scholarly journals Morton Neuroma Surgery: Relation Clinical Results to Excised Sample Length

2020 ◽  
Author(s):  
metin uzun ◽  
Fatma Tokat
Keyword(s):  
Clinical Results ◽  
Sample Length ◽  
Pathological Appearance ◽  
Common Causes ◽  
Proximal Stump ◽  
Morton Neuroma ◽  
Sharp Dissection ◽  
The Common ◽  
Lumbrical Muscles ◽  
Loupe Magnification

Abstract Background:Morton’s neuroma (MN) is mechanical neuropathy of plantar interdigital nerve. It is one of the most common causes of forefoot pain. One of the most undesirable complications of MN surgery is recurrent neuroma. Excision level of MN is important to prevent recurrence. In this study, we aimed to find the relation resection lenght of MN to clinical results of MN surgery cases. Methods:76 samples sent with the diagnosis of Morton neuroma to the pathology department of our hospital between years 2010-2019. 66 patients whose clinical results were available were included in the study. Mean age was 41,5 (between 21 to 70). All of 66 patients were primary diagnosed 22 of them was left foot and the other 170 were right foot. 50 of them were female, and 16 were male. Recurrent neuromas, pathological sample more than one piece from one surgical site were excluded from the study. 72 of them were evaluated as a clinically and compare the sample lenght.Results:76 pathological specimens were prepared and examined by the same pathologist. Gross pathological appearance and histopathology findings were recorded. Mean sample length was 2,05 cm (between 0,7cm and 3,5 cm). 68 samples was smaller (89.5%) than 3 cm and only 8 sample (10.5%) was bigger than 3 cm. Average interdigital neuroma score improved from 20 to 62 points following the surgery (p<0.05).Conclusion:We recommend that, the common digital nerve should be cut from the proximal as much as possible to bury the proximal stump into the lumbrical muscles regardless of the sample size and using loupe magnification, careful and sharp dissection can be prevent injury to the PDNB.Level of Evidence: 2

scholarly journals Level of Excision Matters in Morton Neuroma Surgery.

2020 ◽  
Author(s):  
metin uzun ◽  
fatma tokat
Keyword(s):  
The Other ◽  
Sample Length ◽  
Morton’S Neuroma ◽  
Forefoot Pain ◽  
Pathology Department ◽  
Orthopedic Surgeons ◽  
Pathological Appearance ◽  
Common Causes ◽  
Morton's Neuroma ◽  
Morton Neuroma

Abstract Introduction: Morton’s neuroma (MN) is mechanical neuropathy of plantar interdigital nerve. It is one of the most common causes of forefoot pain. One of the most undesirable complications of MN surgery is recurrent neuroma. Excision level of MN is important to prevent recurrence. In this study, we aimed to figure out preferred excision levels of orthopedic surgeons by evaluating pathological samples. Methods: 192 samples sent with the diagnosis of Morton neuroma to the pathology department of our hospital between years 2010-2017 were added to our study. Mean age was 45,8 (between 23 to 73). All of 192 patients were primary diagnosed 22 of them was left foot and the other 170 were right foot was. 139 of them were female, and 53 were male. Recurrent neuromas, pathological sample more than one piece from one surgical site were excluded from the study. Results: 192 pathological specimens were prepared and examined by the same pathologist. Gross pathological appearance and histopathology findings were recorded. Mean sample length was 2,05 cm (between 0,8cm and 6 cm).145 samples was smaller (75.5%) than 3cm and only 47 sample (24.5%) was bigger than 3 cm.Conclusion: In conclusion our database results showed that majority of surgeons didn't take into account plantarly directed nerve branches.

scholarly journals From “Technical Newbies” to “Optimistic Politicians”

2019 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
James Prater ◽  
Konstantinos Kirytopoulos ◽  
Tony Ma
Keyword(s):  
Information Technology ◽  
Quantitative Research ◽  
Valuable Insight ◽  
Scheduling Problems ◽  
Information Technology Projects ◽  
Content Type ◽  
Common Causes ◽  
The Common ◽  
Project Estimation ◽  
Engineering Projects

