scholarly journals In situ Piezoelectric ESWL for ureteric calculi

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Mohammad Shahzad ◽  
Rana Muhammad Mubeen ◽  
Khursheed Anwar
Keyword(s):  
Prospective Evaluation ◽  
Medical Sciences ◽  
Ureter Stone ◽  
Stone Clearance ◽  
Ureteric Calculus ◽  
Ureteric Calculi ◽  
The Mean ◽  
Positive Results

Objective: To assess in situ Piezoelectric ESWL for ureteric calculi, avoiding false positive results arising from the spontaneous passage of small stones and also to evaluate the efficiency of the EDAP LT02 Lithotriptor for insitu ESWL treatment of ureteric calculi. Study Design: A prospective evaluation of patients with ureteric calculi treated with Piezoelectric ESWL using EDAP LT 02 Lithotriptor. Place & Duration of Study: patients with ureteric calculi treated with Piezoelectric ESWL using EDAP LT 02 Lithotriptor for a period of twelve months, coming to Urology department of Pakistan Institute of Medical Sciences (PIMS), Islamabad, as out door patients. Patients and methods: A prospective evaluation of patients with ureteric calculi treated with Piezoelectric ESWL using EDAP LT 02 Lithotriptor for a period of twelve months, Seventy two patients, 60 males and 12 females, with mean age of 39.6 years, presenting with solitary ureteric calculus were treated using EDAP LT 02 Piezoelectric Lithotriptor, lo calization with fluoroscopy. No regional or general anesthesia given. Results: After 3 months follow-up, of the 72 ureteric calculi cases, 60(83.3%) were successfully fragmented and ureter was stone free in 54 patients (75.1%) after insitu ESWL alone. The mean duration of stone clearance was 50 days (SD +11.58). Sixteen patients required one session only, 28 patients required 2 sessions and twelve patients required three and more than three sessions. Stone location was 28 upper ureteric, 18 middle and 26 in lower ureter. Stone size varied from 7mm.to 17mm. in longest diameter. The average number of session, 1.5 for upper ureteric stone, 1.8 for mid and lower ureteric stones. Stone clearance for upper ureteric calculus was 85.7%, for mid ureteric 66.7% & for lower ureteric 69%, the overall stone clearance was 75%. Conclusion: In situ piezoelectric ESWL is safe, simple and effective technique for treating ureteric calculi. The site and size of the stone affects the success rate.

scholarly journals A CHANGE OF THE LENGTH OF THE ANTERO-POSTERIOR AXIS OF THE EYE IN THE CHILDREN PRESENTING WITH HYPEROPIA FOLLOWING FEMTOSECOND LASER-ASSISTED IN SITU KERATOMILEUSIS: 3 YEAR FOLLOW-UP

2018 ◽  
Vol 13 (1) ◽  
pp. 31-37
Author(s):  
I. L Kulikova ◽  
N. P Pashtaev ◽  
Anastasiya Vladimirovna Gagloeva ◽  
O. V Shlenskaya ◽  
N. V Chapurin
Keyword(s):  
Femtosecond Laser ◽  
Mean Value ◽  
Minimal Growth ◽  
The Mean ◽  
Group 2 ◽  
Contralateral Eye ◽  
High Degree ◽  
Positive Results

