scholarly journals Anesthesia for Awake Craniotomy in Patients with Metastatic Brain Tumor in Ibadan, Nigeria

2020 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Brain Tumor ◽  
Conscious Sedation ◽  
Parietal Lobe ◽  
Perioperative Complications ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Metastatic Brain Tumor ◽  
Awake Craniotomy ◽  
Anaesthetic Technique ◽  
Scalp Block

Introduction: Craniotomies can be performed under general anaesthesia or with the patients awake known as awake craniotomy. Awake craniotomy requires that the patients be conscious and cooperative during intraoperative neurological testing. Methods: This was a retrospective study of the anaesthetic protocol and the complications encountered during the perioperative management of patients who had awake craniotomy for metastatic brain resection in a developing country over a 3- year period. The information retrieved were demographic data, tumor location, anaesthetic technique and perioperative complications. Results: There were ten patients comprising of 9 (90%) females and 1 (10%) male. The age ranged from 33 to 66 years with a mean age of 44.00 ± 12.02 years. Eight patients had metastatic brain tumor from the breast carcinoma, one from the lung and the last patient had metastasis from the colon. Four patients had tumor excision from the frontal lobe while 6 patients had excision from the parietal lobe. They all had solitary brain tumor. The anaesthetic technique used was conscious sedation and scalp block. Propofol and fentanyl were used for the conscious sedation while 0.25% Plain Bupivacaine and 1% Lidocaine with adrenaline (1: 200,00) were used for the scalp block. Patients were allowed to breathe spontaneously 100% oxygen. Two patients had respiratory depression with oxygen saturation less than 95% and laryngeal mask airway was inserted. Hypertension and tachycardia were seen in 4 patients, focal seizure in 2 patients and aphasia in 1 patient. Intensive care unit admission was for 24 hours and the today length of hospital stay was 2-7 days. No mortality in this series. Conclusion: Conscious sedation with scalp block is a safe and a tolerable technique for awake craniotomy. The complications observed were minimal and can be treated to obtain a good outcome.

The Influence of Patellofemoral Degenerative Changes on the Outcome of the Unicompartmental Knee Replacement: A Prospective Study

2020 ◽  
Author(s):  
Ali Abdulkarim ◽  
Ayla C. Newton ◽  
Turlough O'Donnell ◽  
Michael J. Neil
Keyword(s):  
Perioperative Complications ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Medial Compartment ◽  
Unicompartmental Knee Replacement ◽  
Medial Compartment Osteoarthritis ◽  
Unicompartmental Knee ◽  
The Status ◽  
Group B ◽  
A Prospective Study

AbstractUnicompartmental knee arthroplasty (UKA) is a recognized procedure for treatment of medial compartment osteoarthritis. Patellofemoral (PF) joint degeneration is widely considered to be a contraindication to medial compartment UKA. We examined the validity of this preconception using information gathered prospectively on 147 consecutive patients who underwent the Repicci II UKA for medial compartment osteoarthritis between July 1999 and September 2000 by the same surgeon. The status of the PF joint was assessed intraoperatively in all patients, and accordingly patients were divided into two groups. Among them, 69 had associated PF osteoarthritis (group A), while 78 patients had a normal PF compartment (group B). Variables measured included the International Knee Society (IKS) score, limb alignment, and range of motion. Radiographs, demographic data, length of hospital stay, perioperative complications were also measured. All subsequent surgery and survivorship at 10 years were recorded. The mean follow-up was 9.4 years (range: 5–10.7 years) and results of the two groups were compared. We found no significant differences in terms of IKS scores, alignment, and flexion between the two groups. However, measured extension was significantly increased postoperatively in those patients with minimal or no PF joint degenerative disease (p < 0.05).

TRANSIENT FACIAL NERVE PALSY AFTER SCALP BLOCK FOR AWAKE CRANIOTOMY: A CASE REPORT

2018 ◽  
Vol 4 (5) ◽  
pp. 369-371
Author(s):  
Rajashree U Gandhe . ◽  
Chinmaya P Bhave . ◽  
Avinash S Kakde . ◽  
Neha T Gedam .
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Awake Craniotomy ◽  
Scalp Block

Effect of Chewing Gum on Bowel Motility in Women Undergoing Post-Operative Cesarean Section

2018 ◽  
Vol 3 (06) ◽  
Author(s):  
Dr.Randa Mohammed AboBaker
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Chewing Gum ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Bowel Motility ◽  
Gum Chewing ◽  
Significant Difference

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay.  Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.

scholarly journals MS-1 Surgical strategy for brain tumor based on molecular and functional connectomics profiles

