Efficacy Of Local Anaesthesia In Repair Of Inguinal Hernia.

BACKGROUND: Local anaesthesia has been identified as the most favourable anaesthesia for elective inguinal hernia repair with respect to complication rate, cost effectiveness and overall patients' satisfaction. This study was conducted to determine the efficacy of local anaesthesia in inguinal hernia in terms of pain relief, wound infection and hospital stay. METHODS: In this randomized controlled trial (RCT), 60 patients with inguinal hernia were included at the General Surgical 'B' Unit, Ayub Teaching Hospital Abbottabad. RESULTS: The day-case rates were significantly higher when patients underwent surgery under LA compared to GA (82.6% versus 42.6%). The incidence of urinary retention was higher in the GA group (p<0.05). There were 17 (2.9%) re-admissions overall. The reasons for readmission included haematoma (n=6), severe pain (n=4), infection (n=3), fainting (n=2) and urinary retention (n=2). CONCLUSIONS: This study demonstrates that local anaesthesia for inguinal hernia repair has better efficacy as compared to general anaesthesia.

Role Of Symptomatic Treatment In Comparison To Antibiotics In Uncomplicated Urinary Tract Infections.

BACKGROUND: Uncomplicated urinary tract infections (UTIs) are the most common bacterial infections among women presenting to primary care causing rapidly increasing strains of resistant bacteria to the growing antibiotic industry. Restricting antibiotics to necessary indications is the only solution. The objectives of the study were to compare the efficacy of symptomatic treatment vs antibiotic in patients with uncomplicated UTI, in terms of individual symptom score, i.e., frequency, urgency, dysuria, supra pubic pain scores and total symptoms scores. METHODS: A randomized control trial (RCT) in 100 women (15-50 years) with symptoms of urinary frequency, urgency, dysuria and pain supra pubic region, associated with uncomplicated UTI, at Urology department, AMI, Abbottabad. Two treatment strategies were compared in uncomplicated UTI patient). Patients were randomized to antibiotic or symptomatic treatment groups on consecutive non-probability basis (50 in each group) given for 05 days. Efficacy of medications was assessed by comparing pre and post treatment symptom scores along with the post treatment scores of both groups compared to see statistical significance of difference by independent samples t-test. RESULTS: There was a statistically significant difference in symptoms improvement in both treatment arms of all scores, i.e., p-value=0.000. Whereas only dysuria score was able to show a statistically significance of difference in post Rx scores comparison of both groups, p-value=0.004. CONCLUSIONS: Symptomatic treatment is not inferior to antibiotic treatment when proper patient selection is undertaken, resulting in decreased need for unnecessary antibiotics use.