Dacrocystography: a pre requisite to endoscopic dacrocystorhinostomy

Background: Dacryocystography is a simple radiological procedure in which a radiographic water-soluble dye like iohexal or neohydriol is injected into the lacrimal system and free flow of dye is noted from the eyes into the nose and any restriction in the flow of indicates obstruction and site of the same.Methods: This is a prospective study of role of dacryocystography in 31 cases of dacrocystitis who presented to the ENT outpatient clinic of Dayanand Medical College and Hospital over a period of 1.5 years i.e. from June 2016 to December 2017 who were planned for dacrocystorhinostomy. Patient was placed in dorsal decubitus position and local anaesthesia was administered. No. 15 catheter was connected to a syringe containing contrast medium and its ends are introduced into both lacrimal puncta. Head of the patient is fixed and the contrast medium was administered through both the puncta simultaneously and serial radiographs were obtainedResults: The role of dye study, prior to endoscopic dacrocystorhinostomy dacrocystography was studied in 31 subjects. Of the 22 subjects who underwent surgical intervention, 18 (81.8%) had a complete obstruction while 4 (18.2%) had a partial block.Conclusions: Dacryocystography is a useful and cost-effective investigation to delineate the obstruction in the nasolacrimal system. It aids in confirmation of clinical diagnosis as well as making a diagnosis in doubtful cases.

Download Full-text

Role of magnetic resonance cholangiopancreatography in diagnosing pancreatobiliary pathologies: a prospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20182228 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2233

Author(s):

Dakshayani S. Nirhale ◽

Gaurav C. Kulkarni ◽

Pravin Shingade ◽

Shahaji Chavan ◽

Tejas Sonawane ◽

...

Keyword(s):

Prospective Study ◽

Pancreatic Duct ◽

Treatment Modality ◽

Imaging Modality ◽

Magnetic Resonance Cholangiopancreatography ◽

Medical College ◽

Non Invasive ◽

A Prospective Study ◽

Invasive Techniques

Background: Non-invasive techniques such as ultrasound and CT scan (abdomen and pelvis) are widely used in investigations of pancreaticobiliary disease, though easily available and cheap, have limitations in term of sensitivity. Invasive procedures like ERCP, though considered gold standard for diagnosis of pancreaticobiliary disease, requires highly skilled team of supporting doctors. MR Cholangio Pancreatography (MRCP) is evolving as an effective non-invasive imaging technique for examining patients with pancreatic or biliary diseases. The purpose is to illustrate the findings of MRCP in various abnormalities affecting the pancreaticobiliary diseases. Objective was to study the role of MRCP as non-invasive imaging modality for diagnosis of pancreatobiliary diseases, in diagnosing lower biliary tract pathologies, pancreatic duct pathologies, determining treatment modality in pancreatobiliary diseases, surgical or endoscopicMethods: This is a prospective study conducted in Dr. D. Y. Patil Medical College and Hospital, Pimpri, Pune for a period of two years from July 2015 to September 2017. 60 patients were enrolled in the study, their MRCP was performed following ultrasonography.Results: The MRCP diagnosed the following pathologies- cholelithiasis, choledocholithiasis, CBD stricture, chronic pancreatitis, choledochal cyst, cholangiocarcinoma, pseudocyst of pancreas, sclerosing cholangitis and GB perforation. Out of 60, 32 underwent surgical procedure and 20 underwent endoscopic procedure and 8 were treated medically.Conclusions: MRCP is very accurate in diagnosing CBD and pancreatic duct pathologies. Its helps in deciding the treatment modality for the same. It decides whether the patient requires ERCP and thus cuts down the rate of ‘negative’ ERCP.

