scholarly journals Improvement in semen parameters after varicocoelectomy

2020 ◽  
Vol 7 (9) ◽  
pp. 2933
Author(s):  
Sandeep Kumar ◽  
Sakshi Singh
Keyword(s):  
Semen Analysis ◽  
Semen Parameters ◽  
Medical College ◽  
Testicular Dysfunction ◽  
Sperm Counts ◽  
Duration Of Disease ◽  
Low Ligation ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Background: Varicoceles are associated with abnormal sperm parameters. The difference is more marked in cases with infertility and higher grades of varicocele. Following ligation of varicocele, there is a significant improvement in the sperm counts.Methods: The study was conducted in the department of general surgery at Maulana Azad Medical College and associated Lok Nayak Hospital from September 2012 to April 2014. The study was conducted on 40 numbers of patients. These were divided into 2 groups, group 1 (n=20) constituted of patients with varicocele who are symptomatic. Group 2 (n=20) constituted of patients with varicocele who are asymptomatic (infertile). All patients were evaluated by clinical examination and Doppler to grade the varicocele. All patients underwent detailed semen analysis. Patients of both the groups underwent FNAC of bilateral testes. The patients with clinical or Doppler detectable varicocele were taken up for low ligation of varicocele. Patients were followed up and all above parameters were repeated about 3 months after surgery.Results: The sperm morphology, counts and motility increase significantly in group 2 patients and sperm counts and morphology increased significantly in group 1 while motility not increased significantly.Conclusions: Most of the patients who presented to us were in the age group of 25-35 years. Longer duration of disease in patient with infertility is also suggestive of the fact that varicocele is a progressive disease and leads to testicular dysfunction over time leading to infertility. Most of the varicoceles were either left sided or bilateral

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.

scholarly journals Contribution of pre-varicocelectomy color Doppler ultrasonography finding to surgery and its correlation with semen parameters

2021 ◽  
Vol 93 (2) ◽  
pp. 227-232
Author(s):  
Caner Ediz ◽  
Muhammed Cihan Temel ◽  
Suna Şahin Ediz ◽  
Serkan Akan ◽  
Serkan Yenigürbüz ◽  
...  
Keyword(s):  
Physical Examination ◽  
Doppler Ultrasonography ◽  
Semen Analysis ◽  
Color Doppler ◽  
Color Doppler Ultrasonography ◽  
Semen Parameters ◽  
Significant Difference ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Background: This study aimed to determine the contribution of color Doppler ultrasonography (CDUS) performed before varicocelectomy to the success of surgical treatment and to evaluate the correlation between CDUS findings and semen parameters. Methods: A total of 84 patients diagnosed with grade 3 left varicocele in our clinic between 2016 and 2018 were evaluated. The patients in whom the decision for varicocelectomy was based on only physical examination (PE) findings and abnormal semen analysis (SA) were defined as Group 1, while the patients undergoing varicocelectomy based on PE, CDUS and SA findings were defined as Group 2. The patients diagnosed with varicocele based on PE and CDUS findings who were included in a followup protocol due to normal semen parameters were defined as Group 3. Results: In Group 1, there was a total of 28 patients and the mean number of ligated internal spermatic veins was 4.53 (range, 2-10). In Group 2, there was a total of 30 patients and the number of ligated internal spermatic veins was 3.76 (range, 1-8). No statistically significant difference was found between Group 1 and 2 in terms of the number of internal spermatic veins ligated during varicocelectomy. No statistically significant correlation was found between semen parameters and the number of veins ligated during varicocelectomy in Group 1 and 2 and between semen parameters and CDUS findings group 2 and 3. Conclusions: In patients with primary grade 3 varicocele, diagnosed by physical examination there is no need for additional imaging in primary cases.

scholarly journals PREVENTION OF POST OPERATIVE INFECTIONS IN EMERGENCY CAESAREAN SECTIONS: ROLE OF SURGICAL BUNDLE AND VAGINAL CLEANING