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii2-ii2
Author(s):  
Tatsuya Abe
Keyword(s):  
Overall Survival ◽  
Brain Tumor ◽  
Standard Procedure ◽  
Awake Craniotomy ◽  
Surgical Strategy ◽  
Neurological Deficits ◽  
Cortical Mapping ◽  
Photodynamic Diagnosis ◽  
Tumor Surgery ◽  
Brain Tumor Surgery

Abstract It is reported that the development of new perioperative motor deficits was associated with decreased overall survival despite similar extent of resection and adjuvant therapy. The maximum safe resection without any neurological deficits is required to improve overall survival in patients with brain tumor. Surgery is performed with various modalities, such as neuro-monitoring, photodynamic diagnosis, neuro-navigation, awake craniotomy, intraoperative MRI, and so on. Above all, awake craniotomy technique is now the standard procedure to achieve the maximum safe resection in patients with brain tumor. It is well known that before any treatment, gliomas generate globally (and not only focally) altered functional connectomics profiles, with various patterns of neural reorganization allowing different levels of cognitive compensation. Therefore, perioperative cortical mapping and elucidation of functional network, neuroplasticity and reorganization are important for brain tumor surgery. On the other hand, recent studies have proposed several gene signatures as biomarkers for different grades of gliomas from various perspectives. Then, we aimed to identify these biomarkers in pre-operative and/or intra-operative periods, using liquid biopsy, immunostaining and various PCR methods including rapid genotyping assay. In this presentation, we would like to demonstrate our surgical strategy based on molecular and functional connectomics profiles.

scholarly journals Management of post-operative discitis following discectomy in a tertiary-level hospital

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902098821
Author(s):  
Md Kamrul Ahsan ◽  
Md Sariful Hasan ◽  
Md Shahidul Islam Khan ◽  
Najmus Sakeb
Keyword(s):  
Hospital Stay ◽  
Antibiotic Treatment ◽  
Demographic Data ◽  
Japanese Orthopaedic Association ◽  
Clinical Signs ◽  
Length Of Hospital Stay ◽  
Tertiary Level ◽  
Disc Space ◽  
The Difference ◽  
Level Hospital

Purpose: To perform retrospective analysis of 75 post-operative disc space infections after open lumbar discectomy (OLD) and to assess the outcome of their medical and surgical management in a tertiary-level hospital. Methods: Records of 50 men and 25 women aged 26–65 (mean, 42.53) years who underwent treatment for post-operative discitis (POD) after single level OLD at L3–4 (n = 8), L4–5 (n = 42), L5–S1 (n = 25) level. The POD was diagnosed according to specific clinical signs, laboratory and radiographic investigations and all of them received initial intravenous antibiotics (IVA) for at least 4–6 weeks followed by oral ones. Successful responders (n = 55) were considered in Group-C and remainder [Group-S (n = 20)] were operated at least after 4 weeks of failure. Demographic data, clinical variables, hospital stay, duration of antibiotic treatment and post-treatment complications were collected from the hospital record and assessment before and after treatment were done by using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score. Comprehensive outcome was evaluated by modified criteria of Kirkaldy-Willis. Results: The mean follows up was 36.38 months. Significant improvement of mean VAS and JOA score was achieved in both conservative (76.36% satisfactory) and operative (90% satisfactory) groups although the difference was statistically insignificant. Conclusion: Although insignificant, early surgical intervention provided better results (e.g. functional outcomes, length of hospital stay and duration of antibiotic treatment therapy) than conventional conservative treatment in post-operative discitis.

scholarly journals MET-04 A case of Brain Metastases with repeated bleeding from Esophageal carcinoma

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii19-ii19
Author(s):  
Masataka Mikai ◽  
Mitsuyoshi Abe ◽  
Yo watanabe ◽  
Chie Nakada ◽  
Yutaka Huchinoue ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Brain Metastases ◽  
Esophageal Carcinoma ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Cerebral Hemorrhage ◽  
Small Cell ◽  
The Body ◽  
Metastatic Brain Tumor ◽  
Carcinoma Of The Esophagus

Abstract Brain metastases from esophageal cancer is rare and the incidence has been reported at approximately 5%. We report a case of brain metastases with repeated bleeding from Esophageal carcinoma. The case is a 76-year-old man. Three years ago he was diagnosed with small cell carcinoma of the esophagus by endoscopic biopsy. Metastasis was found only in the cervical lymph node, but the condition was stable by chemoradiotherapy and no metastases were found throughout the body before 1 month. He was admitted to the hospital because of a sudden convulsion, and CT scan revealed cerebral hemorrhage in the right frontal lobe. We performed conservative treatment, but rebleeding was observed from the same site repeatedly after 1 month and 2 months. Due to the influence of bleeding, it was difficult to distinguish cerebral hemorrhage from brain tumor by contrast MRI. After surgery, the cause of bleeding was diagnosed as metastatic brain tumor of esophageal small cell carcinoma. Postoperative radiation therapy was performed in another hospital, but rebleeding was observed 3 months after the operation. A reoperation was performed at another hospital, and a recurrence of metastatic brain tumor was diagnosed. In the case of highly malignant metastatic brain tumors, it was considered necessary to frequently follow the images.

