Eyes wide shut: necessity and effect of adjunctive procedures after decompression surgery in patients with endocrine orbitopathy

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Matthias Krause ◽  
Mohammad Kamal ◽  
Dirk Halama ◽  
Thomas Hierl ◽  
Ina Sterker ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Care Center ◽  
Tertiary Care ◽  
Decompression Surgery ◽  
Orbital Decompression ◽  
Endocrine Orbitopathy ◽  
Therapeutic Measure ◽  
Upper Lid ◽  
Surgical Treatments ◽  
Treatment Step

Abstract Background Orbital decompression surgery is frequently the last therapeutic measure in the surgical treatment of endocrine orbitopathy (EO). Additional rehabilitative and corrective surgical treatments are often used to improve the resulting eyelid stigmata, such as an increased lid aperture and scleral show. The aim of the study was to evaluate the effect of adjunctive surgical procedures after orbital decompression surgery in patients with EO. Methods A total of 120 orbitae from 65 patients with EO from 2010 to 2020 at a tertiary care center in Germany were retrospectively evaluated. Ocular surface area (OSA) and vertical palpebral fissures were three-dimensionally analyzed at the following stages: presurgical decompression, postsurgical decompression, and post-adjunctive surgical procedures. For the analysis of vertical palpebral fissures, predefined vertical line distances were measured on the upper and lower lids in the central, medial, and lateral pupillary regions. Results The initial OSA was 2,98 ± 0.85 cm2, and it decreased significantly after decompression surgery to 2.52 ± 0.62 cm2. After adjunct surgical procedures, OSA further decreased to 2,31 ± 0,55 cm2. Furthermore, a statistically significant reduction in all pupillary parameters was noted after each treatment step. More lid-lengthening procedures were performed on the lower lid than on the upper lid. Canthoplasty (n = 13) was the most frequently performed procedure during rehabilitation. Conclusion Surgical decompression surgery improves OSA and leads to a significant reduction in lid aperture. Adjunctive surgical procedures, addressing the upper and lower lid, have a significant influence on the ongoing clinical course and contribute to a reduction in OSA.

scholarly journals Paradigm Shift in Clinical Practice of Sexual Health in Men During COVID-19 Pandemic

2021 ◽  
pp. 263183182110323
Author(s):  
Aditya Prakash Sharma ◽  
Japleen Kaur ◽  
Ravimohan S. Mavuduru ◽  
Shrawan K. Singh
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Surgical Procedures ◽  
Care Center ◽  
Tertiary Care ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Health Seeking ◽  
Number Of Patients ◽  
The Impact

Sexual health-care seeking behavior and practices have been affected during COVID-19 pandemic. The impact of COVID-19 on this subspecialty is far reaching. This study aimed to assess the impact of COVID-19 on health-care seeking practice pertaining to sexual health in men in our tertiary care center and review the relevant literature regarding impact of COVID-19 on sexual health seeking practice and challenges faced. Outpatient data was analyzed from January 2019 to April 2021. Patients awaiting surgical procedures due to COVID were documented. A narrative synthesis of literature based on systematic search using the keywords sexual health, sexual health seeking, sexual health practice, andrology, and COVID with operators “AND” and “OR” was carried out in three search engines PubMed, Scopus, and Embase. The study outcomes were obtained by comparing data of outpatient attendance and compiling the reviewed literature. The mean attendance fell significantly from 95.11±11.17 to 17.25±13.70 persons (P <.0001) per outpatient clinic, March 2020 being the reference point. Teleconsultation has taken over physical consultation. In 98/949 cases, teleconsult could not be provided despite registration. Over 25 patients were waiting for surgical procedures pertaining to andrology due to shut down of elective services. Similar trends have been reported from other countries. Number of patients seeking consultation for sexual health problems has dramatically decreased during COVID-19 era. Establishment of data safe teleconsultation facility and its widespread advertisement is needed to encourage patients to seek consult.

scholarly journals Impact of adenotonsillectomy on acoustic parameters of voice using GRBAS scale in children

