scholarly journals Complications associated with splenectomy in thalassemia

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Farogh Zahra ◽  
Muhammad Ashraf ◽  
Muhammad Aslam ◽  
Qaim Deen ◽  
Javeria Mannan
Keyword(s):  
Clinical Study ◽  
Study Design ◽  
Perioperative Management ◽  
Late Complications ◽  
Prospective Clinical Study ◽  
Massive Splenomegaly ◽  
Study Materials ◽  
Operative Complications ◽  
Post Operative Complications

Aims and Objectives: The study aims at investigating the complications associated with splenectomy in thalassemic patients Study Design: It was a prospective clinical study. Materials and Method: Sixty Splenectomies were preformed electively after pre-operative preparation in Sir Ganga Ram Hospital, Lahore during the year Jan 2003 to Sep 2005. Results: Complications were categorized into per-operative, early post-operative and late complications. The frequency of per-operative complications was 3%, early post-operative complications were 10% and late complications were 1.6%. Interpretation and Conclusion: The rate of complications has decreased markedly as the patients are well prepared and improved post operative carp has also reduced the post-operative complications. With good perioperative management, splenectomy in children with massive splenomegaly is both safe and effective.

scholarly journals Full in-Office Guided Surgery with Open Selective Tooth-Supported Templates: A Prospective Clinical Study on 20 Patients

2018 ◽  
Vol 15 (11) ◽  
pp. 2361 ◽  
Author(s):  
Francesco Mangano ◽  
Uli Hauschild ◽  
Oleg Admakin
Keyword(s):  
Clinical Study ◽  
Low Cost ◽  
Prospective Clinical Study ◽  
3D Printer ◽  
Guided Surgery ◽  
Operative Complications ◽  
Edentulous Patients ◽  
One Year ◽  
Single Crowns ◽  
Surgical Templates

Background: Guided implant surgery appears to have several benefits, such as the possibility of inserting flapless implants in a prosthetically driven manner, avoiding dangerous anatomical structures. However, to date, only a few surgeons routinely use guided surgery in partially edentulous patients. Aim: To present the results obtained with tooth-supported surgical templates characterized by an innovative open design with selective support, and manufactured via a full in-office procedure with a low-cost desktop 3D printer. Methods: Over a two-year period (2016–2018), all partially edentulous patients with one to three missing teeth (in maxilla and/or mandible), referred to a private dental practice for restoration with dental implants, were considered for inclusion in this prospective clinical study. An intraoral scanner (CS 3600®, Carestream Dental) and cone beam computed tomography (CS 9300®, Carestream Dental) were used to acquire the 3D information on the patients. Guided surgery software (SMOP®, Swissmeda) was used to plan the surgeries and to design open, selective, tooth-supported templates that were fabricated with a stereolithographic (SLA) desktop 3D printer (XFAB2000®, DWS). Guided implant surgeries were performed and patients were followed for a period of one year. The study outcomes were fit and stability of surgical templates, duration (time) of surgery, intra and post-operative complications, and implant stability and survival. Results: Twenty (20) partially edentulous patients (9 males, 11 females; mean age 54.4 ± 9.4 years) were included in the study; 28 open, selective, tooth-supported templates were designed with the aim of inserting 38 implants. Among the surgical templates, 24 had optimal fit and stability, three had optimal fit and sufficient stability, and only one had inadequate fit and unsatisfactory stability and was therefore not suitable for clinical use. The average time of the intervention was 15.7 ± 5.2 min per template. No intra-operative complications were reported, but one implant was not stable at placement and had to be removed. In total, 36 implants were restored with 10 two-unit fixed partial prostheses and 16 single crowns. All implants were successfully functioning at one year, even if, in two single crowns, minor prosthetic complications (abutment screw loosening) occurred. Conclusions: Full in-office guided surgery with open, selective, tooth-supported templates seem to represent a clinically predictable surgical procedure to restore partially edentulous patients. Further studies are needed to confirm these positive outcomes.

scholarly journals Design of a field trial to develop a tabletop platform for rapid detection of XDR-TB in clinical samples (Preprint)

2020 ◽  
Author(s):  
Naomi Hillery ◽  
Marva Seifert ◽  
Donald G Catanzaro ◽  
Symone McKinnon ◽  
Rebecca E Colman ◽  
...  
Keyword(s):  
Clinical Study ◽  
Data Collection ◽  
Study Design ◽  
Human Subjects ◽  
Bacterial Load ◽  
Objective Evaluation ◽  
Clinical Samples ◽  
Prospective Clinical Study ◽  
Global Public Health ◽  
Drug Concentrations

