scholarly journals Endoscopic treatment of complex multiloculated hydrocephalus in children, steps that may help to decrease revision rate

2021 ◽  
Vol 12 ◽  
pp. 434
Author(s):  
Sherif Elsayed Elkheshin ◽  
Mohamed Bebars
Keyword(s):  
Randomized Clinical Trials ◽  
Standard Technique ◽  
Ventricular System ◽  
Redo Surgery ◽  
Modified Technique ◽  
Shunt Insertion ◽  
Multiloculated Hydrocephalus ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Multiloculated hydrocephalus (MLH) is associated with increased intracranial pressure, with intraventricular septations, loculations, and isolation of parts of the ventricular system. Search continues for ideal surgical remedy capable of addressing the dimensions of the problem. We aimed to evaluate endoscopic septal fenestration and pellucidotomy combined with proximal shunt tube refashioning and further advancement into isolated loculations of the ventricular system containing choroid plexus. Methods: This retrospective study was conducted on 55 patients with symptomatic complex MLH who underwent endoscopic surgery. The collected data included patients’ age, gender, presenting manifestations, operative details, rate of remission of preoperative clinical and imaging signs, postoperative complications, redo surgery, or extra shunt hardware insertion. Patients were divided into Group A (underwent the standard technique of endoscopic multiseptal wide fenestration and final ventriculoperitoneal shunt insertion) and Group B (modified technique by adding extra side ports along the proximal shunt hardware). Results: Groups A and B included 25 and 30 patients, respectively. The percentage of patients showing improvement of almost all manifestations was higher in Group B compared to Group A, with no significant difference (P > 0.05). Group B had lower rate of complications (20% vs. 36%, P = 0.231), insertion of two shunts (16.7% vs. 20%, P = 1.000), and redo surgery (20% vs. 44%, P = 0.097). Conclusion: The modified technique was associated with better outcomes in terms of the use of single shunt and redo surgery. Launching randomized clinical trials to compare the two techniques are recommended to ascertain the efficacy of the modified technique.

Bicaval Anastomosis Reduces Tricuspid Regurgitation after Heart Transplantation

2005 ◽  
Vol 13 (3) ◽  
pp. 251-254 ◽  
Author(s):  
Kook-Yang Park ◽  
Chul-Hyun Park ◽  
Yang-Bin Chun ◽  
Mi-Seung Shin ◽  
Kyung-Chun Lee
Keyword(s):  
Heart Transplantation ◽  
Tricuspid Regurgitation ◽  
Survival Rates ◽  
Standard Technique ◽  
Ischemic Time ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Bicaval Anastomosis ◽  
Late Postoperative Period

The standard surgical technique utilizing two atrial cuff anastomoses has been used in the majority of transplant centers until recently when bicaval anastomoses was introduced. The purpose of this study was to compare the prevalence of tricuspid regurgitation after the bicaval and standard techniques of anastomosis. Heart transplantation was performed in 43 patients at our institution from April 1994 to December 2003: 15 by the standard technique (group A) and 28 by the bicaval technique (group B). No differences in pre-transplant diagnosis, donor age, immunosuppression, rejection treatment, or graft ischemic time were evident between the two groups. The prevalence of tricuspid regurgitation (≥ moderate) was higher after the standard technique (36.4% vs. 10.5%; p < 0.05). Survival rates at 1 and 3 years in group A were 87% and 55%, and 86% and 78% in group B, with a significant difference in the 3-year mortality. The bicaval anastomosis technique was found to be associated with a lower incidence of tricuspid regurgitation during the late postoperative period, and should be preferred for heart transplantation.

scholarly journals Modified technique of end to side distal radio-cephalic shunt to overcome juxta-anastomotic stenosis