Aim. The objective of the present study was the analysis of the changes in the length of the antero-posterior axis of the eye (AL) in the children and adolescents presenting with hyperopia and anisometropia in 3 years after femtolaser-assisted in situ keratomileusis (FS-LASIK). Material and methods. The study included 33 patients at the age from 5 to 16 years divided into two groups. Group 1 was comprised of the patients having initially the mean spherical refractive equivalent (SE) +3.69 D. Those of group 2 had initial SE +5.88 D. In all the patients, FS-LASIK was carried out at the amblyopic eye in the absence of the positive results of the conventional conservative treatment. Results. During three years after FS-LASIK, AL of the treated patients in the first group increased by 0.41 mm and reached the mean value of 22.41 mm while the spherical refractive equivalent became equal to 0.25 D. During the same period, AL in the contralateral eye increased by 0.92 mm and became equal to 23.47 mm on the average with SE equaling +0.81 D. AL of the patients in the second group increased by 0.29 mm and reached the mean value of 21.59 mm while the spherical refractive equivalent became equal to 0.25 D. During the same period, AL in the contralateral eye increased by 0.97 mm and became equal to 23.32 mm on the average with SE equaling +0.62 D. Conclusion. During three years after hyperopic S-LASIK, the minimal growth of the antero-posterior axis of the eye was documented in the children presenting with hyperopia (+5 D) whereas its length increased by more than 0.29 mm. In the children with hyperopia of less than +5 D, it increased by 0.41 mm. It is concluded that prognosis of the results of femtosecond laser-assisted in situ keratomileusis leading to the alteration of the refraction in the amblyopic eye with the initially moderate or high-degree hyperopia should be made taking into consideration that AL continues to change in the cource of further growth of the child.

scholarly journals Macrolide-Resistant and Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia in Children Treated Using Early Corticosteroids

2021 ◽  
Vol 10 (6) ◽  
pp. 1309
Author(s):  
Hye Young Han ◽  
Ki Cheol Park ◽  
Eun-Ae Yang ◽  
Kyung-Yil Lee
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Serological Test ◽  
Corticosteroid Treatment ◽  
23S Rrna ◽  
Laboratory Parameters ◽  
The Mean ◽  
Domain V ◽  
Positive Results ◽  
Mycoplasma Pneumoniae Pneumonia

We have found that early corticosteroid therapy was effective for reducing morbidity during five Korea-wide epidemics. We evaluated the clinical and laboratory parameters of 56 children who received early corticosteroid treatment for pneumonia that was caused by macrolide-resistant Mycoplasma pneumoniae (M. pneumoniae) or macrolide-sensitive M. pneumoniae between July 2019 and February 2020. All subjects had dual positive results from a PCR assay and serological test, and received corticosteroids within 24–36 h after admission. Point mutation of residues 2063, 2064, and 2067 was identified in domain V of 23S rRNA. The mean age was 6.8 years and the male:female ratio was 1.2:1 (31:25 patients). Most of the subjects had macrolide-resistant M. pneumoniae (73%), and all mutated strains had the A2063G transition. No significant differences in clinical and laboratory parameters were observed between macrolide-resistant and macrolide-sensitive M. pneumoniae groups that were treated with early dose-adjusted corticosteroids. Higher-dose steroid treatment may be needed for patients who have fever that persists for >48 h or increased biomarkers such as lactate dehydrogenase concentration at follow-up despite a usual dose of steroid therapy.

scholarly journals Management of Distal Humerus Fractures With Jess Fixator

2015 ◽  
Vol 3 (4) ◽  
pp. 16-20
Author(s):  
Prakriti Raj Kandel ◽  
Kishor Man Shrestha ◽  
Laxmi Pathak
Keyword(s):  
Distal Humerus ◽  
Humerus Fracture ◽  
Medical Sciences ◽  
Distal Humerus Fracture ◽  
Fixation Technique ◽  
Fixation Techniques ◽  
Humerus Fractures ◽  
The Mean ◽  
Distal Humerus Fractures

