scholarly journals Case series: long term experience with different types of hypospadias and its correction by single stage procedure

2018 ◽  
Vol 5 (4) ◽  
pp. 1428
Author(s):  
Amarendra Kumar ◽  
Chandramohan Narayan ◽  
Nameer Faiz
Keyword(s):  
Primary Repair ◽  
Age Groups ◽  
Case Series ◽  
External Genitalia ◽  
Cost Effective ◽  
Single Stage ◽  
Cosmetic Results ◽  
Flap Technique ◽  
Different Types ◽  
Male External Genitalia

Background: Hypospadias is a relatively common congenital defect of the male external genitalia. It is present in approximately 1 in 250 male newborns. Hypospadias, in boys, is defined as an association of three anomalies of the penis: an abnormal ventral opening of the urethral meatus that may be located anywhere from the ventral aspect of the glans penis to the perineum, an abnormal ventral curvature of the penis (chordee), and an abnormal distribution of foreskin with a “hood” present dorsally and deficient foreskin ventrally.Methods: In this study author operated 250 cases of Hypospadias of different types in different age groups during (1992-2017) using MAGPI for glandular, TIP and Flip-flap procedure for distal penile and Ducket Onlay Flap technique for Proximal penile, penoscrotal and perineal Hypospadias. Complicated / Failed Hypospadias was repaired by Trap door technique or Byer’s double tube technique.Results: After the primary repair of Hypospadias fistula was found in 4.5% of patients. Post-operative haemorrhage was seen in 3.2% of patients. Flap Necrosis was found in 8% of patients after Mathieu’s Flip- Flap technique. The success rate of Complicated Hypospadias was quite satisfactory and Meatal Stenosis was seen in 10% of the cases. Over All study has shown superior cosmetic results and one stage repair is cost effective, satisfactory and less psychologically affecting the parents and the patients.Conclusions: MAGPI and its different modifications in the repair for Glandular and Flip-flap or TIP for distal penile in cases of mild or no chordee. Proximal Penile has sufficient Chordee and can be corrected by dorsal plication and urethroplasty by Ducket’s Onlay flap technique. The cost-effectiveness due to single stage repair and its cosmetic results and there least complications prove the efficacy of this protocol. Single stage repair is also beneficial for developing countries like India where the follow-up compliance in the rural patients is extremely poor.

Incudostapedial Rebridging Ossiculoplasty with Bone Cement

2009 ◽  
Vol 141 (2) ◽  
pp. 243-246 ◽  
Author(s):  
Tekin Baglam ◽  
Erkan Karatas ◽  
Cengiz Durucu ◽  
Ali Kilic ◽  
Enver Ozer ◽  
...  
Keyword(s):  
Bone Cement ◽  
Chart Review ◽  
Case Series ◽  
Cost Effective ◽  
Hearing Results ◽  
Tertiary Referral Center ◽  
Different Types ◽  
The Mean ◽  
One Year

OBJECTIVE: The purpose of this study is to evaluate hearing results of our experience with ionomeric bone cement repair of ossicular discontinuity between incus and stapes. STUDY DESIGN: Case series with chart review. SETTING: Tertiary referral center. SUBJECTS AND METHODS: One hundred thirty-six patients who underwent incudostapedial rebridging ossiculoplasty with ionomeric bone cement were included in the study. Preoperative and postoperative audiologic results of incudostapedial rebridging ossiculoplasty with bone cement were evaluated. One year of follow-up is provided. RESULTS: The postoperative air-bone gap was less than 20 dB in 81.6 percent after one year. The mean preoperative and postoperative pure-tone avarages of the patients were 52.82 ± 5.59 and 32.81 ± 7.18 dB, respectively ( P < 0.01). The mean preoperative and postoperative air-bone gaps were 35.83 ± 4.73 and 16.54 ± 5.01, respectively ( P < 0.01). There were no statistically significant differences among the hearing results of different types of surgeries ( P >0.05). No complications in the middle ear related to bone cements were encountered. CONCLUSIONS: Incudostapedial rebridging ossiculoplasty with ionomeric bone cement is a reliable method for ossicular reconstruction that is cost effective and offers satisfactory hearing results in selected patients.

scholarly journals OUTCOME OF SINGLE STAGE SPHINCTER SPARING SCARLESS ( 5S) PROCEDURE FOR RECTOVESTIBULAR FISTULA: A RETROSPECTIVE ANALYSIS

