboratory, enzyme-linked immunosorbent assay (ELISA) was done in the Multidisciplinary Laboratory, Faculty of Medicine, Universitas Sumatera Utara. This was a cross-sectional study, involving 54 diarrheic HIV positive patients (44 males, 10 females). ⋯ Conclusion The prevalence of cryptosporidiosis among HIV patients was still relatively high. CD4 count showed a significant relationship with Cryptosporidium spp. infection, but not with Blastocystic hominis. Microscopic examination is still the most reliable technique to diagnose the parasites in faecal samples.