scholarly journals FISTLUA-IN-ANO;

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Mohammad Zarin ◽  
Muhammad Asim Khan ◽  
Syed Asad Maroof Shah

Objectives:To determine the frequency ofhealing in patients with high lying fistlua in ano undergoing video assisted anal fistula treatment.Study Design:Descriptive cross sectional.Setting: Department of General Surgery, Khyber Teaching Hospital, Peshawar. Period: One year (1stApril 2014 to 31stMarch 2015). Materials and Methods:Total of 153 patients were observed.Karl Storz Video equipment including MeineroFistuloscope is used. Key steps are visualization of the fistula tract, correct localization of the internal fistula opening under direct vision and endoscopic treatment of the fistula. This is followed by an operative phase of fulguration of the fistula tract with cautery and using glycine solution mixed with manitol, curetting the tract with curette and fistula brush. Internal opening is closed with a Vicryl 1 suture.Results:Our study shows 80% patients were in age range 30-40 years, 17% patients were in age range 41-50 years, 3% patients were in age range 51-60 years. Mean age was 38 years with SD ± 2.03. Seventy seven percent patients were male and 23% patients were female. Seventy percent patients had healing while 30% patients didn’t had healing in the specified duration.Conclusion:The main feature of the VAAFT technique is that the procedure is performed entirely under direct endoluminal vision. Moreover, fistuloscopy helps to identify any possible secondary tracts or chronic abscesses. The VAAFT technique is sphincter-saving, and the surgical wounds are extremely small. Our preliminary results are very promising.

Author(s):  
Carlos Ramon Silveira MENDES ◽  
Luciano Santana de Miranda FERREIRA ◽  
Ricardo Aguiar SAPUCAIA ◽  
Meyline Andrade LIMA ◽  
Sergio Eduardo Alonso ARAUJO

Backgroung : Anorectal fistula represents an epithelized communication path of infectious origin between the rectum or anal canal and the perianal region. The association of endoscopic surgery with the minimally invasive approach led to the development of the video-assisted anal fistula treatment. Aim : To describe the technique and initial experience with the technique video-assisted for anal fistula treatment. Technique : A Karl Storz video equipment was used. Main steps included the visualization of the fistula tract using the fistuloscope, the correct localization of the internal fistula opening under direct vision, endoscopic treatment of the fistula and closure of the internal opening which can be accomplished through firing a stapler, cutaneous-mucosal flap, or direct closure using suture. Results : The mean distance between the anal verge and the external anal orifice was 5.5 cm. Mean operative time was 31.75 min. In all cases, the internal fistula opening could be identified after complete fistuloscopy. In all cases, internal fistula opening was closed using full-thickness suture. There were no intraoperative or postoperative complications. After a 5-month follow-up, recurrence was observed in one (12.5%) patient. Conclusion : Video-assisted anal fistula treatment is feasible, reproducible, and safe. It enables direct visualization of the fistula tract, internal opening and secondary paths.


2020 ◽  
Vol 7 (2) ◽  
pp. 64-67
Author(s):  
Abu Sayeed Mohammad ◽  
Shahadat Hossain ◽  
Zulfiqur Hossain Khan

Background: Crack sole may produce significant morbidity among the physical labourer. Objective: The purpose of this study was to find out the patch test result in crack sole which was due to allergic contactants. Methodology: This test was conducted in the Department at Dermatology and Venereology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2001 to June 2002 for a period of one year. Patients with crack sole were selected as study population. All patients were asked about the details clinical history. Patch test was done by individually prepared alminium Finn Chamber mounted on scanpore tape. Result: A total number of 15 patients were recruited for this study after fulfilling the inclusion and exclusion criteria. The age range was 8 years to 70 years. Among 15 patients 3 patients were patch test positive remaining 12 patients were patch test negative. Two patient were female and one was male. Conclusion: In conclusion patch test is positive among the crack sole patients. Journal of Current and Advance Medical Research 2020;7(2): 64-67


PEDIATRICS ◽  
1978 ◽  
Vol 62 (6) ◽  
pp. 1021-1025
Author(s):  
Gerald R. Greene

A 4-month-old female infant with meningitis caused by Haeinophilus influenzae type f had a hospital course complicated by sterile subclural effusions and persistent neurologic normalities. One year later she was normal in all respects. The infant's mother had serum bactericidal antibodies to H. influenzae type b but not to type f. During recovery the patient had no bactericidal antibodies to type b, and the type f organism could not be maintained in her serum. Review of the literature identified 40 cases of meningitis reported as caused by H. influenzae other than type b. An evaluation of the ten cases described as due to encapsulated strains (a, e, and f) shows that the age distribution and clinical features are similar to those of meningitis caused by type b. Only five cases of meningitis caused by unencapsulated H. influenzae have been described. Four of the patients were older than the usual age range for type b meningitis and two had prior head trauma. A large clinical trial in Finland with a two-year observation period has denionstrated no untoward increase in non-b H. influenzae meningitis in recipients of a type b vaccine. Serious infections caused by other H. influenzae types will continue to occur sporadically and may increase in frequency when an effective vaccine against type b is widely used in infants.


