Stone Cone® in ureteroscopic ballistic lithotripsy of proximal ureteral stones

Stone Cone® (Microvasive-Boston Scientific Corp, USA) is a device which prevents retrograde calculus migration during endoscopic ureterolithotripsy. We have studied the safety and efficacy of this device in endoscopic ureterolithotripsy with ballistic energy in proximal ureteral stones. Materials and Methods. From 01/02/2006 to 01/02/2008 we carried out 36 ureterorenoscopies (URS) for proximal ureteral stones (average age: 46, range: 15–73). A ballistic energy was used for stones fragmentation. In 18 patients (Group A) we carried out URS with the aid of Stone Cone®, which was not used in the other 18 patients (Group B). Semirigid 8 Ch or 10 Ch Storz ureteroscope and ballistic lithotriptor Swiss Lithoclast Master EMS® were used. In cases of migration, edema, and ureteral damage, a ureteral stent was used. Results. In Group B patients (URS performed without Stone Cone®) the migration of the whole stone, or of clinically significant fragments, occurred 8 times (45%). All of these patients underwent external shockwave lithotripsy (ESWL) at a center equipped with a lithotriptor. A ureteral stent was placed in 14 cases (78%). In Group A, the migration of a stone requiring ESWL treatment occurred only once (5%). The ureteral stent was placed 8 times (45%). We had no significant complications during the procedure. Conclusions. The Stone Cone® is a safe and easy-to-use device. The cost of this device can be balanced by the reduction of postoperative ESWL treatments for lithiasic fragments pushing up into the kidneys (p<0.01), and of ureteral stent applications at the end of the procedure (p<0.05).

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A comparative study for management of fissure in ano with glycerin-trinitrate and lignocaine ointment: a randomized control trial

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20183244 ◽

2018 ◽

Vol 6 (8) ◽

pp. 2644

Author(s):

Kamlesh J. Galani ◽

Ashwinkumar S. Gadhvi ◽

Nidhi D. Shah

Keyword(s):

Anal Fissure ◽

Symptomatic Relief ◽

Complete Healing ◽

Fissure In Ano ◽

Group A ◽

Glycerin Trinitrate ◽

Clinically Significant ◽

Group B ◽

The Cost ◽

Pain Improvement

Background: Anal fissure is a very common benign anorectal disorder with significant morbidity among otherwise healthy individuals. Of all the patients coming to our OPD 15-20% have anal fissure. So there arises need to study the best and most compliant conservative treatment modality.Methods: Study was randomized, prospective, observational and longitudinal including 200 patients of age group 18-60 equally divided in 2 groups. Group A given 0.2% GTN ointment and group B given lignocaine ointment.Results: Better and early and sustained symptomatic relief was noted with GTN compared to lignocaine. 80% cases showed complete healing by 8 weeks with GTN compared to 52% healing with lignocaine. Headache was main side effect with GTN. Recurrence rate was high with lignocaine.Conclusions: Topical GTN has a statistically and clinically significant success rate for fissure healing and pain improvement at 8 weeks compared to lignocaine ointment (80% vs. 52%). It came at the cost of clinically acceptable level of morbidity (headache).

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Does Systematic Preliminar Colour Doppler Study Reduce Kidney Biopsy Complication Incidence?

International Journal of Nephrology ◽

10.4061/2011/419093 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5

Author(s):

Antonio Granata ◽

Fulvio Floccari ◽

Angelo Ferrantelli ◽

Ugo Rotolo ◽

Luca Di Lullo ◽

...

Keyword(s):

Kidney Biopsy ◽

Colour Doppler ◽

Doppler Examination ◽

Doppler Study ◽

Group A ◽

Clinically Significant ◽

Perinephric Hematoma ◽

Group B ◽

Biopsy Complications ◽

Optimal Site

While ultrasonography is widely performed prior to biopsy, colour Doppler examination is often used only to discover post-biopsy complications. Aim of this paper was to evaluate the usefulness of colour Doppler examination in planning the optimal site of puncture for renal biopsy. Present analysis includes 561 consecutive percutaneous renal biopsies performed from the same operator. Until August 2000 332 biopsies were performed after a preliminary ultrasonography (Group A). From September 2000, 229 patients underwent even a preliminary colour Doppler study (Group B). Postbioptic bleeding were categorized as minor (gross hematuria or subcapsular perinephric hematoma < 4 cmq of greater diameter) or major (hematoma >4 cmq of greater diameter; requiring blood transfusion or invasive procedures; leading to acute renal failure, urine tract obstruction, septicaemia, or death). Major complications were seen in 2.1% in Group A while in Group B only one case was reported (0.43%). Minor clinically significant complications occur in 7.8% in Group A and in 3.4% of cases of Group B. Colour Doppler reduced drastically the incidence of complications observed before the introduction of routine colour Doppler examination prior to biopsy. In our opinion, these data support the use of preliminary colour Doppler study when a biopsy is planned.

