Role of Aminophylline Intravesical Instillation on Enhancing Ureteral Dilatation prior to Ureteroscopy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Mohamed Saafan ◽  
Mohamed Ismail Shabayek ◽  
Marwa Mamdouh Mohamed ◽  
Mostafa Mabrouk Bayomi Ali

Abstract Background Semi-rigid uretroscopy (URS) is a common intervention approach for lower ureteric stones. Ureteral dilatation is frequently needed before URS to enable ureter accessing. Aminophylline is known by its muscle relaxant effect and has been suggested to be effective in ureteral dilation. Objectives To evaluate the effect of intravesical administration of aminophylline on ureteroscopy and to measure intraureteral pressure Methods This prospective randomized controlled study included 50 before and after aminophylline injection. patients with lower ureteral calculi. In group A, the ureter was dilated by intravesical aminophylline whereas in group B balloon dilator was used. Intraureteral pressure was measured using pressure transducer connected to invasive pressure monitor. Results No statistically significant difference was noticed between both groups in operative time, intra operative complication, need for ureteral stenting or stone free rate. However, post-operative pain and haematuria were statistically significantly higher among balloon group compared to aminophylline group. In group A, there was statistically significant decrease in intraureteral pressure after injection of aminophylline (7.80 ± 1.71) compared to before injection (12.2 ± 1.85) with p-value < 0.001. Conclusion Aminophylline is effective in ureteral dilatation when intravesically injected with less frequent post-operative pain and hematuria.

2020 ◽  
Vol 7 (12) ◽  
pp. 3986
Author(s):  
Arijit Roy ◽  
Pramatha Nath Datta ◽  
Kushankur Guha

Background: Standard four port laparoscopic cholecystectomy is the gold standard in the treatment of gall stones. Modified epigastric port laparoscopic cholecystectomy may be considered an alternative, as this procedure maintains the advantages of four ports and does not require any special set of instruments. In this study we aimed to see whether this procedure is comparable to the standard four port laparoscopic cholecystectomy based on the primary objectives of postoperative pain score, degree of ambulation, time to return to normal activities.Methods: Consecutive patients due to undergo laparoscopic cholecystectomy, meeting all the predefined criteria were recruited into the study. The group A was assigned to receive intervention in the form of modified epigastric port laparoscopic cholecystectomy. The group B was assigned to receive intervention in the form of standard four port laparoscopic cholecystectomy. Patients in group A were compared with patients in group B based on multiple pre-defined parameters.Results: Pain scores were significantly better in group A. Degree of ambulation at was significantly better in group A. In respect to the time to resumption of normal activities there was no significant difference between the two groups. When comparing the quality life at 1 month following surgery with SF-36 health survey, the patients in group A did better than patients in group B with respect to the six scales. Conclusions: Modified epigastric port laparoscopic cholecystectomy appears to be significantly better than the standard four port cholecystectomy in terms of postoperative recovery.


2019 ◽  
Vol 3 (2) ◽  

Objective: Aim of the study is to Compare the astigmatism induced by a reduced temporal sclerocorneal tunnel incision manual small incision cataract surgery with an extended temporal clear corneal Phacoemulsification of similar width . Methods: A Prospective, randomised controlled study was carried out in 224 selected patients who were again divided into two groups - Group A (112 patients) and Group B (112 patients). Group A patients underwent temporal manual small incision cataract surgery with a 5.5 mm sclerocorneal incision and Group B underwent phacoemulsification by a 2.8 mm clear corneal temporal incision which was extended to 5.5 mm before IOL implantation. In both groups, a 5.25 mm rigid PMMA IOL was implanted in the bag. UCVA and BCVA of both group of patients was quantified and analyzed at 1 week and at 6 weeks Observation: It was seen that the mean surgically Induced astigmatism in group A (N=112) was 0.5625D , which was slightly lesser than that in Group B (N=112) which was 0.65D, although the p-value of 0.26 indicated that there was statistically no significant difference in visual outcomes between the two groups of patients. Here, a p-value of < 0.05 was considered statistically significant. Conclusion: In Skilled and Safe hands, refractive outcomes following performing a 5.5mm temporal sclerocorneal frown-incision manual small incision cataract surgery and a phacoemulsification procedure by a 2.8mm temporal clear corneal incision extended to 5.5mm for implanting a 5.25mm rigid PMMA IOL , are comparable.


