scholarly journals Double J stenting compared with ureteral catheterization in percutaneous Nephrolithotomy

2014 ◽  
Vol 3 (2) ◽  
pp. 63-67
Author(s):  
Robin Joshi ◽  
Aakriti Sharma Sharma ◽  
Uday Man Singh Dongol ◽  
Deepak Raj Singh
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
College Teaching ◽  
Minimal Invasive ◽  
Catheter Placement ◽  
Ureteral Catheter ◽  
Stent Removal ◽  
Group I ◽  
Double J Stent ◽  
Group 2 ◽  
Group 1

Background:Nephrolithiasis represents a large portion in the field of Urological pathology. Minimal invasive and non-invasive therapies have become more accessible and efficient in the treatment of nephrolithiasis. Percutaneous nephrolithotomy (PCNL) is an effective minimal invasive modality of treating kidney stones.Objectives: To evaluate the outcome of standard percutaneous nephrolithotomy (PCNL) using two different stenting techniques i.e. externalized ureteral catheter placement compared with Double-J stent placement.Methods: This is a prospective study conducted from January 2012 to June 2013 at Kathmandu Medical College Teaching Hospital among patients undergoing percutaneous nephrolithotomy (PCNL). Fifty patients who underwent PCNL were divided into two equal groups: Group 1 (PCNL with Double-J stent placement) and Group 2 (PCNL with externalized ureteral catheter placement). Factors evaluated included stent-related symptoms, postoperative morbidity, and the cost. Morbidity was classified according to the Modified Clavien classification. SPSS 20 was used for statistical evaluation. P value less than 0.05 was considered significant.Results: Stent related morbidity were fever, dysuria, hematuria, burning micturition. Total of 16 stent related complications were seen in group 1 with four of the patients needing early surgical intervention to remove the Double J stent and injectable antibiotics for urinary tract complication due to in dwelling stent. In Group 2, seven patients experienced postoperative complications, out of which six were managed conservatively and one patient had grade III A dysuria and hematuria, who underwent immediate stent removal and received injectable antibiotics. There was no reported sepsis and mortality in both groups. Stent was removed in 3-4 weeks’ time in group 1 and 3-4 days in group 2. In Group 1, patients had to come one day prior for stent removal. Cost for DJ stent was significantly higher in group I than group II.Conclusion: Standard PCNL with externalized ureteral catheter is as feasible as Double-J stenting. Less cost can be a huge relief to the patients in the third world developing country.DOI: http://dx.doi.org/10.3126/jkmc.v3i2.11228Journal of Kathmandu Medical CollegeVol. 3, No. 2, Issue 8, Apr.-Jun., 2014Page : 63-67

scholarly journals VESICO-VAGINAL FISTULA

2011 ◽  
Vol 18 (03) ◽  
pp. 354-360
Author(s):  
ABDUL RASHEED SHAIKH ◽  
SHAHIDA SHAIKH ◽  
SHABNUM NAZ SHAIKH ◽  
Abdul Haleem Shaikh ◽  
Aijaz Ahmed Memon ◽  
...  
Keyword(s):  
Success Rate ◽  
College Teaching ◽  
Vaginal Fistula ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Group 2 ◽  
Vesico Vaginal Fistula ◽  
Group 1