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Short-term evaluation of an intra-articular technique for cranial cruciate ligament rupture in dogs using nylon or polyester

Semina Ciências Agrárias ◽

10.5433/1679-0359.2018v39n2p593 ◽

2018 ◽

Vol 39 (2) ◽

pp. 593

Author(s):

Tiago Carmagnani Prada ◽

Anderson Coutinho da Silva ◽

Bruno Watanabe Minto

Keyword(s):

Cruciate Ligament ◽

The Other ◽

Polyester Yarn ◽

Short Term ◽

Limb Function ◽

Cranial Cruciate Ligament ◽

Ligament Rupture ◽

Group A ◽

Group B ◽

Cranial Cruciate Ligament Rupture

Cranial cruciate ligament rupture (CCrLR) is a common condition found in the small animal routine, being correlated to traumas, obesity, genetic factors, and primary osteoarthritis (OA) in dogs. Affected animals show articular instability that, if not corrected surgically, may cause secondary OA and loss of limb function. The aim of this study was to compare short-term results of the intra-articular technique for knee stabilization after CCrLR using a surgical button associated with polyester yarn (Group A), the surgical button associated with nylon yarn (Group B), and surgical toggle associated with polyester yarn (Group C). Eighteen dogs presenting CCrLR, weight varying from 5 to 35 kg, and different sex and breed were divided into three groups of six individuals. OA radiographic grade, pre- and post-operative lameness, surgical time, and the macroscopic aspect of cartilage were assessed. The intra-articular technique was performed by passing a suture through two tunnels, drilled in the femoral condyle and tibial crest to stabilize the knee joint. Twelve animals presented a decreased lameness and normal limb function after 15 days. On the other hand, four dogs from Group B presented complications: two dogs had suture rupture after 30 days and other two showed muscular contracture with decreased range of motion, followed by loss of limb function. In Group A, one dog showed suture rupture after 15 days and other had suture infection after 30 days. In Group C, dogs recovered normal limb function without complications. Therefore, surgical toggle associated with polyester yarn was better than the other studied materials.

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Efficacy of High-Power Laser in Alleviating Pain and Improving Function of Patients With Patellofemoral Pain Syndrome: A Single-Blind Randomized Controlled Trial

Journal of lasers in medical sciences ◽

10.15171/jlms.2019.06 ◽

2018 ◽

Vol 10 (1) ◽

pp. 37-43

Author(s):

Farshad Nouri ◽

Seyed Ahmad Raeissadat ◽

Dariush Eliaspour ◽

Seyed Mansoor Rayegani ◽

Maryam Sadat Rahimi ◽

...

Keyword(s):

Controlled Trial ◽

Pain Syndrome ◽

The Other ◽

Short Term ◽

Randomized Controlled ◽

Group A ◽

Laser Group ◽

Group B ◽

Single Blind ◽

Post Therapy

Introduction: In this study, a single-blind and randomized controlled trial (RCT) for assessing the effectiveness of high-power (up to 12 W) laser therapy (HPLT) on patients with patellofemoral pain syndrome (PFPS) was carried out. Methods: Forty-four patients were randomly assigned to two treatment groups by generating random numbers with MATLAB 2014b software, where odd and even numbers were attributed to sham laser group (group A) and actual laser group (group B), respectively. Group B patients underwent HPLT with total dose of 300 J/session for 5 consecutive sessions separated by a 2-day interval. On the other hand, sham laser was applied to group A patients. Both groups had the same exercise therapy programs during the study period (3 months). The exercise therapy program included isometric knee exercise for 3 sets per day and 10 times in each set, with duration of 10 seconds per time and straight leg raise for 15 seconds 10 times a day. The group codes of patients were not revealed to subjects and data analyzer until completion of the study. Kujala, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) questionnaires were chosen as outcome measures. These questionnaires were completed at three points during the study; at the beginning of the study to obtain the pre-therapy conditions and one month and three months after the start of the study to evaluate post-therapy conditions. Results: Two main analyses were conducted: within-group and between-group analyses. Withingroup analyses indicated significant improvements in respect to all measurements where pretherapy and post-therapy comparisons were conducted in both groups (P < 0.05). On the other hand, between-group comparisons did not reveal any statistically significant functional difference between group A and group B regarding the evaluative criteria (P > 0.05) except for pain VAS (P < 0.05). Conclusion: This study indicated that short-term HPLT accompanied by appropriate exercise regimen significantly decreased pain in patients with PFPS. But it was not recommended as an efficient modality in functional improvement. Also, it was observed that, in the short-term period of study, HPLT was a safe modality.

