No abstract

The failure rate of endoscopic retrograde cholangiopancreatography for biliary cannulation is approximately 6%–7% in cases of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice in such cases. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows biliary drainage by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract. Information in PubMed, Scopus, clinicaltrials.gov and Cochrane review were analyzed to obtain studies comparing EGBD and PTBD. Six studies fulfilled the inclusion criteria. Technical (odds ratio (OR): 0.34; confidence interval (CI) 0.10–1.14; p=0.05) and clinical (OR: 1.48; CI 0.46–4.79; p=0.51) success rates were not statistically significant between the EGBD and PTBD groups. Mild adverse events were nonsignificantly different (OR: 0.36; CI 0.10–1.24; p=0.11) but not the moderate-to-severe adverse events (OR: 0.16; CI 0.08–0.32; p≤0.00001) and total adverse events (OR: 0.34; CI 0.20–0.59; p≤0.0001). EGBD is equally effective but safer than PTBD.

Background: Surgical site infection following Cesarean Section is one of the major potential surgical complications with its incidence ranging from 3-15%. Morbidity and mortality are considerably in­creased after a surgical site infection placing a significant physical, emotional and economic burden on the patient herself. This study is aimed to identify the associated risk factors for postcesarean surgical site infection at a tertiary care hospital in Chitwan. Methods: A descriptive cross-sectional study of 186 women who underwent a cesarean section was carried out in Chitwan Medical College Teaching Hospital, Chitwan, Nepal from 27thDecember 2019 to 19th February 2020. Data were collected from patients using a self-constructed questionnaire and their risk factors were studied. Results: A total of 186 cases were studied and the incidence rate of surgical site infection was 13 (6.99%). The mean age was 26.13±4.94. Among the total cases, 87.10% of cases were literate while 12.90% of cases were illiterate. Out of total surgical site infection cases, infection was more prevalent (84.62%) among those with preoperative hospitalization of ≤ 24 hours and (53.85%) among those who stayed in the hospital for < 5 days. Conclusions: Education level, duration of preoperative hospitalization and total hospital stay were found to be significant risk factors associated with surgical site infection and appropriate measures to address these risk factors help to lower the rate of surgical site infection.