INTRODUCTION: Fractures of distal humerus are rare comprising approximately 2% of all fractures and a third of all humerus fractures. Even with the development of newer fixation techniques, the treatment of distal humerus fractures remains a great challenge to any orthopaedic surgeon. Thus this present study was conducted to evaluate the results of Joshi's External Stabilization System (JESS) in the management of distal humerus fracture with or without intercondylar extension. MATERIALS AND METHODS: This retrospective study was conducted by collecting records of thirty two adult patients who sustained distal humerus fracture and were managed with JESS fixation under anaesthesia over a period of two years in Universal College of Medical Sciences Teaching Hospital (UCMSTH) after obtaining permission from Institutional ethical committee. RESULTS: According to AO (Arbeitsgemeinschaft für Osteosynthesefragen) classification, 2 patients had C1 fracture and 30 patients had C2 fractures. The mean duration of JESS application was 16 weeks. The mean follow up was 8 months. The functional outcome was evaluated by using Cassebaum's functional rating system. Among C1 fractures, 50% showed fair and 50% showed good result whereas among C2 fractures, 40% showed good, 46.66% showed fair and 13.33% showed poor results.  CONCLUSIONS: JESS fixation technique represents a viable option in the management of open as well as close intercondylar fractures of the distal humerus.

Preliminary six-month outcomes of LIMBSAVE (treatment of critical Limb IscheMia with infragenicular Bypass adopting in situ SAphenous VEin technique) registry

Vascular ◽  
2020 ◽  
pp. 170853812096612 ◽  
Author(s):  
Nicola Troisi ◽  
Giovanni De Blasis ◽  
Mauro Salvini ◽  
Stefano Michelagnoli ◽  
Carlo Setacci ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Critical Limb Ischemia ◽  
Saphenous Vein ◽  
Limb Ischemia ◽  
Primary Patency ◽  
Secondary Patency ◽  
Bypass Patency ◽  
The Mean

Objectives Guidelines recommend open bypass surgery for long occlusions of infrainguinal arteries. In situ saphenous vein bypass is a standardized technique. The aim of this study was to report preliminary six-month outcomes of a national, multicenter, observational, prospective registry based on the examination of treatment of critical Limb IscheMia with infragenicular Bypass adopting the in situ SAphenous VEin technique (LIMBSAVE). Methods From January 2018 until October 2019, 428 patients from 41 centers were enrolled in the LIMBSAVE registry. Data were prospectively collected in a dedicated database, including demographics, preoperative risk factors, clinical and diagnostic preoperative assessments, intraoperative measures (including safety and effectiveness of the valvulotome during the surgical procedures), and 30-day follow-up data. Furthermore, estimated six-month outcomes according to Kaplan–Meier curves in terms of primary patency, primary assisted patency, secondary patency, and limb salvage were evaluated. Results Patients were predominantly male ( n = 332, 77.6%) with a mean age of 73.3 years (range 39–95). Technical success, defined as bypass pulse after use of the valvulotome, was obtained in all cases. The proximal anastomosis could be reached by the valvulotome in all cases. The mean number of valvulotome uses was 2.5 (range 1–5). No vein perforation was reported. In nine cases (2.1%), a vein lesion with intramural hemorrhage occurred. The mean length of hospital stay was 11.1 days (range 1–60). At 30-day follow-up, the overall bypass patency rate was 97.4%, and the rate of open or endo reinterventions for failing bypass was 5.4%. At six-month follow-up, the estimated primary patency, primary assisted patency, secondary patency, and limb salvage were 78.1%, 86.2%, 92.1%, and 94.7%, respectively. Conclusions Preliminary intraprocedural outcomes of the LIMBSAVE registry show that the in situ technique with the valvulotome is safe and effective in disrupting valves and obtaining pulsatility in the saphenous vein. The complication rate related to the use of the valvulotome is low. The six-month preliminary outcomes in terms of overall patency and limb salvage are promising. Further examinations and continuous follow-up are needed to evaluate long-term outcomes.

scholarly journals The Modulation of Laser Refractive Surgery on Sensory Eye Dominance of Anisometropia

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Hongting Liu ◽  
Qi Chen ◽  
Fangfang Lan ◽  
Yan Luo ◽  
Enwei Lin ◽  
...  
Keyword(s):  
Refractive Surgery ◽  
Ocular Dominance ◽  
Eye Dominance ◽  
The Mean ◽  
Laser Refractive Surgery ◽  
Sensory Eye Dominance ◽  
Stereo Acuity ◽  
Sensory Dominance

