Polynomial design of the stochastic optimal, minimal complication system

Introduction Polypropylene (PP) meshes are safe synthetic products used for hernia repairs and associated with minimal complication. Chronic inflammation is thought to play a pathophysiological role in the development of cancer. Case presentation: We present a 67-year-old female case of squamous cell-cancer (SCC) that developed due to mesh after umbilical hernia operation. The mass in the anterior abdominal wall was totally resected. Pathology was reported as T2N0, moderately differentiated acantholytic type SCC. No recurrence or complication was detected in the fourth-month follow-up. Conclusion Cancer development after mesh is very rare and our case is the third case in the literature. Cancer development should be kept in mind in patients presenting with ulcerated masses if do not regress with infection treatment after mesh application.

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A novel Levator Ani Midurethral Support Via Single Vaginal Incision to Treat Stress Urinary Incontinence: Case Report

10.21203/rs.3.rs-559662/v1 ◽

2021 ◽

Author(s):

Lai-Yet Lam ◽

Janice Santos-Cortes ◽

Timothy O'Rourke

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Severe Infection ◽

Levator Ani ◽

Minimal Invasive ◽

Coital Incontinence ◽

Native Tissue ◽

Urethral Bulking ◽

Minimal Complication ◽

Autologous Fascia Sling

Abstract IntroductionA novel native tissue midurethral support procedure, Levator Ani Midurethral Support via single vaginal incision, to treat patients with stress urinary incontinence is introduced in this case report. After mesh controversy, there is a need for a minimal invasive native tissue surgical procedure to treat stress urinary incontinence with minimal complication.Case PresentationA 51-year-old female with stress urinary incontinence had three mesh midurethral slings and one autologous fascia sling with severe infection that failed. She developed recurrent stress urinary incontinence and coital incontinence. After she was referred to our care, she was initially treated with urethral bulking injections which also failed. There were few alternatives left after failure of three mesh midurethral slings, one autologous fascia sling with severe infection and urethral bulking injections. The patient was successful treated with our novel native tissue midurethral support procedure, Levator Ani Midurethral Support via single vaginal incision. She remains continent 23 months after the Levator Ani Midurethral Support via single vaginal incision and her coital incontinence has also resolved. She reported she has no pelvic pain or dyspareunia. ConclusionsAfter further study, this novel native tissue midurethral support procedure, Levator Ani Midurethral Support via single vaginal incision may meet the need for a minimal invasive native tissue surgical procedure for the treatment of stress urinary incontinence with minimal complication.

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Sutureless, bloodless, safe new circumcision technique

International Surgery Journal ◽

10.18203/2349-2902.isj20173387 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2530

Author(s):

Wael Barakaat Ahmed Mohamed ◽

Ahmed Eisa Ahmed

Keyword(s):

Blood Loss ◽

Prospective Observational Study ◽

Harmonic Scalpel ◽

Postoperative Bleeding ◽

Suture Technique ◽

University Hospital ◽

Intraoperative Blood Loss ◽

Minimal Complication ◽

Male Patients ◽

Surgery Department

Background: Several techniques of circumcision are available such as conventional surgical technique, the device (Gomco, Plastibell), mono and bipolar diathermy and sutureless methods such as fibrin glue. Our knowledge, the first report of using harmonic scalpel in circumcision was published by Peng et al, in the Asian journal of andrology but the study was done on dogs, this one of the little studies describe the use of the harmonic scalpel in male circumcision in humans. Aim was to describe the technique of the harmonic scalpel circumcision and report its outcomes in the term of safety and efficacy.Methods: This was a prospective observational study performed in the general surgery department at Sohag university hospital, Sohag, Egypt from 1st January 2015 to 31 December 2016.Results: 90 male patients were included in this study. Their age ranged between 3 and 18 years. The most common indication was religious circumcision 50%. No intraoperative blood loss or a postoperative bleeding. One case of wound infection and three cases of a postoperative edema respond to conservative treatment. No injury to the surrounding structure.Conclusions: The result of this study determines that the harmonic scalpel circumcision not associated with intraoperative blood loss or postoperative bleeding and a good postoperative cosmetic result, with a minimal complication. So, it is an appropriate alternative to the traditional scalp and suture technique.

