scholarly journals Comparative study between open and laparoscopic lymphadenectomy (pelvic and para-aortic) in gynecological malignancies

2018 ◽  
Vol 5 (5) ◽  
pp. 1657
Author(s):  
Hytham R. Yassin ◽  
Soliman ALShakhs ◽  
Mohammed Hamed ◽  
Adel Karam ◽  
Mohammed Mouneer
Keyword(s):  
Comparative Study ◽  
Radical Surgery ◽  
Safe Procedure ◽  
Gynecological Malignancies ◽  
Number Of Patients ◽  
Significant Difference ◽  
Operative Complications ◽  
Group 2 ◽  
Group 1

Background: Objective of present study was to compare the results of lymphaenectomy (pelvic and para-aortic) between laparoscopy and laparotomy in gynecological malignancies.Methods: Authors analyze the results of 30 patients suffering from gynecological malignancies (Enometrial, Ovarian and cervical) submitted to surgery as apart of treatment. Patients were classified in Two Groups Group (1) included15 patients were submitted to open radical surgery and group (2) included 15 patients Were submitted to laparoscopic radical surgery between May 2016 and October 2017.Results: In present comparative study, there was significant difference regarding intra operative blood loss, operative time and post operative hospital stay (P<0.001) and there was no significant difference regarding intra-operative complications, post-operative complications, total number of lymph node harvested, number of positive lymphnodes (P>0.05).Conclusions: Laparoscopic lymphadenectomy is a technically feasible and safe procedure. Authors recommend further study in large number of patients with longer duration and follow up period for assessment of oncological out-come.

scholarly journals Scanning Electron Microscopy Analysis of the Anterior Capsulotomy Edge: A Comparative Study between Femtosecond Laser-Assisted Capsulotomy and Manual Capsulorhexis

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Daniele Tognetto ◽  
Chiara De Giacinto ◽  
Alberto Armando Perrotta ◽  
Tommaso Candian ◽  
Alessandro Bova ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Femtosecond Laser ◽  
Comparative Study ◽  
Surface Irregularity ◽  
Significant Difference ◽  
Group 2 ◽  
Cut Surface ◽  
Scanning Electron ◽  
Group 1

Purpose. To compare the capsule edges ultrastructure obtained by two femtosecond laser-assisted cataract surgery (FLACS) platforms and manual continuous curvilinear capsulorhexis (CCC) using scanning electron microscopy (SEM). Setting. Eye Clinic, University of Trieste, Italy. Design. Experimental comparative study. Methods. 150 anterior capsules were collected and divided into three groups as follows: Group 1 (50 capsules) obtained with manual CCC, Groups 2 and 3 (each with 50 capsules) obtained with the Catalys Laser and the LenSx Laser, respectively. All samples were imaged by means of SEM and regularity of the cut surface, and thickness of the capsule edge were evaluated and compared. Results. All femtosecond laser (FSL) capsules were perfectly circular, whereas some alteration of the circular shape was observed in the manual ones. Group 1 showed a smooth and regular capsule edge without any surface irregularity, conversely Groups 2 and 3 showed postage-stamp perforations on the capsule edge. The cut surface irregularity value in Group 2 was 1.4 ± 0.63, while it was 0.7 ± 0.49 in Group 3 (p<0.05). Group 1 had a significantly lower thickness of the capsule edge than the FSL groups (p<0.05). No statistically significant difference in the capsule edge thickness between the FSL groups was found (p=0.244). Conclusions. Despite the presence of slight cut surface irregularities, both FSL capsulotomies showed a better geometry and circularity than the manual ones. Capsulotomy specimens obtained using both FSL capsulotomies showed laser-induced alterations of the capsule edge when compared with smooth and regular edges obtained using manual CCC.

scholarly journals Effects of posterior tibial slope on the mid-term results of medial unicompartmental knee arthroplasty

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Zhijie Chen ◽  
Kaizhe Chen ◽  
Yufei Yan ◽  
Jianmin Feng ◽  
Yi Wang ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Tibial Slope ◽  
Posterior Tibial ◽  
Significant Difference ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Group 3 ◽  
Group 2 ◽  
Postoperative Knee ◽  
Group 1

