scholarly journals Clinicopathological study and management of biliary stones

2018 ◽  
Vol 5 (4) ◽  
pp. 1296
Author(s):  
Dasari Naresh ◽  
Darshan A. Manjunath ◽  
S. R. Harwal ◽  
Veerabhadra Radhakrishna
Keyword(s):  
Clinical Presentation ◽  
Biliary Colic ◽  
Biliary Stones ◽  
Biliary Calculi ◽  
Biliary Calculus ◽  
Tertiary Center ◽  
Calculus Disease ◽  
One Year ◽  
A Prospective Study ◽  
Hypochondriac Pain

Background: Biliary calculi are one of the most common problems affecting the digestive tract. Need for the study is to evaluate age, sex, incidence, most common etiopathological factors for the formation of biliary calculi and to illustrate varying clinical presentation with various modes of management adopted in the institution as well as to analyse biochemical types of stones prevalent in the region.Methods: A prospective study of 50 patients with clinical diagnosis of biliary colic was conducted in a tertiary center for a period of one year. Clinical presentation, etiology, and management of biliary calculi were studied.Results: Biliary calculi affect most commonly in fourth to the fifth decade with a higher preponderance in females (72%). Right hypochondriac pain is the commonest presentation (84%). Ultrasonography is sensitive and specific, and hence considered the investigation of choice. Open surgical procedures such as cholecystectomy, choledochotomy with T-tube drainage, choledochoduodenostomy were done in these subjects. Postoperative complications such as wound infection noted in 8% of the subjects. Most of the histopathological specimens (90%) revealed chronic cholecystitis.Conclusions: Biliary calculus disease is multifactorial in origin with slight female preponderance. The most common presentation is a right hypochondriac pain. This can be diagnosed accurately with the aid of ultrasonography and Endoscopic Retrograde Cholangio-pancreatography. Biliary calculus is managed according to the location of the calculus, whether intrahepatic or extrahepatic. Most of the patients presented with chronic cholecystitis. 

scholarly journals 66 Short Term Outcomes Following Fragility HIP Fracture in Malaysia

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Hui Min Khor ◽  
Hui Xin Teh ◽  
Fang Chin Tan ◽  
Tharshne Shanmugam ◽  
Sankara C Kumar ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Kuala Lumpur ◽  
Short Term ◽  
Fragility Hip Fracture ◽  
Tertiary Center ◽  
Mortality Outcome ◽  
One Year ◽  
A Prospective Study ◽  
Mobility Status

Abstract Introduction Hip fracture carries huge burden to the older person with 40% of patients unable to walk independently after a year and mortality risk of 30% at one year. The study aims to report short-term outcomes following hip fracture from the experience of a tertiary center in Kuala Lumpur. Methods A prospective study was performed in University of Malaya where consecutive patients admitted to the orthopaedic wards with fragility hip fracture from March 2016 to August 2018 were recruited. Information on basic socio-demographics, comorbidities, functional status, pre and post-operative assessments, and discharge details were recorded. Outcome measures include the ability to return to pre-fracture mobility status and mortality in 6 months post fracture. Results A total of 302 patients with mean age of 79.8 (SD 7.28) years old were included in the study. 276 (91.4%) underwent surgery with mortality rate of 7% in 30days and 14.4% in 6 months. 16.4% of patients underwent surgery within 48hours of admission. Time to surgery was not associated with morbidity or mortality outcome in our study. In 6 months follow up, 23.6% of patients were freely mobile, 27.1% were mobile with one aid, 35.5% required walking frame and 13.8% were immobile. 41.6% of patients managed to regain prefracture mobility status. Multivariate analysis showed that age, length of hospitalization and prefracture mobility statuses were predictors of mobility recovery after hip fracture. Conclusion Fragility hip fracture has devastating consequences from our study. There is an urgent call to improve acute hip fracture care and post-acute care rehabilitation in Malaysia.

scholarly journals Clinical study and management of vesical calculus

2018 ◽  
Vol 5 (4) ◽  
pp. 1281
Author(s):  
Nagaraj Malladad ◽  
Darshan A. Manjunath ◽  
R. Anil ◽  
Veerabhadra Radhakrishna
Keyword(s):  
Clinical Presentation ◽  
Economic Status ◽  
Hard Water ◽  
Important Place ◽  
Vesical Calculus ◽  
Common Presentation ◽  
Pain Abdomen ◽  
Tertiary Center ◽  
Surgical Modality ◽  
A Prospective Study