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2527-2530
Author(s):  
Adhavan I ◽  
Indu Rajkumar ◽  
Raadhika Shree N
Keyword(s):  
Surgical Procedures ◽  
Care Center ◽  
Tertiary Care ◽  
Voice Quality ◽  
Failure To Thrive ◽  
Upper Respiratory Tract ◽  
Voice Change ◽  
Adenotonsillar Hypertrophy ◽  
Maxillofacial Development ◽  
Tract Infections

Adenoids and tonsils are pharyngeal lymphoid tissue aggregation. Adenotonsillar hypertrophy is usually seen in children. Enlarged adenoid and tonsillar tissue in children causes snoring, sleeping disorders, failure to thrive, frequent upper respiratory tract infections and abnormalities in maxillofacial development. Surgical treatment performed for their removal is termed as adenotonsillectomy. This is one of the most commonly performed surgical procedures in children. The present study was conducted to compare the voice change using the GRBAS scale before and after adenotonsillectomy. This is a prospective study conducted for three months at the Department of Otorhinolaryngology in our tertiary care center. Voice of 35 children with adenotonsillar hypertrophy is analyzed by GRBAS scale in three stages before the surgery, three weeks after surgery and six weeks after surgery. The resulting voice quality improvement is noted in these children after adenotonsillectomy. This study showed that surgical procedures of adenotonsillectomy do not induce drastic adjustments in sound quality and can be performed safely in children. Post-operative voice changes are a significant concern issue among the parents of the children.

scholarly journals Perioperative hypothermia in pediatric patients operated in a tertiary care center: Incidence and correlates

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Osman ESEN ◽  
Gülseren YILMAZ ◽  
Nevin AYDIN
Keyword(s):  
Body Temperature ◽  
Surgical Procedures ◽  
Pediatric Patients ◽  
Care Center ◽  
Tertiary Care ◽  
Fluid Replacement ◽  
Prospective Clinical Study ◽  
Tertiary Care Center ◽  
Body Temperatures ◽  
Perioperative Hypothermia

Background & Objectives: Hypothermia, described as temperature < 35°C, is a frequent condition encountered in patients operated under general anesthesia. It is associated with significant morbidity and mortality. We aimed to estimate its incidence and to investigate the conditions associated with hypothermia in pediatric patients. Methods: This prospective clinical study was carried out in the operating theatre of a tertiary care center between August 2015 and September 2015. A total of 108 pediatric patients who underwent various surgical procedures that lasted for more than 30 minutes were enrolled. Baseline demographic data, types of surgical procedures, duration of operations, preoperative and perioperative body temperatures were recorded. The incidence of hypothermia and its possible correlates were sought. Results: Our series consisted of 108 children (77 males, 71.3%; 31 females, 28.7%) with an average age of 6.08±5.09 years were included in the study. There was no case diagnosed with hypothermia in the preoperative, perioperative and postoperative periods. Patients in American Society of Anesthesiologists classification (ASA) three group had significantly higher preoperative body temperatures compared to those in ASA-1 and ASA-2 groups (p = 0.027). The postoperative body temperature in patients receiving intravenous fluid replacement was significantly lower (p=0.017). Conclusion: For pediatric patients scheduled for surgical interventions, we recommend close monitorization and follow-up of body temperature, implementation of preventive measures to avoid hypothermia and routine perioperative heating. Avoidance of hypothermia may prevent hazardous consequences of postoperative hypothermia. doi: https://doi.org/10.12669/pjms.36.4.456 How to cite this:Esen O, Yilmaz G, Aydin N. Perioperative hypothermia in pediatric patients operated in a tertiary care center: Incidence and correlates. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.456 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals A Study of Surgical Cases During Earthquake Disaster in A Medical College

2019 ◽  
Vol 57 (215) ◽  
Author(s):  
Kanchan K.C ◽  
Raj Kumar Thapa ◽  
Sanubhai Khadka ◽  
Damodar Paudel
Keyword(s):  
Surgical Procedures ◽  
Care Center ◽  
Tertiary Care ◽  
College Teaching ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Female Ratio ◽  
Earthquake Disaster ◽  
Medical College ◽  
Richter Scale

