scholarly journals Capitonnage versus non-Capitonnage surgery for pulmonary hydatid cyst: a head to head study

2015 ◽  
Vol 23 (1) ◽  
pp. 94-101
Author(s):  
Md Osman Goni ◽  
Fazal Karim ◽  
Md Kamrul Alam ◽  
GM Akbar Chowdhury ◽  
Shafiqul Ahsan
Keyword(s):  
Wound Infection ◽  
Hydatid Disease ◽  
Randomized Study ◽  
Left Lung ◽  
Surgical Techniques ◽  
Air Leakage ◽  
Group I ◽  
Significant Difference ◽  
Reasonable Approach ◽  
Group Ii

Background: Hydatid disease is a zoonotic disease caused by Echinococcus granulosus. In humans, lungs are the second common organ involved after liver. Surgical treatment is considered gold standard. Different surgical techniques has developed. However, head to head comparison of these has not yet been done in our country. Methods: A prospective randomized study was done in the Department of Thoracic Surgery, National Institute of Diseases of the Chest and Hospital between July 2004 and June 2006. Patients with pulmonary hydatid disease were offered two surgical techniques, enucleation with or without capitonnage. Group I was offered enucleation of cyst with closure of bronchial opening. Group II was offered enucleation of cyst with capitonnage. Results: 43 patients (age range 7 – 45 years, mean 25 years) having hydatid disease of the lung were enrolled in the study. Group I involved 23 patients, Group II involved 20 patients. There were 15 males and 28 females. Presenting complaints were chest pain [76.7%], cough without sputum [46.5%], haemoptysis [30.2%], respiratory distress [27.9%], cough with sputum [11.6%] while 23.2% were asymptomatic. The right lung was affected more [65.11%] than left lung [23.3%] and bilateral disease was found in 11%. Postoperatively, in group I, 12.9% developed air-leakage, 4.3% wound infection. In group II, 20% developed air-leakage, 5% haemorrhage and 5% empyema. None of the patient in the former group had to stay in the hospital for >15 days, where as 10% of the latter group had to stay in hospital for >15 days. The hospital stay was found to be significantly higher in the latter group compared to the former group (p < 0.05). There was no significant difference between groups in the development of haemorrhage, empyema, wound infection and broncho-pleural fistula. There was also no significant difference in the rate of recurrence. No anaphylaxis or death occurred in either group. Conclusion: Capitonnage offered no added benefit rather increasing complications. So enucleation followed by closure of bronchial opening may be a reasonable approach. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22702 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 94-101

Comparison of a PGA Sheet with a Commercial ePTFE Sheet as a Staple-Line Reinforcement in Lung Surgery

2007 ◽  
Vol 342-343 ◽  
pp. 849-852
Author(s):  
Keon Hyeon Jo ◽  
Seok Whan Moon ◽  
Young Du Kim ◽  
Young Jo Sa ◽  
Si Young Choi ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Polyglycolic Acid ◽  
Lung Surgery ◽  
Resection Margins ◽  
Air Leakage ◽  
Staple Line Reinforcement ◽  
Group I ◽  
Significant Difference ◽  
Similar Threshold ◽  
Group Ii

To prevent prolonged air leakage after lung surgery, we developed a biodegradable polyglycolic acid (PGA) sheet and compared it with an expanded polytetrafluoethylene (ePTFE). Eighteen adult mongrel dogs were used in this experiment. The airway pressures at which air first leaked at the stapled resection margins were measured immediately after surgery in group I (N=5), 2 days after surgery in group II (N=5), and 7 days after surgery in group IIII (N=5), Based on the presence of SLR, there were 3 subgroups in each group: there was no SLR in subgroup a; ePTFE in subgroup b; PGA sheet in subgroup c. The histologic examination was performed 2 months after surgery (N=3). In group I, there was a significant difference in air leakage pressures (mm Hg) between no reinforcement and SLR. We observed the same results in group II and III with statistical significance. However, there was no significant difference between the reinforcement groups. The histologic findings demonstrated more severe adhesions and biodegradation in the dogs in which the PGA sheet was used. Our PGA sheet was considered a useful reinforcement material, because it had a similar threshold for air leakage with the ePTFE with excellent biodegradation.

scholarly journals Correction of the CSA does not decrease the re-tear rate after SSP repair