2017 ◽  
Vol 1 (1) ◽  
pp. 01-05
Author(s):  
Ahmed Elsadeek Radwan ◽  
Mohamed Amr Hussein Elnoury ◽  
Sherif Fathi ElMekkawi

Objective: Acupuncture is frequently utilized to manage climacteric symptoms and other gynecological conditions. Laser acupuncture has the advantages of being noninvasive, reproducible, and convenient. This study sought to explore the effectiveness of laser acupoint stimulation in relieving symptoms associated with menopause. Methods: A randomized, double-blind, controlled study was conducted on 120 women diagnosed as menopausal patients (>1 year past last menstruation), aged 40 - 60 years with a Kupperman Menopause Index (KMI) equal or more than 15. women were randomized into Group A: Laser acupuncture (n=30), Group B: (HRT); Tibolone 2,5 mg/day (n=30) orally, Group C: Laser acupuncture and Tibolone 2,5 mg/day orally (n=30), Group D: Non interventional (self-care group) (n=30). Each patient was given a standard daily log and was required to record the frequency and severity of hot flashes and side effects of the treatment felt daily. The serum levels of follicle stimulating hormone (FSH), LH and E2 were detected before and after the treatment. Results: 120 women with postmenopausal symptoms were divided randomly into four equal groups; After the treatment and the follow-up, in (Group A) there was no significant difference regarding FSH, LH and E2 level before treatment and after treatment with LASER acupuncture, as regard (Group B); there was statistically significant difference before and after treatment concerning hot flashes of KMI and he levels of FSH, LH decreased significantly and the level of E2 increased significantly. Combined treatment using hormonal replacement therapy with Laser Acupoints (Group C) showed dramatic improvement in study subjects and the improvement was more than that in group B. There were no significant differences were found regarding self-care group on either frequency of hot flashes, FSH, LH and E2 level. Conclusions: Laser acupoints are effective and can be used as an alternative treatment to decrease the frequency and severity of postmenopausal hot flashes and postmenopausal symptoms especially if combined with Tibolone.


2018 ◽  
Vol 5 (6) ◽  
pp. 2054 ◽  
Author(s):  
Mohamed Abdelhady Mohamed ◽  
Mohamed Leithy Ahmed ◽  
Mahmoud Gamal Eldin Hagag ◽  
Mohammed Nazeeh Shaker Nassar

Background: Intestinal anastomosis dates back to 1000, B.C but it accompanied with high rates of failure, sepsis, wound infection and mortality until the development of suture materials. Lembert described his seromuscular suture technique in 1826. Surgical Stapler was first introduced by Hultl in 1908. The development of modern devices over the past 30 years changes the surgical practice dramatically. The objective of present study is to compare the outcome between Stapler and handswen anastomosis in the small intestine.Methods: This study is a randome controlled study carried on 40 patients divided into two equal groups, 20 patients were treated by handswen suture method (group A) and the other 20 patients operated by stapling technique (group B).Results: In both elective and emergent cases as regard patient operative time, postoperative passing flatus, begin of oral intake, hospital stay duration and postoperative complications it was lower in Stapler (group B) comparing to handswen (group A) and P-value was statistically significant (P<0.05). In emergent cases postoperative leakage is equal in both handswen (group A) and Stapler (group B) and P-value was non-significant (P>0.05).Conclusions: In both elective and emergent cases the duration of operation, postoperative passing flatus, return of bowel sound, hospitalization days and postoperative complications including (intraoperative bleeding, prolonged ileus >4 days, patient stenosis and wound infection) in Stapler anastomosis it was lower comparing to handswen anastomosis and P-value was statistically significant (P<0.05). No significant difference in postoperative leakage between handswen anastomosis and Stapler anastomosis in emergency cases (P>0.05).


2011 ◽  
Vol 6 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Erkan Vuralkan ◽  
Cem Saka ◽  
Istemihan Akin ◽  
Sema Hucumenoglu ◽  
Binnur Uzmez Unal ◽  
...  

Background: The aim of our study was to compare the effects of montelukast and mometasone furoate nasal spray on the postoperative course of patients with nasal polyposis. Patients and methods: Fifty patients diagnosed with nasal polyposis between March 2006 and August 2007 were included in the study. All patients underwent bilateral endoscopic sphenoethmoidectomy and were randomized postoperatively into two groups. Group A ( n = 25) received 10 mg montelukast per day and group B ( n = 25) received 400 µg mometasone furoate nasal spray twice daily. All patients were followed up for 6 months. Sino-Nasal Outcome Test (SNOT)-22 scores, polyp grades, computerized tomography (CT) scores (Lund–Mackay), eosinophils in peripheral blood and polyp tissue were evaluated before and after surgery. Results: There was a significant reduction in SNOT-22 scores in both groups throughout the study period. There was a significant difference in the recurrence rate between both groups with a marginal advantage of mometasone furoate nasal spray. Eosinophils in peripheral blood were found to be effective on the recurrence rate ( p < 0.05). Conclusions: In conclusion, both drugs seem to have a complementary action and further studies are needed to determine which patients should receive which treatment.


Author(s):  
Priti A. Mehendale ◽  
Mayur T. Revadkar

Background: There is evidence regarding beneficial use of Transcutaneous Electrical Nerve Stimulation (TENS) on post Lower Segment Caesarean Section (LSCS) incision pain. However, efficacy of different types of TENS following C section pain has not yet been explored adequately.Methods: 96 women who had recently undergone LSCS were included for the study. The subjects were in the age group of 20 to 40 years (25.84±3.96); having pain intensity 4 or more on Numerical Pain Rating Scale (NPRS). They were divided into three groups by random allocation method; namely Group A: Acupuncture (Low/Motor) TENS, Group B: Conventional (High/Sensory) TENS and Group C: Control group. Group A and B received specific type of TENS twice a day for 15 minutes. Control group C did not receive any TENS intervention. All subjects received standard post-operative medications and physiotherapy. Pain intensity was recorded on NPRS pre and post intervention.Results: Both Acupuncture TENS and Conventional TENS significantly decreased post-operative pain intensity as compared to control group (p value <0.0001).Conclusions: Both, acupuncture and conventional TENS are equally effective in reducing post LSCS incision pain at a strong and non-painful intensity.