Purpose Despite the advent of sophisticated control methods, there are still significant issues regarding late delivery of information technology projects. The purpose of this paper is to investigate the common causes of scheduling problems specifically in the information technology projects context. Design/methodology/approach Through a quantitative research, the importance of those causes, as well as the underpinning factors driving them, is explored. The causes are ranked according to their relative important index, and exploratory factor analysis is employed to reveal underlying dimensions (factors) of these causes. Findings From the analysis, four factors were extracted, namely, “Dataless Newbie,” “Technical Newbie,” “Pragmatic Futurist” and “Optimistic Politician.” These factors explain the different latent conditions that lead to scheduling problems in information technology projects. Practical implications The key contribution of this research is that it enlightens the latent conditions underpinning scheduling problems. Also, the evidence provides that schedule development for information technology projects is impacted by the same causes that impact engineering projects, and that applying a number of mitigation techniques widely used within the engineering area, such as reference class, would, no doubt, not only improve information technology schedules but also reduce the political pressures on the project manager. Originality/value This research provides a valuable insight into understanding the underlying factors for poor project estimation.

A new endoscopic technique to decompress lumbar nerve roots affected by spondylolysis

2003 ◽  
Vol 98 (3) ◽  
pp. 290-293 ◽  
Author(s):  
Koichi Sairyo ◽  
Shinsuke Katoh ◽  
Tadanori Sakamaki ◽  
Shinji Komatsubara ◽  
Natsuo Yasui
Keyword(s):  
Clinical Outcome ◽  
Nerve Root ◽  
Clinical Results ◽  
Skin Incision ◽  
Endoscopic Technique ◽  
Spinal Instability ◽  
Nerve Roots ◽  
Content Type ◽  
Proximal Stump

✓ The authors describe a new endoscopic technique to decompress lumbar nerve roots affected by spondylolysis. Short-term clinical outcome was evaluated. Surgery-related indications were: 1) radiculopathy without low-back pain; 2) no spinal instability demonstrated on dynamic radiographs; and 3) age older than 40 years. Seven patients, four men and three women, fulfilled these criteria and underwent endoscopic decompressive surgery. Their mean age was 60.9 years (range 42–70 years). No subluxation was present in four patients, whereas Meyerding Grade I slippage was demonstrated in three. For endoscopic decompression, a skin incision of 16 to 18 mm in length was made, and fenestration was performed to identify the affected nerve root. The proximal stump of the ragged edge of the spondylotic lesion, and the fibrocartilaginous mass compressing the nerve root were removed. The follow-up period ranged from 6 to 22 months (mean 11.7 months). Clinical outcome was evaluated using Gill criteria; in three patients the outcome was excellent, and in four it was good. This new endoscopic technique was useful in the decompression of nerve roots affected by spondylolysis, the technique was minimally invasive, and the clinical results were acceptable.

scholarly journals A NEW METHOD OF EPISTAXIS MANAGEMENT USING NASAL GEL: A SINGLE CENTER, RANDOMIZED CLINICAL TRIAL

2018 ◽  
Vol 11 (3) ◽  
pp. 104 ◽  
Author(s):  
Mehdi Torabi ◽  
Ava Roughani Esfahani ◽  
Shiva Moeinaddini ◽  
Mohammad Reza Baneshi
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Randomized Clinical Trial ◽  
Patients Satisfaction ◽  
Stop Time ◽  
Common Causes ◽  
Procedural Time ◽  
Nasal Bleeding ◽  
The Common ◽  
Discharge Length