2021 ◽  
Author(s):  
Christoph Lücke ◽  
Marc Schnetzke ◽  
Jennifer Engelke ◽  
Janis Storg ◽  
Markus Loew ◽  
...  
Keyword(s):  
Normal Values ◽  
Constant Score ◽  
Surgical Techniques ◽  
Supraspinatus Tendon ◽  
Inclusion Criteria ◽  
Resonance Imaging ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Shoulder Angle

Abstract Background The re-tear rate after supraspinatus tendon (SSP) repair is high despite optimization of surgical techniques. The critical shoulder angle (CSA) > 35° has been identified as a risk for re-tear. Surgical reduction of the CSA performing additional lateral acromioplasty (ALAP) is intended to reduce the risk. Objective We aimed to evaluate the effect of ALAP on the re-tear rate in patients with a CSA > 35° after SSP repair. Patients and methods The study included 49 shoulders fulfilling predefined inclusion criteria. The patients were assigned to two groups; group I (25 SSP) was additionally treated with an ALAP. In group II (24 SSP) standard acromioplasty was performed during reconstruction. Magnetic resonance imaging and a clinical examination (Constant Score; CS) were performed 12 months after surgery. Results After 15 months group I showed a re-tear rate of 20%, a decreased CSA (mean 38.0° preoperatively vs. 34.5° postoperatively) and an increase in CS (mean 53.9 vs. 84.6). After 16 months group II showed a re-tear rate of 16.7%, no difference between pre- and postoperative CSA (37.8° vs. 37.6°), and an increase in CS (48.9 vs. 84.5). There was no difference between the groups in terms of re-tears and postoperative CS (p = 0.4557), but there was a significant difference in postoperative CSA (p < 0.0001). We did not find a decrease in the failure rate after ALAP. Unlike other studies, patients with a postoperative CSA > 35° did not have a worse clinical outcome and no increased rate of re-tears compared with patients with a mechanically reduced CSA. Conclusion Additive lateral acromioplasty does not decrease the re-tear rate after arthroscopic SSP repair. However, ALAP significantly decreases the CSA to normal values.

scholarly journals Silodosin versus Tamsulosin as Medical Expulsive Therapy for Children with Lower-Third Ureteric Stones: Prospective Randomized Placebo-Controlled Study

2021 ◽  
pp. 1-6
Author(s):  
Mohamed G. Soliman ◽  
Osama El-Gamal ◽  
Samir El-Gamal ◽  
Ali Abdel Raheem ◽  
Ahmed Abou-Ramadan ◽  
...  
Keyword(s):  
Randomized Study ◽  
Study Groups ◽  
Controlled Study ◽  
Expulsion Rate ◽  
Medical Expulsive Therapy ◽  
Group Iii ◽  
Group I ◽  
Younger Age ◽  
Significant Difference ◽  
Group Ii

<b><i>Aim:</i></b> To compare the efficacy and safety of silodosin versus tamsulosin as medical expulsive therapy for stones of lower-third ureter in children. <b><i>Patients and Methods:</i></b> This prospective single-blind placebo-controlled randomized study included 167 pediatric patients who presented with distal ureteric stone (DUS) less than 1 cm. Patients were randomized into 3 groups; group I received silodosin 4 mg once daily, and group II received tamsulosin 0.4 mg while those in group III had placebo. The side effects of the used drugs, both rate and time of stone expulsion, and number of pain episodes were compared among the study groups for a maximum of 4 weeks. <b><i>Results:</i></b> Follow-up data of our patients after treatment revealed that the stone expulsion rate was significantly higher and the time to stone expulsion was significantly shorter in group I (89.3%, 12.4 ± 2.3 days) and group II (74.5%, 16.2 ± 4.2 days) compared to group III (51.8%, 21.2 ± 5.6). However, a statistically significant difference between silodosin and tamsulosin groups in favor of the former one was reported regarding the 2 studied items. Meanwhile, pain episodes requiring analgesia were statistically fewer in group I and II in contrast to placebo group. Adverse events were comparable among all groups. <b><i>Conclusion:</i></b> Silodosin provides significantly better stone expulsion rate and shorter expulsion time than tamsulosin for treatment of DUS. Both medications showed good safety profiles in children. However, further studies are required on a larger scale to confirm our results. Assessment of drug safety on younger age-group is still needed.

scholarly journals Perioperative manometric studies in laparoscopic Watson’s repair versus Nissen’s fundoplication