2020 ◽  
Vol 8 (11) ◽  
pp. 34-41
Author(s):  
Muhammad Riaz-Ul-Haq ◽  
◽  
Muhammad Kashif Chishti ◽  
Arsalan Raza Wasti ◽  
Mazhar Jam ◽  
...  
Keyword(s):  
Wide Spectrum ◽  
Case Series ◽  
Cost Effective ◽  
Anorectal Malformations ◽  
Single Stage ◽  
Anal Stenosis ◽  
Paediatric Surgery ◽  
Retrospective Case ◽  
Renal Anomalies ◽  
Vestibular Fistula

Background: Anorectal malformations (ARM) in girls comprise of a wide spectrum of disease ranging from imperforate anus to common cloaca, a complex malformation. Recto-vestibular fistula (RVF) is the commonest ARM in female patients. Many surgical procedures have been mentioned in the literature but trend is changing from staged to single stage procedure. Objectives: To evaluate post operative results of Single Stage Sphincter Sparing Scarless (5S) procedure for RVF. Methods: It is a retrospective case series of 24 patients with RVF who were admitted in the Department of Paediatric Surgery Jinnah Hospital Lahore and the Children Hospital and the Institute of Child Health Multan from October 2018 to September 2019, between 14 days and 4 years of age , underwent single stage sphincter sparing scarless procedure without any colostomy, anterior or posterior midline incision or division of sphincteric complex. Site of neo-anus was marked with the help of muscle stimulator and all surgeries were done under general anesthesia after meticulous gut preparation. Post operatively patients were kept nil per oral for 5 days to avoid wound contamination due to stool. Follow up was done for six months to evaluate outcome. Authors used a new name for single stage procedure. Results: Mean age was 160 days, operative time 78 minutes and hospital stay 6.8 days. 9 (37.5%) patients were diagnosed with some other associated congenital anomalies like congenital heart disease (CHD), renal anomalies, hemisacrum, syndactyly, talipes equino varus(TEV) and Downs syndrome. As a whole 13(24) presented with complication. 4(16.64%) patients presented with constipation, 3(12.5%) excoriation, 2(8.32%) anal stenosis, 2(8.32%) soiling, 1(4.16%) retraction of rectum and 1(4.16%) superficial wound infection. Patient with retraction was planned for re-do surgery, all others were managed conservatively. Conclusion: Single stage sphincter sparing scarless ( 5S) procedure for recto-vestibular fistula is safe, simple and cost effective technique. Patient suffering is minimum, as there is no colostomy, so no multiple surgeries. Complications are minimum and comparable to staged procedure.

Esophageal Atresia and Associated Duodenal Atresia: A Cohort Study and Review of the Literature

2020 ◽  
Author(s):  
Maria Enrica Miscia ◽  
Giuseppe Lauriti ◽  
Dacia Di Renzo ◽  
Angela Riccio ◽  
Gabriele Lisi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Esophageal Atresia ◽  
Primary Repair ◽  
English Literature ◽  
Delayed Diagnosis ◽  
Case Series ◽  
Primary Treatment ◽  
Duodenal Atresia ◽  
Staged Approach ◽  
Missed Diagnosis

Abstract Introduction Esophageal atresia (EA) is associated with duodenal atresia (DA) in 3 to 6% of cases. The management of this association is controversial and literature is scarce on the topic. Materials and Methods We aimed to (1) review the patients with EA + DA treated at our institution and (2) systematically review the English literature, including case series of three or more patients. Results Cohort study: Five of seventy-four patients with EA had an associated DA (6.8%). Four of five cases (80%) underwent primary repair of both atresia, one of them with gastrostomy placement (25%). One of five cases (20%) had a delayed diagnosis of DA. No mortality has occurred. Systematic Review: Six of six-hundred forty-five abstract screened were included (78 patients). Twenty-four of sixty-eight (35.3%) underwent primary correction of EA + DA, and 36/68 (52.9%) underwent staged correction. Nine of thirty-six (25%) had a missed diagnosis of DA. Thirty-six of sixty-eight underwent gastrostomy placement. Complications were observed in 14/36 patients (38.9 ± 8.2%). Overall mortality reported was 41.0 ± 30.1% (32/78 patients), in particular its incidence was 41.7 ± 27.0% after a primary treatment and 37.0 ± 44.1% following a staged approach. Conclusion The management of associated EA and DA remains controversial. It seems that the staged or primary correction does not affect the mortality. Surgeons should not overlook DA when correcting an EA.