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Antibiotic usage rates in bacterial versus nonbacterial diseases: a new way to monitor hospital-acquired infections in children: a retrospective case analysis

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20204540 ◽

2020 ◽

Vol 7 (11) ◽

pp. 2176

Author(s):

Jayendra R. Gohil ◽

Chintu C. Chaudary ◽

Sheena D. Sivanandan

Keyword(s):

Antibiotic Usage ◽

Retrospective Case ◽

Hospital Acquired Infections ◽

Group A ◽

Added Benefit ◽

Reduction Of Mortality ◽

Group B ◽

The Cost ◽

Hospital Acquired ◽

Selection Of

Background: While treating children, the selection of antibiotics, when indicated, should be from the point of its effectiveness, safety, suitability, and cost. However, this flow of action does not take place in all cases. Aim of the study was to assess the antibiotic usage in admitted children and mortality.Methods: The case records between January to July 2012 in children wards was evaluated for the use of antibiotics. Patients were grouped into; group A- ‘must use' antibiotic in all, and group B- where antibiotics are not indicated.Results: There were 1852 admissions, including 719 Thalassemia cases. Antibiotic usage was 63% in 1133 cases after excluding thalassemia. Out of 1133 cases, 423 were in group A and 710 cases were in group B. In group B the antibiotic usage was 41%. The mortality was 6.6% and 4.8% in group A and B. Inside group B, mortality was 5.9% versus 4.0% in those administered versus not administered, antibiotics.Conclusions: There was no increase in mortality in patients in whom antibiotics were not prescribed, and no added benefit of prescribing antibiotics was observed in nonbacterial group B disease patients. The mortality was similar in both the groups. In nonbacterial group B, the antibiotics did not offer any advantage in the reduction of mortality, but increased the cost of the treatment, and possibly the chance of development of drug resistance and adverse events. When analysing the hospital antibiotic usage, only the nonbacterial diseases should be considered to get a true picture of the inappropriate prescription of antibiotics.

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Comparative study of endoscopic tympanoplasty and conventional tympanoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204179 ◽

2020 ◽

Vol 6 (10) ◽

pp. 1804

Author(s):

Priyanka Aggarwal ◽

Barjinder Singh Sohal ◽

J. P. Goyal

Keyword(s):

Success Rate ◽

Cost Effective ◽

Patient Comfort ◽

Hearing Improvement ◽

Post Operation ◽

Group A ◽

Group B ◽

The Cost ◽

Results Of Surgery ◽

Endoscopic Tympanoplasty

Background: To compare the results of endoscopic tympanoplasty with that of conventional tympanoplasty and to evaluate and compare the graft uptake in both of these methods. The study was done to evaluate the improvement in hearing after tympanoplasty and the problems faced while doing the endoscope assisted tympanoplasty.Methods: Between July 2010 to June 2013, 50 patients underwent tympanoplasty, 25 were endoscope assisted (group A) and 25 were microscope assisted (group B). Results of surgery were compared at the end of three and six months post operation.Results: The success rate in terms of graft uptake rate was 88% with endoscope assisted tympanoplasty and 84% with other microscope assisted tympanoplasty. Overall success rate was 86.0%. Mean hearing improvement was (16.24±10.21 dB) and (14.28±7.10 dB) in group A and group B respectively.Conclusions: Tympanoplasty with its visualization of hidden corners, justifies tympanoplasty by using endoscope in selected cases with comparable improved results in the literature. Furthermore, the cost of the endoscope is much less (about 10%) in comparision to operating microscope, making it more cost effective in developing countries. However, the endoscope cannot be employed in every case as one hand is blocked. In terms of Patient comfort, the endoscope assisted outnumbers the benefits of other conventional methods.

