scholarly journals Safety and feasibility of video assisted thoracoscopic thymectomy for myasthenia gravis: a single centre experience

2019 ◽  
Vol 6 (6) ◽  
pp. 2159
Author(s):  
Raj N. Gajbhiye ◽  
Hemant Bhanarkar ◽  
Vikrant V. Akulwar ◽  
Bhupesh Tirpude ◽  
Niketan Jambhulkar ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Tertiary Care ◽  
Operating Time ◽  
Neurological Outcomes ◽  
Video Assisted ◽  
Single Centre Experience ◽  
The Mean ◽  
A Prospective Study ◽  
Vats Thymectomy

Background: Myasthenia gravis (MG) is an autoimmune disease affecting acetylcholine postsynaptic receptor of voluntary muscles. Thymectomy is a mainstay in the treatment for myasthenia gravis with or without thymoma. For many years transsternal and transcervical thymectomy had been the most common approaches used, video assisted thoracoscopic thymectomy is still not accepted as approach of choice. We intend to study the role of Video assisted thoracoscopic thymectomy for myasthenia gravis in central Indian population.Methods: Study was conducted in single tertiary care institute from January 2015 to November 2018. It is a prospective study. Aims of the study were to evaluate the safety and feasibility of video assisted thoracoscopic thymectomy for patients of myasthenia gravis. All patients of myasthenia gravis who underwent underwent video assisted thoracoscopic thymectomy (VATS) were included in the study. Intraoperative and postoperative details were studied to assess the safety and feasibility of VATS for treatment of myasthenia gravis.Results: 16 patients including 7 men and 9 women with the mean age of 35.5 years were investigated. All patients had myasthenia gravis, 12 pts had thymoma while remaining 4 pts had normal thymus. Mean operating time was 104 mins, Mean intraoperative blood loss was 45 ml (range 20 to 60 ml). There was no major intraoperative or postoperative complication or mortality. Mean ICU stay and hospital stay was 33 hrs and 4.25 days respectively.Conclusions: VATS thymectomy is safe and effective approach for the treatment of MG with or without thymoma. MG treated by VATS resulted in comparable neurological outcomes to those associated with the transsternal approach.

scholarly journals Role of diagnostic hystero-laparoscopy in the evaluation of female infertility

2019 ◽  
Vol 8 (8) ◽  
pp. 3156
Author(s):  
Deepa Shanmugham ◽  
Nambala Divya Sahitya ◽  
Sindhu Natarajan ◽  
Deepak Kannan Saravanany
Keyword(s):  
Tertiary Care ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Tertiary Care Centre ◽  
Male Factor ◽  
Acute Pelvic Inflammatory Disease ◽  
Tubal Factor ◽  
The Mean ◽  
A Prospective Study

Background: Infertility affects about 10-15% of reproductive age couples. The main causes of infertility include male factor, ovulatory disorders, tubal factor and endometriosis. This study was conducted to determine the role of Diagnostic hystero-laparoscopy (DHL) in the evaluation of female infertility.Methods: This study was a prospective study done in a tertiary care centre over a period of 1 year on all infertile couples. The exclusion criteria: male factor infertility, hypothyroidism, hyperprolactinemia, acute pelvic inflammatory disease. Diagnostic hysterolaparoscopy was performed in all study patients in pre ovulatory phase, under general anaesthesia. The findings were then documented and analysed.Results: A total number of 90 patients were recruited for the study. The mean age of the patients was 28±3 years. The mean BMI of the study patients was 25±4 kg/m2. The mean duration of infertility was 5.4 years. On laparoscopy, 28 patients had polycystic ovaries (31.1%), 4 patients had pelvic adhesions (4.4%), 2 patients had endometriosis (2.2%) and tubal block was identified in 10 patients (11.11%). 10 patients had abnormal findings on hysteroscopy.Conclusions: Hystero laparoscopy is an effective diagnostic tool in the evaluation of infertility and has to be included in basic diagnostic workup.

scholarly journals Initial Experience Of Laparoscopic Incisional Hernia Repair

1970 ◽  
Vol 5 (2) ◽  
pp. 41-45
Author(s):  
SK Biswas ◽  
MM Arefin ◽  
JC Saha ◽  
T Ahmed ◽  
MM Rahman
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Laparoscopic Repair ◽  
Operating Time ◽  
Incisional Hernia Repair ◽  
Safe Alternative ◽  
Laparoscopic Incisional Hernia Repair ◽  
Open Mesh Repair ◽  
The Mean ◽  
A Prospective Study