Objective: To evaluate the outcome of Vesico-vaginal Fistulae (VVF) repair by abdominal and vaginal route. Design: Interventional / clinical trial. Setting: Department of Urology, Chandka Medical College Teaching Hospital and Almas Medical Centre Larkana. Period: Feb; 2005 to Nov; 2010. Patients/Methods: After routine clinical examination and investigation, patients having Vesico-vaginal Fistulae (VVF) were selected for repair. All patients had under gone examination those anesthesia (EUA) and cystoscopy. The patients having complex fistulae or associated with urethral, ureteric and colonic involvement or with preexisting malignant pelvic pathology were excluded from the study. Patients were divided in to 02 groups on the basis of the site of the fistula and the method of repair. Group-I comprised of those patients who had low type or uncomplicated fistulae and were operated by vaginal approach. Group-II consisted of those patients who had high type or large fistulae and were operated by abdominal approach. Postoperative follow up was carried out on weekly basis for 03 to 06 months. Results: Our study included 32 cases. Group-I and II comprised of 18 and 14 patients respectively. The mean age was 34 years (ranged from 22 to 45 years). The main cause of vesico-vaginal fistulae was obstetrical in 28(87.5%) and iatrogenic gynecological (hysterectomy) in 04 (12.5%) patients. No major difficulty was experienced except in 01(0.83%) case in group-1 who had a previous failure history of repair. The mean operative time was 95 minutes (range 80 to 125 minutes) & 145 minutes (range 110 to 175 minutes) in group-1 and group-2 respectively. Peroperative blood transfusion was required in 06 (33.33%) and 13 (93%) patients of group-1 and group-II respectively. Statistically significant difference was found between these two groups (P< 0.05). Postoperative complications like wound infection occurred in 01(7.15%) of group- 1 and haematuria was present for few days in o4 (22.22%) and 05(35.5%) in group-1 and group-2 respectively. The mean hospital stay was 07 (range 5-10) days. Foleys catheter was removed at 02 week time in all cases. The success rate was achieved 15(83.33%) and in all 14 (100%) cases for group-1 and group-2 respectively and statistically no significant difference was found between two groups (P=NS). All the patients were followed up regularly except 03 (16.5%) and 05 (35.5%) patients of group-1 and group-II respectively. Long term complications like urinary stress incontinence was observed in 2 (11.1%) patients of group-I, where as small capacity bladder and stone formation was observed in 02(14.3%) of group-11 cases. Conclusions: Birth trauma is still a major cause of vesico vaginal fistula in our region. Although, there is no significant difference in outcome of different technique but interposition of tissue between suture lines have a vital role to achieve a high success rate. Further more, best chance of success achieved with first attempt of repair. Strategic approach and proper training of medical and paramedical staff is recommended.

scholarly journals Ischemia-reperfusion histopathology alterations of the rabbit intestinal wall with and without exclusion of the collateral mesenteric circulation supply

2010 ◽  
Vol 25 (4) ◽  
pp. 318-321 ◽  
Author(s):  
Otoni Moreira Gomes ◽  
Geraldo Brasileiro Filho ◽  
Luiz Alberto Bomjardim Porto ◽  
Pedro Henrique de Lima Prata ◽  
Rafael de Mattos Paixão
Keyword(s):  
Small Bowel ◽  
Mesenteric Artery ◽  
Collateral Circulation ◽  
Ischemia Reperfusion ◽  
Celiac Artery ◽  
Artery Occlusion ◽  
Intestinal Wall ◽  
Group I ◽  
Group 2 ◽  
Group 1

PURPOSE: To evaluate the histopathology alterations of the intestinal mucosa of rabbits submitted to different times of mesenteric artery ischemia and reperfusion with and without celiac artery collateral circulation supply. METHODS: Two groups of eight male New Zealand white rabbits (weight 2.2-3.5 kg) were used in this study. In the Group 1 animals, the proximal mesenteric artery was occluded for 60 min with an atraumatic vascular clamp, followed by reperfusion for 60 min. In the Group 2 animals the small bowel and mesentery were cut 30cm and 60cm far from the gastroduodenal pyloric transition before the proximal mesenteric artery occlusion. Small bowel biopsies were obtained before ischemia (control), after 30 min and 60 min of mesenteric ischemia and at 30 and 60 min. of mesenteric artery reperfusion. RESULTS: In the Group I animals, the followings histopathology grade results were observed: t1, mean 0.4 + 0.29; t2, mean 1.9 ± 0.38; t3, 1.9 ± 0.33; t4, 1.2 ± 0.36 and t5, 1.2 ± 0.32. Differences between t0 and t2 and between t3 and t4 were statistically significant (p<0.05). Differences between t2 and t3 and t4 and t5 were not significant (p>0.5). In the Group II animals, it was observed: t1, mean 1.6 ± 0.33; t2, 2.4 ± 0.36; t3, 3.0 ± 0.35; t4 3.4 ± 0.31; t5, 3 ± 031. Differences between t0 and t1, t1 and t2, and t2 and t3 were significant (p<0.05). Differences between histopathology grades results of samples t1 to t5 in Group 1 and 2 were statistically significant (p<0.5). CONCLUSION: Microscopic examination of the biopsies revealed significant evidence of worse small bowel wall ischemia-reperfusion lesions by exclusion of the celiac artery collateral circulation supply.