2021 ◽  
pp. 1-4
Author(s):  
Asma Nagori ◽  
Deeba Khanam ◽  
Shaheen Shaheen ◽  
Meher Rizvi
Keyword(s):  
Caesarean Section ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Infectious Complications ◽  
Medical College ◽  
Antibiotic Regime ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Introduction: Caesarean section (CS) is one of the commonest surgical procedures performed in obstetrics. Postoperative infectious complications including surgical site infections (SSI) are a cause of significant morbidity after CS as compared to vaginal delivery. Aim: To assess the role of application of surgical bundle and vaginal cleaning before caesarean section in preventing postoperative infectious complications. Design: Prospective randomised interventional study. Place and duration of study: Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College and hospital,Aligarh from November 2016 to October 2018. Methodology: Total of 216 patients undergoing emergency CS in the hospital was enrolled in the study. Patients were kept in 2 groups. In group 1, women undergoing emergency C-Section whom conventional preoperative preparation was done using savlon-povidone iodine as skin antiseptic and a 7 day postop prophylactic antibiotic regime was administered.In group 2,surgical bundle and vaginal cleaning was done but postop prophylactic antibiotic regime was reduced to 3 day Results:Overall,SSIs were most common infectious morbidity in both groups with highest incidence in group 1(14.7%) and lower in group 2(7.01%), and the difference was statistically significant. Rates of endometritis, UTI and URTI were similar among 2 groups.Duration of hospital stay was lower for group 2 (6.43+_3.29days).No Significant association was noted between haemoglobin levels <8g/dl and number of >4 vaginal examinations with risk of development of SSI (p<0.05). Conclusion:Bundled approach including vaginal cleaning has decreased the incidence of SSIs after emergency CS but larger clinical studies are needed to prove the definite role

scholarly journals COMPARISON OF POST OPERATIVE CORNEALASTIGMATISM FOLLOWING FROWN VERSUS CHEVRON INCISION IN MANUAL SMALL INCISION CATARACT SURGERY

2020 ◽  
pp. 1-3
Author(s):  
Vabita Bhagat ◽  
Anu Radha Bharti* ◽  
Dinesh Gupta
Keyword(s):  
Cataract Surgery ◽  
Small Incision Cataract Surgery ◽  
Medical College ◽  
Small Incision ◽  
Age Related ◽  
Induced Astigmatism ◽  
The Difference ◽  
Group 2 ◽  
Chevron Incision ◽  
Group 1

Introduction: To study the comparison of post operative corneal astigmatism following frown versus chevron incision in manual small incison in manual small incision cataract surgery. Material and Methods:The study was conducted at govt. medical college jammu over a period of one year. The study includes a total of 100 pts. With age related cataract and were divided into two groups of 50 each. Detailed ocular examination of the cases with calculation of preoperative astigmatism were carried out in eye OPD. Results: st rd th th st All cases were assessed postoperatively at 1 , 3 , 6 and 12 week for surgical induced astigmatism .At the end of 1 week surgical induced astigmatism of more than 1D was seen in 72% pts. of group 1 with frown incision as compared to 48 % in group 2 with chevron incision. At the end of 12 weeks 54% of cases in group 1 with frown incision and only 8% in group 2 with chevron incision had astigmatism of more than 1 D. The difference between the two groups was statistically signicant. Conclusion: It is possible to reduce the amount of postoperative astigmatism signicantly by choosing the incision shape .Surgical induced astigmatism is less seen in patients with chevron incision as compared to patients with frown incision.

Administration of Single-Dose Antibiotic Does Not Decrease Oronasal Fistula Rates After Primary Palatoplasty

2021 ◽  
pp. 105566562199265
Author(s):  
Ishwarya Shradha Mamidi ◽  
Esperanza Mantilla-Rivas ◽  
Brynne A. Ichiuji ◽  
Md Sohel Rana ◽  
Karen I. Ramirez ◽  
...  
Keyword(s):  
Single Dose ◽  
Fistula Formation ◽  
Readmission Rates ◽  
Oronasal Fistula ◽  
Inadequate Sample Size ◽  
Perioperative Antibiotics ◽  
The Difference ◽  
Group 2 ◽  
National Databases ◽  
Group 1

Objective: Oronasal fistula (ONF) is a known complication after primary palatoplasty (PP). Studies investigating the effect of perioperative antibiotics on fistula rates after PP are limited by inadequate sample size or reliance on self-reporting through national databases. In this study, the authors evaluated the association between single-dose perioperative antibiotics and postoperative fistula rates after PP at a single institution. Design: A retrospective study. Participants: Children younger than 2 years who underwent PP from April 2009 to September 2019 were included. Interventions: Patients were divided into 2 categories: Group 1 received a single intraoperative dose of IV antibiotic, while group 2 did not. Main Outcome Measure(s): Outcome measures included ONF formation, length of stay (LOS), and 30-day readmission rates. Multivariable firth logistic regression, quantile regression, and χ2 tests were performed. Results: Of the 424 patients, 215 and 209 patients were in groups 1 and 2, respectively. The overall ONF rate was 1.9% among all patients. Patients in group 1 experienced an ONF rate of 3.3%, while patients in group 2 had an ONF rate of 0.5%. After correcting for confounding variables, the difference in ONF rates was not statistically different ( P = .68). Median LOS was 35.7 hours and 35.5 hours ( P = .17), while the rate of readmission within 30 days was 4.7% and 2.4% for group 1 and 2, respectively ( P = .96). Conclusions: Administration of a single-dose perioperative antibiotic did not decrease fistula formation after PP, nor did it affect the patient’s LOS or 30-day readmission rate.