The laparoscopic incisional hernia repair is a safe alternative to open mesh repair. The procedure has the advantages of minimal access surgery and lower recurrence rate. A prospective study of laparoscopic incisional hernia repair of our first 11 patients was performed from July 2008 to December 2009. No serious intraoperative or postoperative morbidity was encountered, only two patients developed seroma. The mean operating time was 90 minutes (60 to 180 minutes). The mean day of discharge after surgery was 3 days (2-7 days). No patient developed a recurrence during mean follow up period of 10 months. Laparoscopic repair of incisional hernia has been shown to be feasible, safe and effective. However, careful patient selection and acquiring the necessary advanced laparoscopic surgical skills coupled with the proper use of equipment are mandatory before embarking on this procedure.Key Words: Incisional hernia; Laparoscopic repair; Mesh; Polypropylene DOI: 10.3329/fmcj.v5i2.6819Faridpur Med. Coll. J. 2010;5(2):41-45

Bilateral Video-Assisted Thoracoscopic Thymectomy vs. Extended Transsternal Thymectomy in Myasthenia Gravis: A Prospective Study

2005 ◽  
Vol 37 (4) ◽  
pp. 199-203 ◽  
Author(s):  
P.C. Chang ◽  
S.H. Chou ◽  
E.L.. Kao ◽  
Y.J. Cheng ◽  
H.Y. Chuang ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Prospective Study ◽  
Video Assisted ◽  
A Prospective Study

Direct and indirect cost of myasthenia gravis: A prospective study from a tertiary care teaching hospital in India

2017 ◽  
Vol 38 ◽  
pp. 114-117 ◽  
Author(s):  
Kamlesh Kumar Sonkar ◽  
Sanjeev Kumar Bhoi ◽  
Deepanshu Dubey ◽  
Jayantee Kalita ◽  
Usha Kant Misra
Keyword(s):  
Myasthenia Gravis ◽  
Prospective Study ◽  
Indirect Cost ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
A Prospective Study

scholarly journals Endoscopic Extraction of CBD Stone: single centre experience in tertiary care centre

2020 ◽  
Vol 9 (1) ◽  
pp. 29-33
Author(s):  
Arun Gnawali ◽  
Rahul Pathak ◽  
Rajesh Pandey ◽  
Prem Krishna Khadga ◽  
Sashi Sharma ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Balloon Catheter ◽  
Tertiary Care Centre ◽  
Initial Attempt ◽  
Cbd Stones ◽  
Single Centre Experience ◽  
Endoscopic Extraction ◽  
Retroperitoneal Perforation ◽  
Cbd Stone ◽  
A Prospective Study

Background and Aims: Introduction: Endoscopic Retrograde Cholangiopancreatography(ERCP) has become the first line treatment for patients with common bile duct (CBD) stones. This technique may fail, however, due to presence of a large stone, multiple stones, periampullary diverticula or CBD stricture. The aim of this study was to evaluate the success of CBD cannulation, Endoscopic Sphincterotomy(EST) and CBD clearance in initial attempt, identify the failures of stone extraction and assess the post-ERCP complications. Methods: A prospective study was carried out over the period of January 2019 to January 2020 on 100 consecutive patients with CBD stones. ERCP was done and the stone size and number recorded. EST was performed using a diathermy unit with a cutting current and stones were extracted using a Balloon catheter or a Dormia basket. Results: Of the 100 patients, 44 were male and 56 were female with mean age of 52}17years. Selective CBD cannulation and cholangiogram was achieved in 90%, EST was successful in 90% and complete stone clearance was achieved in first attempt in 46 patients (59%). 52 patients had difficult CBD stone. There were nine complications, most of which rapidly resolved on conservative treatment (four post-ERCP pancreatitis, three bleeding and one retroperitoneal perforation) and one mortality in an old lady due to PSVT that couldn’t be directly attributed to ERCP. Among patients with Stone less than 15 mm in diameter(n=58), stone was removed successfully in 45 patients(78%) whereas in patients with stones over 15 mm (n=20) only one was removed successfully (5%) at initial attempt. Of these 32 patients with residual stones, 13 were referred for surgery and 19 had insertion of biliary stent to be followed by repeat ERCP. Conclusion: Endoscopic therapy is a simple, effective and safe method of treatment in patients with CBD stone.  