scholarly journals Effect of anterior capsular polishing on the incidence of YAG capsulotomy

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Muhammad A Ahad ◽  
Mohammad Rashad Qamar ◽  
Sameh K Hindi ◽  
Martin N Kid
Keyword(s):  
Outcome Measure ◽  
Early Postoperative Period ◽  
Controlled Study ◽  
Control Group ◽  
Anterior Capsule ◽  
Main Outcome Measure ◽  
Group I ◽  
Group 2 ◽  
One Year ◽  
Group 1

Purpose: To study the effect of anterior capsule polishing during phacoemulsification on the incidence of post operative YAG laser capsulotomy. Method: A retrospective controlled study of 159 patients who underwent uncomplicated phacoemulsification with anterior capsular polishing between October 1998 and March 2000. 169 age matched patients who underwent phacoemulsification but without anterior capsule polishing served as controls. Main outcome measure: Incidence of visually significant YAG capsulotomy, which improved the Snellen acuity for more than 1 line or at least 1 line with subjective improvements in symptoms. Results: 2.51 % of patients with anterior capsular polishing (Group 1) had YAG capsulotomy compared to 7.1% of patients in control group at one year. However, after two years, 11.3% of patients in Group I had YAG capsulotomy compared to 12.4% in Group 2. Conclusion: Anterior capsular polishing during cataract surgery may delay the opacification of posterior capsule during the early postoperative period. But does not decrease the incidence of YAG capsulotomy after two years.

Relationships between follicle-stimulating hormone, follicle growth and ovulation rate in sheep

1996 ◽  
Vol 8 (2) ◽  
pp. 279 ◽  
Author(s):  
RC Fry ◽  
MA Driancourt
Keyword(s):  
Follicle Stimulating Hormone ◽  
Follicular Phase ◽  
Oestrous Cycle ◽  
Ovulation Rate ◽  
Follicle Growth ◽  
Group I ◽  
Group 3 ◽  
Group 2 ◽  
Group 1 ◽  
Stimulating Hormone

The changes in follicle-stimulating hormone (FSH) concentration required to affect follicle growth and ovulation rate within individual ewes were examined. Relationships between peripheral FSH concentrations during the late-luteal and follicular phase and subsequent ovulation rates were investigated in 22 ewes from 4 breeds over 3 successive cycles (Experiment 1). Ewes were grouped as follows: Group 1 (n = 6), ewes exhibiting the same ovulation rate at each oestrous cycle: Group 2 (n = 5), ewes with three different ovulation rates at each oestrous cycle; and Group 3 (n = 11), ewes with the same ovulation rate at two oestrous cycles and a different ovulation rate on one occasion. Data from ewes in Group 1 and 3 provided estimates on the variation in FSH concentrations between cycles which were not large enough to alter ovulation rate (range, 0-67% variation in FSH concentration). In Group-2 ewes, there was no consistent association between increases in ovulation rate and the proportional increases in FSH concentrations. Differences in FSH concentrations were often less than those that did not alter ovulation rate in Group-I ewes. Furthermore, only 3 of 11 Group-3 ewes demonstrated high FSH concentrations associated with high ovulation rate (or low FSH concentrations and low ovulation rate) when compared with the concentrations found at the two cycles in which ovulation rate was similar. Hence, there was little evidence that FSH concentrations during the late-luteal and follicular phase are associated with changes in ovulation rate within individual ewes. In Experiment 2, follicles of similar size obtained from the same ewe (FecBFec+ and Romanov) showed markedly different responses in vitro to graded doses of FSH as measured by aromatase activity. It is concluded that, within a ewe, the large variability between gonadotrophin-dependent follicles in their requirement for FSH prevented the expression of any thresholds of ovarian response to FSH.

scholarly journals Topical Nitroglycerine Versus Lateral Sphincterectomy for Fissure in Ano: A Hospital Based Comparative Study

