Evaluation of the Effects of Silver Nitrate Renal Pelvic Instillation and Retroperitoneoscopic Renal Pedicle Lymphatic Disconnection for Chyluria

Introduction: In this study, the efficacy, advantages, and disadvantages of transurethral cystoscopic silver nitrate renal pelvic instillation and retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria were compared to provide a clinical reference. Methods: Forty patients with chyluria who were admitted to our hospital between June 2007 and June 2017 were selected as the research subjects and divided into two groups. The patients in group A (n=25) were treated with transurethral cystoscopic silver nitrate renal pelvic instillation regimen, while those in group B (n=15) were treated by retroperitoneoscopic renal pedicle lymphatic disconnection. Operative time, intraoperative blood loss volume, length of postoperative hospital stay, cure rate, complication rate and recurrence rate were compared between the two groups. Results: All the 40 patients were successfully treated. Group B had a higher cure rate, lower complication rate and lower recurrence rate than in group A, the differences were statistically significant (P < 0.05). But group A had a shorter length of hospital stay and less surgical trauma, the differences were statistically significant (P < 0.05). Conclusion: Retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria can be used as one of the first choices of treatment for chyluria. Although the recurrence rate with transurethral cystoscopic silver nitrate renal pelvic instillation is high, the treatment can be administered again when the disease recurs. At the same time, it is less invasive to the patients and they are more receptive.

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Routine Ultrasound Control after Successful Intussusception Reduction in Children: Is It Really Necessary?

European Journal of Pediatric Surgery ◽

10.1055/s-0040-1719055 ◽

2020 ◽

Author(s):

Carlos Delgado-Miguel ◽

Antonella García ◽

Bonifacio Delgado ◽

Antonio Jesús Muñoz-Serrano ◽

Miriam Miguel-Ferrero ◽

...

Keyword(s):

Hospital Stay ◽

Recurrence Rate ◽

Oral Tolerance ◽

Length Of Hospital Stay ◽

Asymptomatic Patients ◽

Intussusception Reduction ◽

Group A ◽

Laboratory Variables ◽

Group B ◽

Enema Reduction

Abstract Introduction Recurrence of ileocolic intussusception (ICI) has been related to residual bowel wall edema after enema reduction. Early oral tolerance has been associated with a higher risk of re-intussusception, so an imaging test (ultrasound) has traditionally been performed before restarting oral tolerance. Our aim is to analyze the cost-effectiveness of performing a routine ultrasound in patients who remain asymptomatic after successful enema reduction. Materials and Methods A retrospective observational study was performed in patients with ICI who underwent a successful enema reduction between 2005 and 2019 and distributed in two groups according to whether or not a routine ultrasound was performed before restarting oral tolerance: group A (ultrasound) or B (no ultrasound). We analyzed demographic, clinical and laboratory variables, length of hospital stay, and recurrence rate. Results We included 366 patients who presented 373 ICI episodes (165 in group A and 208 in group B), without significant differences in gender and age. Group A patients presented a higher percentage of vomiting and bloody stools than those in group B without differences in the other clinical features studied, time of evolution, or laboratory variables. Group A presented a higher length of hospital stay than group B (36 vs. 24 hours), although it was not statistically significant (p = 0.30). No statistically significant differences were observed in the recurrence rate between both groups (10.3% A vs. 10.8% B; p = 0.83). Conclusion Performing routine ultrasound before restarting oral tolerance in asymptomatic patients after successful ICI reduction does not decrease the risk of re-intussusception and should not be routinely encouraged.

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Local anesthesia versus general anesthesia for evacuation of chronic subdural hematoma in elderly patients above 70 years old

Surgical Neurology International ◽

10.25259/sni_425_2021 ◽

2022 ◽

Vol 13 ◽

pp. 13

Author(s):

Ahmed Ashry ◽

Hieder Al-Shami ◽

Medhat Gamal ◽

Ahmed M Salah

Keyword(s):