Background: Vesical calculus accounts for 5% urolithiasis and is the most common urolithiasis in pediatric age. Although incidence has drastically reduced of late, vesical calculi continue to occupy an important place in everyday urological practice. Hence a study was performed to evaluate the clinical presentation and management of vesical calculus.Methods: A prospective study was conducted in the Department of General Surgery in a tertiary center between December 2012 to May 2014.Results: A total of 42 patients with vesical calculi were studied. Males were more affected than females (6:1). Pain abdomen was the most common presentation (71%). Fifty-two percentage patients were using bore well water to drink. Ultrasonography was the most sensitive investigation. All the cases were treated by surgical modality. Fifty percentage cases were treated with transurethral cystolithotripsy using 80-watt holmium laser. Twenty-one percentage cases underwent Percutaneous cystolithotripsy and the remaining 12 (29%) underwent the open suprapubic cystolithotomy. No complication was noted following percutaneous cystolithotripsy. Most of the vesical calculi were of mixed variety with predominant composition being calcium phosphate, calcium oxalate, and uric acid.Conclusions: Vesical calculus most commonly affects children less than ten years. Most of them present with pain abdomen. Low socio-economic status is more affected. Drinking hard water carries a high risk of vesical calculus. Ultrasonography is the investigation of choice in vesical calculus as it is 100% sensitive.

scholarly journals Symptomatic Biliary Pseudolithiasis in Adult Patients Treated with Parenteral Ceftriaxone: A Prospective Study

2020 ◽  
Author(s):  
Sibi Eranki ◽  
Aman Arora ◽  
Vasundhara Singh
Keyword(s):  
Bacterial Infections ◽  
Biliary Colic ◽  
Common Side Effect ◽  
Sonographic Examination ◽  
Abdominal Symptoms ◽  
Long Term Follow Up ◽  
One Year ◽  
Upper Abdominal ◽  
A Prospective Study ◽  
Biliary Pseudolithiasis

Introduction: Ceftriaxone is a frequently used antibiotic in inpatients treated for a number of bacterial infections. Biliary calculi formation called pseudolithiasis is a well-known asymptomatic and reversible complication of this drug. However, a percentage of patients do present with new onset of abdominal symptoms which can be attributable to presence of pseudoliths. Aim: To evaluate incidence of pseudolithiasis in inpatients treated with parenteral Ceftriaxone, to assess resolution of pseudoliths and development of abdominal symptoms attributable to pseudolithiasis on long term follow-up over one year. Materials and Methods: A prospective observational cohort study including all patients admitted at our centre and started on Ceftriaxone. These patients were subjected to sonographic examination on day 1 and day 7 of treatment. Patients who developed pseudolithiasis were prospectively followed-up at one month, three months, six months and one year to assess for resolution or whenever they presented with symptoms. Incidence of pseudolithiasis and complications in patients who developed pseudolithiasis was calculated using standard formulae. Descriptive statistics in terms of numbers and percentages were used. Results: A total of 1490 patients were included in the study from August 2016 till July 2017 and followed for a period of one year (June 2018). The incidence of pseudolithiasis in inpatients treated with parenteral ceftriaxone was 8.7% (131 patients) as observed on Sonographic examination performed on day 7 of therapy. Ten (7.6%) patients had pseudoliths at one month and 1 (0.76%) patient out of these had persistent pseudoliths at all subsequent reviews till one year after diagnosis of the condition. Eleven (8.3%) patients who developed pseudolithiasis during therapy with Ceftriaxone had presented with upper abdominal symptoms suggestive of biliary colic before resolution of pseudolithiasis. Conclusion: Biliary pseudolithiasis is a common side effect of ceftriaxone therapy, occurring in approximately 10% of patients. Biliary colic, cholecystitis and pancreatitis may also result due to these pseudoliths complicating the course of primary illness. Further consultations and interventions like cholecystectomy can be reserved not only to symptomatic individuals but also for those with persistent pseudoliths.