2010 ◽  
Vol 62 (3) ◽  
pp. 555-563 ◽  
Author(s):  
E.C. Soares ◽  
G.G. Pereira ◽  
L.C. Petrus ◽  
M. Leomil Neto ◽  
F.L. Yamaki ◽  
...  

Sixty dogs with idiopathic dilated cardiomyopathy were randomly treated with traditional therapy - digitalis, diuretics, angiotensin-converting inhibitors - (group A) or treated with these drugs plus carvedilol (group B). Echocardiographic variables were measured before and after 3, 13, 26, and 52 weeks of treatment or until death. Comparisons between groups and time were performed. No significant differences between groups were found in the most of the echocardiographic variables. The left ventricular end-systolic diameter indexed to body surface area (LVESDi) increased significantly in the group A dogs compared to the group B animals. The survival of groups A and B dogs were not different (P-value=0.1137). In conclusion, the stability of the LVESDi observed in the group treated with carvedilol may represent the beneficial effect over the ventricular remodeling.


2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.


2021 ◽  
Vol 9 (4) ◽  
pp. 3949-3953
Author(s):  
Minhaj Tahir ◽  
◽  
Tahzeeb Fatima ◽  
Devendra Trivedi ◽  
Manjit Kumar ◽  
...  

Background: Pleural effusion is one of the commonly seen respiratory conditions in India with approximately 1 million people being diagnosed each year. Twenty to forty percent of hospitalized patients with bacterial pneumonia develop pleural effusion. In India unlike western countries, tuberculosis pleura effusion is common. The pleural cavity is involved in approximately 5% of all patients with tuberculosis. Since there was no literature regarding the effectiveness chest mobility exercise with staked breathing or chest mobility exercises with incentive spirometery in pleural effusion. There was a need to find out as to which approach are the best ones to implement. Objective: To compare the efficacy of chest mobility exercise with stacked breathing versus chest mobility exercise with incentive spirometery on chest expansion in patients with pleural effusion. Materials and Method: 20 patients with pleural effusion were selected by easy sampling and randomly assigned into two groups (10 patients each groups). Group A received chest mobility exercises and intensive spirometery and group B received chest mobility exercises and stacked breathing. Both groups were instructed to perform the intervention 3 time per day, 8 to 10 time per session for one week. Chest expansion was measured by thoracic flow cytometry before and after one week of intervention. Result: In group A chest expansion increase from 2.68 to 2.87 which was statistically significant (P value < 0.0023). In Group B the chest expansion increases from 2.94 to 3.09 which was not statistically significant (P value < 0.216). Conclusion: It was concluded from the result that both chest mobility exercises with intensive spirometery and chest mobility exercise with stacked breathing are equally effective in improving the chest expansion in subject with pleural effusion. KEY WORDS: Pleural effusion, Chest mobility exercises, Incentive Spirometry, Stacked breathing, Thoracic flow cytometry.


2021 ◽  
Vol 15 (5) ◽  
pp. 1024-1027
Author(s):  
Asma Samreen ◽  
Aamir Waseem ◽  
Muhammad Azam ◽  
Itrat Hussain Kazmi ◽  
Aamir Bashir ◽  
...  

Background: Procedural sedation is required for multiple short duration procedures outside of the operating rooms especially in radiology and endoscopy suites. Intravenous anesthetic agent with rapid recovery profile is desirable in such circumstances. This study aims to compare two regimens of intravenous anesthetic agents. Aim: To compare the mean recovery time of propofol and midazolam with propofol alone for sedation in endoscopic retrograde cholangiopancreatography. Study Design: Randomized controlled trial. Settings: Department of Anesthesia, Shalamar Hospital, Lahore. Study Duration: June 2017 to December 2017. Methods: A total of 70 adult patients aged 20-60 years undergoing ERCP under sedation were included. Patients were given a combination of propofol and midazolam in group A while propofol alone was given in group B. After procedure, pts were transferred to recovery room and were followed for assessment of recovery time. Data were analyzed in SPSS vr 21, Independent t-test was applied & p-value ≤0.05 was considered statistically significant. Results: Significant difference was found in mean recovery time amongst both the groups. Mean recovery time in Group A (propofol and midazolam) was 19.29±4.50 minutes while in Group B (propofol alone) was 26.66±3.70 minutes showing statistically significant result with p-value = 0.0001. Conclusion: We conclude that mean recovery time with propofol plus midazolam is shorter as compared to propofol alone for sedation in ERCP. Keywords: Propofol, midazolam, sedation outside operation theatre.


Sign in / Sign up

Export Citation Format

Share Document