Elderly Patients ◽

Hospital Stay ◽

Local Anesthesia ◽

Subdural Hematoma ◽

Complication Rate ◽

Operative Time ◽

Chronic Subdural Hematoma ◽

Length Of Hospital Stay ◽

Group A ◽

Group B

Background: The aim of this study was to assess the safety and efficacy of chronic subdural hematoma (CSDH) evacuation by two burr-hole craniostomies under local versus general anesthesia (GA) in elderly patients over 70 years. Methods: This retrospective study included 45 patients with CSDH aged over 70 years old treated from March 2018 to April 2020. The cases were subdivided into Group A (n = 22) that underwent evacuation under local anesthesia and Group B (n = 23) that was treated under GA. Patients’ demographics and history of comorbidities were recorded. Variables including pre- and post-operative neurological status and Markwalder’s score, complication rate, operative time, and length of hospital stay were evaluated. Results: The mean and standard deviation of patients’ age of groups (A) and (B) were 74.3 ± 2.5 and 73.2 ± 1.7 years, respectively. Postoperative Glasgow Coma Scale of group (A) was statistically higher than Group B at postoperative day 1 (P = 0.01). Operative time was statistically shorter in Group A than B (P < 0.0001). The length of hospital stay was found to be longer in group (B) than (A) (P = 0.0001). The complication rate was found to be higher in group (B) than (A) (P = 0.044). Conclusion: Evacuation of CSDH under local anesthesia in elderly patients over 70 years is effective, safe, and economic with less complication rate than the traditional technique with GA.

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An observational study of endoscopic versus microscopic type I tympanoplasty in tubotympanic chronic otitis media in a tertiary health care centre

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20210536 ◽

2021 ◽

Vol 7 (3) ◽

pp. 434

Author(s):

Amrita Chowdhury ◽

Shatabdi Das

Keyword(s):

Observational Study ◽

Hospital Stay ◽

Otitis Media ◽

Chronic Otitis Media ◽

Type I ◽

Advantages And Disadvantages ◽

Type 1 Tympanoplasty ◽

Group A ◽

Group B

Background: Chronic otitis media (COM) is a widespread disease in the developing countries. It is treated by tympanoplasty, traditionally performed with the microscope which limits the visual field in the deep recesses of the middle ear, especially in narrow external auditory canal. Using endoscope has minimised these difficulties by providing a wide field view with angled magnification, reducing the duration of surgery. The advantages and disadvantages of both techniques is evaluated in our study.Methods: In this observational study, 60 patients of tubotympanic COM between 12-60 years of age with small to medium sized central perforation and air-bone gap of less than 45 decibel were included. They were divided into two groups (group A and group B) of 30 patients each. Group A underwent microscopic type 1 tympanoplasty and group B underwent endoscopic type 1 tympanoplasty. The duration of the surgery, the post-operative improvement in hearing and the graft uptake was analysed after 3 months of surgery. The post-operative hospital stay duration was noted. Results: The post-operative hearing improvement and the graft uptake after 3 months of the surgery was statistically not significant between the two groups. But the mean duration of the operation and the post-operative hospital stay was significantly lower in the endoscopic group with a p value <0.05.Conclusions: Endoscopes are better in otological procedures as it reduces the surgical duration, provides better visibility, lessens the post-operative hospital stay, reducing the economic burden of the patient.

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LAPAROSCOPIC CHOLECYSTECTOMY

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.02.2059 ◽

2011 ◽

Vol 18 (02) ◽

pp. 237-242

Author(s):

AWAIS SHUJA ◽

ABID BASHIR ◽

ABID RASHID

Keyword(s):

Laparoscopic Cholecystectomy ◽

Hospital Stay ◽

Complication Rate ◽

Conversion Rate ◽

Gall Stone ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B ◽

The Impact

Laparoscopic cholecystectomy is the gold standard treatment for patients presenting with acute gall stone disease necessitating hospital admission. Objective: To assess the impact of timing of laparoscopic cholecystectomy on conversion rate, hospital stay and morbidity. Period: Jan 2008-2010. Setting: Department of Surgery, Independent University Hospital, Faisalabad. Study Design: Experimental study. Material & Methods: The subjects were included by consecutive sampling technique. 81 cases were divided into 3 groups. Group A (Surgery within 72 hrs of onset symptoms). Group B (surgery between 72hrs to 96 hours of onset of symptoms). Group C (surgery after 96 hours of onset of symptoms). Results: The mean age was 41-95 years. Female to male ratio was 4.5:1. The overall complication rate was 12.69%. Mean hospital stay was 2.85 days. The open conversion rate was 8.64%. In group A the complication rate was 6%, group B 11.5% and group C 12.8&. The mean hospital stay and conversion rate had no significant difference. Conclusions: The timing of laparoscopic cholecystectomy has no significant impact on the conversion rate and length of hospital stay in cases with acute cholecystitis. However the complication rate was higher when surgery performed after 72 hours of onset of symptoms.