Purpose. To evaluate the effect of laser refractive surgery on sensory eye dominance of anisometropia. Methods. A total of 156 subjects with nonanisometropic myopia and 70 subjects with anisometropic myopia were enrolled in the first part of the study. The dichoptic motion coherence threshold technique was applied to collect the normal dataset and distribution of sensory eye dominance. The second part of the study included 40 subjects with nonanisometropic myopia and 40 subjects with anisometropic myopia who received the femtosecond laser-assisted in situ keratomileusis (Fs-LASIK). A comprehensive ophthalmologic evaluation was performed with particular attention to sensory eye dominance preoperatively and one-week and one-month postoperatively. The ocular dominance index (ODI) was applied to evaluate the subject’s overall degree of sensory ocular dominance. Visual acuity, sighting eye dominance, and stereo acuity were also accessed. Results. In experiment one, the mean ODI in the nonanisometropic group and the anisometropic group was 1.48 ± 0.63 and 1.95 ± 1.07, respectively. The ODI values of the anisometropic group were significantly higher than those of the nonanisometropic group (Mann–Whitney U test, P<0.001). The demographics information and the distribution of ODI values in both groups are summarized in tables and figures. In experiment two, all LASIK procedures were uneventful and no postoperative complications were observed during the postoperative follow-up. Preoperatively, the ODI values of the anisometropic LASIK group were significantly higher than those of the nonanisometropic LASIK group, which was consistent with the results of part 1. However, one week after operation, the mean ODI values of the anisometropic LASIK group had significantly decreased from 1.89 ± 1.09 to 1.39 ± 0.44. And, the mean ODI values slightly increased to 1.65 ± 0.61 one-month postoperatively. In the nonanisometropic LASIK group, there were no statistically significant differences of ODI changes among preoperative, post-one-week and post-one-month visits. The demographics information and the changes of ODI of both LASIK groups are summarized in tables and figures. Conclusion. Stronger sensory eye dominance is seen in the subjects with anisometropic myopia compared to subjects with nonanisometropic myopia. The strong sensory dominance of anisometropia becomes more balanced at one week of postoperation but returns to the preoperative level after one month. Laser refractive surgery had a short-term modulation of sensory eye dominance.

scholarly journals Early experience of laparoscopic varicocelectomy in College of Medical Sciences, Teaching Hospital, Bhartpur, Nepal

2012 ◽  
Vol 8 (2) ◽  
pp. 32-36
Author(s):  
A Agarwal ◽  
G Sigdel ◽  
N Lamichhane ◽  
WK Belokar
Keyword(s):  
Teaching Hospital ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Operation Time ◽  
Medical Sciences ◽  
Surgical Indications ◽  
Scrotal Pain ◽  
Pampiniform Plexus ◽  
The Mean

Varicocele is dilatation of pampiniform plexus of veins in the scrotum. Laparoscopic varicocelectomy is gaining popularity since its introduction in 1990s. We present our experience of laparoscopic varicocelectomy in College of Medical sciences, Teaching Hospital, Bharatpur, Nepal. Ten patients underwent laparoscopic varicocelectomy between Jan 2009 to July 2010. The mean age of patients was 25.7 (range, 14 to 38) years. All varicoceles were detected clinically and confirmed by scrotal color Doppler ultrasonography. The varicocele was left sided in 6 (60%) and bilateral in 4 cases(40%). The surgical indications were scrotal pain and discomfort in 8, infertility in 1, and both in 1. Mean operation time was 50 ± 22 minutes (range, 35-110). Following operation 6 patients were symptom free immediately and remaining 2 patients also became asymptomatic on 15 days followup. Both patients of infertility, lost follow up, post operatively. Neither recurrent varicocele nor hydrocele was detected with a mean follow-up of 13 months. All patients were discharged within 24 hours postoperatively. Every attempt was made to preserve spermatic artery and lymphatic vessel. The procedure is safe and effective. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-2, 32-36 DOI: http://dx.doi.org/10.3126/jcmsn.v8i2.6835

scholarly journals Antegrade Percutaneous Versus Retrograde Ureteroscopic Lithotripsy in Upper Ureteric Cases

