scholarly journals Tunica Vaginalis Thickening, Hemorrhagic Infiltration and Inflammatory Changes in 8 Children with Primary Hydrocele; Reactive Mesothelial Hyperplasia? A Prospective Clinical Study

2018 ◽  
Vol 61 (2) ◽  
pp. 41-46
Author(s):  
Ioannis Patoulias ◽  
Evangelia Rachmani ◽  
Maria Kalogirou ◽  
Kyriakos Chatzopoulos ◽  
Dimitrios Patoulias
Keyword(s):  
Biochemical Analysis ◽  
High Ligation ◽  
Prospective Clinical Study ◽  
Case Group ◽  
Tunica Vaginalis ◽  
Operative Strategy ◽  
One Year ◽  
Operative Findings ◽  
Inflammatory Changes

The aim of this study is to describe an entity of primary hydrocele accompanied with fibrosis, thickening and hemorrhagic infiltration of parietal layer of tunica vaginalis (PLTV). During a 4-year period (2011–2014), 94 boys (2.5–14 years old) underwent primary hydrocele repair. Hydrocele was right sided in 55 (58.5 %), left sided in 26 (28.7%) and bilateral in 12 patients (13.8%). Eighty three out of 94 patients (88.30%) had communicating hydrocele and the rest eleven patients (11.7%) had non-communicating. Our case group consists of 8 patients (8.51%) based on operative findings consistent with PLTV induration, thickening and hemorrhagic infiltration. Preoperative ultrasonography did not reveal any pathology of the intrascrotal structures besides hydrocele. There weren’t hyperechoic reflections or septa within the fluid. Evaluation of thickness of the PLTV was not feasible. Presence of lymph or exudate was excluded after fluid biochemical analysis. Tunica vaginalis histological examination confirmed thickening, hemorrhagic infiltration and inflammation, while there was absence of mesothelial cells. Immunochemistry for desmin was positive, excluding malignant mesothelioma. One patient underwent high ligation of the patent processus vaginalis and PLTV sheath fenestration, but one year later, he faced a recurrence. An elective second surgery was conducted via scrotal incision and Jaboulay operation was performed. The latter methodology was our treatment choice in other 7 out of 8 patients. During a 2-year postoperative follow-up, no other patient had any recurrence. We conclude that in primary hydrocele with macroscopic features indicative of tunica vaginalis inflammation, reversion of the tunica should be a part of operative strategy instead of sheath fenestration, in order to minimize the recurrence.

scholarly journals CLINICAL PRESENTATION AND SURGICAL TREATMENT OF THYROGLOSSAL DUCT ANOMALIES (TGDAS).

1969 ◽  
Vol 1 (2) ◽  
pp. 60-63
Author(s):  
Mahid Iqba ◽  
Sanaullah ◽  
Muhammad Hussain ◽  
Gulshan Hussain ◽  
Sharafat Ali ◽  
...  
Keyword(s):  
Hyoid Bone ◽  
Clinical Presentation ◽  
Histopathological Study ◽  
Neck Swelling ◽  
Socioeconomic Condition ◽  
Thyroglossal Duct ◽  
One Year ◽  
Operative Findings ◽  
Sistrunk Operation

Objectives: To study the profdes of patients presenting with Thyroglossal duct anomalies and the outcomeof their surgical treatment.Study Design: Descriptive.Setting and duration of the study: Saidu Teaching Hospital Saidu Sharif Swat, from November 2005 toNovember 2006.Patients and methods: All patients were admitted through Out- patient department. They were analyzed onthe basis of location, age, sex, clinical presentation, operative findings, surgical procedure performed andduration of follow up. All the operations were done by the fellows of Oto-rhino-laryngology.Diagnosis was based on clinical examination in all cases. Ultrasound was carried out in all the patients tolocalize thyroid gland.Thyroid isotope scan and fistulogram are necessary preoperatively to find outfunctioning ectopic thyroid tissues and to see the extant of the tract. These investigations were not carriedout due to poor socioeconomic condition of the patients. Histopathological study was done in all the casesResults: A total of fifteen patients with clinically suspected thyroglossal duct anomalies were admitted fromNovember 2005 to Nov 2006. Out of the fifteen patients, one was female while the 14 cases were male.Age of the patients ranged from 2-16 years. Ten patients were below 8 years of age while 05 patients wereabove 8 years. Majority (53.5%) presented with neck swelling followed by discharging fistula (33.3%). Allpatients presented with midline swelling except one on the left side. Majority of swellings, i.e. 66% werepresent in the infra-hyoid region, while 26% presented at the pre-hyoid area. Per-operative findingsincludes 07 cases with tract up to the hyoid, 3 up to the tongue base, 3 tract attached to the hyoid bone, oneup to thyro-hyoid membrane, while in one case no tract was found.Conclusion; It is concluded from our study that most of the patients were below 8 years of age; malechildren were predominantly affected and majority of them presented with cystic swelling on one side ofneck.In 10 patients, the anomalies were situated in the infrahyoid region.No recurrence occurred viaperforming standard Sistrunck procedure at one year follow up.Key words; Key words: Thryoglossal duct anomalies, Sistrunk operation