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Effects of Allogenic Dermal Fibroblasts on Rotator Cuff Healing in a Rabbit Model of Chronic Tear

The American Journal of Sports Medicine ◽

10.1177/0363546518770428 ◽

2018 ◽

Vol 46 (8) ◽

pp. 1901-1908 ◽

Cited By ~ 9

Author(s):

Jieun Kwon ◽

Yun Hee Kim ◽

Sung-Min Rhee ◽

Tae In Kim ◽

Jimin Lee ◽

...

Keyword(s):

Rotator Cuff ◽

Laboratory Study ◽

Bone Healing ◽

Rabbit Model ◽

Dermal Fibroblasts ◽

The Other ◽

Histological Evaluation ◽

Load To Failure ◽

Group A ◽

Group B

Background: The failure of rotator cuffs to heal after repair is an unresolved surgical issue. There have been substantial efforts, including the use of biological supplements, to enhance tendon healing. Dermal fibroblasts are a good candidate for tendon tissue engineering because they are similar to the tenocytes used for collagen synthesis. In addition, they are easily accessible because autologous dermal fibroblasts can be obtained from individual skin without major skin defects and allogenic dermal fibroblasts (ADFs) have already been commercialized in the field of skin engineering. Purpose: To determine the effects of dermal fibroblasts on tendon-to-bone healing in a rabbit model of a chronic rotator cuff tear. Study Design: Controlled laboratory study. Methods: A total of 33 rabbits were randomly allocated into 3 groups (n = 11 each). Supraspinatus tendons were detached and left for 6 weeks to establish a chronic rotator tear model. Torn tendons were repaired in a transosseous manner with the injection of 5 × 106 ADFs with fibrin in group A, fibrin only in group B, and saline only in group C. At 12 weeks after repair, the mechanical test and histological evaluation were performed. Results: Seven rabbits died before the evaluation (1 in group A, 2 in group B, 4 in group C). In the final evaluation, the mean ± SD load to failure was 48.1 ± 13.3 N/kg for group A, 34.5 ± 8.9 N/kg for group B, and 31.1 ± 8.3 N/kg for group C, and group A showed significantly higher load-to-failure values than the other groups ( P = .011). The midsubstance tear rate, which presented stronger tendon-to-bone healing than insertional tear, was 50.0% in group A, 22.2% in group B, 28.6% in group C, but the differences were not statistically significant ( P = .413). In the histological evaluation, group A showed greater collagen fiber continuity and better orientation than the other groups. Conclusion: This controlled laboratory study verified, on the basis of biomechanics and histology, the potential for the use of ADFs in rotator cuff healing. The current results suggest a new biological supplement to increase the rate of rotator cuff healing. Clinical Relevance: The most important finding of this study was the potential for a new biological supplement to enhance rotator cuff healing—a continuing challenge.

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The Treatment of Wrist Ganglion Cyst by the Chinese Acupotomy and Crisscross Thread

10.21203/rs.3.rs-94895/v1 ◽

2020 ◽

Author(s):

Shuliang Zhang ◽

Bin Xu ◽

Yangjun Lao ◽

Di Lu

Keyword(s):

Recurrence Rate ◽

Ganglion Cyst ◽

Combined Treatment ◽

Vas Score ◽

Ganglion Cysts ◽

Significant Difference ◽

Group A ◽

Group B ◽

The Cost ◽

Open Excision

Abstract Background: The current treatments of wrist ganglion have considerable recurrence rate, we developed a new treatment for ganglion cysts in our clinical practice, which combined acupotomy with crisscross thread method, so we now to compare the clinical effectiveness of Chinese acupotomy and crisscross thread with aspiration followed by injection of steroid and open excision for ganglion cysts treatment. Methods: Recruited patients with wrist ganglion were divided into three groups according to the treatments. Among them, 27 patients who were treated by a new combined treatment of Chinese acupotomy and crisscross thread method in group A, 30 patients who were treated by aspiration followed by steroid injection in group B, and 28 patients who were treated by open excision in group C. The data of age, gender, weight, size of ganglion cysts, visual analogue scale (VAS) , cost were recorded and compared by One-way analysis of variance, followed by an LSD (Least Significant Difference)test. The recurrence rates were recorded were analysed by chi-square test.Results: At the first day and one week after treatment, VAS score of group A was similar to group B with no statistic difference. VAS score of group C was higher than group A and B with statistic difference. Six months later, there was no statistic difference among the three groups about VAS. The recurrence rate was 3.7% in group A and 36.7% in group B and 10.7% in group C. No patient infected in three groups. The cost of group A was more than group B with no statistic difference. The cost of group A was much less than group C with statistic difference.Conclusions: The combination of Chinese acupotomy and crisscross thread method was a simple, economical and effective procedure for wrist ganglion cysts.