A volumetric three-dimensional evaluation of invasiveness of an endoscopic and microscopic approach for transmeatal visualisation of the middle ear

2021 ◽  
pp. 1-5
Author(s):  
A H A Baazil ◽  
J G G Dobbe ◽  
E van Spronsen ◽  
F A Ebbens ◽  
F G Dikkers ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Middle Ear ◽  
Three Dimensional ◽  
Endoscopic Approach ◽  
Microscopic Approach ◽  
Significant Difference ◽  
Computed Tomography Scans ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Abstract Objective This study aimed to compare the necessary scutum defect for transmeatal visualisation of middle-ear landmarks between an endoscopic and microscopic approach. Method Human cadaveric heads were used. In group 1, middle-ear landmarks were visualised by endoscope (group 1 endoscopic approach) and subsequently by microscope (group 1 microscopic approach following endoscopy). In group 2, landmarks were visualised solely microscopically (group 2 microscopic approach). The amount of resected bone was evaluated via computed tomography scans. Results In the group 1 endoscopic approach, a median of 6.84 mm3 bone was resected. No statistically significant difference (Mann–Whitney U test, p = 0.163, U = 49.000) was found between the group 1 microscopic approach following endoscopy (median 17.84 mm3) and the group 2 microscopic approach (median 20.08 mm3), so these were combined. The difference between the group 1 endoscopic approach and the group 1 microscopic approach following endoscopy plus group 2 microscopic approach (median 18.16 mm3) was statistically significant (Mann–Whitney U test, p < 0.001, U = 18.000). Conclusion This study showed that endoscopic transmeatal visualisation of middle-ear landmarks preserves more of the bony scutum than a microscopic transmeatal approach.

scholarly journals Neuropsychological development of children with biliary atresia after liver transplantation

2021 ◽  
Vol 23 (3) ◽  
pp. 66-72
Author(s):  
A. V. Syrkina ◽  
I. E. Pashkova ◽  
A. R. Monakhov ◽  
O. V. Silina ◽  
E. V. Chekletsova ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Surgical Treatment ◽  
Biliary Atresia ◽  
Psychomotor Development ◽  
Two Stage ◽  
Neuropsychological Development ◽  
One Stage ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Background. In young children, the most common liver disease leading to transplantation is biliary atresia. Liver transplantation has fundamentally improved the survival rate of children with biliary atresia. Studies on developmental outcomes in children are mostly limited to small samples; there are no such studies in the Russian Federation.Objective: to determine the cognitive outcomes in children undergoing one-stage or two-stage surgical treatment of biliary atresia.Materials and Methods. 83 children were divided into groups: 36 children underwent transplantation without previous surgical interventions (group 1), 47 children underwent the Kasai palliative portoenterostomy (group 2). Inclusion criteria: 24 months of age or younger at the moment of transplantation, no medical history of neurological pathology. All children were examined before transplantation and at 1, 3, 6 and 12 months after liver transplantation. Psychomotor development was assessed using the Griffiths Psychomotor Development Scale for children under 24 months (translated by E.S. Keshishian), the Griffiths Intellectual Development Scale for children aged 2 to 8 years, and the Modified Checklist for Autism in Toddlers, Revised, for children 16-30 months old.Results. All children had developmental delays at the time of transplantation. Up to 50% of the children had signs of cachexia, with a shoulder circumference of less than 3 percentile. Only two children showed obvious hepatic encephalopathy in the form of depressed consciousness. After liver transplantation, 94% of group 1 children recovered their preoperative psychomotor development levels, and only 68% in group 2 made these gains. At 3 and 6 months after transplantation, about 80% of group 1 children showed normal psychomotor development, whereas in group 2, only 61% did. By 12 months after liver transplantation, the difference between the groups was more evident: 83.3% of group 1 children and only 53.2% of group 2 children were developing according to age. The difference between the groups was statistically significant (p < 0.05).Conclusion. Children who received one-stage treatment of biliary atresia and underwent liver transplantation have better neuropsychological development within a year after surgery than children with two-stage surgical treatment.

scholarly journals Accelerated versus conventional Ponseti protocol for the treatment of idiopathic talipes equinovarus deformity: A short term follow up in Iraq

2021 ◽  
Vol 25 (1) ◽  
pp. 473-479
Author(s):  
Jagar Doski ◽  
Berivan Jamal
Keyword(s):  
Ponseti Method ◽  
Congenital Talipes Equinovarus ◽  
Talipes Equinovarus ◽  
The Mean ◽  
Congenital Talipes ◽  
The Difference ◽  
Group 2 ◽  
Accelerated Protocol ◽  
Group 1