Download Full-text

Improving the Management of Acute Adhesive Small Bowel Obstruction with CT-Scan and Water-Soluble Contrast Medium: A Prospective Study

Yearbook of Surgery ◽

10.1016/s0090-3671(10)79709-3 ◽

2010 ◽

Vol 2010 ◽

pp. 251-252

Author(s):

K.E. Behrns

Keyword(s):

Small Bowel ◽

Prospective Study ◽

Ct Scan ◽

Contrast Medium ◽

Small Bowel Obstruction ◽

Water Soluble ◽

Adhesive Small Bowel Obstruction ◽

Water Soluble Contrast ◽

A Prospective Study ◽

Water Soluble Contrast Medium

Download Full-text

Improving the Management of Acute Adhesive Small Bowel Obstruction with CT-Scan and Water-Soluble Contrast Medium: A Prospective Study

Diseases of the Colon & Rectum ◽

10.1007/dcr.0b013e3181b35c06 ◽

2009 ◽

Vol 52 (11) ◽

pp. 1869-1876 ◽

Cited By ~ 24

Author(s):

Christophe Trésallet ◽

Nicolas Lebreton ◽

Benoît Royer ◽

Pierre Leyre ◽

Gaelle Godiris-Petit ◽

...

Keyword(s):

Small Bowel ◽

Prospective Study ◽

Ct Scan ◽

Contrast Medium ◽

Small Bowel Obstruction ◽

Water Soluble ◽

Adhesive Small Bowel Obstruction ◽

Water Soluble Contrast ◽

A Prospective Study ◽

Water Soluble Contrast Medium

Download Full-text

A prospective study of obstetric and gynaecological emergencies in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201794 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1992

Author(s):

Shahna Anishbhai Jindani ◽

Asha Bhagwatibhai Sailor ◽

Dipti A. Modi ◽

Somika Kaul ◽

Bijal D. Rami

Keyword(s):

Prospective Study ◽

Surgical Intervention ◽

Tertiary Care ◽

Care Hospital ◽

Emergency Case ◽

Mortality And Morbidity ◽

Obstetrics And Gynaecology ◽

Septic Peritonitis ◽

A Prospective Study

Background: The management of obstetrics and gynaecological emergency is directed at the preservation of life, health, sexual function and the perpetuation of fertility. The main aim of the study was to access the burden of surgical emergency and to study the course of management at a tertiary care hospital.Methods: This prospective study was carried out in the department of obstetrics and gynaecology, S. S. G. Hospital, Baroda for a period from January to December 2018.Results: A total of 73 patients presented to our emergency room who required urgent surgical intervention. All patients were resuscitated and surgery was done at earliest possible time. The age of patient ranged from 18 to 45 years. About 75.8% of female presented with the complaint of acute abdomen, followed by 32.9% with bleeding per vaginum. 16.4% had vomiting, 6.8% with fever and 4.1% with mass per abdomen. In majority of cases a diagnosis of ruptured ectopic pregnancy (34 patients) was made, followed by PPH in 14 patients and 12 cases of rupture uterus. Four cases of torsion of ovarian mass and 3 cases of septic peritonitis were operated. The most common surgery performed was salpingectomy followed by subtotal obstetric hysterectomy. A mortality rate of 8.2% was noted.Conclusions: This study emphasized the great role of timely surgical intervention as lifesaving procedures. Skilled clinicians and immediate intervention in a tertiary care is the main-stay of the emergency case management and are indispensable for decreasing mortality and morbidity.

Download Full-text

Role of methotrexate in ectopic pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205433 ◽

2020 ◽

Vol 10 (1) ◽

pp. 84

Author(s):

Munjal J. Pandya ◽

Neha V. Ninama ◽

Chirag V. Thummar ◽

Meet K. Patel

Keyword(s):