2018 ◽  
Vol 6 (1) ◽  
pp. 244
Author(s):  
Moharam Abdelshahid ◽  
Mohammed Sabry Ammar ◽  
Mohammed Nazeeh SH. Nassar
Keyword(s):  
Hiatus Hernia ◽  
Surgical Techniques ◽  
Partial Fundoplication ◽  
Reflux Symptoms ◽  
Anterior Fundoplication ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Partial Anterior Fundoplication

Background: Hiatus Hernia (HH) and GERD are common upper gastroesophageal disorders, The Nissen`s fundoplication is one of the most effective and commonly used surgical techniques in management of both GERD and hiatus hernia (HH). many surgeons are searching for alternative procedures due to the mechanical obstructive effects of Nissen's fundoplication, one of these procedures is partial anterior fundoplication (Watson’s repair).Methods: Eighty two patients, diagnosed to have GERD and/or HH, were scheduled for present study for laparoscopic anti-reflux surgery. They were randomized to either Watson’s repair (anterior partial fundoplication) (group I) or Nissen repair (group II) in the period between June 2012 and March 2017. Forty two patients for group I and forty patients were included in group II. Group I had partial anterior fundoplication and group II had Nissen's fundoplication. Follow up for all patients included in our study was scheduled at (2, 4weeks and 3, 6, 12months postoperatively) both subjectively - using a standardized scoring system for reflux symptoms (heartburn, regurgitation and dysphagia), gas bloating and objectively-using esophago-gastroscopy at 6ms and 12ms postoperatively, esophageal manometry, 24hours PH monitoring at 6ms and 12ms post operatively.Results: Three cases were excluded from the study because they were converted to open procedure, one of group I and two of group II. Mean operative time was significantly shorter in group I. As regarding to reflux symptoms (heartburn and regurgitation) Nissen was significantly higher in control of reflux symptoms at 3months but at 6, 12months Nissen still higher but without a clear significant difference. On the opposite side dysphagia was significantly higher in Nissen group than in Watson group at 3months and remained higher at 6,12months but with no significant difference, also gas related symptoms were higher in Nissen group than in Watson group all the time of follow up. Objectively, esophagitis improved to a similar extent in both groups. Watson was less effective in improving LES characters, and 24hours PH parameters in comparison to Nissen group but without any significant difference in both groups.Conclusions: Partial anterior fundoplication (Watson repair) can be safe, effective and simple alternative procedure for Nissen's fundoplication with less obstructive symptoms and complications.

scholarly journals Comparative, prospective, and randomized study between urotherapy and the pharmacological treatment of children with urinary incontinence

2013 ◽  
Vol 11 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Renata Martins Campos ◽  
Antonio Gugliotta ◽  
Osamu Ikari ◽  
Maria Carolina Perissinoto ◽  
Adélia Correia Lúcio ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Floor ◽  
Pharmacological Treatment ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Randomized Study ◽  
Muscle Training ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

OBJECTIVE: To verify and compare the results of behavioral modification plus pelvic floor muscle training and behavioral modifications plus oxybutynin chloride in children with nonmonosymptomatic enuresis. METHODS: A total of 47 children were randomized using opaque and sealed envelopes sequentially numbered. Group I was composed of 21 children who underwent antimuscarinic treatment (oxybutynin), and Group II was composed of 26 patients who underwent pelvic floor muscle training. Both groups were instructed as to behavioral modifications. RESULTS: The voiding diary results were compared each month between Groups I and II. In the first month of treatment, children in Group I presented 12.2 dry nights, 13.4 in the second month, and 15.9 in the last month. In Group II, the results were: 14.9 dry nights in the first month, 20.8 dry nights in the second and 24.0 dry nights in the last month. There was a significant difference between the groups in second and third months. CONCLUSION: Pelvic floor exercises associated with behavioral changes were more effective than pharmacological treatment in children with urinary incontinence.

scholarly journals Impact of hemodialysis on the wellbeing of chronic kidney diseases patients: a pre-post analysis

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Um-e-Kalsoom ◽  
Sabiha Khan ◽  
Israr Ahmad
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Perceived Social Support ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
The Impact