2018 ◽  
Vol 16 (2) ◽  
pp. 40-43
Author(s):  
Bimarsh Adhikari ◽  
Sunil Kumar Yadav ◽  
S. N. Gupta
Keyword(s):  
Comparative Study ◽  
College Teaching ◽  
Pain Reduction ◽  
Lateral Sphincterotomy ◽  
Female Ratio ◽  
Benign Condition ◽  
Number Of Patients ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Anal fissure is a common benign condition presenting as severe pain, constipations and bleeding per rectum. It is defined as longitudinal tear or defect in anal canal skin. Surgical treatment of this conditions requires hospital admission and complications, like bleeding, infection and to its severe extent continence disturbances. That warrants a new treatment modality as pharmacological sphincterotomy i. e topical GTN (glycerine trinitrate) whose effects are reversible, cost effective and simple. Objective: The objective is to compare the effectiveness of topical GTN over lateral sphincterotomy in terms of pain management and healing of fissure. Method: This was a comparative study carried out in the department of Surgery at Nepalgunj Medical College, Teaching Hospital. Two groups were created and 25 patients in each group were put randomly. First group (Group 1) used topical GTN whereas second group(Group 2) underwent lateral sphincterotomy for treatment of fissure. The two groups were reassessed at 4 and 8 weeks for pain and fissure healing. Result: Total number of patients was 50. Each group consisted of 25 patients. The male to female ratio in group 1 was 1:1.5 and in group 2 it was 1: 1.8. In group 1 patients after 4 weeks of application of GTN pain reduced from the mean of 80±15 at the time of presentation to 50±9.27. When these patients were seen after 8 weeks, the pain reduction on VAS was nil in 21 patients out of 25. In group 2 the mean score fell from 75±15 to 20±10 after 4 weeks and at 8weeks 23 out of 25 patients didn't have any pain. It was observed that the pain reduction and healing were faster in group 2 patients when evaluated after 4 weeks (p=0.0029). but at the end of 8 weeks both group patients were similar in terms of pain reduction and healing of fissure (p=.28). Conclusion: According to study local GTN application is as effective as lateral sphincterotomy with cost effectiveness, simple with tolerable side effect and no continence disturbances.

Analysis of the Incidence and Characteristics of Venoocclusive Disease (VOD) of the Liver in Pediatric Hematopoietic Progenitor Cell Transplant (HPCT) Patients with Heparin Alone Vs. Heparin and Ursodiol Prophylaxis at the Medical College of Wisconsin.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4306-4306
Author(s):  
Julie-An Talano ◽  
Jessica Brown ◽  
Jennifer McArthur ◽  
Mollie Mulberry ◽  
Daniel Eastwood ◽  
...  
Keyword(s):  
Medical Records ◽  
Low Dose ◽  
Pediatric Patients ◽  
Hematologic Malignancy ◽  
Post Transplant ◽  
Dose Heparin ◽  
Group I ◽  
Group 2 ◽  
Low Dose Heparin ◽  
Group 1