2019 ◽  
Vol 44 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Meltem Gursu ◽  
Mustafa Arici ◽  
Kenan Ates ◽  
Rumeyza Kazancioglu ◽  
Pinar Guneser Yavas ◽  
...  

Background/Aims: Refugee dialysis is a worldwide growing dilemma with limited experience. This report presents the largest hemodialysis (HD) patient registry data of Syrian refugees in Turkey. Methods: Demographic, clinical, laboratory, and dialysis practice data of 345 Syrian HD patients during one year were collected and analyzed. Results: There were 345 prevalent Syrian HD patients at the end of 2016. Majority of the patients were placed in the Southeast Anatolian Region. The majority of the patients (74.8%) are in the age range of 20-64 years. Dialysis vintage in Turkey is less than 12 months in 20.8% and less than one month in 29.3% of patients. The vascular access was arteriovenous fistula in the majority of patients (72.5%). Kt/V is over 1.7 in 57%, serum albumin is above 35 g/L in 65.8% and hemoglobin level is more than 100 g/L in %65.2 of the patients. The ratio of patients with serum phosphorus level of 1.13-1.77 mmol/L was 56.2%. Twenty Syrian HD patients (14 male, 6 female) died within the year 2016 and annual mortality rate was 5.7%. Conclusion: This study with the largest number of Syrian refugees undergoing maintenance hemodialysis showed good dialysis practices, acceptable values for dialysis adequacy and biochemical parameters along with lower mortality compared to native HD population of Turkey. Longer follow up will enrich the knowledge related to care of refugee population in all over the world.


2018 ◽  
Vol 5 (6) ◽  
pp. 2223 ◽  
Author(s):  
Ramachandra M. L. ◽  
Mayank Garg

Background: Fistula in ano is a track that connects deeply the anal canal or rectum to the skin around the anus. Fistula in ano most commonly follows an anorectal sepsis1. The main principles of management of anal fistula are closure of internal opening of fistula tract, drainage of infection or necrotic tissue, and eradication of fistulous tract with preservation of sphincter function. The objectives were to compare the various aspects like per operative complications, post-operative complications, mean hospital stay in the treatment of fistula in ano using various modalities like fistulotomy, fistulectomy, setons and lift procedure.Methods: This is a randomised, comparative, prospective study of 80 cases of fistula in ano, presenting at surgical opd of K.R. Hospital, Mysore attached to Mysore Medical College and research Institute. Out of which, 20 cases are treated by fistulectomy, 20 by seton, 20 by fistulotomy and the rest 20 cases by LIFT procedure by random selection method, during period of NOVEMBER 1, 2016 to 31st October 2017.Results: Most common age of presentation is 31-40 years and more common in males then females (M:F= 2.3:1 ). Per operative complications include bleeding seen more in patients undergoing fistulectomy. Per operative course of LIFT procedure patients was complication free. Postoperative pain seen more in patients undergoing setons procedure.Conclusions: we conclude that LIFT procedure and Fistulotomy were acceptable procedures for simple, uncomplicated low lying and high lying fistula.


Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1267
Author(s):  
Claudia Brogna ◽  
Lara Cristiano ◽  
Tommaso Verdolotti ◽  
Giulia Norcia ◽  
Luana Ficociello ◽  
...  

Background and Objectives: The aim of this study was to evaluate longitudinal changes using both upper limb muscle Magnetic Resonance Imaging (MRI) at shoulder, arm and forearm levels and Performance of upper limb (PUL) in ambulant and non-ambulant Duchenne Muscular Dystrophy (DMD) patients. We also wished to define whether baseline muscle MRI could help to predict functional changes after one year. Materials and Methods: Twenty-seven patients had both baseline and 12month muscle MRI and PUL assessments one year later. Results: Ten were ambulant (age range 5–16 years), and 17 non ambulant (age range 10–30 years). Increased abnormalities equal or more than 1.5 point on muscle MRI at follow up were found on all domains: at shoulder level 12/27 patients (44%), at arm level 4/27 (15%) and at forearm level 6/27 (22%). Lower follow up PUL score were found in 8/27 patients (30%) at shoulder level, in 9/27 patients (33%) at mid-level whereas no functional changes were found at distal level. There was no constant association between baseline MRI scores and follow up PUL scores at arm and forearm levels but at shoulder level patients with moderate impairment on the baseline MRI scores between 16 and 34 had the highest risk of decreased function on PUL over a year. Conclusions: Our results confirmed that the integrated use of functional scales and imaging can help to monitor functional and MRI changes over time.


2019 ◽  
Vol 2 (1) ◽  

Introduction: Primary osteosarcoma (OS) is the second most common primary bone malignancy, the first being multiple myeloma. OS occurs in the second decade, with a predilection for ends of long bones. Head and neck involvement is seen in 2-9% with extragnathic craniofacial bones in 1–2% of cases. Small Cell OS (SCO) constitutes 1.3-4% of all OS, skeletal distribution and age range being similar. Materials and Methods: We report two rare osteosarcoma and we done the review of the literature about the management and the outcome about intracranial osteosarcoma in our department of neurosurgery. Results: It is two osteosarcoma cases about a 72-year-old man and one 49-year-old man who both mimiking first meningioma. The first case is an unusual site parietal and the second case is occipital. The both benefited surgery with excision and exam of histology confirm diagnosis. But the first case died 15 days after surgery in intensive unit care and the second cases died after one year, he benefited surgery and chemotherapy. Conclusion: Small cell osteosarcoma (SCO) is an extremely uncommon entity that mainly involves the metaphysics of long bones and, rarely, the skull. Histopathology is the key to establishing the correct diagnosis, including sub typing for appropriate management and prognostication, as radiological features are not specific.