Background and objective: The accelerated protocol of Ponseti method was suggested to shorten the period of treatment of the conventional one for the cases of talipes equinovarus deformity. This study aimed to compare the accelerated protocol of Ponseti method in the treatment of clubfoot deformity with the conventional one. Methods: A prospective comparative study was conducted for infants less than six months with congenital talipes equinovarus deformity. The patients were randomized to either Group 1 (casts changed every week, conventional protocol of Ponseti method) or Group 2 (twice weekly, accelerated one). Pirani score was used to assess the severity of the deformity at presentation, at time of last cast removal, and at the last follow up visit (6th months). Results: The patients included were 48 cases with 79 feet. Group 1 (39 clubfeet) had a mean Pirani score of 5.6 (± 1.15) at presentation, which dropped to 0.47 (± 0.41) when the last cast was removed. In Group 2 (40 clubfeet), it dropped from 5.57 (± 0.83) to 0.77 (± 0.01). The result of each treatment protocol was significant, but the difference between them was not significant. Five cases (three patients aged more than three months) of Group 2 needed eight casts to reach an acceptable position of correction. The difference between the mean number of casts applied in Group 1 (5.09) and Group 2 (5.82) was statistically not significant. However, the difference between the mean number of days spent in the cast was significant. The complications occurred in 12 out of 79 feet, with no statistically significant difference between both groups. Conclusion: The accelerated protocol of Ponseti method for treating clubfoot deformity is as effective and as safe as the conventional one. It shortens the time required to complete the treatment program. Those who present lately (beyond the age of three months) may require an additional number of casts. Keywords: Clubfoot; Congenital talipes equinovarus; Ponseti; Accelerated; Cast.

scholarly journals The Impact of Switching from Short-Term Teriparatide Treatment to Denosumab Therapy Compared with Denosumab Alone for Patients with Osteoporotic Hip Fracture: A 1-Year Follow-up Study

2020 ◽  
Author(s):  
Chan Ho Park ◽  
Jun-Il Yoo ◽  
Chang Hyun Choi ◽  
You-Sung Suh
Keyword(s):  
Hip Fracture ◽  
Mineral Density ◽  
Short Term ◽  
Short Term Treatment ◽  
T Score ◽  
The Difference ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Abstract Background: Switching the prescription from bone-forming medication to resorptive agents is reportedly effective for patients with severe osteoporosis. The objective of this study is to determine the impact of implementing short-term teriparatide (TPTD) intervention before denosumab (DMab) therapy compared with DMab therapy alone for 1 year after hip fracture.Methods: TPTD was administered to 24 patients for an average of 12.1 weeks after which the intervention was switched to DMab therapy for 12 months (group 1). DMab alone was administered to 16 patients for 12 months (group 2). Bone mineral density (BMD) was evaluated before and after treatment at the 1-year follow-up. The improvement of BMD and T-score in hip and spine was compared with the levels of bone turnover marker.Results: The difference of hip BMD after osteoporosis treatment was -0.0081±0.03 in group 1 and 0.0074±0.04 in group 2 (p=0.180). The difference of spine BMD was 0.0819±0.04 in group 1 and 0.0145±0.03 in group 2 (p<0.001). BMD and T-score of the spine improved significantly in groups 1 and 2 (p < 0.001). There was no statistical difference in C-terminal telopeptide and osteocalcin level. Conclusion: Short-term TPTD administration followed by DMab alone was effective only in improving spine BMD. Short-term treatment with TPTD caused mild improvement in femur neck BMD compared with DMab alone. However, further research with a longer duration of TPTD treatment is warranted, as our findings lack statistical significance.

scholarly journals The difference in outcome of patients with open inguinal hernia repair by using delayed absorbable sutures instead of non-absorbable sutures for mesh fixation

2020 ◽  
Vol 8 (1) ◽  
pp. 24
Author(s):  
Ali G. Mohammed Redha ◽  
Adil A. Jaber ◽  
Aqeel M. Nasser
Keyword(s):  
Hernia Repair ◽  
Mesh Fixation ◽  
Good Alternative ◽  
P Value ◽  
Absorbable Sutures ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
One Year ◽  
Group 1

Background: Different methods are found for mesh fixation in inguinal hernioplasty both open and laparoscopic. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Whether absorbable instead of non-absorbable sutures can be used still a matter of debate in view of hernia recurrence and post-operative complications.Methods: This is a prospective done on 158 male patients with uncomplicated unilateral inguinal hernias. Two groups of 69 patients were evaluated after periods up to 1 year after open hernioplasty by using delayed absorbable sutures in one group (group 1) and non-absorbable sutures in the other group (group 2) for fixation of mesh.Results: In spite of a noticeable reduction in complication in the group 1 in term of number and percentage when compared with group 2 mainly chronic pain, there is no significant difference (p value>0.05). However, these results are associated with zero recurrence in both groups during a period of one year follow up.Conclusions: Delayed absorbable sutures are good alternative of non-absorbable sutures in open mesh hernia repair associated with less complications and almost no increase in chance of recurrence.  

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