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Comparative Evaluation Of “Onlay” Versus “Intraperitoneal Onlay” Novel Polyester Meshplasty In Ventral Hernia Of Rabbits

by Bilal Ahmed Shah (2010-VA-196) | Dr. Hamad Bin Rashid | Dr. Ayesha Safdar | Dr. Mamoona Chaudhry.

Material type: book Book; Literary form: not fiction Publisher: 2017Dissertation note: Polyester (Polyethylene terephthalate) is hydrophilic material works with the body’s natural systems to improve tissue integration while reducing negative foreign material response. Polyester offers extremely lower pain intensity and less foreign body reaction. The purpose of designated research was to compare the efficacy of two placement techniques “Onlay” versus “Intraperitoneal Onlay” polyester meshplasty for the treatment of ventral hernia. Polyester is a non-absorbable mesh. Polyester mesh is not available in Pakistan and was acquired from a local healthcare company in Dubai, United Arab Emirates. Polyester mesh is available with brand name of (Parietex®, Covidien, France). The experimental study was conducted on 24 (twenty four) healthy rabbits presented for massive ventral hernia repair. All rabbits were thoroughly examined to rule out any other anomaly before the study. The rabbits were allocated into two different groups, viz. group-A and group-B with 12 rabbits in each group respectively. All treatments were administered intramuscularly using 1 ml insulin syringe. The “Onlay Polyester Meshplasty” (Parietex®, Covidien) a placement technique that was used for the treatment of ventral hernia in group-A. The rabbits of group-B were treated with “Intraperitoneal Polyester Meshplasty” (Parietex®, Covidien) placement technique. Ventral herniorhaphy was performed in both groups using Polyester mesh with two different placement techniques. The surgery was performed at Surgery Section, Department of CMS, UVAS, Lahore for 3 months duration (including adaptation and postoperative period). Both techniques were compared on the basis of postoperative complications (wound healing, pain evaluation, hematoma, seroma and abscess formation), inflammatory responses and adhesion formation after application of mesh fixation. SUMMARY 47 During the experiment, it was observed that “Onlay Polyester Meshplasty” resulted in a prominent pain sensation, persistent inflammatory reaction, proliferating fibroblast, more granulating tissue, macrophages appearance, increased connective tissue thickness and proliferating collagen fiber. It was observed that “Intraperitoneal Polyester Meshplasty” resulted in less pain sensation, no foreign body reaction, no neutrophil appearance and rare granulating tissue. “Intraperitoneal Polyester Meshplasty” showed remarkable advantages over “Onlay Polyester Meshplasty” in terms lower pain level, reduced size seroma and extremely less scar tissue formation. Based upon all the findings it was concluded that “Intraperitoneal Polyester Meshplasty” placement technique is safer and more effective in terms of post-operative complications and outcomes. Availability: Items available for loan: UVAS Library [Call number: 2809-T] (1).

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Comparative Efficacy Of Ketamine-Xylazine-Tramadol Combination With Ketamine-Xylazine-Ketorolac Tromethamine In Dogs

by Ameer Hamza Rabbani (2009-VA-58) | Dr. Hamad Bin Rashid | Prof. Dr. Muhammad Arif Khan | Dr. Mamoona Chaudhry.

Material type: book Book; Literary form: not fiction Publisher: 2017Dissertation note: The study was designed on the premise that use of Ketamine-Xylazine-Tramadol combination was more efficacious in providing better depth of anesthesia and postoperative analgesia than the combination of Ketamine-Xylazine-Ketorolac tromethamine. Two separate combinations of anesthetic cocktails i.e. ketamine-xylazine-tramadol and ketamine-xylazine-Ketorolac tromethamine were tested for their comparative efficacies. A total of 8 mongrel adult clinically healthy male dogs between 1 to 2 years of age which were presented to clinic for castration, were managed in to two groups comprising 4 (n=4) individuals in each. These groups were designated as group A and B. General and clinical examination of the animal, LFT and RFT were performed prior to surgery. Atropine was administered at dose rate of 0.04mg/kg SC twenty minutes prior to the surgery. Both anesthetic regiments were used respectively in either groups and their efficacy was tested based upon the depth of anesthesia and postoperative analgesia. In case of group A ketamine was used at a dose rate of 6mg/kg, xylazine at 0.5mg/kg and tramadol at a dose rate of 2mg/kg. These anesthetic agents were administered intramuscularly. The time it took for onset of sedation and depth of anesthesia was monitored, while presence of ocular, oropharyngeal, and anal sphincter reflexes indicated induction, depth, maintenance and recovery from sedation. In case of group B, ketamine was used at a dose rate of 6mg/kg, xylazine at 0.5mg/kg and ketorolac tromethamine at a dose rate of 0.5mg/kg. These anesthetic agents were administered intramuscularly. The time it took for onset of sedation and depth of anesthesia were monitored, while presence of ocular, oropharyngeal, and anal sphincter reflexes indicated induction, depth, maintenance and recovery from sedation. Surgical procedure for castration was SUMMARY 58 performed as surgical plane of anesthesia was acquired. Postoperatively, Intramuscular antibiotics were injected for 5 days to avoid secondary bacterial infections to wounds. Cleaning of the wound with good antiseptic solution and excellent hygienic measures were adopted to minimize infection. Balanced diet was given to improve health of animals. LFT and RFT were performed preoperatively (baseline), and one hour postoperatively in each dog. The measurements were analyzed as change from baseline in each dog. The results were statistically analyzed using t-test with significant level 0.05% (p≤0.05), using statistical analysis software Statistica. The results of temperature, pulse and respiration were statistically analyzed using t-test with significant level 0.05% (p≤0.05). Observations pertaining to depth and quality of sedation were analyzed by using t-test with statistical analysis software Statistica. Statistical significance was assigned at p≤0.05. This study was helpful in determining efficacy of tramadol an opioid against ketorolac tromethamine which is an NSAID. This study emphasized upon discovering the most efficacious adjuvant to anesthetic combination of ketamine and xylazine. This study aimed to reduce the dose of xylazine without compromising the anesthetic effect of the combination while mitigating its side effects as well. This study provided us with a viable analgesic agent which may be administered peri-operatively to provide analgesia during immediate post-surgery period. Furthermore magnitude of improvement in depth of anesthesia helped determine an effective and cheap adjuvant to ketamine-xylazine combination. Availability: Items available for loan: UVAS Library [Call number: 2807-T] (1).

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