Online ISSN: 2515-8260

Keywords : VAS

Bilateral Segmental Internal Anal Sphincterotomy Outcomes for Chronic Anal Fissure Treatment

Hesham Bahlul Mohamed Marzogi, Samir Ibrahim Mohammad, Mohamed Farouk Amin, Ashraf Abdel Monem Elsayed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3352-3360

Background: Chronic anal fissures are harder to treat and surgery may be the best
option. The goal of surgery is to help the anal sphincter muscles relax which
reduces pain and spasms, allowing the fissure to heal. The aim of the present study
was to assess the Improving outcome of patients of chronic anal fissure. Patients
and methods: This clinical trial study was conducted in General Surgery
Department, Faculty of Medicine, Zagazig University on 18 chronic anal fissure
cases. All patients were subjected to full history taking, proper local examination
and baseline investigations. Anorectal manometry was performed for all patients
preoperatively. Then, bilateral segmental internal sphincterotomy was done for all
patients. Results: In our study, age was 37.77 ± 6.44 with minimum of 24 and
maximum of 50 years. Regard sex distribution, males and females were matched
(50/50 percentage). Majority were posterior (66.7%) then anterior (22.2%) and
finally both (11.1%). Operation time was 17.77 ± 3.62 with minimum of 12 and
maximum of 25 minutes. After internal sphincterotomy, complete healing was
5.16±1.09 with minimum of 4 and maximum of 7 weeks. VAS significantly
decreased from pre to 1st 24 hours till the end of follow up. Incontinence score
significantly decreased from preoperatively to 1st week till the end of follow up.
Conclusion: bilateral segmental internal sphincterotomy is a novel, safe, and
effective way of treating chronic anal fissure, and it is not associated with any risk
of anal incontinence.

Giant Cell Tumor Treatment by Curettage and Bone Cement in Proximal End of Tibia

Mohammed Basheer Wali, Elsayed Eletawy Soudy, Mohsen Fawzy Omar, Mohamed Ismael Kotb

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4046-4054

Background: Surgical treatment stills the most effective treatment for a giant cell
tumor of bone (GCTB). The aim of the present study was to evaluate the outcomes
of surgical treatment of giant cell tumor in proximal end of tibia by curettage and
bone cement. Patients and methods: This clinical trial study was conducted on 18
patients underwent surgical treatment of giant cell tumor in proximal end of tibia
by curettage and bone cement at orthopedic department, Zagazig University
Hospitals. Their age was ranged from 22 to 41 years. Two thirds (66.7%) of the
studied group were females and one third (33.3%) of them were males (2:1). After
completion of the investigations, staging of the tumor was recorded using
Campanacci's radiological grading method. Postoperative follow up was done to
assess the functional outcome and to detect the presence of complications. Results:
The present study showed that, 83.3% had companaccis grade I and grade II
(16.7%). 88.8% underwent cement and hydrogen peroxide and 11.2%underwent
cement, hydrogen peroxide and internal fixation. Regarding MSTS, only 33.3% of
them had intermediate pain, all patients had enthused emotional acceptance and
66.7% had unlimited walking ability and 22.2% had intermediate gait. Post
operative follow up showed the recurrence rate was zero (0.0%) after a follow up
time (11.2±1.04) months ranged from 9 to12 months. There was only 11.1% of
patients had superficial infection. Conclusion: Surgical treatment of a giant cell
tumor of bone using Cement filling after extended curettage is provide a good
oncological outcome and joint preservation. Curettage with adjuvants is a feasible
first choice treatment option for GCTB with Cement filling does not increase the
recurrence rate.

Addition Of Eccentric Elbow Exercises To Local Corticosteroid Injection For Tennis Elbow – A Prospective Randomized Study

Niranjanan Raghavn Muralidharagopalan; Raghav Gopal; Sugumar Natarajan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 3528-3537

Lateral epicondylitis or Tennis elbow is a painful condition of the elbow that is characterized by pain and weakness of grip strength. It is usually due to a tendinopathy involving the origin of the ECRB and EDC tendons. Wide variety of treatment options exists. Injection corticosteroids are considered to be a good choice for short term improvement of the problem but has doubtful effects in the medium to long term.
This study is a randomized study that compares the short to medium term effect of addition of eccentric elbow strengthening exercises to local corticosteroid injections
This is a prospective randomized study with 1 year follow up. 24 subjects received corticosteroid injections alone while 26 underwent eccentric elbow strengthening additionally.
The patients were administered VAS , DASH score and tenderness on resisted dorsiflexion of wrist and middle finger initially. This was followed up after 2 weeks, 6 weeks, 3 months , 6 months and 1 year.
The groups were also well matched for age, sex, time since diagnosis.
The VAS, DASH and the tenderness scores were also similar in the two groups.
In the injection only group there was reduction of VAS from 7.08 to 2.83 in 2 weeks which showed a decreasing trend till 6months follow up. Similarly, the DASH scores decreased from 33.40 to 13.63 in 2 weeks and the same trend was seen till 6 months. However, at 1 year follow up both scores showed a slight increase.
In the injection plus exercises group the reduction of VAS and DASH scores continues till one year. Also comparing the two groups the injection plus exercise group shows significant improvement at 2weeks, 6 weeks and 1 year follow up
Addition of eccentric elbow strengthening exercises significantly improves the benefit of having a local corticosteroid injection for tennis elbow