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Sequential versus Alternating Regimens in the Treatment of Advanced Breast Cancer

Tumori Journal ◽

10.1177/030089168907500211 ◽

1989 ◽

Vol 75 (2) ◽

pp. 137-140 ◽

Cited By ~ 2

Author(s):

Omar Fernández Giachella ◽

Carlos Gálvez ◽

Carlos Rufino ◽

Adelina Rufino ◽

Federico Morera ◽

...

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Response Rate ◽

Advanced Breast ◽

The Other ◽

Trial Group ◽

Duration Of Response ◽

Group A ◽

Alternate Forms ◽

Group B

With the object of proving whether seqeuntial or alternate forms of chemotherapy would be advantageous one over the other in treating advanced breast cancer and with the purpose of evaluating two different anthracyclines at equimolecular doses in the above-mentioned alternating regimens, 250 patients who had received no prior chemo- or hormonotherapy were entered in a prospective randomized trial. Group A was administered 4-epiadriamycin and cyclophosphamide for 8 courses, followed by 6 cycles of CMF, and medroxyprogesterone acetate (MPA) from the beginning of therapy until progression. In group B, adriamycin + cyclophosphamide were alternated with CMF every two courses until 14 cycles were completed. Group C received 4'-epiadriamycin + cyclophosphamide alternated with CMF for 14 courses. In groups B and C, MPA was administered as in group A. Two hundred and twenty-four patients were evaluated. CR+PR were observed in 55.8 % of group A, 43.4 % of group B, and 46.4 % of group C. Median duration of responses was 16 months (m) in group A, 13 m in group B and 20 m in group C., and median survival (CR + PR) was 16.5 m in group A, 16 m in group B and 24 m in group C. There were no statsitically significant differences among the three groups in terms of response rate, duration of response and survival; furthermore, toxicity was moderate in all groups. At equimolecular doses there were no differences between adriamycin and epirubicin in the alternating schedules.

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Comparison between subcutaneous ketamine with intramuscular pethidine versus intramuscular pethidine for post-operative analgesia after cesarean section

QJM ◽

10.1093/qjmed/hcaa039.039 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

B M E Noureldin ◽

M M Kamal ◽

A A A Bedewy ◽

H M M Sultan

Keyword(s):

Cesarean Section ◽

Total Dose ◽

Pain Control ◽

Well Being ◽

University Hospitals ◽

Common Procedure ◽

Operative Care ◽

Group A ◽

Group B ◽

The Cost

Abstract Background Cesarean section is one of the most common operations. Women undergoing cesarean delivery should achieve adequate postoperative pain relief because of different factors related to the operation complications as well as maternal and neonatal well-being. Immobility due to inadequate pain control could result in thrombo-embolic events, inappropriate neonatal care and delay in discharge which consequently increase the cost of this common procedure both for patients and health care system. Objective to investigate the efficacy of adding subcutaneous ketamine for postoperative analgesia in cesarean section and comparing it to using intramuscular pethidine only regarding opioid requirements and pain level. Patients and Methods The present study was carried out on two groups of women (each group consists of 25) after undergoing cesarean section under spinal anesthesia in Ain Shams University Hospitals and Helwan University Hospitals. Group A patients were given three doses of subcutaneous ketamine (0.9 mg/kg) at post-operative care unit (PACU), 12 and 24 hours after the operation with intramuscular pethidine (50mg) given when patients’ numerical pain score exceeded 5. Group B patients were given three doses of placebo at same intervals as group A and were given intramuscular pethidine (50mg) when NRS score exceeded 5. Results There was significant decrease in pain scores between two groups PACU, 12 and 24 hours postoperative with no significant change in the rest of the study. There was highly significant increase in the time to first pethidine demand in group A than B. There was highly significant decrease in total dose of pethidine given (in group A than in B. Conclusion Subcutaneous ketamine with a dose of (0.9mg/kg) can be used in reducing pain in postoperative period after CS with minimal side effects. The addition of SC ketamine to the pethidine appear to cause more pain control and decrease the total dose of pethidine given in post-operative period.

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