Abstract Background Hemodialysis may have serious psychological impact upon patients suffering from chronic kidney diseases. The aim of the present study is to investigate the impact of hemodialysis on the wellbeing of individuals with chronic kidney diseases (CKD). Result A sample consists of (N = 100) CKD patients referred from neurology ward of Leady Reading Hospital Peshawar. Data was collected from both male (50%) and female (50%) in 2017. Participants were divided into two groups on the basis of pre-set criteria. In group I, individuals with 4–5 stage of CKD referred first time for dialysis treatment were recruited. Group II comprised of CKD patients with 1–3 stage. Demographic data sheet, Pakistan Anxiety and Depression, WHO Quality of Life scale, and Perceived Social support scale (PSS) were used to test the hypotheses. Paired sample t test was use to see the difference between pre- and post-analysis of depression, anxiety, QOL, and PSS in group I (experimental group). Results suggests significant difference on depression (p > .001), anxiety (p > .001), and QOL (p > .001), while no significant difference was reported on perceived social support (p <.673). Findings also indicate no significant difference between group I and group II on QOL depression, anxiety, and PSS. Conclusion The findings concluded that patients under hemodialysis treatment suffered from depression, anxiety, and poor quality of life.

Role of Cord Blood Carboxyhemoglobin in Detecting Significant Hyperbilirubinemia in Term Neonates with ABO Alloimmunization

2021 ◽  
Author(s):  
Mahir Tıraş ◽  
Emrah Can ◽  
Şahin Hamilçıkan
Keyword(s):  
Cord Blood ◽  
Total Serum ◽  
Healthy Controls ◽  
Term Neonates ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Positive Direct ◽  
Severe Hyperbilirubinemia

Objective This study aimed to assess whether cord blood carboxyhemoglobin (COHb) levels in jaundiced term neonates with and without a positive direct Coombs test (DCT) and in healthy controls could be used as a predictor of severe hyperbilirubinemia. The percentage of cord blood COHb should be higher among neonates with Coombs-positive ABO hemolytic disease than among those with Coombs-negative ABO incompatibility and higher than that of ABO-compatible control neonates. Study Design This cross-sectional descriptive study of 198 term neonates comprised three subgroups: group I featured 68 DCT-positive ABO-incompatible neonates (ABO + DCT), group II featured 60 DCT-negative ABO-incompatible neonates with hyperbilirubinemia (ABO–DCT), and group III featured 70 healthy controls. COHb was determined by an OSM3 hemoximeter. Results Group I differed from groups II and III for cord blood bilirubin, cord blood hemoglobin, and cord blood hematocrit. Groups I and II had higher mean total serum bilirubin (TSB) levels than group III, while there was no difference in the mean TSB levels between groups I and II. There was no significant difference between the COHb group means for groups I, II, and III (p = 0.98). The area under the receiver operating characteristic curve calculated for group I/group III and group II/group III were found to be 0.62 and 0.54, respectively. Conclusion COHb levels did not prove to be superior to the DCT for predicting the risk of developing severe hyperbilirubinemia in term neonates. Key Points

scholarly journals Experimental Study on a Prediction Model of the Shrinkage and Creep of Recycled Aggregate Concrete

2019 ◽  
Vol 9 (20) ◽  
pp. 4322 ◽  
Author(s):  
Lv ◽  
Liu ◽  
Zhu ◽  
Bai ◽  
Qi
Keyword(s):  
Substitution Rate ◽  
Recycled Aggregate Concrete ◽  
Recycled Aggregate ◽  
Creep Model ◽  
Aggregate Concrete ◽  
Ordinary Concrete ◽  
Group I ◽  
Significant Difference ◽  
Shrinkage And Creep ◽  
Group Ii

The significant difference between recycled aggregate and natural aggregate is the content of the attached mortar layer. With the increase of the replacement rate of recycled aggregate, the shrinkage and creep of recycled aggregate concrete is significantly increased. In this paper, 180-day shrinkage and creep tests of recycled aggregate concrete with different water–cement ratios were designed in order to analyze the effect of the substitution rate and water–cement ratio on shrinkage and creep properties. The results show that the shrinkage strain of recycled aggregate concrete with a substitution rate of 50% and 100% at 180 days is 26% and 48% higher than that of ordinary concrete, respectively, and the growth of group II is 22% and 47%, respectively. When the load was 180 days old, the creep coefficient of recycled aggregate concrete with a substitution rate of 50% and 100% in group I increased by 19.6% and 39.6%, respectively compared with ordinary concrete, and group II increased by 23.6% and 44.3%, respectively. Based on the difference of adhering mortar content, the creeping increase coefficient and shrinkage increase coefficient of the attached mortar were proposed, and a shrinkage and creep model of recycled aggregate concrete was established. When compared with the experimental results, the model calculation results met the accuracy requirements.

