scholarly journals Laproscopic intravesical vesicovaginal fistula repair after removal of an old vaginal drain tube-a rare case

2017 ◽  
Vol 6 (6) ◽  
pp. 2654
Author(s):  
Hafeez Rahman ◽  
Nikita Trehan ◽  
Dhruv P. Gohil ◽  
Ajay Aggarwal
Keyword(s):  
Rare Case ◽  
Vesicovaginal Fistula ◽  
Direct Access ◽  
Drain Tube ◽  
Fistula Repair ◽  
Vaginal Repair ◽  
The Past ◽  
Standard Laparoscopy ◽  
History Of ◽  
Good Exposure

The management of vesicovaginal fistula is difficult and challenging We are presenting a rare case of a 24-year-old unmarried girl with history of vaginoplasty and multiple surgeries done in the past, with a vaginal drain tube kept for 12 years and a Vesicovaginal fistula at the bladder trigone. Patient was successfully treated with a laproscopic Intravesical vesicovaginal Fistula repair. As advances in understanding the etiology of VVF have been made, the laproscopic approach has become the gold standard. Laparoscopy allows an excellent view, good exposure of pelvic structures, provides direct access to the fistula and for repair of complex VVF that may not be amenable to vaginal repair.

scholarly journals Case Report: Migrainous Infarct without Aura

2017 ◽  
Vol 9 (3) ◽  
pp. 241-251
Author(s):  
Kamesh Gupta ◽  
Anurag  Rohatgi ◽  
Shivani Handa
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Report ◽  
Rare Case ◽  
Case Presentation ◽  
The Past ◽  
Need To Evaluate ◽  
History Of ◽  
Complicated Migraine ◽  
Full Investigation

Background: Stroke in a migraine with aura has been documented in several cases, even deserving the merit of a classification as complicated migraine. Herein, we present a rare case of migrainous infarct without aura. The diagnosis was challenging due to lack of risk factors. The patient was unique in not having any other comorbidities. Case Presentation: The case is of a 21-year-old female presenting with right-sided hemiplegia and facial drooping. She had had an index presentation of throbbing headaches for the past 2 years, typical of a migraine but not preceded by any aura symptoms. However, in the current episode, the pain became excessively severe and accompanied by right-sided hemiplegia and facial drooping. A full investigation workup using MRI revealed evidence of infarct in the left temporoparietal and basal ganglion region. Conclusion: Our case highlights the need to evaluate silent ischemic stroke in case of prolonged headache with a history of migraine as well as the need for precaution to avoid the use of triptans or opioids in such a case. It also highlights the conditions that need to be excluded before labeling it as a migrainous infarct.

scholarly journals Repair of Vesicovaginal FistulA: Experiene of 30 Cases and Analysis of Outcome Predictors

2020 ◽  
Vol 22 (2) ◽  
pp. 136-140
Author(s):  
Mrinmoy Biswas ◽  
Sharif Mohammad Wasim Uddin ◽  
Jasmine Sharifa ◽  
Sharmishtha Ghosa ◽  
AKM Musa Bhuiyan ◽  
...  
Keyword(s):  
Vesicovaginal Fistula ◽  
Primary Repair ◽  
Univariate Analysis ◽  
Predictors Of Outcome ◽  
Fistula Repair ◽  
Abdominal Approach ◽  
Ureteric Stenting ◽  
Chi Squared ◽  
History Of ◽  
Individual Variables

Objective:To find out the predictors of outcome of vesicovaginal fistula repair. Method: From 2013 t0 2015,thirty patients with vvf from different hospitals were managed surgically by different approach by single surgeons. During evaluation patients records,the duration of vvf,time of surgical repairs,site of fistulas, positionof fistulas,approach of repairs,ureteric stenting,and catheteruzation were considered. A univariate analysis was used to assess individual variables, by the chi - squared test andsignificant variables found in univariate analysis were considered in a mulivariate analysis. Result: Among 30 cases 90% were successful repair. We consider the following variables to be important risk factors like history of previous repair,timeof surgery,site of fistulas and surgical approach. Conclusion: Earlier correction of vvf, abdominal approach,high variety and primary repair has good outcome. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.136-140

scholarly journals Success Rate of Urogenital Fistula Repair and Predictors of Success-An Audit of Ten Years Data