Introduction: An earthquake is an intense shaking of earth’s surface which is caused by movements in earth’s outermost layer. The earthquake of 25th April 2015, with a magnitude of 7.8 richter scale with its major aftershock on 12th May 2015 of 7.3 richter scale claimed around 8,962 lives across several districts of Nepal with 22,302 injuries. In this study we tried to figure out various surgical cases and the surgical procedures performed in a tertiary care hospital during an earthquake disaster.Methods: This study was a descriptive cross-sectional study of hospital data on all admitted surgical cases during an earthquake disaster. A total of 238 earthquake victims brought to emergency department of Kathmandu Medical College Teaching Hospital , a tertiary care center, from 26th April 2015 to 7th Jun 2015, for the period of 42 days were included. Those brought dead and discharged after primary treatments were excluded. Data obtained were entered and analysed in Microsoft Excel 2010.Results: Among 238 patients enrolled, 122 (51%) were male and 116 (49%) female with male to female ratio of 1.05:1. Age group (31-60 years) with an average age of 45 years were encountered most frequently 110 (46%) with the maximum number of patient burden from Sindhupalchowk district 80 (33.6%). Orthopedic surgery 185 (76%) appeared to be the most frequent followed by neurosurgery, plastic surgery, general surgery and dental surgery.Conclusions: In natural disaster like earthquakes, traumatic injuries are very common and thereby various surgical procedures especially ortho-plastic are the domain of treatment modalities. Disaster preparedness and combined surgical team effort needs to be focused to reduce both mortality and morbidity. Keywords: disaster; earthquake; Nepal; surgery.

scholarly journals Orthopedic Implant Removal in the Department of Orthopedics of a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (234) ◽  
Author(s):  
Ravi Bhandari ◽  
Pravakar Dawadi ◽  
Mohit Thapa Magar ◽  
Ritesh Sinha ◽  
Nirab Kayastha ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Implant Removal ◽  
Orthopedic Implant ◽  
Age Group ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Implant removal surgery is one of the common surgical procedures done in orthopedics. Studies report that a major portion of orthopedic surgeries carried out in different institutions comprises implant removal procedures. This can be challenging in limited manpower and infrastructure availability scenarios, like in developing countries like Nepal. This study aims to study the prevalence of orthopedic implant removal procedures carried out among overall surgical procedures in the orthopedic department of a tertiary care center in Nepal. Methods: A descriptive cross-sectional study was performed on the medical records of the department of orthopedics of a tertiary care center after approval from the institutional review committee. The data included records from the starting of 2018 to the end of 2019. Data related to the number of implant removal procedures, types of implants, indications, fracture sites, anesthesia use, gender and age distribution were studied. Statistical Package for Social Sciences version 20 was used to study descriptive data. Results: Out of 2557 orthopedic operations carried out in the study duration, 458 (17.91%) of implant removal procedures were done in the department. The most common age group was the young adult age group, 255 (55.68%). Medium-sized implants were the commonly removed ones, 337 (73.58%). Elective procedures were the most common indication, 369 (80.57%). Conclusions: Implant removal procedures cover a major fraction of overall orthopedic operations carried out by the department, most of which are elective procedures. In limited-resource settings, this can be challenging, and a proper evaluation with counseling could be done before implant removal surgery.

EPIDEMIOLOGY AND OUTCOMES OF ELECTRIC BURN INJURY AT TERTIARY CARE CENTER IN JODHPUR, RAJASTHAN

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Bharti Saraswat ◽  
Ashok Yadav ◽  
Krishna Kumar Maheshwari
Keyword(s):  
Burn Injury ◽  
Low Voltage ◽  
Care Center ◽  
Tertiary Care ◽  
The Body ◽  
Electrical Injury ◽  
Age Group ◽  
Electric Circuits ◽  
Medical College ◽  
Social Burden

Background- Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Methods- This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail. Results- In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury. Conclusion- Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.

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