Ectopic Pregnancy ◽

Success Rate ◽

Surgical Intervention ◽

Cost Effective ◽

First Trimester ◽

Medical College ◽

Beta Human Chorionic Gonadotropin ◽

Ectopic Pregnancies

Background: Ectopic pregnancy is an acute emergency in obstetric if not timely diagnosed and timely treated. Ectopic pregnancy is leading cause of death in first trimester. Ectopic pregnancy can be managed surgically or medically. Medical management with Methotrexate administration avoids anesthesia in surgery, is cost effective and also offers success rate comparable to surgical management. Aim and objectives were to study the role of methotrexate in ectopic pregnancyMethods: This will be a retrospective observational study conducted in Obstetrics and Gynecology department of AMC MET medical college. Study group constitutes of 30 females with ectopic pregnancy. Preliminary blood investigations, ultrasonography and beta-human chorionic gonadotropin (b-hcg) level will be tested. Patients will be treated with single dose of methotrexate 50 mg/M2. Follow up b-hcg level will be done after 48 hours. Response and tolerance to methotrexate will be monitored.Results: The success rate of methotrexate therapy in our study was 83.33% (n=25) and 16.66% (n=5) required surgical intervention with tubal ruptured and abdominal pain.Conclusions: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. It has the advantage of tubal conservation and saves patients from surgical intervention.

Download Full-text

Role of Intravenous Dexmedetomidine as an Adjuvant in Labour Analgesia in Pre-eclampsia: A Prospective Study

Academia Anesthesiologica International ◽

10.21276/aan.2020.5.1.11 ◽

2020 ◽

Vol 5 (1) ◽

pp. 57-60

Author(s):

Jyothsna C ◽

Roopa Kotha

Keyword(s):

Prospective Study ◽

Pregnant Women ◽

Test Group ◽

Labour Analgesia ◽

Control Group ◽

Medical College ◽

A Prospective Study ◽

Age Range ◽

And Control

Background: Dexmedetomidine is a highly selective α-2 adrenergic receptor agonist with several diverse actions like sedation, anxiolysis, sympatholysis, analgesia, and decreased intraoperative anesthetic requirements (narcotic, inhalational). Intravenous (IV) dexmedetomidine can be used as an adjuvant in labour analgesia in preeclampsia patients as onset is faster and duration of analgesia is longer. Aim of the study: The aim of the study was to determine the role of intravenous Dexmedetomidine as an adjuvant in Labour analgesia in PIH.Subjects and Methods:This was a prospective study and was done in the department of Anaesthesia at Maheshwara Medical College. Our study included 60 full term pregnant women with preeclampsia, within 25 to 45 years age range. They were divided into two groups, as Test group and Control group of 30 patients each. Test group received IV Dexmedetomidine and Control group received IV Fentanyl.Results:Maximum number of cases 15/30 (50%) were in the age group 31-35 years, Majority were primigravida ie, 60% ( 36/60). Onset of analgesia was faster, duration of analgesia was longer and uterine contraction was greater with IV Dexmedetomidine as compared to IV fentanyl.Conclusion:From the present study we conclude that IV Dexmedetomidine can be used for labour analgesia in pregnant women with preecampsia and observed that onset and duration of analgesia are better and also it gives stable maternal parameters of maternal heart rate and mean blood pressure.

Download Full-text

Mid Trimester Missed Abortion Termination Using Intravaginal Misoprostol - A Prospective Study In DMCH

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v25i2.13742 ◽

2013 ◽

Vol 25 (2) ◽

pp. 65-70

Author(s):

Sharmeen Mahmood ◽

Sadia Afrin ◽

Farhana Dewan

Keyword(s):

Prospective Study ◽

Side Effect ◽

Surgical Intervention ◽

Efficacy And Safety ◽

Common Complication ◽

Missed Abortion ◽

Medical College ◽

Surgical Evacuation ◽

Time Required ◽

A Prospective Study

Objectives: The objective of the study was to find out the efficacy and safety of misoprostol in termination of missed abortion.Materials and Methods: This was a prospective study carried out during the time from August 2009 to April2010 in Dhaka Medical College Hospital.Results: A total 50 cases of missed abortion (12-28weeks) were included in the study. Tab.misoprostol(2oo?gm) was used pervaginally 4hourly for termination of pregnancy. Maximum 4tab.were used. Outcome variables were doses of misoprostol, expulsion times need for use of oxytocin and D and C and side effect of misoprostol. In the present study, 58% percent (29 out of 50 ) experienced complete expulsion (20% after 1st dose, 24% after 2nd dose 24% after 3rd dose and, 31% after 4th dose).24% cases needed oxytocin drip as an adjunct and 18% needed surgical evacuation when 4 doses of misoprostol (tab cytomis)and oxytocin fail to expel the product of conception. Mean (±SD) time required for expulsion of product of conception was 11.44 ± 4.43 hours in 29 (58%) women who were given tab misoprostol only. The results showed that 5(out of 25) has a complete expulsion after first dose, 13 after second 4 after 3rd and Mean induction expulsion time was 6.1 hours The most common complication was temperature 6%, vomiting 4%, and diarrhoea 2%.Conclusion: Vaginal application of misoprostol can be used to women with missed abortion for complete expulsion of the product of conception and may reduce the need for surgical intervention. DOI: http://dx.doi.org/10.3329/bjog.v25i2.13742 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(2) : 65-70