scholarly journals Treatment of Metastatic Brain Tumor from Esophageal Carcinoma

1991 ◽  
Vol 31 (8) ◽  
pp. 518-522 ◽  
Author(s):  
Hisashi KOGA ◽  
Jiro MUKAWA ◽  
Koichi MIYAGI ◽  
Susumu NAKASONE ◽  
Toshihiko KINJO ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Esophageal Carcinoma ◽  
Metastatic Brain Tumor

Chimerization of Monitor Flap in a Vascularized Ulnar Nerve Flap Is an Efficient Way for Vascularity Monitoring and the Reinnervation Checkup after Its Transplantation

2021 ◽  
Author(s):  
Lisa Wen-Yu Chen ◽  
Abraham Zavala ◽  
David Chwei-Chin Chuang ◽  
Johnny Chuieng-Yi Lu ◽  
Tommy Nai-Jen Chang
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Perioperative Complications ◽  
Microvascular Complications ◽  
Demographic Data ◽  
Skin Flap ◽  
Ulnar Artery ◽  
Functional Improvement ◽  
External Compression ◽  
Skin Paddle

Abstract Background Free vascularized ulnar nerve flaps (VUNF) are effective method for long nerve defects reconstruction. However, the monitorization of its microvascular circulation and the nerve regrowth can be challenging since it is usually designed as a buried flap. We designed a skin paddle based on a septocutaneous perforator from the ulnar artery that can be dissected and raised in conjunction with the vascularized ulnar nerve flap, which aims to improve postoperative monitorization to optimizing the clinical results. Methods We retrospectively reviewed 10 cases with long nerve defects who underwent reconstruction using VUNF between June 2018 and June 2019, including eight acute brachial plexus injuries, 1 multiple nerve injury due to a rolling machine accident, and 1 sequalae of nerve injury after arm replantation. All the demographic data, surgical details, outcomes, and perioperative complications were recorded. Results We evaluated 10 male patients, with a mean age of 34 ± 16 years. Cases included 5 antegrade, 4 retrograde, and 1 U-shaped VUNF. All chimeric skin paddles survived, and all of the underlying nerves presented with adequate circulation and functional improvement. There were no intraoperative or microvascular complications. One skin paddle had a transitory postoperative circulation compromise due to external compression (bandage) which resolved spontaneously after pressure release. Conclusion VUNF chimerization of a septocutaneous perforator skin flap is a relatively easy and efficient method for postoperative monitorization of the nerve’s microvascular circulation as well as beneficial for postoperative Tinel’s sign checkup to confirm the success of the nerve coaptation. The outcome is potentially improved.

scholarly journals Outcome of intussusception among children in Kano

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Lawal B. Abdullahi ◽  
Mohammad A. Mohammad ◽  
Lofty-John C. Anyanwu ◽  
Mohammad S. Aliyu ◽  
Bilya I. Liman
Keyword(s):  
Intestinal Obstruction ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Wound Dehiscence ◽  
Exploratory Laparotomy ◽  
Late Presentation ◽  
Adjacent Segment ◽  
Common Cause ◽  
A Prospective Study ◽  
Resection And Anastomosis

Intussusception is defined as the telescoping of a segment of the gastrointestinal tract within the lumen of the adjacent segment usually proximal to distal. It is a common cause of intestinal obstruction in children, rarely it can occur in adult. This condition is reported in both developed and developing countries, however there are few publications in Nigeria about the incidence, presentation and outcome of its management, most especially in children. This is a prospective study of pediatric patients managed in single center Kano over a period of 18months. The demographic data, clinical features, treatment and outcome of the management were evaluated and analyzed using SPSS version 23. Between June 2018 to December 2019, twenty-five children were managed with intussuception at Aminu Kano Teaching Hospital, there were 16 males and 9 females. The age of the patients ranges between 5 months to 6 years with most of patients in the ager range between 6 and 12 months. All of the 25 patients had exploratory laparotomy with manual reduction in 12 patients, while 13 patients had resection and anastomosis. Non-operative reduction using normal saline under ultrasound guidance was attempted for 2 patients, which was not successful. The length of hospital stay ranged between 4 days and 22 days. Few complications were observed which includes surgical site infection, wound dehiscence, postoperative ileus. One patient was re-operated for recurrent intussuception. Two patients died post operatively, while 23 patients were discharged home alive. Intussuception is still a common cause of intestinal obstruction in children in Kano. Late presentation was found to be associated with higher morbidity (complications).

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