scholarly journals INTRASITE VANCOMYCIN POWDER AS A PROPHYLACTIC ADJUVANT IN LUMBAR FUSION

2016 ◽  
Vol 15 (1) ◽  
pp. 44-47 ◽  
Author(s):  
Jorge Álvaro González Ross ◽  
Alfredo Javier Moheno Gallardo ◽  
Eulalio Elizalde Martínez ◽  
José Manuel Pérez Atanasio ◽  
Ruth Martínez Martínez
Keyword(s):  
Odds Ratio ◽  
Protective Factor ◽  
Lumbar Fusion ◽  
Deep Infection ◽  
Control Group ◽  
Case Group ◽  
Fusion Surgery ◽  
Vancomycin Powder ◽  
One Year

ABSTRACT Objective: To identify whether the use of prophylactic intrasite vancomycin as an adjuvant is a protective factor against deep tissue infection of the surgical site. Methods: Retrospective, descriptive, case-control study evaluating 210 patients, of whom 70 received intrasite vancomycin (case group) and 140 were controls. It was made a follow up for at least one year, reviewing the physical and electronic records. Data were tabulated in spreadsheets (Excel) including all variables and the statistical analysis was made with Epi InfoTM 7 to calculate the odds ratio. Results: Seven cases of deep infection occurred in the control group and none was found in the case group (odds ratio [95% confidence interval]: 0.1262 [0.007-2.24], P = 0.1585). Among the predisposing factors, diabetes and surgical time were the most relevant. Conclusions: Intrasite use of vancomycin has a protective effect against deep infection in patients undergoing lumbar fusion surgery without presenting considerable side effects.

scholarly journals Prospective clinical study of once monthly ibandronate in the treatment of osteoporosis and prevention of fractures in postmenopausal women: Orpheum study

2011 ◽  
Vol 139 (11-12) ◽  
pp. 790-794
Author(s):  
Marko Bumbasirevic ◽  
Aleksandar Lesic ◽  
Ljiljana Denic-Markovic ◽  
Kristina Zivkovic ◽  
Studijska ORPHEUM
Keyword(s):  
Osteoporotic Fractures ◽  
Prospective Clinical Study ◽  
Treatment Of Osteoporosis ◽  
Subsequent Fracture ◽  
Menopausal Women ◽  
History Of ◽  
The Mean ◽  
Multicenter Prospective Observational Study ◽  
One Year

Introduction. Osteoporosis is a serious problem, since about 50% of women over the age of 50 suffer at least one osteoporotic fracture. Objective. The aim of this study was to evaluate compliance as well as the efficiency and safety of ibandronate treatment over a 6-month period in reducing the risk of subsequent fracture in women with postmenopausal osteoporosis. Methods. A multicenter, prospective, observational study was conducted during one year in thirteen medical centres in Serbia. In the first part of the study the participants received ibandronate tablets (150 mg) once a month for six months. In the second part, the patients were under clinical follow-up. Results. The mean age of the 184 menopausal women included in the study was 66.2?9.4 years. In 40.2% of the subjects the disease had been clinically manifest during the five preceding years. The mean T-score value at the onset of our investigation was -3.1?0.84 in 160 (87%) patients who were diagnosed osteoporosis. Compression vertebral fractures alone were noted in 24% of the women, spontaneous nonvertebral fractures in 49.4% and both in 4.9%. A history of osteoporotic fractures was much more common in patients with three or four risk factors (p=0.001). Out of 39 adverse events during therapy with once monthly bisphosphonates only 2 (3.3%) were classified as severe. During the treatment, spontaneous fractures occurred in 13 (7.1%) patients. Conclusion. Ibadronate treatment once a month for 6 months was shown to be very safe, tolerated well and without more serious side effects.