BACKGROUND Extensively drug-resistant tuberculosis (XDR-TB) continues to be a serious threat to global public health, due in part to the lack of accurate and efficient diagnostic devices for XDR-TB. A prospective clinical study in an intended-use cohort was designed to evaluate the Akonni Biosystems XDR-TB TruArray® and Lateral Flow Cell (XDR-LFC), which has the potential to address this gap in TB diagnostics. OBJECTIVE The objective of this publication is to share documentation of the study conceptualization and design that is replicable and of use to the scientific community. METHODS This clinical study was conducted in three phases, the first to observe changes in bacterial load and culture positivity in patient sputa over time and better understand the diversity of prospective clinical samples, the second to prospectively collect clinical samples for sensitivity and specificity testing of the Akonni Biosystems XDR-LFC device, and the third to explore anti-TB drug concentrations in serum over the course of DR-TB treatment. RESULTS The methodology described includes the study design, laboratory sample handling, data collection, and human subjects protection elements of the clinical study to evaluate a potential new XDR-TB diagnostic device. The complex systems implemented facilitated thorough clinical data collection for objective evaluation of the device. This trial is closed to recruitment. Follow-up data collection and analysis are in progress. CONCLUSIONS This publication outlined the methods used in a prospective cohort study to evaluate a device to rapidly detect XDR-TB. The documentation of this clinical study design may be of use to other researchers with similar goals.

scholarly journals Management of syndactyly: a clinical study

2019 ◽  
Vol 6 (8) ◽  
pp. 2806
Author(s):  
Nagaprasad Nangineedi ◽  
Gangavaram Praveen Harish ◽  
Mohammed Rafi
Keyword(s):  
Clinical Study ◽  
Treatment Strategies ◽  
Prospective Clinical Study ◽  
Basic Principles ◽  
Operative Complications ◽  
Web Space ◽  
Almost All ◽  
Surgical Corrections ◽  
The Web

Background: Syndactyly is a congenital anomaly, basic principles of surgical release of syndactyly have been well established, each patient requires a thorough assessment of the soft-tissue and bony components in the syndactylized region. Reconstruction must be planned carefully when more than two digits are involved or when the syndactyly is a component of a systemic congenital syndrome. The aim of the treatment strategies for syndactyly is to separate the fused digits, create a functional hand, and produce an aesthetically acceptable web.Methods: The prospective clinical study is conducted in the Department of Plastic & Reconstructive surgery, between October 2016 to October 2018. Twenty six patients with congenital syndactyly and post burn syndactyly of fingers were included in this study.Results: There were no intra operative complications and no cases had any neurovascular compromise. Integrity of Dorsal and volar flaps, quality of scars, aesthetical aspects of fingers are reasonably good in almost all the cases that are operated in this study. Overall 97% of patients treated achieved good function and superior results following single surgery.Conclusions: Primary syndactyly is more common than secondary syndactyly. In this study the primary goal is separation of fused digits/toes and covering the web space with dorsal flap, and covering the separated digits/ toes with a graft and create a functional hand and produce an aesthetically web with fewest complications and fewest surgical corrections. 

Post Operative Complications in Hydrocele: Clinical Study

2016 ◽  
Vol 7 (2) ◽  
pp. 121-123
Author(s):  
Nagaraj Bhalki ◽  
◽  
Vinayak N. Tukka ◽  
Keyword(s):  
Clinical Study ◽  
Operative Complications ◽  
Post Operative Complications

scholarly journals Surgical outcome comparison between endoscopic septoplasty and conventional septoplasty among patients with nasal septal deviation

2020 ◽  
Vol 6 (3) ◽  
pp. 501
Author(s):  
K. Sharath Babu ◽  
R. Shankar
Keyword(s):  
Nasal Obstruction ◽  
Surgical Outcome ◽  
Lateral Wall ◽  
Sinus Surgery ◽  
Nasal Endoscopy ◽  
Prospective Clinical Study ◽  
Endoscopic Septoplasty ◽  
Operative Complications ◽  
Outcome Comparison ◽  
Post Operative Complications

<p class="abstract"><strong>Background:</strong> When compared with standard head light technique, endoscopic septoplasty provides important advantages which include adequate visualization, room for instrumentation during functional endoscopic sinus surgery, access to para nasal sinuses and for other surgeries like trans-septal approach to the sphenoid sinus, visualization and stoppage of post-nasal bleeds. The aim of the study was to assess and compare the surgical outcome between endoscopic septoplasty and conventional septoplasty techniques in terms of anatomical correction and its complications.</p><p class="abstract"><strong>Methods:</strong> A prospective clinical study was conducted on hundred patients with nasal obstruction. Group A patients (n=50) underwent conventional septoplasty and group B (n=50) patients were operated by endoscopic septoplasty technique. Patients were subjected to diagnostic nasal endoscopy examination before and after surgery. Post-operative complications like trauma to lateral wall of nose, injury to cribriform plate, post-operative epistaxis, post-operative septal hematoma and septal abscess if occurred were noted.  </p><p class="abstract"><strong>Results:</strong> Post-operatively diagnostic nasal endoscopy results show that there was a statistically significant improvement in endoscopic septoplasty group compared to conventional septoplasty and similarly the mean nasal obstruction symptom evaluation score. The most common post-operative complications which were occurred are synechiae and septal perforation and both these complications were more common among the conventional septoplasty group and the difference was found to be statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> The study showed a better surgical outcome with a lesser complication among the endoscopic septoplasty as compared to conventional septoplasty. The only disadvantage of using endoscopic septoplasty was of binocular vision and repeated cleaning of the endoscope.</p>