2019 ◽  
Vol 6 (4) ◽  
pp. 1029
Author(s):  
Haitham Atif ◽  
Nehad Abdou Zaid ◽  
Abd El-Mieniem Fareed Mohamed ◽  
Yehia Mohamed Alkhateep
Keyword(s):  
Patency Rate ◽  
Intervention Group ◽  
Anastomotic Stenosis ◽  
Control Group ◽  
P Value ◽  
Modified Technique ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Juxta-anastomotic stenosis (JAS) is one of the predominant causes of arteriovenous fistula (AVF) failure, with the reported incidence of 65%, so that technical modification to alter the outflow vein configuration using the modified technique has been applied to prevent JAS and improve AVF maturation. The aim of the study to evaluate the modified technique of end-to-side distal radiocephalic A-V fistula regarding maturation, patency rate and the resultant juxta-anastomotic stenosis.Methods: This prospective study was carried out on 80 patients with end stage renal disease (ESRD) at vascular surgery unit in general surgery department, Menoufia university hospital that prepared for dialysis. 40 patients "intervention group" underwent the modified technique to establish a functioning radiocephalic fistula; the other group (40 patients, control group) had the conventional technique of end to side radiocephalic fistula. Follow up of patients was over 6 months regarding function, patency rate and development of juxta-anastomotic stenosis.Results: There was statistically significant difference between 2 groups regarding primary failure, patency and JAS. Primary failure was detected in 2 patients in group A and in 5 patients in group B (p-value is 0.04). Considering patency rate, after 3 months the ratio between group A and group B was 37:34 with significant P value of 0.02, and after 6 months the ratio was 35:33 with P value of 0.03. Regarding JAS, by the end of follow up period, 4 patients diagnosed with JAS in group A, while group B had 8 patients, with p value of 0.01.Conclusions: Modified technique of end to side anastomosis for primary radio-cephalic fistula creation has better patency rate and low incidence of JAS than conventional method.

scholarly journals Equianalgesic Oxycodone, Continuous Intravenous Morphine in Post- Long Bone Surgery

2019 ◽  
Vol 2 (3) ◽  
pp. 133-145
Author(s):  
Franz Josef Tarigan ◽  
Achsanuddin Hanafie ◽  
Hasanul Arifin ◽  
Dadik Wahyu Wijaya
Keyword(s):  
Randomized Clinical Trials ◽  
Drug Dose ◽  
Long Bone ◽  
Average Dose ◽  
Morphine Group ◽  
Double Blind ◽  
Significant Difference ◽  
Intravenous Morphine ◽  
Group A ◽  
Group B

Oxycodone and morphine are powerful analgesic drugs used for post-operative pain management. There is no studies have been conducted to assess the dose equivalency between the two drugs. To get an equianalgesic dose of Oxycodone and Morphine. This study was using a double-blind randomized clinical trials, 48 samples, ages 21-60 years, PS ASA I-II, which will get an elective orthopedic surgery using general anesthesia tech-niques. Oxycodone (group A) : Morphine (group B) (Initial 5mg than continuous 1 mg/hour : initial dose 4mg than continuous 0,5 mg/hour). Average drug dose for group that takes morphine and oxycodone  (3.90 ± 0.46 mg : 1.46 ± 0.51 mg).  No significant difference between the average dose (p <0.05).  Equianalgesic dosein group Oxycodone and Morphine is 1.4 mg: 3.9mg.

scholarly journals Fixation of orbicularis oculi muscle and orbital septum to pretarsal fascia and correction of blepharoptosis in construction of double eyelids

2020 ◽  
Vol 48 (4) ◽  
pp. 030006051987041
Author(s):  
Ziying Dong ◽  
Pingping Meng ◽  
Lei Zhang ◽  
Zhenyu Chen
Keyword(s):  
Orbicularis Oculi Muscle ◽  
Modified Technique ◽  
Upper Eyelid ◽  
Orbicularis Oculi ◽  
Orbital Septum ◽  
Significant Difference ◽  
Degree Of Satisfaction ◽  
Group A ◽  
Group B ◽  
Method Group

Objective This study was performed to evaluate a novel method of constructing double eyelids by fixation of the orbicularis oculi muscle and orbital septum to the pretarsal fascia and correction of blepharoptosis. Methods In total, 285 patients requesting aesthetic construction of double eyelids were divided into three groups: those treated by the modified method (Group A, n = 108), those treated by traditional construction of the upper eyelid (Group B, n = 85), and those treated by the Park method (Group C, n = 92). The patients were followed up for 3 to 12 months (average, 6 months). The surgical effects and degree of satisfaction were compared among the three groups. Results In Group A, the mean operative time was 1.0 ± 0.2 hours. The degree of satisfaction with the surgical effect was significantly different between Group A (95.37%) and Group B (87.06%). However, no significant difference in satisfaction was noted between Group A (95.37%) and Group C (91.30%) or between Group B (87.06%) and Group C (91.30%). Conclusions The modified technique is simple and effective for construction of double eyelids and correction of blepharoptosis. All patients were satisfied with the surgical and aesthetic effects.