Abstract Objective To evaluate the effect of medial posterior tibial slope (PTS) on mid-term postoperative range of motion (ROM) and functional improvement of the knee after medial unicompartmental knee arthroplasty (UKA). Methods Medical records of 113 patients who had undergone 124 medial UKAs between April 2009 through April 2014 were reviewed retrospectively. The mean follow-up lasted 7.6 years (range, 6.2–11.2 years). Collected were demographic data, including gender, age, height, weight of the patients. Anteroposterior (AP) and lateral knee radiographs of the operated knees were available in all patients. The knee function was evaluated during office follow-up or hospital stay. Meanwhile, postoperative PTS, ROM, maximal knee flexion and Hospital for Special Surgery (HSS) knee score (pre−/postoperative) of the operated side were measured and assessed. According to the size of the PTS, patients were divided into 3 groups: group 1 (<4°), group 2 (4° ~ 7°) and group 3 (>7°). The association between PTS and the knee function was investigated. Results In our cohort, the average PTS was 2.7° ± 0.6° in group 1, 5.6° ± 0.9° in group 2 and 8.7° ± 1.2° in group 3. Pairwise comparisons showed significant differences among them (p < 0.01). The average maximal flexion range of postoperative knees in each group was 112.4° ± 5.6°, 116.4° ± 7.2°, and 117.5° ± 6.1°, respectively, with significant difference found between group 1 and group 2 (p < 0.05), and between group 1 and group 3 (p < 0.05). However, the gender, age, and body mass index (BMI) did not differ between three groups and there was no significant difference between groups in terms of pre−/postoperative HSS scores or postoperative knee ROM. Conclusion A mid-term follow-up showed that an appropriate PTS (4° ~ 7°) can help improve the postoperative flexion of knee. On the other hand, too small a PTS could lead to limited postoperative knee flexion. Therefore, the PTS less than 4° should be avoided during medial UKA.

The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients

2021 ◽  
pp. 1-7
Author(s):  
Emre Erdem ◽  
Ahmet Karatas ◽  
Tevfik Ecder
Keyword(s):  
Serum Ferritin ◽  
Hemodialysis Patients ◽  
Rank Test ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Group 3 ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

<b><i>Introduction:</i></b> The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. <b><i>Methods:</i></b> A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin &#x3c;800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin &#x3e;1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. <b><i>Results:</i></b> Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, <i>p</i> = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; <i>p</i> = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; <i>p</i> = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; <i>p</i> = 0.063). <b><i>Conclusion:</i></b> Time-averaged serum ferritin levels &#x3e;1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.

scholarly journals Impact of percutaneous embolization versus subinguinal microsurgical ligation on semen parameters in primary varicocele patients: comparative study

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Haytham M. Nasser ◽  
Ahmed Hussein ◽  
Gad M. Behairy ◽  
Mostafa Abdo
Keyword(s):  
Sperm Count ◽  
Semen Analysis ◽  
Statistical Significance ◽  
Semen Parameters ◽  
Male Factor ◽  
Percutaneous Embolization ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background Varicocele is an abnormally dilated pampiniform plexus of the veins within the spermatic cord and is considered the most common correctable cause of male factor infertility. Many approaches are described for treatment either surgical (tradition inguinal, subinguinal, and laparoscopic) or non-surgical percutaneous embolization. During the period from August 2017 to December 2018, we prospectively analyzed the preoperative and post-operative alteration of semen parameters (at 3 and 9 months) of the data collected from 63 patients with clinically evident varicocele referred to our tertiary hospital. Patients were divided into two groups: group 1, thirty-three patients who underwent subinguinal microsurgical ligation, and group 2, thirty patients who underwent percutaneous embolization. Results Sixty-three patients enrolled in this study were divided in two groups: group 1, patients who underwent surgery, and group 2, patients who underwent embolization; the mean age is 24.6 ± 1.27 years in group 1 and 23.7 ± 2 years in group 2; there was no statistically significant difference between the two groups as regards BMI, diabetes, hypertension, and smoking. Bilaterality was present in 15.2% of group 1 patients and 10% in group 2 patients (P value 0.06). Most of the patients were classified as grades 2 and 3 with no statistical significance regarding severity of the disease. Preoperative semen parameters for patients including sperm count, motility, and abnormal forms showed no statistically significant difference between the two groups. Post-intervention semen analysis was done twice during follow-up after 3 months and 9 months from the date of intervention. After 3 months, the semen parameters were improved in both groups in spite of the higher sperm count in group 2 but with no statistical significance. After 9 months follow-up, semen analysis showed persistent increase in sperm mobility in group 1 patients in comparison to group 2 patients. Both groups had better improvement in count of normal form with no statistical significant change. Conclusion Improvement of semen parameters while treating primary varicocele by either subinguinal microsurgery approach or percutaneous embolization shows equivalent outcomes.