The CSF p-tau181/Aβ42 Ratio Offers a Good Accuracy “In Vivo” in the Differential Diagnosis of Alzheimer’s Dementia

2019 ◽  
Vol 16 (7) ◽  
pp. 587-595 ◽  
Author(s):  
Roberto Santangelo ◽  
Alessandro Dell'Edera ◽  
Arianna Sala ◽  
Giordano Cecchetti ◽  
Federico Masserini ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Diagnosis ◽  
Fdg Pet ◽  
Amyloid Β ◽  
Cost Effective ◽  
Daily Clinical Practice ◽  
Different Types ◽  
Experimental Trials ◽  
Csf Findings

Background: The incoming disease-modifying therapies against Alzheimer’s disease (AD) require reliable diagnostic markers to correctly enroll patients all over the world. CSF AD biomarkers, namely amyloid-β 42 (Aβ42), total tau (t-tau), and tau phosphorylated at threonine 181 (p-tau181), showed good diagnostic accuracy in detecting AD pathology, but their real usefulness in daily clinical practice is still a matter of debate. Therefore, further validation in complex clinical settings, that is patients with different types of dementia, is needed to uphold their future worldwide adoption. Methods: We measured CSF AD biomarkers’ concentrations in a sample of 526 patients with a clinical diagnosis of dementia (277 with AD and 249 with Other Type of Dementia, OTD). Brain FDG-PET was also considered in a subsample of 54 patients with a mismatch between the clinical diagnosis and the CSF findings. Results: A p-tau181/Aβ42 ratio higher than 0.13 showed the best diagnostic performance in differentiating AD from OTD (86% accuracy index, 74% sensitivity, 81% specificity). In cases with a mismatch between clinical diagnosis and CSF findings, brain FDG-PET partially agreed with the p-tau181/Aβ42 ratio, thus determining an increase in CSF accuracy. Conclusions: The p-tau181/Aβ42 ratio alone might reliably detect AD pathology in heterogeneous samples of patients suffering from different types of dementia. It might constitute a simple, cost-effective and reproducible in vivo proxy of AD suitable to be adopted worldwide not only in daily clinical practice but also in future experimental trials, to avoid the enrolment of misdiagnosed AD patients.

scholarly journals Atypical presentation of testicular torsion: a case series

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Uzodimma Ejike Onwuasoanya
Keyword(s):  
Physical Examination ◽  
Testicular Torsion ◽  
Age Groups ◽  
Case Series ◽  
Atypical Presentation ◽  
Testicular Pain ◽  
Future Fertility ◽  
Urological Emergency ◽  
High Index Of Suspicion ◽  
Symptoms And Signs

Abstract Background Testicular torsion is a urological emergency and needs urgent intervention to prevent testicular loss and impaired future fertility. It is commonly seen in the neonatal and adolescent age groups. Testicular torsion can also present outside these common age groups with uncommon symptoms and signs. We report case series of patients managed at Lily Hospitals Limited, Warri, Delta State, Nigeria with atypical presentation of testicular torsion. Case Presentation The first patient was a 35-year-old male that presented with recurrent right testicular pain of 1-year duration, described as dull aching with no constitutional symptoms, physical examination findings were not pathognomonic of testicular torsion, he had scrotal exploration with right orchidectomy and left orchidopexy. The second patient was a 39-year-old male who presented with recurrent right testicular pain of 4-days duration, described as dull aching with no constitutional symptoms. Physical examination findings were not classical for testicular torsion, he had scrotal exploration with bilateral orchidopexy. Conclusion Testicular torsion although common in neonatal and adolescent age groups can also present outside these age groups with uncommon symptoms and signs, a high index of suspicion is thus invaluable in any patient presenting with testicular pain despite the age and severity to avoid missing the diagnosis as this can lead to testicular loss.

scholarly journals Autologous Platelet-Rich Fibrin (PRF) as an Adjunct in the Management of Osteoradionecrosis and Medication-Related Osteonecrosis of Jaws. Case Series in A Single Centre

2021 ◽  
Vol 11 (8) ◽  
pp. 3365
Author(s):  
Benjie Law ◽  
Hui Yuh Soh ◽  
Syed Nabil ◽  
Rama Krsna Rajandram ◽  
Abd Jabar Nazimi ◽  
...  
Keyword(s):  
Case Series ◽  
Cost Effective ◽  
Control Group ◽  
Platelet Rich Fibrin ◽  
Tissue Healing ◽  
Number Of Patients ◽  
Short Period ◽  
Oral And Maxillofacial Region ◽  
Surgical Adjunct ◽  
Autologous Platelet