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COMPARATIVE STUDY IN BETWEEN INTRALESIONAL VITAMIN D3 AND INTRALESIONAL BLEOMYCIN IN THE TREATMENT OF CUTANEOUS VERRUCAE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i8.1372 ◽

2020 ◽

Vol 4 (8) ◽

Author(s):

Shrikant . ◽

R.D. Mehta ◽

B.C. Ghiya

Keyword(s):

Partial Response ◽

Comparative Study ◽

Recurrence Rate ◽

Vitamin D3 ◽

Complete Response ◽

Recurrence Rates ◽

Additional Advantage ◽

Cost Effective Treatment ◽

Group A ◽

Group B

Background: Verruca is one of the common dermatopathologies which has multiple therapeutic options but with variable success rates, refractory cases and high recurrence rates. Nowadays, treatment with intralesional injections has gained recognition due to its effectiveness in clearing verrucae. These act by stimulating the cell-mediated immunity. Out of scores of options available for intralesional therapeutics, Vitamin D3 appears to be more promising but least evaluated. Therefore, we planned to evaluate the efficacy of intralesional Vitamin D3 in various types of cutaneous verrucae. Simultaneously the results were compared with intralesional bleomycin, also. Methods: A total of 200 patients of cutaneous verrucae with varying size and duration were included in the experimental randomized comparative study. We divided them into two groups. Group A, comprising of 100 patients, received 0.2-0.5 ml intralesional Vitamin D3 (600,000 IU, 15mg/ml) and Group B, also of hundred subjects, received intralesional Bleomycin (1 mg/ml) into the base of verrucae. A maximum of 5 verrucae were injected per session at 3 weeks interval until resolution or for a maximum of 4 sessions. Patients were followed up for 6 months after the last injection to assess the clearance status and detect any recurrence. Results: In Group A (Vitamin D3), 'Complete response', 'Partial response' and 'No response' were observed in 85.07%, 6.74% and 8.17% respectively after 4 sessions. Recurrence rate was 0.81% after 6 months. In Group B (Bleomycin), 'Complete response', 'Partial response' and 'No response' were found in 77.99%, 10.47% and 11.53% in the series. Recurrence rate was 1.71%, comparatively higher in group B. Conclusion: The efficacy of intralesional Vitamin D3 was found significantly higher as compared to intralesional Bleomycin in the treatment of cutaneous verrucae with less recurrence rates. Vitamin D3 has an additional advantage of cost-effective treatment over Bleomycin. We purpose its use, as a primary mode of treatment in various types of cutaneous verrucae. Keywords: Bleomycin, Vitamin D3, Verrucae.

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Out Come of Wide Local Excision with and without Corticosteroid Therapy in Management of Idiopathic Granulomatous Mastitis

Tumori Journal ◽

10.1177/03008916211012342 ◽

2021 ◽

Vol 107 (1_suppl) ◽

pp. 13-13

Author(s):

R Amira Maher ◽

Ahmed Gamal Eldin Osman ◽

K Fahmy ◽

Shinamwi M ◽

Osama Al Atarash

Keyword(s):

Recurrence Rate ◽

Corticosteroid Therapy ◽

Surgical Excision ◽

Cosmetic Outcome ◽

Systemic Steroid ◽

Granulomatous Mastitis ◽

Idiopathic Granulomatous Mastitis ◽

Palpable Mass ◽

Group A ◽

Group B

Introduction: Idiopathic granulomatous mastitis is a rare benign breast disease. Initial reports from hospitals in Egypt from Departments of Pathology at Cancer Institutes of Cairo, Tanta and Mansoura Universities; indicate that the disease is not as rare as that in the developed countries. It often mimics breast carcinoma both clinically and radiologically. Histological examination is the gold standard for diagnosis. Management of Idiopathic granulomatous mastitis is still debatable. In our study, we aimed to evaluate the addition of corticosteroid therapy to surgical excision in management of idiopathic granulomatous mastitis. Patients and Methods: This is a comparative study was conducted at Ain-Shams University Hospital’s breast clinic on patients with idiopathic granulomatous mastitis from to August 2015 till September 2018. Thirty patients were divided into 2 groups. Group (A) includes patients who underwent surgical management only. Group (B) includes patients who received corticosteroid therapy according to the severity of the cases then surgical Excision was done for the residual lesion. Follow up of all cases up to 1-2 years was done to document the recurrence rate and compare the cosmetic outcome of both groups. Informed consent was obtained from all patients included in the study. Results: The mean age of the affected women was 38.80 and 33.13 in group (A) and group (B), respectively and it wasn’t statistically different (p value = 0.099). The most common presenting symptom was a palpable mass in the breast (66.7% and 93.3%) in group (A) and group (B) respectively. Recurrence rate was higher in group (A) (40%) with no recurrence documented in group (B) however 2 cases were omitted from the study due to steroid noncompliance and complications. Cosmetic outcome was excellent in 76.9% of group (B) and good in 53.3% of group (A). Conclusion: Systemic steroid therapy with surgical resection is the recommended as first-line treatment strategy for IGM as it shows less recurrence rate and surgical scarring. Increased awareness of IGM will increase their understanding and improve their management.