COMPARATIVE EVALUATION OF RESTORATIVE TREATMENTS ON NON-CARIOUS CERVICAL LESIONS OF COMPOSITE AND GLASS IONOMER CEMENT

2020 ◽  
pp. 38-45
Author(s):  
Duong Nguyen Thi Thuy ◽  
Huong Nguyen Thi Kim
Keyword(s):  
Glass Ionomer Cement ◽  
Glass Ionomer ◽  
Cervical Lesions ◽  
Composite Restorations ◽  
Significant Difference ◽  
Composite Glass ◽  
Group 2 ◽  
Ionomer Cement ◽  
Group 1

Background: Composite and Glass ionomer cement (GIC) are common restorative materials of non carious cervical lesions (NCCLs), which effects are controverisial. The aim of the present study was to compare the result of restorations on NCCLs between Composite and GIC. Materials and Methods: follow-up clinical trial with split-mouth design. Thirty-six patients with 96 NCCLs were divided into 2 groups (n=48/group): Group 1 restored by Composite, Group 2 restored by GIC. The restorations were evaluated at baseline, 1 and 3 months for pulpal sensitivity, restoration morphology and overall success grade. Results: GIC restorations gained 100% Good results for all parameters at 3 time points. Composite showed 87.5%, 93.8% and 97.9% Good results at baseline, 1 and 3 months, sequentially. At 3 weeks recall, 1 Composite restorations (2.1%) showed Moderate results of Retention and 2 Composite restorations (4.2%) changed colour. Conclusions: There was no statistically significant difference seen among the three groups for 3 parameters. Key words: non-carious cervical lesion, Composite, Glass ionomer cement

scholarly journals Comparison of Changes in Number of Hyperreflective Dots After İntravitreal Ranibizumab or Dexamethasone İmplant in Patients with Branch Retinal Vein Occlusion

2021 ◽  
Author(s):  
Aylin Karalezli ◽  
Sema Kaderli ◽  
Ahmet Kaderli ◽  
Cansu Kaya ◽  
Sabahattin Sul
Keyword(s):  
First Year ◽  
Intravitreal Ranibizumab ◽  
Retinal Layers ◽  
Vein Occlusion ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Purpose: To compare the effect of intravitreal ranibizumab (IVR) or intravitreal dexamethasone implants (IVD) on regression of hyperreflective dots (HRDs) on optical coherence tomography (OCT) B-scan in patients with branch retinal vein occlusion (BRVO). Methods: 37 eyes of 37 patients with cystoid macular edema who received IVR or IVD and followed up for at least 12 months were included in this study. The patients were divided into three groups according to intravitreal treatment. Group 1 consisted of 12 eyes who received only IVD, group 2 consisted of 10 eyes who received only IVR on a pro re nata and group 3 consisted of 15 eyes who received both IVD and IVR. OCT parameters (CMT, number of HRDs, status of external limiting membrane (ELM) and ellipsoid zone (EZ)) and best-corrected visual acuity (BCVA) were compared between the groups over the follow-up time. HRDs were categorized as HRD in inner retinal layers (from the internal limiting membrane to the inner nuclear layer) or HRD in outer retinal layers (from the outer plexiform layer to the outer border of the photoreceptor layer).Results: There was no significant difference between groups in terms of BCVA, CMT, HRDs in the inner and the outer retinal layers at baseline visit. (p˃0.05 for all) Comparing the baseline values in all groups, a significant decrease was observed in CMT in the first year. (For group 1; p=0.013, group 2; p=0.010; group 3, p<0.001) The BCVA was significantly increased after 1 year in all groups. (p=0.001, p=0.006, p<0.001) The mean number of HRDs in inner and outer retinal layers were significantly decreased in group 1 and group 3. (For group 1; p<0.001, p=0.001, for group 3; p<0.001, p<0.001) However, there was no significant difference in terms of the mean number of HRDs in inner and outer retinal layers for group 2. (p=0.134, p=0.477) At the first year, the number of HRDs in inner and outer retinal layers was significantly lower in group 1 and group 3 than group 2. (For inner HRDs; group 1 vs. group 2 p=0.007, group 2 vs. group 3 p<0.001. For outer HRDs group 1 vs. group 2 p<0.001, group 2 vs. group 3 p<0.001.) The BCVA was higher in group 3 than group 2 at 1year. (p=0.048). There was no significant difference in terms of post-treatment CMT and the number of HRDs between group 1 and group3 in posthoc tests (p=0.621, p=0.876, and p=0.632).Conclusion: The reduction in HRDs at 12 months and better BCVA after IVD intimates that the HRDs should be considered as inflammatory markers in the follow-up of CME in BRVO. Thus, IVD injection could be more appropriate for patients with higher HRDs after BRVO.