Blood-borne HEV transmission: A one year experience with routine HEV screening at a tertiary center

2018 ◽  
Vol 56 (01) ◽  
pp. E2-E89
Author(s):  
M Lütgehetmann ◽  
J Hiller ◽  
U Denzer ◽  
D Westhölter ◽  
S Peine ◽  
...  
Keyword(s):  
Tertiary Center ◽  
One Year

Evaluation of Breast Lumps by Ultrasound and Correlation with Histological Findings

2020 ◽  
Vol 23 (1) ◽  
pp. 10-12
Author(s):  
Nelema Jahan ◽  
Md. Mamunur Rahman ◽  
Mohammad Shahidul Alam ◽  
Md Saiful Islam
Keyword(s):  
Histopathological Examination ◽  
Breast Diseases ◽  
Histopathological Study ◽  
Common Symptom ◽  
Breast Lump ◽  
Histopathological Findings ◽  
Malignant Breast ◽  
Breast Lumps ◽  
One Year ◽  
A Prospective Study

Background: A breast lump is the most common symptom associated with both benign and malignant breast diseases. Therefore, a distinction of benign from malignant lump is of importance for proper management. Though a definitive diagnosis is possible with imaging for all the lesions, histopathological study is proven essential for confirming the diagnosis. Objective: The objective of this study was to evaluate the role of USG and histopathological findings of different breast lump in diagnosis and their comparison. Methods: A prospective study was conducted over a period of one year from January 2017 to December 2017. A total of 116 patients were included in this study. All breast lumps underwent surgery and the ultrasound findings of these lumps were compared with the histopathological findings. Data were collected from these patients by a preformed questionnaire and finally the data were analyzed. Results: Out of 116 patients only 21 cases were reported as malignant in ultrasound report but histopathology revealed 31 malignant patients. On histopathological examination 10 benign cases turned out to be malignant. Conclusion: The present study was undertaken to evaluate in diagnosing breast mass lesions individually by ultrasound and compared with histopathology for definitive management of a patient. Journal of Surgical Sciences (2019) Vol. 23 (1) : 10-12

scholarly journals Ectopic pregnancy in a tertiary care centre of Jharkhand, India

2019 ◽  
Vol 8 (8) ◽  
pp. 2969
Author(s):  
Meetali Parashar ◽  
Meena Mehta
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Previous History ◽  
First Trimester ◽  
Near Miss ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Β Hcg ◽  
A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

The Burden of Reoperations and Timeline of Problems in 1,530 Cases of Mesh-Related Complications

2021 ◽  
pp. 1-8
Author(s):  
Paulo Rodrigues ◽  
Shlomo Raz
Keyword(s):  
Clinical Presentation ◽  
Complex Interventions ◽  
Complete Removal ◽  
Time Frame ◽  
Pelvic Organ ◽  
Pelvic Floor Reconstruction ◽  
Tertiary Center ◽  
Surgical Treatments ◽  
Voiding Dysfunctions ◽  
Clinical Complaint

<b><i>Background:</i></b> Mesh-related complications resulting from pelvic organ prolapse (POP) reconstruction operations may be a devastating experience leading to multiple and complex interventions. <b><i>Objectives:</i></b> The aim of the study was to describe the experience and time frame of management of mesh-related complications in women treated for POP or stress urinary incontinence in a tertiary center. <b><i>Methods:</i></b> 1,530 cases of mesh-related complications were accessed regarding their clinical presentation, number of surgeries, and timeline of surgical treatments to treat multiple clinical complaints until the ultimate operation where all the meshes were removed in a single tertiary center. <b><i>Results:</i></b> The studied population revealed to be a highly referred one with only 10.2% of the cases implanted at our center. Clinical presentation varied widely with 48.7% referring pain as the chief complaint, while 31.3% complained of voiding dysfunctions, 2.5% reported genital prolapses, 2.2% complained of vaginal problems, and 1.2% noted intestinal problems as the main clinical complaint. Only 4.8% of the cases presented mesh erosion at examination; 57.8% of the cases required more than 1 operation to address the mesh-related problems. Sixty-eight cases had more than 10 operations up to complete removal. Three clusters of patients could be identified: (i)–those from whom the mesh was promptly removed after clinical problems emerged, (ii) those with slowly evolving problems, and (iii) those with escalating problems despite treatment attempts. <b><i>Conclusions:</i></b> Mesh-related complications after pelvic floor reconstruction are an evolving disease with diverse clinical presentation. The identified time-related problems and the multiple failed attempts to treat their complications warrant attention with continuous monitoring of these patients and aggressive removal of the mesh if the clinical complaint cannot be swiftly managed.