 Objective: Epistaxis is one of the common causes of patients’ referral to the emergency departments. In the majority of cases, epistaxis is managed by traditional methods. We investigated the efficacy of nasal gel (NG) in comparison to anterior nasal packing (ANP) to stop mild-to-moderate anterior nasal bleeding.Methods: In this prospective, randomized clinical trial, patients were divided into two groups of ANP (n=60) and NG (n=40). We determined and compared the efficacy of treatment (bleeding stop time and recurrence), patients’ satisfaction at discharge (length of stay in the hospital, pain during the procedure, and procedural time), and safety (less side effects) in both groups.Results: The procedural time ≤2 min was observed in 90% and 58.33 % of NG group and ANP group, respectively (p<0.001). Pain score during procedure ≤4 and patients’ satisfaction ≥7 were, respectively, seen in 87.5% and 65% of NG group, but it was 43.33% and 41.7% in ANP group, respectively (p<0.001, p=0.02). The side effects in ANP group were 35%; however, no side effects were observed in NG group.Conclusion: In the management of mild-to-moderate anterior nasal bleeding although NG efficacy is equivalent to ANP, using NG may be more convenient and satisfactory for patients. In addition, the use of this gel may result in more safety and fewer side effects.

scholarly journals Clinicopathological study of patients with pancytopenia

2020 ◽  
Vol 9 (1) ◽  
pp. 169
Author(s):  
Y. Srinivas ◽  
Mohammed Elyas
Keyword(s):  
Bone Marrow ◽  
Blood Cells ◽  
Reticulocyte Count ◽  
Megaloblastic Anemia ◽  
Bone Marrow Failure ◽  
General Medicine ◽  
Large Sample Size ◽  
Age Group ◽  
Common Causes ◽  
The Common

Background: Pancytopenia is due to bone marrow failure characterized by anemia, leukopenia, and thrombocytopenia. It a common hematological disorder. Low blood counts in the bone marrow failure disease result from deficient hematopoiesis. Marrow damage and dysfunction also may be secondary to infection, inflammation, or cancer. Pancytopenia has an extensive differential diagnosis and it can result from damage to bone marrow destruction of preformed blood cells peripherally with increased reticulocyte count. Aim of the study were to study the different etiological conditions and clinical features of pancytopenia in rural medical college.Methods: This study has been conducted in the department of general medicine in association with the pathology department and between March 2019 to February 2020, 45 patients were included in this study. males were 27 and females were 18. The age group is between 20 years and 60 years. 2 ml of anticoagulant blood send for HB% total count, platelet count, packed cell volume, and RBC indices.Results: The total no. of patients included in this study were 45 among these 45 patients, males were 27, and females were 18. The common age group is between 20 and 60 years and the common causes of aplastic anemia in our study are megaloblastic anemia.Conclusions: Pancytopenia is a common hematological problem in India. In our study megaloblastic anemia is the most common cause of pancytopenia females are affected during pregnancy. So, periodical clinically examined and investigations may reduce the incidence. of further research with a large sample size and meticulous investigations required to replicate the finding of the study.

scholarly journals An unusual cause of edema in a child with congenital heart disease post Fontan procedure

2019 ◽  
Vol 7 (11) ◽  
pp. 4396
Author(s):  
Minal Wade ◽  
Shweta Shettiwar ◽  
Ankita Shah
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Rare Complication ◽  
Fontan Procedure ◽  
Protein Losing Enteropathy ◽  
Common Causes ◽  
Disease Protein ◽  
The Common ◽  
Fontan Palliation

Protein Losing Enteropathy Post Fontan procedure. Protein Losing Enteropathy (PLE) is an uncommon cause of edema in children with congenital heart disease. Protein-Losing Enteropathy may be defined as excessive loss of proteins across the intestinal mucosa and is due to either a primary gastrointestinal abnormality or secondary to cardiac disease. Protein-losing enteropathy (PLE) is a rare complication of the Fontan palliation for functional single-ventricle. Although PLE occurs in about 3.5% of patients post-Fontan, it confers marked morbidity and high mortality within 5 years of diagnosis. The pathogenesis of Fontan-related PLE is not completely understood, and it is unclear why it develops in some patients post-Fontan and not others. We describe a child with Double Inlet Right Ventricle who had undergone Fontan procedure, and presented to us with generalised oedema. The child had hypoproteinaemia, the common causes for which were ruled out and was diagnosed as Protein Losing Enteropathy (PLE) related to his surgical intervention. Though, not frequently encountered it should be kept in mind as one of the causes of anasarca.