scholarly journals Long-term outcome of endocardial-only versus combined endocardial-epicardial homogenization of the scar for treatment of ventricular tachycardia in patients with ischemic cardiomyopathy

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Mohanty ◽  
C Trivedi ◽  
D G Della Rocca ◽  
C Gianni ◽  
B MacDonald ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Ischemic Cardiomyopathy ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Long Term Outcome ◽  
Obstructive Sleep ◽  
Number Of Patients ◽  
Group 2 ◽  
Group 1

Abstract Introduction We investigated the ablation success of scar homogenization with combined (epicardial + endocardial) versus endocardial-only approach for ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) at 5 years of follow-up. Method Consecutive ICM patients undergoing VT ablation at our center were classified into group 1: endocardial scar homogenization and group 2: endocardial +epicardial scar homogenization. Patients with previous open heart surgery were excluded. All patients underwent bipolar substrate mapping with standard scar settings defined as normal tissue &gt;1.5 mV and severe scar &lt;0.5 mV. Non-inducibility of monomorphic VT was the procedural endpoint in both groups. Patients were followed up twice a year for 5 years with implantable device interrogations. Results A total of 361 (Group 1: 291 and group 2: 70) patients were included in the study (mean age: 67 years, male: 88.4%). At 5 years, significantly higher number of patients from group 2 remained arrhythmia-free (figure 1). Of those patients, 87 (45%) and 51 (89%) from group 1 and 2 respectively were off-anti-arrhythmic drugs (AAD) (p&lt;0.001). After adjusting for age, gender, hypertension, diabetes, and obstructive sleep apnea, scar homogenization using endo-epicardial approach was associated with 51% less recurrence compared to the endocardial ablation strategy (Hazard Ratio: 0.49, 95% CI: 0.27–0.89, p: 0.02). Conclusion In this series of patients with ischemic cardiomyopathy and VT, endo-epicardial scar homogenization was associated with a lower need for AAD and a significantly lower recurrence rate at 5-years of follow-up compared to the endocardial ablation alone. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

scholarly journals Reduction of the Risk of Relapse of Symptoms When Using Esophagoprotector in Patients Requiring Temporary Cancellation of Antisecretory Therapy

2021 ◽  
Vol 17 (16) ◽  
pp. 26-30
Author(s):  
Yu.A. Kucheryavy ◽  
◽  
P.R. Movtaeva ◽  
D.N. Andreev ◽  
R.I. Shaburov ◽  
...  
Keyword(s):  
Comparative Study ◽  
Underlying Disease ◽  
On Demand ◽  
Long Time ◽  
Prospective Comparative Study ◽  
Group 2 ◽  
Significant Regression ◽  
Risk Of Relapse ◽  
Group 1

Objective: to evaluate the effectiveness of an esophagoprotector in reducing the risk of recurrent symptoms of gastroesophageal reflux disease (GERD) in patients who requiring temporary cancellation of therapy with proton pump inhibitors (PPIs). Material and methods. For the prospective comparative study there were selectively chose patients who had been taking PPIs for a long time (at least one month) for the underlying disease and who required temporary discontinuation of antisecretory therapy due to objective medical reasons. The study included patients with endoscopically and/or pH-metrically verified GERD, as well as histologically verified Barrett's esophagus. In the process of randomization of patients, two equal groups were formed, depending on the therapy received at the time of PPI withdrawal: group 1 received antacids on demand, group 2 received antacids on demand, as well as the esophagoprotector Alfasoxx at a dose of 10 ml four times a day (after each meal and at night). The follow-up period was two weeks. The patients recorded episodes of heartburn in their personal diaries. Results. The study included 60 patients (28 men and 32 women). The average age of the examined patients was 43.1 ± 5.3 years. By the end of the two-week follow-up period, the frequency of recurrent symptoms in group 1 was 36.7%, while in group 2 it was 13.3%. The use of the esophagoprotector Alfasoxx contributed to the significant regression of the risk of heartburn recurrence (odds ratio 0.2657; 95% confidence interval (CI) 0.07328-0.9637; p = 0.0438) in comparison with the group of patients who received only antacids in the on-demand mode. When analyzing the population of patients who had relapsed symptoms, it was demonstrated that the average number of heartburn episodes in group 1 was 6.18 (95% CI 4,1930-8,1706), and in group 2 – 4.50 (95% CI 0,7121-8,2879). Conclusion. This prospective comparative study demonstrated that the use of the esophagoprotector Alfasoxx helps to reduce the risk of relapse of GERD symptoms in patients requiring temporary cancellation of PPI therapy.

