BACKGROUND: Laparoscopic cholecystectomy, although is less invasive than open surgery, is not completely pain free. The use of local anaesthesia to relieve pain following this procedure is a common practice. However, it remains debatable whether a pre- or post-operative drug administration is more effective. Here, we investigated the role of preemptive local anaesthetic infiltration given pre- or post-incisional, in relieving the pain during laparoscopic surgery. METHODOLOGY: A randomized controlled trial was conducted with 96 patients receiving 0.5% Bupivacaine 100mg. Group A (n=48) received post-incisional skin infiltration whilst Group B (n=48) received pre-incisional infiltration. Incisional (somatic) and intra-abdominal (visceral) pain was assessed using Visual Analog Scale (VAS) at day 0, day 1 and day 7 post-operative days. RESULT: Baseline characteristics between the two groups were similar. Incisional pain was lower in Group B as compared to Group A at day 0 (P=0.03) and day 1 (P<0.01). Intra-abdominal pain was also lower in Group B at day 0 and day 1 (P= 0.04). VAS score was similar at day 7 although analgesia requirement is higher in Group A (P>0.05). CONCLUSION: Administration of pre-incisional local anaesthesia offers better pre-emptive pain relief measure than postincisional administration by reducing somatic and visceral pain in laparoscopic gall bladder surgery.
Cholecystectomy, Laparoscopic

Introduction: The transmigration scheme of the Indonesian government was aimed at easing overpopulation in Java by moving people to less populated areas. This study investigated food consumption and dietary diversity of women from the original location and transmigration rice farming areas. Methods: Food intake using a single 24-hour dietary recall was determined among women of reproductive age in Demak, Central Java (original location) and Buol, Central Sulawesi (transmigrant area). Food taboos were investigated using focus group discussions (FGDs). Dietary diversity and its score were obtained from 387 and 121 women in Demak and Buol, respectively, while 38 women from both areas participated in four FGDs on food taboos. Results: On average, women from both study areas had low dietary diversity scores, especially among lactation mothers. Rice, swamp cabbage, spinach and tempeh were popular in both areas. Fruits and vegetables from own cultivation or collected as wild foods were consumed in Buol, while women in Demak consumed comparatively more purchased foods (fruits and vegetables, legumes, meat and fish). Fewer types of food was avoided during pregnancy and lactation in Buol. Conclusion: While some food intake behaviour was similar in both study areas, differences were observed as influenced by economic and environment factors. Food intake of Demak women was influenced by household purchasing power, while Buol women depended on own grown food and gatherings from nearby forest. As dietary diversity scores in both areas was low, nutrition interventions are suggested to improve maternal food intake during pregnancy and lactation.

Humans ; Infant ; Prevalence ; Risk Factors ; Vitamin D Deficiency/epidemiology*