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Perawatan Satu Kunjungan pada Premolar Pertama Atas Menggunakan Protaper Rotary dan Restorasi Resin Komposit

Majalah Kedokteran Gigi Indonesia ◽

10.22146/majkedgiind.8385 ◽

2013 ◽

Vol 20 (1) ◽

pp. 85

Author(s):

Sherli Diana ◽

Pribadi Santosa

Keyword(s):

Root Canal ◽

Composite Resin ◽

Root Canal Treatment ◽

Posterior Teeth ◽

Many Instruments ◽

Composite Resin Restoration ◽

Minimal Complication ◽

Instruments And Techniques ◽

Correct Technique ◽

Rotary Instrument

Preparasi kemomekanik pada saluran akar meliputi instrumentasi mekanis dan irigasi antibakteri yang secara prinsip dapat langsung mengeliminasi mikroorganisme pada sistem saluran akar. sejak diperkenalkan pada tahun 1988, instrumen rotary nikel-titanium (niti) telah digunakan secara umum dalam perawatan endodontik karena kemampuannya membentuk saluran akar dengan prosedur komplikasi yang minimal. Tujuan dari laporan kasus ini adalah untuk memaparkan perawatan saluran akar satu kunjungan menggunakan protaper rotary dan restorasi resin komposit gigi premolar. Penderita pria 21 tahun datang ke RSGM Prof. Soedomo UGM Yogyakarta mengeluhkan gigi belakang atas kiri yang berlubang tapi tidak sakit dan pasien ingin dirawat.Gigi Premolar satu atas kiri terdapat kavitas disto oklusal dengan pulpa terbuka. Pemeriksan objektif pada gigi 24 sondasi, perkusi, palpasi, dan tes termal menunjukkan hasil negatif.Pemeriksaan radiografis tidak terdapat lesi, lamina dura tidak terputus dan saluran akar jelas dan lurus. Pada kasus ini dilakukan perawatan saluran akar dengan menggunakan ProTaper rotary ( X-Smart, Dentsply). Pasca perawatan saluran akar, gigi premolar satu atas kiri dilakukan tumpatan resin komposit kelas II.Hasil evaluasi klinik saat kontrol tidak ada keluhan rasa sakit, pemeriksaan objektif juga tidak ada rasa sakit, warna gigi serasi dengan warna gigi tetangga.prognosis pada kasus ini baik dan tidak ada keluhan. Kesimpulan paska perawatan saluran akar satu kunjungan dengan instrumenrotary, tidak terdapat keluhan.Penggunaan Instrumen rotary Nikel-Titanium (NiTi) sangat flexible dengan prosedur komplikasi yang minimal, dan hemat waktu.One Visit Treatment of Upper Premolar Tooth Using Rotary Protaper and Composite Resin Restoration. Chemomechanical preparation for root canal including mechanic instrumentation and anti-bacterial irrigation principally could eliminate microorganisms in root canal system. Many instruments and techniques have been described and developed for initial root canal treatment. Since first established in 1988, nikel-titanium (NiTi) rotary instrument has been used for endodontic treatment because of its capability in forming the root canal with minimal complication procedure. Clinically, safe use of NiTi instrument and understanding of the alloy basic metallurgy including fracture mechanism and its correlation with root canal anatomy in order to set the safe use of NiTi instrument are required. This research will explain about biological principal of root canal preparation with correct technique and instrumentation system using NiTi. A 21 year-old patient in RSGM Prof. Soedomo UGM Yogyakarta complained about his left side upper jaw, posterior teeth with cavity, painless and the patient wanted to treat the teeth. The left maxilla first premolar teeth has a distooclussal cavity, open pulp. Based on the radiograph test, there found no lession, lamina dura was fine, and root canal was clear and straight. In this case, the patient was treated with crown down rotary X-Smart (Dentsply) technique for root canal treatment. After the root canal treatment had been conducted, the teeth were restorated with class II composite resin. After the treatment, it is found that there is no pain in the teeth, the colour of teeth match with others, and the prognosis for this case is good.

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Transarterial Chemoembolization of Metastatic Colorectal Carcinoma with Drug-Eluting Beads, Irinotecan (DEBIRI): Multi-Institutional Registry

Journal of Oncology ◽

10.1155/2009/539795 ◽

2009 ◽

Vol 2009 ◽

pp. 1-6 ◽

Cited By ~ 47

Author(s):

Robert C. G. Martin ◽

Jonathan Joshi ◽

Ken Robbins ◽

Dana Tomalty ◽

Ryan O’Hara ◽

...

Keyword(s):

Adverse Reactions ◽

Hepatic Metastases ◽

First Line ◽

Open Label ◽

First Line Therapy ◽

Patient Tolerance ◽

Drug Eluting Beads ◽

Drug Eluting ◽

Modified Recist ◽

Minimal Complication

The purpose of this study was to evaluate the patient tolerance and efficacy of delivering locoregional chemotherapy to metastatic colorectal (MC) hepatic metastases via hepatic trans-arterial approach using irinotecan loaded drug eluting beads. This open-label, multi-center, single arm study included 30 MC patients, who had failed first line therapy. Of the 57 total embolization sessions, 12 (21% of sessions) were associated with adverse reactions during or after the treatment. After a median followup of 9 months, response rates by modified RECIST were 75% at 3 months and 66% at 6 months. Hepatic trans-arterial therapy using Irinotecan loaded DCBeadTMwas safe and effective in the treatment of MCC as demonstrated by a minimal complication rate and acceptable tumor response.