Compare the Incidence of Surgical Site Infection after Appendectomy Wound Irrigation with Normal Saline and Imipenem Solutions

2021 ◽  
Vol 15 (8) ◽  
pp. 2184-2186
Author(s):  
Ahmad Shah ◽  
Nazeer Ahmad Sasoli ◽  
Farrukh Sami
Keyword(s):  
Surgical Site Infection ◽  
Wound Infection ◽  
Saline Solution ◽  
Abscess Formation ◽  
Site Infection ◽  
Wound Irrigation ◽  
Group I ◽  
Perforated Appendix ◽  
The Mean ◽  
Group Ii

Objective: To compare the incidence of surgical site infection after appendectomy wound irrigation with regular saline solution and imipenem solution. Study Design: Comparative randomized control trial Place and Duration of Study: Department of Surgery Unit-1, Sandeman Provincial Hospital Quetta from 1st September 2020 to 30th April 2021. Methodology: Eighty patients of both genders were presented in this study. Patients detailed demographics age, sex and body mass index were recorded after taking informed written consent. Patients underwent for appendectomy wound irrigation were included. Patients were equally divided into two equal groups, I and II. Group I had 40 patients and received imipenem and group II irrigated with saline solution with 40 patients. Outcomes were surgical site infection, deep abscess formation was observed post-operatively. Results: The mean age of the patients in group I was 26.11±2.03 years with mean BMI 23.61±3.32 kg/m2 and in group II mean age was 25.14±3.12 years with mean BMI 22.14±4.88 kg/m2. In group I, 32 (80%) patients had inflamed appendix, perforated appendix was in 7 (17.5%) and gangrenous appendix in 1 (2.5%) while in group II inflamed appendix in 34 (85%), perforated appendix in 4 (10%) and gangrenous appendix 2 (5%). Surgical site infection in group I was 3 (7.5%) and abscess formation in 2 (5%) cases while in group II SSI in 6 (15%) and abscess formation in 3 (7.5%) cases. Conclusion: Imipenem irrigation after appendectomy reduces wound infection. Healthcare costs and patient suffering due to infection can be reduced. Keywords: Imipenem solution, Wound irrigation with saline, Appendectomy wound infection

Immersive and Non-Immersive Virtual Reality Distraction on Pain Perception to Intraoral Injections

2021 ◽  
Vol 45 (6) ◽  
pp. 389-394
Author(s):  
Supriya Kumari ◽  
Rachana Bahuguna ◽  
Nishita Garg ◽  
Ramakrishna Yeluri
Keyword(s):  
Virtual Reality ◽  
Pain Perception ◽  
Dental Treatment ◽  
Immersive Virtual Reality ◽  
Dental Procedures ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Chi Square Analysis

Objective: To evaluate the efficacy of immersive VR (IVR) and non-immersive VR (NIVR) distraction on perceived pain during intraoral injections in children undergoing dental procedures. The objective was to introduce 3-dimensional nature of virtual reality during the provoking phase of dental treatment as a means of distraction in children. Study design: A total of 200 children were selected for the study, 100 for IVR group and 100 for NIVR group. After randomization, children were introduced to Oculus Go Standalone equipment; MCDAS (f), VAS, WBFRS and the treatment procedure using tell show do technique. Group I children were introduced to oculus go standalone headset with hand held controller to play temple run or roller coaster game while in group II, children watched cartoon movies of their choice. Pre-operative & post-operative MCDAS scores were obtained using MCDAS (f) questionnaire in local language. Post-operatively, VAS and WBFRS scores were also obtained. The data was analyzed using independent t-test and chi-square analysis. Results: Pre-operatively, the mean MCDAS scores were similar in both the groups viz. Group–I (29.20 ± 3.197) and Group–II (29.09 ± 3.803) and is statistically not significant. Post-operatively, the mean MCDAS scores were higher in non-immersive group (20.72 ± 2.822) as compared to immersive group (10.99 ± 2.227). VAS score was higher in non-immersive group (2.72 ± 0.99) as compared to immersive group (0.75 ± 0.88). WBFRS scores were higher in non-immersive group (2.78 ± 1.097) as compared to immersive group (0.82 ± 1.104). Conclusion: Three-dimensional virtual reality was found to be an effective means of distraction in children undergoing dental procedures and especially during the provoking phase. The significant difference obtained clearly indicates irrespective of immersiveness of virtual reality, anxiety had been decreased and on comparison the pain perception to intraoral injection is less in immersive virtual reality environment. Immersive VR distraction technique can serve as an adjunct to traditional behavior management strategies already available to the pediatric dentist.

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