scholarly journals Ultrasound cycloplasty in Chinese glaucoma patients: Results of a 6-month prospective clinical study

2021 ◽  
Author(s):  
Qin Luo ◽  
Wenwen Xue ◽  
Yulan Wang ◽  
Bin Chen ◽  
Shuangshuang Wang ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Safety Evaluation ◽  
Angle Closure ◽  
Prospective Clinical Study ◽  
Success Rates ◽  
Therapeutic Success ◽  
Primary Angle Closure Glaucoma ◽  
Operative Complications ◽  
Post Operative Complications

Purpose: The aim of this study was to evaluate the short-term efficacy and safety of ultrasound cycloplasty (UCP) procedure in Chinese glaucoma patients. Methods: As a single-centre, prospective, non-comparative study, 23 eyes of 23 patients suffering from glaucoma with uncontrolled intraocular pressure (IOP) ≥ 21 mmHg underwent a multi-dose UCP treatment with the activations of 6, 8 or10 sectors. Types of glaucoma include primary open-angle glaucoma (POAG) (7/23), primary angle closure glaucoma (PACG) (9/23) and secondary glaucoma (SG) (7/23). A complete ophthalmic examination including intraocular pressure (IOP) measurements was performed before UCP procedure and at 1 day, 1 month, 3months and 6 months after the procedure. An IOP reduction of ≥20% and IOP > 5 mmHg without increasing hypotensive medication at the follow-up visit was defined as therapeutic success. The post-operative complications were also recorded and compared to baseline for safety evaluation. Results: The mean baseline IOP of 23 treated eyes was 37.2 ± 12.1 mmHg. The IOP reduction after UCP procedure were 23%, 49%, 33% and 34% at 1 day, 1 month, 3 months and 6 months, respectively. Thus, the corresponding overall therapeutic success rates reached 61% (14/23), 83% (19/23), 65% (15/23) and 61% (14/23), respectively. Baseline IOPs of 8 and 10 sectors group (37.0 ± 9.9 mmHg and 50.1 ± 12.2 mmHg) were significantly higher than that of 6 sectors group (30.1 ± 8.2 mmHg). Therapeutic success rates of 6, 8 and 10 sectors groups reached 44% (4/9), 56% (5/9) and 100% (5/5), respectively. There were the highest percentage of IOP reduction (50% and 41%) and therapeutic success rate (6/7; 86% and 7/9; 78%) in SG group and PACG groups respectively. In addition, pre-operative ocular pain symptoms of four patients were all disappeared within one week after UCP. No serious intra-operative or post-operative complications occurred. Conclusion: UCP procedure is an effective and well-tolerated treatment to reduce IOP in Chinese glaucoma patients, which offered a novel alternative for glaucoma treatment.

scholarly journals Virtual pre-operative planning in acetabular surgery using a patient-specific biomechanical model: a prospective clinical study.

10.29007/gp5w ◽  
2020 ◽  
Author(s):  
Mehdi Boudissa ◽  
Matthieu Chabanas ◽  
Gaetan Bahl ◽  
Hadrien Oliveri ◽  
Jérôme Tonetti
Keyword(s):  
Clinical Study ◽  
Blood Loss ◽  
Acetabular Fracture ◽  
Biomechanical Model ◽  
Patient Specific ◽  
Prospective Clinical Study ◽  
Anatomic Reduction ◽  
Operative Complications ◽  
Simulation Surgery ◽  
Operative Planning