2021 ◽  
Vol 28 (06) ◽  
pp. 804-807
Author(s):  
Mohammad Alam

Objective: To analyse the efficacy of non-surgical Crigler massage for treatment of congenital nasolacrimal duct obstruction in infants below one year age. Study Design:  Setting: Khyber Medical University Institute of Medical Sciences (KMU-IMS) KDA Teaching Hospital Kohat. Period: April 2014 to June 2019.  Materials & Methods:  on Non-Surgical Crigler massage for conservative   treatment of congenital nasolacrimal duct obstruction in infants below one year age. Proper proforma was designed for documentation of patients and their follow up. Consents were taken from their parents. 93 patients with age range of 2-6 months with congenital nasolacrimal duct obstruction were included in the study out of which 51(54.83%) were male and 42(45.16%) were female. 79(84.94%) patients had unilateral while 14(15.05%) patients had bilateral congenital nasolacrimal duct obstruction. So total 107 eyes with congenital nasolacrimal duct obstruction were included. Parents were trained and educated for conservative non-surgical Crigler massage of the lacrimal sacs along with topical antibiotics. Parents were instructed to do 8-10 massage four times a day. Patients were followed up to one year of age. 11 patients were lost from complete follow up in which 9 had unilateral while 2 patients had bilateral congenital nasolacrimal duct obstruction. Cumulatively 13 eyes were missed from follow up. Final results of remaining 82 patients with 94 eyes were analysed. Results: Out of 94 eyes epiphora was abolished with negative regurgitation test in 68(72.34%) patients at the end of one year while in 26(27.65%) the procedure was failed. Conclusion: Non-surgical conservative Crigler massage is very successful in management of congenital nasolacrimal duct obstruction.


Author(s):  
JAIDEV KUMAR ◽  
MAHENDRAPPA ◽  
PRAMOD KUMAR

Objective: To assess medication adherence among patients with chronic diseases. Methods: This was a prospective observational study carried out over period of one year in mysuru city. The subjects who meet study criteria were enrolled in this research study. The enrolled subjects were administered with simplified medication adherence questionnaire. The criteria to establish adherent and non-adherent were calculated as per simplified medication adherence questionnaire directions. Results: The gender distribution of this research study was reflected with male accountable for 45.63 % followed by female 54.36%. Asper simplified medication adherence questionnaire88% were adherent and remaining 12% were non-adherent in this research study. Conclusion: Patients with good adherence in this research study showed that they have good literacy status as well as better awareness about the existing medical condition and more consciousness may be there among these patients, what will be going to happen if their medical condition is left untreated.46.29 % males and 59.58 % females were adherent in this research study followed by 59.24% were adherent in the age range of 60-70 y as they were more conscious and less forgetfulness about medications as per the directions given by patient consultant which was oral feedback taken by research investigators during medication review in subjects home.


KYAMC Journal ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 166-169
Author(s):  
Md Towhid Belal ◽  
Md Mostafizur Rahman ◽  
Tanvir Ahmed Chowdhury ◽  
Md. Shamim Hossain ◽  
Md Shafiqul Alam Chowdhury ◽  
...  

Background: Radical prostatectomy is the best treatment option for clinically localized prostate cancer. But oncological as well as functional outcomes of this procedure including incontinence and erectile dysfunction are a big challenge for the surgeon. Objectives: This paper has focused on our initial experiences of oncological and functional outcomes of open radical retropubic prostatectomy. Materials and methods: Total five cases underwent open radical retropubic prostatectomy between January'2016 to October' 2017. All patients had clinically organ confined prostatic adenocarcinoma. Open radical retropubic prostatectomy with bilateral pelvic lymph node dissection was done through a lower midline incision. We observed the surgical experiences and assess the oncological and functional outcomes postoperatively. Results: The median age (range) of patients at diagnosis was 63 (56-72) years. The median Gleason sum (range) was 7 (6-9) and mean pretreatment PSA was 16.2±5.4 ng/ml. There was no perioperative mortality and no major complications in immediate postoperative period. Final pathological specimen shows negative surgical margin in all cases but one patient has positive unilateral lymph nodes. One patient achieved continence within 3 months; three patients achieved continence at 6 months, one patient after one year. Two patients had satisfactory erection at 6 months; onepatients are at 9 months, and two patients could not gain erection after one year. Conclusion: Though open radical retropubic prostatectomy is tough procedure due to its difficult access to the surgical field. Oncological and functional outcome is totally depending on the skill of the surgical team. KYAMC Journal Vol. 9, No.-4, January 2019, Page 166-169


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