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MODIFIED KSHARSUTRA TECHNIQUE IN COMPLEX FISTULA IN ANO - A CASE STUDY

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj6308102020 ◽

2020 ◽

Vol 8 (10) ◽

pp. 4939-4943

Author(s):

Rashmi Gupta

Keyword(s):

Success Rate ◽

Recurrence Rate ◽

Fistulous Tract ◽

High Success Rate ◽

Treatment Modalities ◽

Daily Routine ◽

Fistula In Ano ◽

Complex Fistula ◽

Minimal Complication

Fistula in ano is an anorectal disorder in which two openings are present. One is located near perianal re-gion and another is at anal canol or rectum. Fistula in ano is itself a challenging disease for patients because of mortality is not associated but daily routine life of patients become crushed. Ayurveda also said about Bhagandar (fistula in ano) that it is Kashta Shadhya Vyadhi i.e. difficult to treat because its take time and recurrence rate is also associated. But Ayurveda has described the Kshar sutra therapy for the treatment of fistula in ano which have high success rate, but time taken. With time, revolution has also come in Ayurve-dic treatment modalities for anorectal fistulas. A modified Ksharsutra technique is new technique for treatment of complex fistula in ano. The name of this technique is interception of fistulous tract and appli-cation of Ksharsutra (IFTAK). This technique has high success rate with minimal complication, early re-covery and there is no recurrence is associated. Cosmetically, this technique is good.

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Combined approach for management of gynecomastia: Subcutaneous mastectomy and liposuction

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v7i3.22674 ◽

2018 ◽

Vol 7 (3) ◽

pp. 78-81

Author(s):

Amir Bajracharya

Keyword(s):

Patient Satisfaction ◽

Surgical Techniques ◽

Cost Effective ◽

Subcutaneous Mastectomy ◽

Combined Approach ◽

Exclusion Criteria ◽

Patient Satisfaction Score ◽

Fat Removal ◽

Grade Ii ◽

Minimal Complication

Introduction: There are different modalities for the treatment of gynecomastia. Open surgical techniques have become less popular with the advent of liposuction and its variants, including power-assisted and ultrasound-assisted liposuction. Methodology: This is a descriptive study done to observe the combined approach of liposuction and subcutaneous mastectomy for the treatment of gynecomastia and to evaluate aesthetic aspects using Surgeon’s evaluation score for size, shape, scarring, overall outcome and patient satisfaction score by using visual analogue scale. Inclusion criteria consist of all the patients with bilateral or unilateral gynecomastia using Simon Grade I and II. , Exclusion criteria consist of patients having pseudogynecomastia, pathological and with Simon Grade III gynecomastia. Frequency analysis was done using Statistical Package for Social Sciences version 20.0. Results: Twenty-one patients were included in the study, out of which there were 12 (57%) cases of bilateral, six (29%) cases of right and three (14%) cases of left sided gynecomastia. Mean age was 23.8 years range (14-32) years, mean body mass index 22.52 kg/m2 (18-26) kg/m2 mean volume of fat removal through liposuction 136.43 ml (40-300) ml, and mean resected breast tissue was 89.29 gm (40-150) gm. In our study 33.3% cases were of Simon Grade I and 66.7 % cases were of Grade II gynecomastia with one (4.7%) case had post-operative hematoma. With combined approach liposuction and subcutaneous mastectomy results showed overall excellent patient satisfaction, minimal complication, less scarring and cost effective. Conclusions: Management of gynecomastia with subcutaneous mastectomy and liposuction can be a combined approach with less complication and overall excellent patient satisfaction.