2020 ◽  
Vol 3 (1) ◽  
pp. 84-87
Author(s):  
A. Nischal Prasad ◽  
Prasad PVGS
Keyword(s):  
Operative Time ◽  
Stone Size ◽  
Ureteroscopic Lithotripsy ◽  
Stone Clearance ◽  
Medical College ◽  
Ureteric Calculus ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
The Difference

Background: The technical advancements in urology have profoundly changed the management of upper ureteric calculus. The present study compared antegrade percutaneous versus retrograde ureteroscopic lithotripsy in upper ureteric cases. Subjects and Methods: The present study was conducted at NRI Medical College & Hospital, Chinakakani, Mangalagiri Mandal, Andhra Pradesh from May 2013 to April 2014  on 60 patients with upper ureteric stones of both genders. Patients were divided into 2 groups. Group I patients were treated with antegrade percutaneous and group II with retrograde ureterolithotripsy. Outcome in both groups was recorded and compared. Results: The mean anesthetic time in group I was 82.4 minutes and in group II was 73.1 minutes, operative time was 45.2 minutes in group I and 58.4 minutes in group II, post- operative stay in group I was 2.6 days and in group II was 1.7 days, stone clearance was seen in 26 patients in group I and 22 in group II. Mean stone size in group I was 1.89 cm and in group II was 1.49 cm. Follow ups days were 71.2 in group I and 83.4 in group II. Clavien-Dindo categorization grade 0 was seen in 16 in group I and 13 in group II, grade 1 in 10 in group I and 12 in group II and grade 2 in 4 in group I and 5 in group II. The difference was significant (P< 0.05). There were 4 and 5 patients in group I and group II with post- operative complications (P< 0.05). Conclusion: Authors found that antegrade percutaneous has better stone clearance rates as compared to retrograde ureterolithotripsy for an upper ureteric calculus.

scholarly journals Five year refractive outcome of LASIK for myopia and myopic astigmatism in Vietnam

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Thanh Ngoc Dan Pham
Keyword(s):  
Refractive Surgery ◽  
Laser In Situ Keratomileusis ◽  
Ho Chi Minh City ◽  
Refractive Outcome ◽  
Vietnamese Population ◽  
The Mean ◽  
Myopic Astigmatism

Purpose: To assess the long-term refractive outcome of laser in situ keratomileusis (LASIK) for myopia and myopic astigmatismDesign:  An observational, single center, multisurgeon case seriesMethods: This study was a follow up study of 128 patients contacted to return for repeat investigation post refractive surgery. It included 245 eyes of 128 patients who underwent LASIK for myopia or myopic astigmatism at the Ho Chi Minh City Eye Hospital, Vietnam in 2008. Surgical parameters as well as patient data at presentation, three months and five years after surgery were analyzed. The main outcome was spherical equivalent (SE) within ± 0.5D at 5 years. Results: At the fifth year follow up, 80% of eyes were within ± 0.5D and 98% of eyes were within ± 1.0D of emmetropia. No eyes underwent laser enhancement prior to the last visit although the retreatment criteria was met in 45 eyes (18.4%). The mean SE decreased from 0.16 ± 0.33 at 3 months to -0.07 ± 0.50 at 5 years for the whole cohort. Patients with severe myopia were most susceptible to myopic regression and had a less predictable refractive outcome. The overall UCVA of 20/20 or better and of 20/40 or better were obtained in 68.2% and 95.1% of eyes. Fourteen eyes (5.7%) improved 1 line of BCVA. Forty two eyes (17.1%) lost 2 lines of BCVA which were unrelated to laser complications.Conclusion: Although there was myopic regression over time, LASIK provided excellent  5 year refractive outcome for myopia and myopic astigmatism.  Almost 20% of patients meet criteria for retreatment but do not seek a retreatment in this Vietnamese population.