2018 ◽  
Vol 13 (2) ◽  
pp. 15-18
Author(s):  
Nasira Tasnim ◽  
Kauser Bangash ◽  
Oreekah Amin ◽  
Afshan Batool ◽  
Nosheela Javed
Keyword(s):  
Success Rate ◽  
Vesicovaginal Fistula ◽  
Surgical Repair ◽  
Previous Attempt ◽  
Medical Sciences ◽  
Fistula Repair ◽  
Urogenital Fistula ◽  
History Of ◽  
Repair Attempts ◽  
And Child Health

Aims: To evaluate the association of various predictive factors with the outcome of surgical repair of vesicovaginal fistula. Methods: The retrospective analysis was conducted at Maternal and Child Health, Pakistan Institute of Medical Sciences, Islamabad, and it comprised data related to patients having undergone vesicovaginal fistula repair from January 2008 to June 2018. Statistical analysis of the record was done using SPSS 21 software. Results: A total of 364 patients of urogenital fistula repair were reviewed, with an overall success in 318 (87.4%) cases. There were no significant differences in fistula duration (p0.4), size of fistula (p 0.34) and accessibility (p0.5) between successful and unsuccessful group. However, we found the association between the type of fistula and history of previous repair attempts with the success of fistula repair. Primary surgical repair of vesicovaginal (90.0%), vesicouterine (86%), ureteric (100%) and ureterovaginal (98%) were more successful as compared to repair with the history of 1 previous attempt (90.3%, 83.3%, 66.6% and 75% respectively). Success rate was found to further decrease with the history of more than one repair attempt of vesicovaginal (71.4%) and vesicouterine (66.5%) fistula. Further, successful fistula repair in women was also found to be significantly associated with parity less than 4 (p 0.038). Conclusion: Despite the higher success rate of urogenital fistula repair, it’s important to refer the urogenital fistula patients timely to specialized fistula centres in order to achieve best results.

scholarly journals Primary renal leiomyosarcoma: A rare case report

2021 ◽  
pp. 503-505
Author(s):  
Sudeshna Nandi ◽  
Smritiparna Das ◽  
Chhanda Das ◽  
Madhumita Mukhopadhyay
Keyword(s):  
Abdominal Pain ◽  
Immunohistochemical Staining ◽  
Rare Case ◽  
Past History ◽  
Renal Calculi ◽  
Rare Type ◽  
The Past ◽  
Rare Case Report ◽  
History Of ◽  
The Right

Leiomyosarcoma of the kidney is a rare type of adult renal sarcoma. Here, we presented a case of a 68-year-old female who had a past history of bilateral renal calculi 3 years back with hydronephrotic changes, now presented to the OPD with complaints of abdominal pain for the past few months. On further evaluation, a heterogeneously enhancing necrotic mass was identified in the right kidney measuring 7.5 cm in the greatest dimension. A right radical nephrectomy with left Double J stenting was done. From histopathological and immunohistochemical staining, it was diagnosed as leiomyosarcoma.

scholarly journals A Rare Case of Ossified Chronic Subdural Hematoma Complicated with Tension Pneumocephalus

2019 ◽  
Vol 80 (04) ◽  
pp. e44-e45
Author(s):  
Mehmet Turgut ◽  
Murat Ö. Yay
Keyword(s):  
Subdural Hematoma ◽  
Rare Case ◽  
Chronic Subdural Hematoma ◽  
Epileptic Seizures ◽  
Resonance Imaging ◽  
Microsurgical Technique ◽  
Tension Pneumocephalus ◽  
The Past ◽  
History Of ◽  
The Right

