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        Wound complication among different skin closure techniques in the emergency cesarean section: a randomized control trial

        ( Bhimeswar Nayak G ),( Pradip Kumar Saha ),( Rashmi Bagga ),( Bharti Joshi ),( Minakshi Rohilla ),( Shalini Gainder ),( Pooja Sikka ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.1

        Objective Cesarean section is the most commonly performed obstetrical surgical procedure; however, there are no standard guidelines on appropriate skin closure techniques and materials. Only few comparative studies have been conducted on different skin closure techniques, and they have shown conflicting results. Therefore, we compared different skin closure techniques during emergency cesarean section to identify the best technique with minimal wound complication rates. Methods Patients were randomized into 3 groups (group A, n=100; group B, n=102; and group C, n=98). In group A, the skin was closed using staples; in group B, via the subcuticular technique using monocryl 3-0; and in group C, using mattress suture nylon (2-0). The primary outcome was a composite of wound complications, including infection, seroma, gaping, and need for resuturing and antibiotic administration. The secondary outcome included closure time, pain perception, patient satisfaction, and cost. Analyses were performed in accordance with the intention-to-treat principle. Results The composite wound complication rate in the entire cohort was 16.6% (n=50); the complication rate was significantly higher in group A than in the other groups. Infection was the most common wound complication observed in the entire study group (86%) and was significantly higher in group A than in groups B and C (P≤0.001). Conclusion The use of staples for cesarean section skin closure is associated with an increased risk of wound complications and prolonged hospital stay postoperative visits.

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        Progressive muscle relaxation technique on anxiety and depression among persons affected by leprosy

        Senthilkumar Ramasamy,Suganya Panneerselvam,Pitchaimani Govindharaj,Archana Kumar,Rashmi Nayak 한국운동재활학회 2018 JER Vol.14 No.3

        Anxiety and depression have been found to be increasing among peo-ple with leprosy and it may lead to decreased social participation. The progressive muscle relaxation technique (PMRT) is widely used today in choice of treatment for reducing the anxiety and depression. This study aimed to assess the effectiveness of PMRT in reducing anxiety and depression among the hospitalized leprosy affected person in a tertiary care centre. This study is a case series of 50 leprosy affected people aged between 18–60 years who were admitted for leprosy com-plications in tertiary leprosy referral hospital. The Anxiety-Depression scale was developed and validated by the investigators and adminis-tered before intervention of PMRT and after 2 weeks. The follow-up as-sessment was done at 6 weeks after the initial intervention. The finding shows that a statistically significant difference was observed on anxiety domain before and after application of PMRT. The anxiety means score showed steady decline from 6.76 at pretest to 3.0 (t=25.068, P≤0.001) at post test and 1.12 (t=22.679, P≤0.001) at follow-up. In depression do-main, a statistically significant difference was seen in before and after application of PMRT. The depression means score showed steady de-cline from 6.92 at pre test to 3.28 (t=16.082, P≤0.001) at post test and to 1.16 (t=18.918, P≤0.001) at follow-up. This study proved that the PMRT as a valid treatment option for hospitalized person with leprosy in mini-mizing the anxiety and depression related symptoms and to benefit the psychosocial wellbeing of leprosy affected patients.

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