The first patient-specific biomechanical model for pre-operative planning in acetabular surgery was developed in our institution and validated in previous retrospective studies. The aim of this prospective clinical study was to confirm the previous promising.Between January 2019 and June 2019, every patients operated by the first author for acetabular fracture were included in this prospective study. A biomechanical model was implemented in acustom software made from combination of several open-sources software allowing a biomechanical simulation. The surgery was then performed according to the simulation. Surgery duration, blood loss, radiological results and per- operative complications were recorded.Ten patients were included. Mean simulation time was 22 min ± 4 [range, 18-31]. The mean operative time was 113 min ± 33 [range, 60-180] and mean blood loss was 505 mL ± 189 [range, 100-750]. On Matta’s criteria, anatomic reduction was achieved in 9 of the 10 patients (90%; 0.8 mm ± 1 [range, 0-3]). No per-operative complications were recorded.This study confirms the promising results of pre-operative planning in acetabular surgery based on a patient-specific biomechanical model.The model needs larger-scale prospective validation, but offers a new tool suitable for teaching purposes and for assessment of surgical strategies in acetabular fracture.

scholarly journals A clinical study of inguinal hernia with special reference to laparoscopic trans-abdominal pre peritoneal repair

2016 ◽  
Vol 4 (1) ◽  
pp. 282
Author(s):  
Suraj Singh ◽  
Rajkumar Prakash ◽  
Vasundhara Singh
Keyword(s):  
Inguinal Hernia ◽  
Clinical Study ◽  
Hernia Repair ◽  
Abdominal Cavity ◽  
Operating Time ◽  
Abdominal Viscus ◽  
Conversion To Open Surgery ◽  
Early Return ◽  
Operative Complications ◽  
Post Operative Complications

Background:Hernia may be generally defined as the protrusion of an abdominal viscus outside the abdominal cavity through a natural or acquired defect. Latin meaning of the word “hernia” is tear or rupture. A Clinical study on inguinal hernia is undertaken to assess the incidence of inguinal hernia in relation to age, gender and occupation, the different types and modes of clinical presentation of patients, the management of patients with special consideration to laparoscopic (TAPP) repair, to evaluate the operating time, pre-operative and post-operative complications, duration of hospital stay, time taken for recovery, recurrence rate and limitations with respect to laparoscopic TAPP repair.Methods: This is a prospective study of 54 cases of inguinal hernia admitted and underwent surgery for inguinal hernia in Department of General Surgery in Guwahati Medical College and Hospital during the study period of August 2014 to July 2015.Results:The highest number of cases presenting with inguinal hernia were over 45 years and it was more common in males which constituted 96.3 percent of cases. It is more common on right side and indirect hernia is more common than direct hernia. The major possible risk factors are smoking and strenuous work. The commonest presenting mode was swelling followed by swelling with pain. The mean time taken for TAPP was 91.85±15.85 minutes and the median time was 87.50 minutes. There were no intra operative (neurovascular, visceral) complications in any of the patient and there was no conversion to open surgery. There was no mortality in present study and none of the patient had any testicular complication.Conclusions:Laparoscopic hernia repair is associated with steep learning curve for surgeons and is more costly both to patients and health care system in the present scenario. Laparoscopic TAPP hernia repair is found to have encouraging results which is a safe and viable option for repair of inguinal hernia with less postoperative pain and discomfort, improved cosmesis, less post-operative complications and early return to work.

scholarly journals Indications and Outcomes of the Kocher-Langenbeck Surgical Approach in the Management of Acetabular Fractures in a Resource Limited Setting

2022 ◽  
pp. 30
Author(s):  
Keyword(s):  
Sciatic Nerve ◽  
Surgical Site Infections ◽  
Posterior Wall ◽  
Late Complications ◽  
Fracture Reduction ◽  
Acetabular Fractures ◽  
Posterior Fixation ◽  
Operative Complications ◽  
Poor Outcomes ◽  
Post Operative Complications

The Kocher-Langenbeck (K-L) approach is the ‘workhorse’ of surgery for acetabular fractures needing posterior fixation. It is indicated for most of these fractures for proper surgical technique and optimal outcome. We therefore evaluated the outcome of surgically treated acetabular fractures through the K-L approach in our setting with limited resources. 57 patients were operated by the K-L approach during the 3-year study period. The most common indications of this approach were: posterior wall (38.6%) and transverse + posterior wall fractures (36.8%). Based on Matta’s criteria of fracture reduction, 81 % were judged anatomic, 16% imperfect and 3 % poor. A surgery waiting time of 8 to 14 days after injury, significantly favoured anatomic fracture reduction. The MAP score was excellent in 72 % and unacceptable in 10.6 %. Factors associated with poor outcomes were poor fracture reduction and the development of early post-operative complications. Iatrogenic sciatic nerve palsy (ISNP) was the most significant post-operative complication (19.3%). The levering of Hohmann retractors in the sciatic notches was the major risk factor for developing ISNP, compared to the use of sciatic nerve retractors. Other early and late complications included surgical site infections (12.3%) and heterotopic ossification (8.8 %), respectively. The overall outcome following surgery by the K-L approach is satisfactory. However, there is need to ameliorate the technique, especially at the level of instrumentation, to limit post-operative complications.

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