AbstractA 59-year-old man presented with epileptic seizures interpreted as episodic syncope in the past 3 years and the patient had a history of head trauma about 4 years ago. Computed tomography revealed an ossified chronic subdural hematoma involving the right frontotemporoparietal region, which was totally resected using microsurgical technique. Postoperatively, weakness developed in right arm and magnetic resonance imaging revealed a bilateral tension pneumocephalus, which was immediately treated by a left frontal burr hole trepanation, and the patient was discharged uneventfully.

scholarly journals An Adolescent Boy with Acquired Epileptic Aphasia - Landau Kleffner Syndrome: A rare case report

2011 ◽  
Vol 31 (1) ◽  
pp. 57-60
Author(s):  
SR Sharma ◽  
N Sharma ◽  
ME Yeolekar
Keyword(s):  
Rare Case ◽  
Speech Therapy ◽  
Wave Activity ◽  
Abnormal Behavior ◽  
Abnormal Behaviour ◽  
The Past ◽  
Progressive Loss ◽  
Rare Case Report ◽  
History Of ◽  
Clonic Seizures

A 13 year adolescent boy presented with complaints of progressive loss of speech and seizure disorder for the past 1 year. The boy was developmently normal before the onset of illness. There was history of subtle trauma to head. He started communicating with signs followed by paucity of speech progressed to complete aphasia and abnormal behavior in the form of burst of aggressiveness and hyperactivity. Boy had partial, generalized tonic-clonic seizures occurred during sleep. Mental status examination revealed abnormal behaviour, attention deficits, auditory agnosia and aphasia (both expressive and receptive). All relevant investigations including BERA were normal. EEG showed repetitive spikes and wave activity in bilateral parietooccipital regions during nonrapid eye movement. Clinical features and EEG led to a diagnosis of Landau Kleffner Syndrome. He was started on Lamotrigine, steroid and speech therapy. The boy started showing improvement of symptoms in form of understanding of short sentences. Key words: Landau Kleffner Syndrome; EEG; Seizures DOI: 10.3126/jnps.v31i1.3543J Nep Paedtr Soc 2010;31(1):57-60

scholarly journals A Rare Case of Polypoidal Cystitis in Adult without History of Prolong Catheterization

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Mohd Azren ◽  
Mohd Nazli ◽  
Asmah Hanim
Keyword(s):  
Rare Case ◽  
Histopathological Examination ◽  
Obstructive Uropathy ◽  
Transitional Cell ◽  
Urinary Calculi ◽  
Bladder Mucosa ◽  
Indwelling Catheter ◽  
The Past ◽  
Rare Case Report ◽  
History Of

Introduction: Polypoidal cystitis is a rare lesion of the bladder mucosa characterized by benign exophytic inflammation,epithelial proliferation and development of polypoid mass without evidence of neoplasm histologically. Polypoid cystitis is rarely seen in patient without prolong used of indwelling catheter. Other cases of polypoidal cystitis are associated with post-radiation, post chemotherapy bladder reaction, colovesicular fistula are extremely rare. Case Report: 66 year old Malay male ,underlying hypertension and Benign Prostatic Hyperplasia (BPH) on treatment, complaining of difficulty in urination, straining on voiding  for the past 6 months and on and off  hematuria for the past 2 months. He denied any history of CBD insertion or prolong cataheterization. Blood investigations are Normal. X-Ray KUB showed unremarkable. Ultrasound KUB revealed Prostatomegaly, no evidence of renal or ureteric calculi or evidence of Obstructive uropathy,No obvious bladder mass. Cystoscopy Examination (CE)  showed enlarged occlusive prostate and noted bladder growth at base of bladder. The growth is malignant looking however no active bleeding seen. No bladder stone seen. Patient subsequently underwent TransUrethral Resection of Bladder Tumor (TURBT) and Trans-Urethral Resection of Prostate (TURP) in same setting. Intra operatively was uneventful. HistoPathological Examination (HPE) from TURBT specimens showed in favour of Polypoidal Cystitis and  TURP revealed Nodular Hyperplasia. Discussion: Polypoidal Cystitis is a form or chronic cystitis characterized by exophytic inflammatory   lesion of bladder mucosa. The polypoidal mass is mimicking neoplasm. At the initial evaluation, it may be confused with transitional cell carcinoma of the urinary bladder, especially in patient without an indwelling catheter. The most common aetiology of this condition is long-standing indwelling catheterization.. There is also  reported that any factors that irritates the bladder mucosa may result in Polypoidal Cystitis.  In our patient ,there was no history of such other causes, including prolong catheterization, fistula, urinary calculi or radiation therapy.