The use of Ligasure Vessel Sealing System in thyroid surgery

2005 ◽  
Vol 132 (3) ◽  
pp. 487-489 ◽  
Author(s):  
Vassilios A. Lachanas ◽  
Emmanuel P. Prokopakis ◽  
Antonios A. Mpenakis ◽  
Alexander D. Karatzanis ◽  
George A. Velegrakis
Keyword(s):  
Postoperative Complications ◽  
Thyroid Surgery ◽  
Operating Time ◽  
Operation Time ◽  
Vessel Sealing System ◽  
Vessel Sealing ◽  
Ligasure Vessel Sealing System ◽  
Primary Means ◽  
A Prospective Study

OBJECTIVES: To evaluate the role of Ligasure Vessel Sealing System (LVSS) (Valleylab, Boulder, CO) in thyroid surgery, with emphasis given to the duration of the procedure, as well as potential relevant postoperative complications. STUDY DESIGN AND SETTINGS: A prospective study was conducted from November 1, 2002 to October 31, 2003, on patients undergoing thyroid surgery with the use of LVSS device as the primary means of ligation. All patients' records were placed in a database. Efficacy of hemostasis, operation time, and postoperative complications were assessed. Results were compared with previous surgical procedures done by our team when the LVSS was not available. RESULTS: LVSS proved effective in providing ligation and hemostasis during thyroid surgery in 72 consecutive patients. There was a mean reduction in operating time of 23 minutes compared with previous surgical thyroid procedures. Transient hypocalcaemia occurred in 4 subjects (5.55%); one incidence of transient paresis of the recurrent laryngeal nerve was also observed. CONCLUSION: LVSS proved quite a reliable and safe device in thyroid surgery; it provided sufficient hemostasis and reducing operative time.

scholarly journals ROLE OF TLC NLR & SERUM CREATININE IN DIAGNOSING ACUTE APPENDICITIS: A PROSPECTIVE STUDY IN A TERTIARY CARE CENTRE

2021 ◽  
pp. 1-3
Author(s):  
Madhu B S ◽  
Shraddha Shenoy
Keyword(s):  
Acute Appendicitis ◽  
Serum Creatinine ◽  
Prospective Study ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cutoff Value ◽  
A Prospective Study ◽  
Complicated Acute Appendicitis

Aim- To assess the role of TLC and NLR and serum creatinine in diagnosing acute appendicitis. Background-Acute appendicitis being the most common surgical emergency globally can lead to varied consequences if not detected and treated accurately. Early and precise biochemical detectors affect the severity of acute appendicitis. Materials and methodology- A prospective study was conducted in K R Hospital, Mysore from 2019-2020. All cases of acute appendicitis during this period were assessed for severity. TLC, NLR and serum creatinine were assessed and correlated with severity of acute appendicitis. Results- A total of 96 patients were included in the study, 72 patients had SAA and 24 had CAA. This was classified in accordance to the cut off values. TC cut off point was 15,050 cells/cumm ,Sn 91.7 %, Sp 74.6%. The NLR cutoff value was 4.56, Sn of 83.3%, Sp of 66.2%. The cutoff value for neutrophil count was 77.6%, Sn 91.7% , Sp 71.18%. The cutoff value for lymphocyte count was 18.2%, Sn was 91.7%, Sp 65.8%. The cutoff value of creatinine was 0.73, Sn of 83.3%, Sp 80.03%. Conclusion- TC, TLC, NLR and Serum creatinine combinedly help distinguishing between the simple acute appendicitis and complicated acute appendicitis and is a very economical measure for the prediction

scholarly journals Analysis of waiting time for elective surgical procedures in neurosurgery department at a tertiary care teaching hospital in NCT, India

2017 ◽  
Vol 5 (10) ◽  
pp. 4538
Author(s):  
Sapna Ramani Sardana ◽  
Shakti Kumar Gupta ◽  
D. K. Sharma ◽  
Aarti Vij ◽  
S. S. Kale
Keyword(s):  
Waiting Time ◽  
Waiting Times ◽  
Tertiary Care ◽  
Operating Time ◽  
Healthcare Providers ◽  
Publicly Funded ◽  
Clinical Criteria ◽  
Elective Surgical Procedures ◽  
Patient Prioritization ◽  
A Prospective Study

Background: Reported increases in waiting times for publicly-funded elective surgeries have intensified the need to decrease wait by healthcare providers and hence the study.Methods: Descriptive study done in neurosurgery department, to ascertain waiting times for its elective surgeries, included a retrospective analysis of admitted post-surgical patients and a prospective study using interviews with relevant stakeholders to do a process mapping.Results: Median time from decision of surgery to actual date of surgery was found to be 110.5 days. It was calculated that for optimum utilization of present available OTs, 19 extra beds are required and to address the existing load of patients waiting for their respective surgeries there is a need of 63 additional beds with 2 additional OTs functioning per day.Conclusions: The most common cause of waiting time was unavailability of vacant beds due to mismatch in demand-supply. The reason for postponement of surgery after admission was found to be lack of availability of theatre time followed by patient not being fit for surgery. Shortage of operating time was due to delayed start of operation theatre time. The study recommends improving admission process, restricting OPD time, standardized patient prioritization depending on relevant clinical criteria.

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