scholarly journals Clinical Profile and Outcome of Neonates Admitted to Neonatal Intensive Care Unit of NGMC

2017 ◽  
Vol 15 (1) ◽  
pp. 20-22
Author(s):  
Roma KM ◽  
Manita Pyakurel ◽  
Veena Gupta ◽  
Piush Kanodia
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Study Data ◽  
Clinical Profile ◽  
Mortality And Morbidity ◽  
Medical Practitioners ◽  
Common Causes ◽  
Causes Of Mortality ◽  
The Common

Background: Neonatal period is a period from birth to under 28 days of life. The common causes of mortality and morbidity in our region are preventable, among which neonatal sepsis is the commonest one. Most of the deaths occur within 7 days of life. Objectives: To study the clinical profile, pattern of diseases, causes of morbidity and mortality amongst newborns. Materials and methods: A hospital based descriptive study was done among total 967 newborns including both inborn and out born admitted in NICU, NGMC from January 2016 to December 2016. Age, sex, gestational age, diagnosis at admission, outcome of admitted th newborns were the main variables under study. Data was entered in Excel and analyzed using SPSS 20th version. Data were presented through pie, bar graph and table with frequency and percentage. Results: Male were predominant in the study (65%). One third of the admitted newborns were preterms. Half of the admitted newborns were admitted on their first day of life. Neonatal sepsis was the most common cause of admission. Deaths occured in 7.4%of total babies. Seventy-six percent got improved after treatment. Only 2.8% were referred to higher center. Conclusions: Most of the neonates got admitted in first day of life with commonest cause being neonatal sepsis. Recovery rate was satisfactory. To reduce the mortality and morbidity of neonates, we need to increase awareness level in general population and proper aseptic practices in medical practitioners.

scholarly journals Common causes of vertigo and dizziness in Gujarat

2016 ◽  
Vol 3 (4) ◽  
pp. 250 ◽  
Author(s):  
Mohan Bansal
Keyword(s):  
Prospective Study ◽  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Neuritis ◽  
Medical Conditions ◽  
Positional Vertigo ◽  
Common Causes ◽  
Common Ailment ◽  
The Common ◽  
Vestibular Neuronitis ◽  
Paroxysmal Positional Vertigo

<p class="abstract"><strong>Background:</strong> Dizziness is one of the most common complaints in medicine just second to headache. It frightens not only the patient but also frustrates the physicians. There is a long list of causes of dizziness but the common causes vary from place to place. The aim of this study was to know the common causes of dizziness and vertigo in Gujarat to generate the awareness among the doctors who get the patients with this common ailment so that they can better manage dizzy patients.</p><p class="abstract"><strong>Methods:</strong> This prospective study included thirty-five patients with dizziness and vertigo that came to the Department of ENT for their management.</p><p class="abstract"><strong>Results:</strong> Patients were divided into three categories. The first group of patients was having associated cochlear symptoms. Second group patients had isolated vertigo. Third group patients had associated CNS or medical conditions. The largest was the second group (37.5%) of isolated vertigo patients. The commonest diagnosis (18.75%) in this group was benign paroxysmal positional vertigo, followed by acute vestibular neuritis. Meniere’s disease and migraine and its variant were the most common causes in first and third group respectively.  </p><strong>Conclusions:</strong>The overall scenario of causes of dizziness and vertigo in our study follow the international trend. Benign paroxysmal positional vertigo, acute vestibular neuronitis, Menieres disease and migraine were found the most common causes of vertigo.<div> </div>

scholarly journals Free Newborn Care Services: A New Initiative in Nepal

2018 ◽  
Vol 16 (3) ◽  
pp. 340-344
Author(s):  
Gambhir Shrestha ◽  
Prajwal Paudel ◽  
Parashu Ram Shrestha ◽  
Shambhu Prasad Jnawali ◽  
Deepak Jha ◽  
...  
Keyword(s):  
Human Resources ◽  
Neonatal Mortality ◽  
Newborn Care ◽  
Public Hospitals ◽  
Significant Progress ◽  
The Public ◽  
Care Services ◽  
Common Causes ◽  
The Status ◽  
The Common