scholarly journals Percutaneous Nephrolithotomy: A Comparison of Tubeless versus the Standard technique

2021 ◽  
Vol 25 (1) ◽  
pp. 140-144
Author(s):  
Zein El Amir ◽  
Muhammad Ali Shahiman ◽  
Zeeshan Qadeer ◽  
Rameez Ahmed Mughal ◽  
Ashfaq Ali
Keyword(s):  
Major Complication ◽  
Postoperative Outcome ◽  
Standard Technique ◽  
Significant Difference ◽  
Postoperative Drainage ◽  
Dj Stent ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Tubeless Pcnl

Objective: The proposed study aimed to assess the utility of tubeless PCNL in terms of efficacy and safety when compared with the standard tubed PCNL. Materials & Methods: In this study 280 patients (age ranged 08-70 years) who underwent PCNL were included. Results: The patients were from both genders i.e., 156 males and 124 females. Out of 280 patients, 140 had a 16 FR nephrostomy tube (Group A) whiles an equal number had 4.8F DJ Stent (Group B) for postoperative drainage. A comparison of the postoperative outcome among the two groups was made for a period of two years (November 2017 to October 2019). Neither any significant difference was found in the mean stone size, operative time, nor was stone-free status, nor any major complication observed. The mean hospital stay for group A and group B was 4.5 days (range 3 to 6) and 3.2 days (range 2 to 4) respectively. An early postoperative wound soakage was found in 18 (12.8%) cases of group A in contrast to the group B patients in whom only 2 (1.4%) had soakage. Conclusion: It was concluded that Tubeless PCNL as compared to the standard tubed PCNL was found more efficacious and safer and it should be adopted as a routine procedure.

scholarly journals Modified MCL Indentation Technique in Total Knee Arthroplasty With Severe Type II Valgus Deformity

2021 ◽  
Author(s):  
Feng Li ◽  
Cheng Wang ◽  
Minwei Zhao ◽  
Xiao Geng ◽  
Junyang Li ◽  
...  
Keyword(s):  
Valgus Deformity ◽  
Type Ii ◽  
Modified Technique ◽  
Indentation Technique ◽  
Valgus Angle ◽  
Significant Difference ◽  
Functional Scores ◽  
Group A ◽  
Group B ◽  
Severe Type

Abstract Purpose A modified technique, medial indentation of the medial collateral ligament(MCL),was usedin total kneearthroplastywith severe type II valgus deformity. The study compared the clinical outcomes of the technique relative to conventional release group. Methods Consecutive patients with a Krackow type II valgus deformity of >20° who underwent a primary unilateral TKA between May 2008 and June 2017 were retrospectively studied. Modified MCL indentation technique was performed in 20 patients (group A), while the remaining 23 patients (group B) received routine release technique. Radiological parameters, such as the valgus angle (VA), and functional outcomes including the use of constraint implants, Knee Society Score(KSS), Knee Society function score(KSF), and height of the polyethylene insert, were compared between the two groups.Results 43 consecutive patients had a minimum 2-year follow-up. The preoperative VA was comparable between group A (23.5° ± 5.8°) and group B (21.3° ± 3.2°, P =0.134), so was the postoperative VA (1.1° ± 2.1° and 2.5° ± 3.0°, P =0.084 in groups A and B, respectively).The postoperative KSS and KSF showed marked improvement. While no statistically significant difference in preoperative or postoperative functional scores was found between two groups, group A had thinner PE insert (9.5 ± 1.1 mm vs. 12.9 ± 1.5 mm) and less use of constrained condylar inserts(15% vs. 69.6%). Conclusion Modified MCL indentation technique can achieve good outcomes in TKA with type II valgus deformity of >20°.

Randomized trial of medical compression stockings versus two-layer short-stretch bandaging in the management of venous leg ulcers

Phlebologie ◽  
2009 ◽  
Vol 38 (04) ◽  
pp. 157-163 ◽  
Author(s):  
A. Franek ◽  
L. Brzezinska-Wcislo ◽  
E. Blaszczak ◽  
A. Polak ◽  
J. Taradaj
Keyword(s):  
Drug Therapy ◽  
Randomized Clinical Trials ◽  
Therapy Group ◽  
Long Term Results ◽  
Leg Ulcers ◽  
Compression Stockings ◽  
Venous Leg Ulcers ◽  
Group A ◽  
Group B ◽  
Medical Compression Stockings