scholarly journals Comparison of postoperative results after implantation of hydrophilic acrylic or hydrophobic acrylic intraocular lens: Data of one-year prospective clinical study

Medicina ◽  
2008 ◽  
Vol 44 (12) ◽  
pp. 936 ◽  
Author(s):  
Reda Žemaitienė ◽  
Martynas Špečkauskas ◽  
Brigita Glebauskienė ◽  
Vytautas Jašinskas
Keyword(s):  
Visual Acuity ◽  
Clinical Study ◽  
Posterior Capsule Opacification ◽  
Intraocular Lenses ◽  
Posterior Capsule ◽  
Prospective Clinical Study ◽  
Single Piece ◽  
One Year ◽  
Hydrophobic Acrylic

Objective. To evaluate and compare the impact of two sharp-edge optic foldable intraocular lenses (IOLs) of similar design made from different material (hydrophilic acrylic or hydrophobic acrylic) on visual function, anterior and posterior capsule opacification at one-year follow-up after cataract phacoemulsification. Material and methods. Seventy-two eyes of 72 patients scheduled for cataract surgery were included in a prospective clinical study. Two foldable sharp-edge optic posterior chamber acrylic IOLs of similar design were used. Thirty-nine eyes of 39 patients received a single-piece hydrophilic acrylic (PC 511, Ophtec) IOL and 33 eyes of 33 patients – single-piece hydrophobic acrylic (AcrySof, SA60AT, Alcon) IOL. Visual acuity, anterior capsule opacification (ACO), capsulorrhexis/optic overlapping, and posterior capsule opacification (PCO) were evaluated. The intensity of ACO was assessed subjectively. PCO values in the entire IOL optic area and in the central 3-mm optic zone were assessed using a photographic image analysis system (EPCO 2000). The patients were examined at one year postoperatively. Results. There were no significant differences in best-corrected visual acuity and capsulorrhexis/optic overlapping between IOL types at 1-year follow-up after surgery. In the single-piece hydrophilic acrylic IOL group, the grade of ACO density was significantly higher in capsulorrhexis rim area (1.56±0.71 and 1.00±0.75) and in the capsule/optic area (1.62±0.67 and 1.00±0.75) (P<0.05). PCO values of the entire IOL optic area (0.12±0.13 and 0.024±0.02) as well as in the central 3-mm optic zone (0.06±0.11 and 0.001±0.003) was significantly higher in the single-piece hydrophilic acrylic IOL group one year postoperatively (P<0.05). In 33.3% of cases of the single-piece hydrophilic acrylic IOL group, contraction of haptics to IOL optics was present one year postoperatively, which was not present in any case of the single-piece hydrophobic acrylic IOL group. Conclusions. One-year follow-up after cataract surgery has shown a significant difference in ACO and PCO development comparing single-piece hydrophilic acrylic and single-piece hydrophobic acrylic intraocular lenses. The effect of hydrophobic acrylic foldable lenses on preventing anterior and posterior capsule opacification is mainly a result of the acrylic hydrophobic biomaterial.

scholarly journals Inguinal Hernia Containing Uterus, Fallopian Tube, and Ovary in a Premature Newborn

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Kıvılcım Karadeniz Cerit ◽  
Rabia Ergelen ◽  
Emel Colak ◽  
Tolga E. Dagli
Keyword(s):  
Fallopian Tube ◽  
High Ligation ◽  
Internal Inguinal Ring ◽  
Incarcerated Hernia ◽  
Processus Vaginalis ◽  
Hernia Sac ◽  
Postoperative Course ◽  
One Year ◽  
Left Inguinal Region

A female infant weighing 2,200 g was delivered at 34 weeks of gestation by vaginal delivery. She presented with an irreducible mass in the left inguinal region at 32 days of age. An ultrasonography (US) was performed and an incarcerated hernia containing uterus, fallopian tube, and ovary was diagnosed preoperatively. Surgery was performed through an inguinal approach; the uterus, fallopian tube, and ovary were found in the hernia sac. High ligation and an additional repair of the internal inguinal ring were performed. Patent processus vaginalis was found during contralateral exploration and also closed. The postoperative course was uneventful. After one year of follow-up, there have been no signs of recurrence.