scholarly journals Iatrogenic Genitourinary Fistula: Changing Trends

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
T Pradhan ◽  
A Agrawal ◽  
MC Regmi
Keyword(s):  
Decision Making ◽  
Retrospective Study ◽  
Work Environment ◽  
Vesicovaginal Fistula ◽  
Emergency Caesarean Section ◽  
Fistula Repair ◽  
Genitourinary Fistula ◽  
Changing Trends ◽  
Increasing Trend ◽  
History Of

Aims: To study the frequency of iatrogenic cause amongst the surgery done for genitourinary fistula and to study the type and cause of iatrogenic genitourinary fistula. Methods: This is a 5 year retrospective study analyses 73 iatrogenic fistulas from 217 women undergoing surgery for genitourinary fistula repair from year 2013 to 2018 on going. The analysis considers frequency and characteristics of type of fistula. Results: Out of 217 genitourinary fistula 73(33.6%) were iatrogenic. Vaginal vault fistulas were 54.7% followed by ureteric fistula 32.8%, vesicovaginal fistula 10.9% and there were 2 iatrogenic RVF. The frequency of surgeries for iatrogenic fistula were found to be in increasing trend towards current years and 83.5% of the iatrogenic fistula were found with history of hysterectomy followed by emergency caesarean section 16.4%.  Conclusions: Women undergoing hysterectomy were under risk for iatrogenic fistula. Optimum work environment is important to reduce surgical error during procedures. Operating training should be emphasized on optimal surgical skills, decision making.

scholarly journals Germs, genomes, and global history in the time of COVID-19

2020 ◽  
Vol 15 (3) ◽  
pp. 350-362
Author(s):  
Kyle Harper
Keyword(s):  
Direct Access ◽  
Evolutionary Relationships ◽  
Global History ◽  
Interdisciplinary Work ◽  
The Past ◽  
Historical Archives ◽  
History Of Disease ◽  
History Of ◽  
Health And Disease

AbstractThe COVID-19 pandemic presents opportunities and challenges for historians working on the global history of health and disease. This article argues that the history of disease will benefit from interdisciplinary work that brings together historians, microbiologists, and archaeologists. Genomes are historical archives, in two complementary ways. Palaeogenomics provide direct access to genomes of the past, while phylogenetics furnish historical insight from evolutionary relationships. Both palaeogenomics and phylogenetics have already contributed enormously to the history of disease, helping us understand how human ecological transformation drives the evolution of our microparasites.

On Writing a History of Quantum Gravity

2020 ◽  
pp. 17-40
Author(s):  
Dean Rickles
Keyword(s):  
General Relativity ◽  
Quantum Theory ◽  
Quantum Gravity ◽  
Life Histories ◽  
Rare Case ◽  
Historical Research ◽  
The Past ◽  
Funding Sources ◽  
History Of

This chapter describes some of the special challenges and novelties facing historical research in quantum gravity. Though often looked at with wry amusement when mentioned in the same breath, “history” and “quantum gravity” fit remarkably well together. Not only is there more than enough in chronological terms, the episodes are closely intertwined with other important developments in the life histories of the ingredient theories, quantum theory and general relativity. However, there are also more sociologically interesting aspects having to do with the emergence of a community of quantum gravity scholars, itself piggybacking on the availability of funding sources. Finally, we note the special status of quantum gravity, historiographically speaking, as a rare case of a field of research with more than a century of history behind it, including within it various rejections and selections of results, and yet which has as yet no experiments of its own, and no final endpoint from which to interpret the past.

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