scholarly journals Zika RNA and Flavivirus-Like Antigens in the Sperm Cells of Symptomatic and Asymptomatic Subjects

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 152
Author(s):  
Hernan Vanegas ◽  
Fredman González ◽  
Yaoska Reyes ◽  
Edwing Centeno ◽  
Jayrintzina Palacios ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Time Frame ◽  
Sperm Cells ◽  
Human Semen ◽  
Zikv Infection ◽  
Virus Shedding ◽  
One Year ◽  
Asymptomatic Subjects ◽  
A Prospective Study ◽  
Male Subjects

Zika virus (ZIKV) RNA has been found to remain in human semen for up to one year after infection, but the presence of Flavivirus antigens in the different compartments of semen has been largely unexplored. Following the introduction of ZIKV in Nicaragua (2016), a prospective study of patients with clinical symptoms consistent with ZIKV was conducted in León to investigate virus shedding in different fluids. ZIKV infection was confirmed in 16 male subjects (≥18 years of age) by RT-qPCR in either blood, saliva or urine. Of these, three provided semen samples at 7, 14, 21, 28, 60 and 180 days postsymptom onset (DPSO) for Flavivirus antigens and RNA studies. These cases were compared with 19 asymptomatic controls. Flavivirus antigens were examined by immunofluorescence (IF) using the 4G2 Mabs, and confocal microscopy was used to explore fluorescence patterns. The three (100%) symptomatic subjects and 3 (16%) of the 19 asymptomatic subjects had Flavivirus antigens and viral RNA in the spermatozoa fraction. The percentage of IF Flavivirus-positive spermatozoa cells ranged from 1.9% to 25% in specimens from symptomatic subjects, as compared with 0.8% to 3.8% in specimens from asymptomatic controls. A marked IF-pattern in the cytoplasmic droplets and tail of the spermatozoa was observed. The sperm concentrations (45 × 106/mL vs. 63.5 × 106/mL, p = 0.041) and the total motility percentage (54% vs. 75%, p = 0.009) were significantly lower in specimens from ZIKV-positive than in those of ZIKV-negative. In conclusion, this study demonstrated the presence of Flavivirus antigens and RNA within a time frame of 28 DPSO in sperm cells of symptomatic and asymptomatic subjects during the ZIKV epidemic. These findings have implications for public health, in terms of nonarthropod-born, silent transmission facilitated by sperm cells and potential transmission from asymptomatic males to pregnant women, with consequences to the fetus.

scholarly journals Neuropathic Pain in Children with Sickle Cell Disease: The Hidden Side of the Vaso-Occlusive Crisis

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 84
Author(s):  
Jeanne Sigalla ◽  
Nathalie Duparc Alegria ◽  
Enora Le Roux ◽  
Artemis Toumazi ◽  
Anne-Françoise Thiollier ◽  
...  
Keyword(s):  
Risk Factors ◽  
Neuropathic Pain ◽  
Sickle Cell Disease ◽  
Sex Ratio ◽  
Prospective Study ◽  
Sickle Cell ◽  
Clinical Presentation ◽  
Early Stage ◽  
Cell Disease ◽  
A Prospective Study

The majority of hospitalizations of patients with sickle cell disease (SCD) are related to painful vaso-occlusive crises (VOCs). Although the pain of VOC is classically nociceptive, neuropathic pain (NP) has also been demonstrated in SCD patients. The aim of our study is to specify the prevalence of NP during VOCs in SCD children using a dedicated scale and to measure its characteristics. We performed a prospective study that included SCD children hospitalized for an acute VOC. The presence of NP was sought with the DN4 scale on the second and fourth days of hospitalization. A total of 54 SCD children were included in the study. Overall, 41% of the patients (n = 22) experienced neuropathic pain during the VOC, mostly at an early stage (Day 2). The median age, the sex ratio, the location of the pain, and the morphine consumption were similar for patients with and without NP. Our study shows that neuropathic pain is very common during VOCs in SCD children. The absence of identified risk factors should prompt us to be vigilant regardless of the patient’s age, sex, and clinical presentation.

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