Download Full-text

Role of Color Doppler Ultrasonography in Differentiation of Graves’ Disease from Thyroiditis: A Prospective Study

World Journal of Endocrine Surgery ◽

10.5005/jp-journals-10002-1208 ◽

2017 ◽

Vol 9 (2) ◽

pp. 41-45

Author(s):

Rv Suresh ◽

KS Thalavai Sundarram, ◽

Dhalapathy Sadacharan, ◽

Krishnan Ravikumar, ◽

S Kalpana,

Keyword(s):

Prospective Study ◽

Doppler Ultrasonography ◽

Color Doppler ◽

Cost Effective ◽

Color Doppler Ultrasonography ◽

Graves Disease ◽

Group I ◽

Group Ii ◽

A Prospective Study

ABSTRACT Introduction Thyrotoxicosis due to Graves’ disease (GD) and destructive thyroiditis (DT) needs differentiation, as management strategy differs. Factors that help in diagnosis are biochemical and nuclear imaging. Utility of high-resolution ultrasonography (HRUSG) and color Doppler (CD) in differentiation is not widely practiced. We undertook the prospective study in the Department of Endocrine Surgery at a tertiary care center among South Indian population in 1 year as a cost-effective model Materials and methods Out of 120 newly diagnosed thyrotoxicosis patients, 54 were GD (group I) and 66 were DT (group II) patients. Totally, 55 euthyroid patients served as controls. Parameters analyzed were demography, free thyroid function test (TFT) anti-thyroid-stimulating hormone receptor antibody (TSHrAB), antithyroid peroxidase antibody (ATPO), anti-thyroglobulin antibody (ATG), and Tc-99m thyroid scintigraphy. Parameters analyzed using HRUSG and CD were peak systolic velocity (PSV), end-diastolic volume (EDV), pulsatility index (PI), resistive index (RI) of bilateral superior thyroid artery (STA) and inferior thyroid artery (ITA). Results Both groups were age and sex matched. The TFT, ATPO, and ATG were comparable between both groups (p = 0.609). The TSHrAB (IU/mL) was significantly higher in group I (36.11 ± 0.82) than group II (1.23 ± 0.24) (p < 0.001). Mean thyroid volume (mL) was higher in group I (28.9 ± 14.9) than group II (26.2 ± 8.81) (p = 0.022). Mean PSV-STA (cm/s) was statistically higher in group I (54.09 ± 4.67) than group II (28.92 ± 4.39) (p ≤ 0.001). Mean PSV-ITA (cm/s) was higher in group I (32.11 ± 2.45) than group II (25.23 ± 3.45) (p = 0.006). Other parameters measured in both arteries like mean EDV (cm/s), mean RI, and mean PI were comparable between both groups. Conclusion The HRUSG with CD evaluation of PSV STA and ITA is a cost-effective alternative to TSHrAB and thyroid scintigraphy in differentiating GD from DT patients. Additionally, we observed that PSV in STA was higher than in ITA in patients with GD. To conclude, HRUSG and CD are simple, cost-effective, and widely available tools in the differentiation of GD from DT. How to cite this article Sundarram KST, Sadacharan D, Ravikumar K, Kalpana S, Suresh RV. Role of Color Doppler Ultrasonography in Differentiation of Graves’ Disease from Thyroiditis: A Prospective Study. World J Endoc Surg 2017;9(2):41-45.

Download Full-text