Osteoradionecrosis (ORN) of the jaws and medication-related osteonecrosis of the jaws (MRONJ) are uncommon but serious diseases affecting the oral and maxillofacial region with clinically similar appearance but distinct pathophysiology. Management of ORN and MRONJ is inherently challenging and the treatment outcomes are unpredictable. The use of autologous platelet concentrates (APCs) to promote hard and soft tissue healing is well described in the literature, and the efficacy of leucocyte and platelet-rich fibrin (L-PRF) has been well documented in a number of clinical studies. The aim of this study was to present our treatment strategy and the outcomes of incorporating L-PRF as a surgical adjunct in management of ORN and MRONJ in our centre. Methods: eight cases of ORN and MRONJ were treated with a combination of sequestrectomy and L-PRF as a surgical adjunct. Results: the overall success was 87.5%. Using L-PRF as an adjunct, we were able to predictably manage ORN and MRONJ without causing significant morbidity. Conclusion: our experience shows that L-PRF may be used as a valuable and cost-effective adjunct to surgical management of ORN and MRONJ. However, due to a limited number of patients, and a short period of review, the true effectiveness of the method is yet to be demonstrated in a longer follow-up study including a greater number of patients, besides the inclusion of a control group.

scholarly journals Are the Acute Effects of THC Different in Aging Adults?

2021 ◽  
Vol 11 (5) ◽  
pp. 590
Author(s):  
Raeghan L. Mueller ◽  
Jarrod M. Ellingson ◽  
L. Cinnamon Bidwell ◽  
Angela D. Bryan ◽  
Kent E. Hutchison
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Age Groups ◽  
Young Group ◽  
Self Administration ◽  
Behavioral Measures ◽  
Younger Adults ◽  
Different Types ◽  
Before And After ◽  
Aging Adults

In recent years of expanding legalization, older adults have reported the largest increase in cannabis use of any age group. While its use has been studied extensively in young adults, little is known about the effects of THC in older adults and whether the risks of cannabis might be different, particularly concerning intoxication and cognition. The current study investigated whether age is associated with the deleterious effects of THC on cognitive performance and other behavioral measures before and after ad libitum self-administration of three different types of cannabis flower (THC dominant, THC + CBD, and CBD dominant). Age groups consisted of young adults (ages 21–25) and older adults (ages 55–70). Controlling for pre-use scores on all measures, the THC dominant chemovar produced a greater deleterious effect in younger adults compared with older adults in tests of learning and processing speed, whereas there were no differences between old and young in the effects of the other chemovars. In addition, the young group reported greater cannabis craving than the older group after using the THC chemovar. Consistent with some reports in the preclinical literature, the findings suggest that older adults may be less sensitive to the effects of THC on cognitive and affective measures.

scholarly journals Ethnic Specific body fat percent prediction equation as surrogate marker of obesity in Ethiopian adults

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Makeda Sinaga ◽  
Melese Sinaga Teshome ◽  
Tilhun Yemane ◽  
Elsah Tegene ◽  
David Lindtsrom ◽  
...  
Keyword(s):  
Body Fat ◽  
Age Groups ◽  
Surrogate Marker ◽  
Cost Effective ◽  
Prediction Equation ◽  
Prediction Equations ◽  
Altman Plot ◽  
Cross Sectional ◽  
Bland Altman Plot ◽  
Body Fat Percent

Abstract Background Application of advanced body composition measurement methods is not practical in developing countries context due to cost and unavailability of facilities. This study generated ethnic specific body fat percent prediction equation for Ethiopian adults using appropriate data. Methods A cross-sectional study was carried ifrom February to April 2015 among 704 randomly selected adult employees of Jimma University. Ethnic specific Ethiopian body fat percent (BF%) prediction equation was developed using a multivariable linear regression model with measured BF% as dependent variable and age, sex, and body mass index as predictor variables. Agreement between fat percent measured using air displacement plethysmography and body fat percent estimated using Caucasian prediction equations was determined using Bland Altman plot. Results Comparison of ADP measured and predicted BF% showed that Caucasian prediction equation underestimated body fat percent among Ethiopian adults by 6.78% (P < 0.0001). This finding is consistent across all age groups and ethnicities in both sexes. Bland Altman plot did not show agreement between ADP and Caucasian prediction equation (mean difference = 6.7825) and some of the points are outside 95% confidence interval. The caucasian prediction equation significantly underestimates body fat percent in Ethiopian adults, which is consistent across all ethnic groups in the sample. The study developed Ethnic specific BF% prediction equations for Ethiopian adults. Conclusion The Caucasian prediction equation significantly underestimates body fat percent among Ethiopian adults regardless of ethnicity. Ethiopian ethnic-specific prediction equation can be used as a very simple, cheap, and cost-effective alternative for estimating body fat percent among Ethiopian adults for health care provision in the prevention of obesity and related morbidities and for research purposes.

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