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Biologic restoration: A successful treatment option for immediate esthetics – A case report

10.25259/jrde_7_2020 ◽

2021 ◽

Vol 1 ◽

pp. 17-22

Author(s):

Deep Shah ◽

K. C. Ponnappa ◽

Neha Subbaiah ◽

M. C. Ponappa

Keyword(s):

Case Report ◽

Motor Vehicle ◽

Simple Procedure ◽

Dental Trauma ◽

Invasive Procedure ◽

Dental Student ◽

Vehicle Accidents ◽

Dentoalveolar Trauma ◽

Minimal Complication ◽

Long Term Prognosis

Crown fractures mainly in the anterior region are the most common outcome of traumatic injuries. The common cause is ascribed to falls, motor vehicle accidents, and contact sports. Out of all the dental trauma injuries, dentoalveolar trauma contributes to about 25%, which may vary from simple crown fracture of enamel and/or dentin to complicated crown root fractures. In this case report, an undergraduate dental student reported with a fractured crown due to a fall an hour earlier. The clinical and radiographic assessment leads to the diagnosis of an uncomplicated crown fracture. Fracture line was extending obliquely till the middle third of the crown involving enamel and dentin. Tooth segment adaptation was evaluated, and decision was made to attempt for reattachment procedure. The tooth was isolated using rubber dam and tooth fragment was reattached using flowable composite. Follow up period was noted for 6 months. Tooth segment reattachment is a minimally invasive procedure with immediate aesthetic and it is not time consuming. This procedure has a predicable long-term prognosis with minimal complication due to advances in adhesive technique. Various factors should be taken into consideration for maximizing the benefits. Thus, this simple procedure is an alternative to the other complex restorative procedure for restoring tooth function, form, and esthetics. Recent advances in flowable composites can be used for a much more predictable result pertaining to strength and aesthetics.

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A Case on Fracture of Os Penis and Partial Penectomy in a Raccoon

International Journal of Veterinary Science ◽

10.47278/journal.ijvs/2020.031 ◽

2021 ◽

Vol 10 (3) ◽

pp. 244-246

Keyword(s):

Broad Spectrum ◽

Clinical Case ◽

Clinical Symptoms ◽

Postoperative Treatment ◽

Broad Spectrum Antibiotic ◽

Preventive Method ◽

Minimal Complication ◽

Os Penis ◽

Partial Penectomy ◽

Veterinary Hospital

The os penis is a unique structure existing in some placental mammals, however it predisposes the organ to fracture. Partial penectomy is an incomplete penile amputation which is carried out when the transection site needed. In this report, a clinical case of partial penectomy in a raccoon was described. A 20-month-old, male albino raccoon (Procyon lotor) was referred to University Veterinary Hospital in Universiti Putra Malaysia with the penile prolapse. Preliminary therapeutic plan included prescription of broad-spectrum antibiotic and anti-inflammatory. Partial penectomy was arranged in this case. Postoperative treatment prescribed were fluoroquinolone antibiotic and analgesics. The prognosis was good due to minimal complication. The clinical symptoms on fracture of os penis, complications of partial penectomy, and options for treatment on fracture of os penis were discussed in this report. Castration can be an alternative preventive method to prevent trauma related to the fracture of masturbation os penis.

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A modified technique for nipple-areola complex reconstruction

Indian Journal of Plastic Surgery ◽

10.1055/s-0039-1699483 ◽

2011 ◽

Vol 44 (01) ◽

pp. 076-080

Author(s):

Shoeib A. Mohamed ◽

Peir Camillo Parodi

Keyword(s):

Patient Satisfaction ◽

Nipple Reconstruction ◽

Modified Technique ◽

Composite Grafts ◽

Areola Complex ◽

Classical Technique ◽

Minimal Complication ◽

Implant Reconstruction ◽

Reconstructed Breast

ABSTRACT Background: From a historical perspective, many techniques of nipple reconstruction have been performed, including a graft from the contralateral nipple, composite grafts such as toe pulp or earlobe tissue and even an intra-dermal tattoo alone. This is the final stage of breast reconstruction, and is carried out only when the surgeon is confident that acceptable symmetry and shape of the reconstructed breast has been achieved. The technical challenges of nipple reconstruction include correcting position, maintaining adequate projection and creating an inconspicuous scar. An alternative to a surgically reconstructed nipple is the use of silicone prosthetic nipples. Materials and Methods: From August 2006 until September 2007, 80 cases of nipple/areola reconstruction were performed in our department (UDINE UNIV.) following mammary reconstruction or conservative breast surgery. Forty cases were carried out with the classical technique and another 40 cases with the introduction of our modification in the form of deepithelization of a semicircular area of the adjacent skin at the base of the flap. Postoperative follow-up as regards the nipple size, site, projection, symmetry and donnar scar were assessed. Patient satisfaction was also addressed and evaluated. Results: There were good to excellent results as regards nipple size, symmetry and projection. The technique is suitable for different autologous and implant reconstruction. The technique is an outpatient procedure, is easy and is not consuming time. Areolar graft from the contra-lateral areola is colouur matching and shows nearly no deference from the opposite one. Conclusions: Simple technique and not time consuming. Maintains the consistency and projection of the new nipple. Patient satisfaction. Minimal complication.

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