scholarly journals An open-label prospective clinical study of the efficacy and tolerability of brand-name and generic levetiracetam in the monotherapy of focal epilepsy in adults

2018 ◽  
Vol 10 (1S) ◽  
pp. 12-17 ◽  
Author(s):  
V. A. Karlov ◽  
P. N. Vlasov ◽  
I. A. Zhidkova
Keyword(s):  
Clinical Efficacy ◽  
Focal Epilepsy ◽  
Clinical Results ◽  
Prospective Clinical Study ◽  
Brand Name ◽  
Open Label ◽  
International Nonproprietary Name ◽  
Group 2 ◽  
One Year

Objective: to comparatively evaluate the clinical efficacy and tolerability of monotherapy with levetiracetam (LEV), a brand-name drug (bLEV; Keppra, UCB Pharma, Belgium) and its generic (gLEV;  Epiterra, TEVA, Israel) in adolescent (over 16 years of age) and adult patients with focal epilepsy (FE) during a one-year follow-up period.Patients and methods. The patients were divided into two groups: 1) bLEV (n = 143) and 2) gLEV (n = 63). Group 2 received monotherapy with gLEV at baseline, or was switched to it from  another drug within the international nonproprietary name, or to LEV from monotherapy with another antiepileptic drug (AED) due to  inefficiency and/or poor tolerability. The median doses of bLEV and  gLEV were 1000 and 1500 mg/day, respectively.Results and discussion. The results of the clinical trial suggest that LEV shows high efficacy and excellent tolerance in FE therapy. The clinical efficacy of bLEV and gLEV at 12-month follow-up was  high and amounted to 82.5% for the two dosage forms. The  frequency of adverse events was 17.5% for both bLEV and gLEV. The median dose of LEV was 1000 mg/day for Group 1 and 1500 mg/day for Group 2. Higher LEV doses in Group 2 patients were probably  due to their longer disease duration. All patients taking LEV had an  excellent or good quality of life and, when switched from other AEDs,  showed even an improvement. The comparability of clinical  results suggests that there may be bLEV to gLEV and gLEV to bLEV  switches, especially during forced drug supply disruptions; however,  this substitution should be done only after mandatorily discussing  this matter with the patient and telling him about all possible  consequences of this substitution. 

scholarly journals CLINICAL EVALUATION OF UNSTABLE INTER-TROCHANTERIC HIP FRACTURE BY INTRAMEDULLARY NAIL (PROXIMAL FEMORAL NAIL) - A PROSPECTIVE CLINICAL STUDY

2020 ◽  
pp. 1-3
Author(s):  
Appurv jaiswal ◽  
Rajeev joshi ◽  
Mahendra Panwar
Keyword(s):  
Proximal Femoral Nail ◽  
Prospective Clinical Study ◽  
Trochanteric Fractures ◽  
Level Of Evidence ◽  
Superficial Infection ◽  
Femoral Nail ◽  
Duration Of Surgery ◽  
Hip Screw ◽  
One Year

Introduction Dynamic hip screw and cephalomedullary nails are currently considered as a standard treatment for inter-trochanteric fractures. Although both clinical and biomechanical studies suggest that intramedullary implants have a mechanical advantage over extramedullary implants. We report the results of 118 unstable inter-trochanteric hip fractures internally fixed with proximal femoral nail Materials and methods Between Dec 2013 and Dec 2015, 138 patients with unstable inter-trochanteric fractures were internally fixed with proximal femoral nail.Number of patients requiring open reduction, duration of surgery and hospitalization, post-operative complications, implant-specific complications were recorded in a predefined proforma; serial post-operative radiographs taken. Functional outcomes were assessed according to the Harris Hip scoring (HHS) system. Results: Mean HHS at one year follow up was 93.356 (range-60-100). There were four superficial infection, one lag screw migration in to joint (fixation revised) and one implant failure (converted to hemiarthroplasty). Union was achieved in 117 cases. Fourteen patients expired due to unrelated reasons and six patients could not complete the follow up. Conclusion: We have used proximal femoral nail for fixation of unstable inter-trochanteric fractures with less operative time, good clinico-radiological outcome and low complication rate. Level of evidence: IV

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