Background: Nepal has made a significant progress in reducing child mortality. However, the annual rate of reduction in neonatal mortality is not satisfactory. As safeguarded by constitution of Nepal and to address neonatal mortality due to poverty and inequity, government has introduced free newborn care (FNC) package. This study aims to assess the status of FNC services in all the public hospitals.Methods: Child Health Division organized 5 workshops region-wise with the theme of newborn care services in March/April 2018 to cover all the public hospitals in the country. A template was designed comprising of duration of FNC implementation, number of newborns admitted since implementation, morbidities pattern, and number of babies served. It was circulated and all hospitals were advised to fill it and present in the review. Later, the data were compiled and analyzed.Results: Only 58 presentations out of 93 participated hospitals were included in this study. The total admitted cases were 8564 newborns. The common causes of admission were neonatal sepsis (44.5%) followed by asphyxia (14.29%) and hyperbilirubinemia (11.4%). A total of 1573 neonates received services of FNC package C, 3722 package B, 3081 received package A. The main challenges faced in implementation reported were lack of infrastructure and human resources to provide services and the reimbursement is not enough.Conclusions: Free newborn care is a new initiative taken to reduce neonatal mortality. This package is very helpful to serve sick newborns. However, the package should be revised taking into consideration the appropriate reimbursement and extra staffs to provide this service.Keywords: Free newborn care; government efforts; health services.

Diagnostic Evaluation of Patients Presenting with Rectal Bleeding by Colonoscopy

2020 ◽  
Vol 42 (1) ◽  
pp. 36-39
Author(s):  
Bala R Malla ◽  
Suyog Simkhada
Keyword(s):  
Rectal Bleeding ◽  
Diagnostic Yield ◽  
Adult Population ◽  
Common Finding ◽  
Common Causes ◽  
Optic Colonoscopy ◽  
The Common ◽  
Gastro Intestinal Tract ◽  
Histopathologic Findings ◽  
Malignant Mass

Introduction Rectal bleeding indicates the bleeding from lower gastro-intestinal tract occurring distal to ligaments of Treitz. Annual incidence of per rectal bleeding has been estimated to be 20% . Colonoscopy is the examination of choice for investigation. The objective of this study is to know the diagnostic yield of colonoscopy in cases with per rectal bleeding and to know the common causes of per rectal bleeding in adults MethodsOne hundred and twenty-nine adult patients, age more than 18years, who presented to Surgical OPD and ward of Dhulikhel Hospital during the year 2018 and 2019 were taken for the study irrespective of their sex. All the patients were subjected to fibre-optic colonoscopy after necessary preparation and the findings were recorded. Diagnosis was based on colonoscopic and histopathologic findings. ResultsA total of 129 (77 male and 52 female )patients with per rectal bleeding were evaluated with colonoscopy. The age ranged from 18 years to 79 years with the mean age 42.25 (SD+/- 15.29). Colonoscopy showed abnormalities in 102 patients (79.06%). The most common finding was hemorrhoids in 36 patients (27.90%) followed by colorectal malignant mass in 20 patients (15.50%). Polyps were diagnosed as the cause of rectal bleeding in 14 patients (10.84%). ConclusionColonoscopy has good diagnostic yield at evaluating cases with per rectal bleeding. Hemorrhoids, colorectal malignant mass and polyps are the common causes producing PR bleeding in Nepalese adult population.

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