Abstract Abstract 4306 VOD is a serious and potentially life-threatening complication of HPCT as a result of liver injury from the effect of chemotherapy and/or radiation. The reported incidence rate in pediatric HPCT patients varies widely from 5% to 40%. Previous studies have shown the beneficial effects of post-transplant pharmacological therapies such as ursodeoxyholic acid (ursodiol), heparin, and defibrotide at preventing VOD. However, the combined effect of heparin and ursodiol prophylaxis in preventing VOD in pediatric patients has yet to be determined. This study evaluated retrospectively whether there was a benefit of such combined therapy in pediatric HPCT patients. Our center adopted as standard practice for all HPCT patients the initiation of low dose heparin at 4 units/kg/hour with the commencement of conditioning for HPCT until day +28 post transplant. In 2003, we combined ursodiol 10 mg/kg TID to start with HPCT conditioning and to continue until day + 100 post transplant with low dose heparin through day + 28 for all pediatric HPCT patients. We performed a retrospective chart review and compared the characteristics and the incidence of VOD in patients who underwent transplantation from 1996-2002 and received heparin alone compared to 2003-2008 when the patients received the combination of heparin and ursodiol prophylaxis. Patients were identified through medical records with the ICD diagnosis of VOD. The medical records were reviewed and those patients who did not meet the Baltimore criteria for the diagnosis of VOD were excluded. Only patients who developed VOD with their first transplants were included. Group I = Heparin (216) Group II = Heparin + Ursodiol (220) Allogeneic 187 (86.5%) 160 (72.7%) Autologous 29 (13.5%) 60 (27.3%) Median Age 9 yrs 8 yrs Male 123 (57%) 135 (62%) Female 93 (43%) 85 (38%) Non-malignant 34 (15.7%) 50 (22.8%) Hematologic malignancy 143 (66.2%) 109 (49.5%) Non-hematologic malignancy 39 (18.1%) 61 (27.7%) # VOD 13 5 The 100 day incidence of VOD was 0.0605 (SE 0.01618) in group 1 and 0.0227 (SE 0.01002) in group 2. The difference is 0.0377 (SE 0.0190) and based on a standard normal distribution with a p = 0.0473. The estimated risk of VOD for patients receiving Heparin + Ursodiol is 0.94 (risk or hazard ratio) that of the risk with Heparin alone, with a 95% confidence interval of (0.918, 0.960). This represents about a 6% reduction in risk for those receiving Heparin + Ursodiol. The day 100 survival in the VOD patients was 6 out of 13 in group 1 and 3 out of 5 in group 2. In conclusion, low dose heparin and ursodiol prophylaxis appears to be an effective strategy in VOD prevention in pediatric patients. The combination appeared to be more effective than heparin alone. However, this study is limited in that it is retrospective in nature. Disclosures: Off Label Use: heparin and ursodiol as VOD prophylaxis.

Preoperative antibiotic prophylaxis of odontogenic maxillary sinusitis, as a result of the formed oroantral joint

2020 ◽  
Vol 18 (4) ◽  
Author(s):  
Nalaliya V. Maksimova ◽  
Filipp V. Dulov ◽  
Maksim F. Tkachuk
Keyword(s):  
Antibiotic Prophylaxis ◽  
Tooth Extraction ◽  
Antimicrobial Agents ◽  
Maxillary Sinusitis ◽  
Alveolar Process ◽  
Group I ◽  
Preoperative Antibiotic Prophylaxis ◽  
The Difference ◽  
Group 2 ◽  
Group 1

The article describes clinical research methods as an assessment of the effectiveness of preoperative antibiotic prophylaxis in operations on the alveolar process of the upper jaw. Methods.70 patients underwent a tooth extraction operation, complicated by perforation of the Schneider membrane in the period 2018-2019. These patients are conditionally divided into two homologous groups (body weight, gender, age, information from the medical history). Group I (34 patients) is scheduled to prescribe antimicrobial agents as preoperative antibiotic prophylaxis. In group II (36 patients), standard seven-day antibiotic therapy was performed. Results.Infectious and inflammatory complications in group 1 occurred in 5.4% of cases, in group 2 in 6.2% of cases, the difference in the occurrence of infectious and inflammatory complications was 1.2%.

Preoperative antibiotic prophylaxis of odontogenic maxillary sinusitis, as a result of the formed oroantral joint

2020 ◽  
Vol 18 (4) ◽  
pp. 359-363
Author(s):  
Nalaliya V. Maksimova ◽  
Filipp V. Dulov ◽  
Maksim F. Tkachuk
Keyword(s):  
Antibiotic Prophylaxis ◽  
Tooth Extraction ◽  
Antimicrobial Agents ◽  
Maxillary Sinusitis ◽  
Alveolar Process ◽  
Group I ◽  
Preoperative Antibiotic Prophylaxis ◽  
The Difference ◽  
Group 2 ◽  
Group 1

The article describes clinical research methods as an assessment of the effectiveness of preoperative antibiotic prophylaxis in operations on the alveolar process of the upper jaw. Methods.70 patients underwent a tooth extraction operation, complicated by perforation of the Schneider membrane in the period 2018-2019. These patients are conditionally divided into two homologous groups (body weight, gender, age, information from the medical history). Group I (34 patients) is scheduled to prescribe antimicrobial agents as preoperative antibiotic prophylaxis. In group II (36 patients), standard seven-day antibiotic therapy was performed. Results.Infectious and inflammatory complications in group 1 occurred in 5.4% of cases, in group 2 in 6.2% of cases, the difference in the occurrence of infectious and inflammatory complications was 1.2%.

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