Vipul Patel

Abstract

Introduction: To create pneumoperitoneum is the first step to any successful laparoscopic procedure. Various techniques for creation of pneumoperitoneum are traditional veress needle, open method, visual entry system and direct trocar insertion (DTI). Despite of rapid increase in the number of laparoscopic surgeries every year there is no clear guideline on the safe method of entry into the abdomen. Objective: The aim of this study is to evaluate safety and complications of direct trocar insertion. Materials and Methods: Retrospective multicenters study of patients who were undergoing various gynecological laparoscopic surgeries. All patients were undergoing DTI access method for primary port insertion. The study focuses on effectiveness of BMI, parity, previous surgery for DTI and evaluates complications. Conclusion: DTI is safe, fast and reliable alternative to primary peritoneal access and creation of pneumoperitoneum. Keywords: Laparoscopy, DTI (direct trocar insertion), Veress needle, Pneumoperitoneum.

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Abstract

Objectives: To compare empirical treatment with fosfomycin and nitrofurantoin in uncomplicated lower urinary tract infection during pregnancy. Materials and Methods: Patients were recruited from OPD of obstetrics and gynecology presenting with symptoms of lower (UTIs) urinary tract infection. Patients were divided randomly alternately in two groups. Fosfomycin therapy was given in group 1 (n=60) and seven days nitrofurantoin therapy was given in group 2(n=60). Patients were evaluated for symptoms improvement, compliance, side effects and cost of treatment. Results: Efficacy of fosfomycin on day 7 post treatment is 98% compare to nitrofrantoin I s83.3%. Side effect is 15% in fosfomycin group as compare to 28.3% in nitrofurantoin group. Compliance is 100% in fosfomycin group as compare to 96.6% in nitrofrantoin group. Cost of therapy in fosfomycin group is 300 Rs average while 170 Rs in nitrofurantoin group. Conclusion: Fosfomycin is first line empirical treatment of uncomplicated UTIs during pregnancy because it is safe, effective, less resistance, higher patient’s compliance with fewer side effect and equal cost of therapy. Keywords: Pregnancy, Cystitis, Nitrofurantoin, Fosfomycin, UTIs.

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