scholarly journals Comparison of Three Different Methods to Detect Bone Marrow Involvement in Patients with Neuroblastoma

2021 ◽  
Author(s):  
Felix Schriegel ◽  
Sabine Taschner-Mandl ◽  
Marie Bernkopf ◽  
Uwe Grunwald ◽  
Nikolai Siebert ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Involvement ◽  
Diagnostic Tools ◽  
Solid Malignancy ◽  
Additional Information ◽  
The Central Nervous System ◽  
Positive Results ◽  
Observation Period

Abstract Purpose Neuroblastoma (NB) is the most frequent solid malignancy in children outside the central nervous system. Detection of bone marrow (BM) involvement is crucial for correct staging and risk-adapted treatment. We compared three different methods regarding the detection of NB involvement in BM. Methods Eighty-one patients with NB were included in this retrospective study. BM samples were obtained at designated time points at study entry and during treatment or follow-up. The diagnostic tools for BM analysis included cytomorphology (CM), flow cytometry (FCM) and automatic immunofluorescence plus fluorescence in situ hybridization (AIPF). Results We analyzed 369 aspirates in 81 patients in whom AIPF, CM, and FCM were simultaneously available. During the observation period, NB cells were detected in 86/369 (23.3%) cases, by CM in 32/369 (8.7%) samples, by FCM in 52 (14.1%) samples, and by AIPF in 72 (19.5%) samples. AIPF and/or FCM confirmed all positive results obtained in CM and detected 11 additional BM aspirates with NB cells in 294 CM negative samples (p < 0,001). Survival of patients with BM involvement at entry into the study identified solely by FCM / AIPF was 17.4% versus 0% for patients in whom BM involvement was already identified by CM. Conclusion The combination of AIPF and FCM yielded the highest detection rate of NB cells in BM. AIPF was the single, most sensitive method in detecting NB cells in BM. Although CM did not contribute additional information, it is still a useful tool because of its rapid availability and cost-efficiency.

scholarly journals 324 Outcomes of the Exeter V40 Cemented Femoral Stem at a Minimum of 10 Years in a Non-designer Centre

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J Mahon ◽  
C McCarthy ◽  
G Sheridan ◽  
J Cashman ◽  
J O'Byrne ◽  
...  
Keyword(s):  
Femoral Stem ◽  
High Volume ◽  
Womac Score ◽  
Long Term Outcomes ◽  
Data Set ◽  
The Mean ◽  
Primary Total Hip Arthroplasty

Abstract Introduction The Exeter V40 cemented femoral stem was first introduced in 2000. The largest single-centre analysis of this implant to date was published in 2018, with excellent results at a minimum of 10-years for the first 540 cases performed at the designer centre in the Exeter NHS Trust. The aim of this current study is to report long term outcomes and survivorship for the Exeter V40 stem in a non-designer centre. Method All patients undergoing primary total hip arthroplasty using the Exeter V40 femoral stem between January 1st 2005 and January 31st 2010 were eligible for inclusion. Outcome measures included data on all components in situ beyond 10 years, death occurring within 10 years with components in situ and all-cause revision surgery. Results A total of 829 stems were included in the data set. Of these, 808 (97.5%) had no further surgery within the follow-up period; 648 stems (78.1%) were in situ beyond 10 years, and 165 (19.9%) were in situ at death before 10 years. The mean preoperative WOMAC score was 61±15.9 with a mean postoperative score of 20.4±19.3. Conclusions The Exeter V40 cemented femoral stem demonstrates excellent functional outcomes and survival when used in a high-volume non-designer centre.

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