SummaryA prospective randomized clinical trial was undertaken to compare a medical compression stockings with two-layer short-stretch bandaging in the management of venous leg ulcers. Study endpoints were number of completely healed wounds and the clinical parameters predicting the outcome. Patients, methods: Eighty patients with venous leg ulcers were included in this study, and ultimately allocated into two comparative groups. Group A consisted of 40 patients (25 women, 15 men). They were treated with the compression stockings (25–32 mmHg) and drug therapy. Group B consisted of 40 patients (22 women, 18 men). They were treated with the short-stretch bandages (30–40 mmHg) and drug therapy, administered identically as in group A. Results: Within two months the 15/40 (37.50%) patients in group A and 5/40 (12.50%) in group B were healed completely (p = 0.01). For patients with isolated superficial reflux, the healing rates at two months were 45.45% (10/22 healed) in group A and 18.18% (4/22 healed) in group B (p = 0.01). For patients with superficial plus deep reflux, the healing rates were 27.77% (5/18 healed) in group A and 5.55% (1/18 healed) in group B (p = 0.002). Comparison of relative change of the total surface area (61.55% in group A vs. 23.66% in group B), length (41.67% in group A vs. 27.99% in group B), width (46.16% in group A vs. 29.33% in group B), and volume (82.03% in group A vs. 40.01% in group B) demonstrated difference (p = 0.002 in all comparisons) in favour of group A. Conclusion: The medical compression stockings are extremely useful therapy in enhancement of venous leg ulcer healing (both for patients with superficial and for patients who had superficial plus deep reflux). Bandages are less effective (especially for patients with superficial plus deep reflux, where the efficiency compared to the stockings of applied compression appeared dramatically low). These findings require confirmation in other randomized clinical trials with long term results.

DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

2019 ◽  
Vol 1 (4) ◽  
pp. 133-139
Author(s):  
Yasser Hamdy ◽  
Mohammed Mahmoud Mostafa ◽  
Ahmed Elminshawy
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Early Postoperative Period ◽  
Tricuspid Valve Repair ◽  
Ring Annuloplasty ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

Effect of short-term use of oral contraceptive pills on intraocular pressure

2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik ◽  
Hina Nadeem ◽  
Eiman Ayesha ◽  
Rabail Alam
Keyword(s):  
Oral Contraceptive ◽  
Childbearing Age ◽  
Short Term ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Time Period ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Short Time

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age.   Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21.   Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.

Comparative Clinical study of Jatyadi Taila and Jatyadi Ghrita in the management of Dushta Vrana

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Rajendra Joshi ◽  
N. B. Mashetti ◽  
Rakesh Kumar Gujar
Keyword(s):  
Clinical Study ◽  
Burning Sensation ◽  
Normal Process ◽  
Surgical Practice ◽  
Local Factors ◽  
Significant Difference ◽  
Comparative Clinical Study ◽  
Group A ◽  
Contaminated Wound ◽  
Group B

Dushta Vrana is a common and frequently encountered problem faced in surgical practice. The presence of Dushta Vrana worsens the condition of the patient with different complications and may become fatal. Local factors on wound like slough, infection and foreign body, affect the normal process of healing. A healthy wound in a normal body heals earlier with a minimum scar as compared to a contaminated wound. Therefore in this study all the efforts are made to make a Dushta Vrana into a Shuddha Vrana. Once the Vrana becomes Shuddha, Ropana of the Vrana will start. The objective of the study was to evaluate the clinical efficacy of Jatyadi Taila and Jatyadi Ghrita in Dushta Vrana. Clinically diagnosed 60 Patients of Dushta Vrana were randomly divided into two groups, each consisting of 30 Patients. Group A were treated with the Jatyadi Taila and Group B was treated by Jatyadi Ghrita. The results observed was based on the relief obtained on the subjective and objective parameters taken for consideration for this study viz, size of ulcer, discharge, smell, pain, burning sensation, itching and granulation were found significant (P Lass Than 0.05). On the basis of assessment criteria and overall result of treatment, the patients of Jatyadi Taila group showed better results when compared to Jatyadi Ghrita group. Even though statistically there is no much significant difference between the two groups, but by seeing the effect on individual parameters (subjective and objective) and over all response, Jatyadi Taila seems to be effective when compared to Jatyadi Ghrita. It is having more Ropana qualities when compared to Shodhana.

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