scholarly journals Frequency and severity of general surgical emergencies during the COVID-19 pandemic: single-centre experience from a large metropolitan teaching hospital

2020 ◽  
Vol 102 (6) ◽  
pp. 457-462 ◽  
Author(s):  
R Patel ◽  
AJ Hainsworth ◽  
K Devlin ◽  
JH Patel ◽  
A Karim
Keyword(s):  
Teaching Hospital ◽  
General Surgery ◽  
Trauma Centre ◽  
Early Warning Score ◽  
Emergency General Surgery ◽  
Number Of Patients ◽  
Major Trauma Centre ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Introduction The COVID-19 pandemic has put significant stress on healthcare systems globally. This study focuses on emergency general surgery services at a major trauma centre and teaching hospital. We aimed to identify whether the number of patients and the severity of their presentation has significantly changed since the implementation of a national lockdown. Materials and methods This study is a retrospective review of acute referrals (from general practice and accident and emergency) to the emergency general surgery team over a 14-day period before (group 1) and during (group 2) lockdown. Results A total of 151 patients were reviewed by the general surgical team in group 1 and 75 in group 2 (a 50.3% reduction). The number of days with symptoms prior to presentation was significantly shorter in group 1 compared with group 2 (3 vs 4, p = 0.04). There was no significant difference in the National Early Warning Score, white blood cell count, lymphocytes and C-reactive protein on admission between the two groups of patients. There were significantly fewer patients admitted after lockdown compared with pre-lockdown (66% vs 48%, p = 0.01). Length of hospital stay was significantly shorter during lockdown compared with pre-lockdown (5 days vs 4 days, p = 0.04). Conclusion Fewer patients were referred and admitted during lockdown compared with pre-lockdown, and the length of stay was also significantly reduced. There was also a delay in presentation to hospital, although these patients were not more unwell based on the scoring criteria used within this study.

scholarly journals Topical Nitroglycerine Versus Lateral Sphincterectomy for Fissure in Ano: A Hospital Based Comparative Study

2018 ◽  
Vol 16 (2) ◽  
pp. 40-43
Author(s):  
Bimarsh Adhikari ◽  
Sunil Kumar Yadav ◽  
S. N. Gupta
Keyword(s):  
Comparative Study ◽  
College Teaching ◽  
Pain Reduction ◽  
Lateral Sphincterotomy ◽  
Female Ratio ◽  
Benign Condition ◽  
Number Of Patients ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Anal fissure is a common benign condition presenting as severe pain, constipations and bleeding per rectum. It is defined as longitudinal tear or defect in anal canal skin. Surgical treatment of this conditions requires hospital admission and complications, like bleeding, infection and to its severe extent continence disturbances. That warrants a new treatment modality as pharmacological sphincterotomy i. e topical GTN (glycerine trinitrate) whose effects are reversible, cost effective and simple. Objective: The objective is to compare the effectiveness of topical GTN over lateral sphincterotomy in terms of pain management and healing of fissure. Method: This was a comparative study carried out in the department of Surgery at Nepalgunj Medical College, Teaching Hospital. Two groups were created and 25 patients in each group were put randomly. First group (Group 1) used topical GTN whereas second group(Group 2) underwent lateral sphincterotomy for treatment of fissure. The two groups were reassessed at 4 and 8 weeks for pain and fissure healing. Result: Total number of patients was 50. Each group consisted of 25 patients. The male to female ratio in group 1 was 1:1.5 and in group 2 it was 1: 1.8. In group 1 patients after 4 weeks of application of GTN pain reduced from the mean of 80±15 at the time of presentation to 50±9.27. When these patients were seen after 8 weeks, the pain reduction on VAS was nil in 21 patients out of 25. In group 2 the mean score fell from 75±15 to 20±10 after 4 weeks and at 8weeks 23 out of 25 patients didn't have any pain. It was observed that the pain reduction and healing were faster in group 2 patients when evaluated after 4 weeks (p=0.0029). but at the end of 8 weeks both group patients were similar in terms of pain reduction and healing of fissure (p=.28). Conclusion: According to study local GTN application is as effective as lateral sphincterotomy with cost effectiveness, simple with tolerable side effect and no continence disturbances.

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