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Infective complications after percutaneous nephrolithotomy in relation to preoperative urine culture status

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v6i1.27070 ◽

2019 ◽

Vol 6 (1) ◽

pp. 8-13

Author(s):

Birendra Kumar Yadav ◽

Robin Bahadur Basnet ◽

Anil Shrestha ◽

Parish Mani Shrestha

Keyword(s):

Hospital Stay ◽

Percutaneous Nephrolithotomy ◽

Urine Culture ◽

Operation Time ◽

Group A ◽

One Year ◽

Group B ◽

Stone Characteristics ◽

Negative Urine Culture ◽

Infective Complications

Introductions: Fever and sepsis after percutaneous nephrolithotomy (PCNL) secondary to urinary tract infection is a major determinant of overall post PCNL complications. This study aims to analyse infective complications after PCNL in relation to pre-operative urine culture status. Methods: A comparative analysis of post PCNL infective complications in pre-operative urine culture positive (Group A) and negative (Group B) was done for one year during June 2017 to May 2018 in department of urology, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal. Demographics, stone characteristics, mean operative time, post-operative hospital stay and post-operative complications as per Modified Clavien classification were compared between the two groups. Results: Out of total 136 PCNL patients, 51 were in Group A and 85 in Group B. Infective complications were significantly high, 28 (54.90%) in group A compared to 20 (23.53%) in group B, p=0.004. The most common isolate was Escherichia coli 19 (37.25%), sensitive to amikacin 37 (72.55%). The mean operation time, transfusion and hospital stay was not statically different in two groups. Morality occurred in 1 (1.96%) in group A. Conclusions: Infective complications were significantly high after PCNL in patients with preoperative positive urine culture, even when it was treated to sterile with sensitive antibiotics, compared to patients with preoperative negative urine culture.

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Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

KYAMC Journal ◽

10.3329/kyamcj.v10i1.41478 ◽

2019 ◽

Vol 10 (1) ◽

pp. 21-24

Author(s):

Md Abdus Salam ◽

Md Mahbub Alam ◽

Rezwan Ahmed ◽

Md Sultan Mahmud

Keyword(s):

Postoperative Pain ◽

Postoperative Bleeding ◽

Throat Pain ◽

Medical College ◽

Advantages And Disadvantages ◽

Case Surgery ◽

Group A ◽

The Difference ◽

Group B ◽

Dissection Method

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24

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Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

BioMed Research International ◽

10.1155/2019/1491796 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Yangjing Lin ◽

Jin Cao ◽

Changgui Zhang ◽

Liu Yang ◽

Xiaojun Duan

Keyword(s):

Achilles Tendon ◽

Recurrence Rate ◽

Operative Time ◽

Achilles Tendon Rupture ◽

Tendon Lengthening ◽

Group A ◽

Achilles Tendon Lengthening ◽

The Mean ◽

Group B

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.

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Comparison of montelukast and mometasone furoate in the prevention of recurrent nasal polyps

Therapeutic Advances in Respiratory Disease ◽

10.1177/1753465811427577 ◽

2011 ◽

Vol 6 (1) ◽

pp. 5-10 ◽

Cited By ~ 21

Author(s):

Erkan Vuralkan ◽

Cem Saka ◽

Istemihan Akin ◽

Sema Hucumenoglu ◽

Binnur Uzmez Unal ◽

...

Keyword(s):

Recurrence Rate ◽

Nasal Spray ◽

Peripheral Blood ◽

Nasal Polyposis ◽

Mometasone Furoate ◽

Significant Difference ◽

Before And After ◽

Group A ◽

Group B ◽

Snot 22

Background: The aim of our study was to compare the effects of montelukast and mometasone furoate nasal spray on the postoperative course of patients with nasal polyposis. Patients and methods: Fifty patients diagnosed with nasal polyposis between March 2006 and August 2007 were included in the study. All patients underwent bilateral endoscopic sphenoethmoidectomy and were randomized postoperatively into two groups. Group A ( n = 25) received 10 mg montelukast per day and group B ( n = 25) received 400 µg mometasone furoate nasal spray twice daily. All patients were followed up for 6 months. Sino-Nasal Outcome Test (SNOT)-22 scores, polyp grades, computerized tomography (CT) scores (Lund–Mackay), eosinophils in peripheral blood and polyp tissue were evaluated before and after surgery. Results: There was a significant reduction in SNOT-22 scores in both groups throughout the study period. There was a significant difference in the recurrence rate between both groups with a marginal advantage of mometasone furoate nasal spray. Eosinophils in peripheral blood were found to be effective on the recurrence rate ( p < 0.05). Conclusions: In conclusion, both drugs seem to have a complementary action and further studies are needed to determine which patients should receive which treatment.

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