Outcome of Partial Splenectomy for Hypersplenism in Children with Thalassemia

Background: Total splenectomy, exposes children to the high risk of overwhelming postsplenectomy infections (OPSI). To avoid these adverse consequences, partial splenectomy has long been practiced for thalasseemia in children. It has been reported that the partial splenectomy keeps the child immunologically competent, hematologically stable with minimum blood transfusion and makes their life more comfortable in comparison to total splenectomy.Objectives: To compare the results of partial and total splenectomy.Methodology: This prospective interventional comperative study was done in the department of Pediatric Surgery, BSMMU from 2010 to 2012. Children who underwent partial splenectomy were considered as the case and who underwent total splenectomy as the control. Number of blood (RCC) transfusions (ml/ kg/year), Peripheral blood film (Hb%, WBC count, platelet count, Howell-Jolly body, serum bilirubin), volume of liver (ml), volume of spleen (ml), number of OPSI case, were compared between the case and control groups both pre and postoperatively.Results: Postsplenectomy blood transfusion requirement is comparatively more decreased in control group than case group. The inter group difference at 6 month is significant (p= 0.004). Peripheral blood pictures are improved in both groups. Post splenectomy hemoglobin level was increased in both groups but it was maintained at a more static fashion in control group than case group (P = 0.114). Howell-jolly body in the partial splenectomy group disappeared almost completely at month 6, while the same inclusion body in the total splenectomy group appeared in all the children (p= 0.001). There was no postsplenectomy infection in case group while two found in control group. After partial splenectomy the residual volume of the spleen was gradually increasing. The increase in volume of the liver was notably greater in the total splenectomy group than that in the partial splenectomy group (p< 0.05).Conclusion: Partial splenectomy in patients with ²-thalassemia is effective in controlling hemolysis, improving peripheral blood picture while preserving the residual splenic phagocytic and immune function.J. Paediatr. Surg. Bangladesh 6(2): 39-46, 2015 (July)

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Effects of Tranexamic Acid on Mortality and Blood Transfusion in Trauma Patients with Significant Hemorrhage: A Clinical Trial

Advances in Bioscience and Clinical Medicine ◽

10.7575/aiac.abcmed.17.05.04.04 ◽

2017 ◽

Vol 5 (4) ◽

pp. 24

Author(s):

Farzad Kakaei ◽

Peyman Virani ◽

Shahriar Hashemzadeh ◽

Sina Zarrintan ◽

Samad Beheshtirouy ◽

...

Keyword(s):

Blood Transfusion ◽

Tranexamic Acid ◽

Study Groups ◽

Control Group ◽

Case Group ◽

Trauma Patients ◽

Transfusion Rate ◽

Control Groups ◽

Significant Difference ◽

And Control

Extensive hemorrhage is a significant cause of mortality in trauma patients. Tranexamic acid has been used for controlling bleeding in cardiovascular surgeries and dental manipulations in patients with hemophilia. However, in traumatic patients with bleeding, its use dates back to more recent years. This study aims to examine the effects of this drug on reducing mortality and blood transfusion rate in trauma patients with significant hemorrhage. A total of 60 patients with significant trauma-related hemorrhage (systolic blood pressure < 90 mmHg/heart rate > 110/min) from the emergency department of Imam Reza Hospital (Tabriz, Iran), were randomized in two groups. The case group received intravenous Tranexamic acid (1 g in 10 min and then 1 g over 8 h). The control group received placebo. Rate of transfusion and rate of one-month mortality were compared between the study groups. The mean ICU stay and overall hospitalization times did not have significant difference between two groups (p<0.05). Transfusion of packed cells was 6.03±1.50 and 6.03±1.22 units in case and control groups respectively. Transfusion of fresh frozen plasma (FFP) was 2.50±1.36 and 3.03±0.96 units in case and control groups respectively (p=0.09). Transfusion of platelets was 0.40±0.20 1.33±0.31 units in case and control groups respectively (p=0.01). Three patients (10%) in the case group and 4 patients (13.3%) in the control group were expired (p=0.50). Tranexamic acid is safe and effective in reducing platelet transfusion rate in patients with trauma-related significant hemorrhage. However, transfusion need and mortality would not reduce by its use in trauma patients.

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Hepatic steatosis: a risk factor for increased COVID-19 prevalence and severity—a computed tomography study

Egyptian Liver Journal ◽

10.1186/s43066-021-00131-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Asmaa Ali ◽

Mona Hasan ◽

Shaimaa Hamed ◽

Amir Elhamy

Keyword(s):

Hepatic Steatosis ◽

Severe Disease ◽

Severe Pneumonia ◽

Liver Disorder ◽

Control Group ◽

Case Group ◽

World Population ◽

Positive Class ◽

The Mean ◽

And Control

Abstract Background Around 25% of the world population was affected by the metabolic-related fatty liver disorder. Hepatic steatosis is frequently observed in conjunction with hypertension, obesity comorbidities, and diabetes. We evaluate the hepatic steatosis frequency found in chest CT exams of COVID-19-positive cases compared to non-infected controls and evaluate the related increased prevalence and severity of COVID. Results Our research includes 355 subjects, 158 with positive PCR for COVID-19 (case group) and 197 with negative PCR and negative CT chest (control group). The mean age in the positive group was 50.6 ± 16 years, and in the control, it was 41.3 ± 16 years (p < 0.001). Our study consists of 321 men (90.5%) and 34 women (9.5%). The number of males in both cases and control groups was greater. In the case group, 93% men vs. 6.9% women, while in controls, 88.3% men vs.11.6% women, p < 0.001. CT revealed normal results in 55.5% of individuals (i.e., CORADs 1) and abnormal findings in 45.5% of participants (i.e., CORADs 2–5). In abnormal scan, CO-RADs 2 was 13.92%, while CO-RADs 3–4 were 20.89% of cases. CO-RADs 5 comprised 65.19% of all cases. Approximately 42.6% of cases had severe disease (CT score ≥ 20), all of them were CO-RADs 5. The PCR-positive class had a greater prevalence of hepatic steatosis than controls (28.5% vs.12.2%, p < 0.001). CO-RADs 2 represented 11.1%, CO-RADs 3–4 represented 15.6%, and CO-RADs 5 represented 73.3% in the hepatic steatosis cases. The mean hepatic attenuation value in the case group was 46.79 ± 12.68 and in the control group 53.34 ± 10.28 (p < 0.001). When comparing patients with a higher severity score (CT score ≥ 20) to those with non-severe pneumonia, it was discovered that hepatic steatosis is more prevalent (73.2% vs. 26.8%). Conclusions Steatosis was shown to be substantially more prevalent in COVID-19-positive individuals. There is a relation among metabolic syndrome, steatosis of the liver, and obesity, as well as the COVID-19 severity.

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Safety and effectiveness evaluation of a two-handed technique combining harmonic scalpel and laparoscopic Peng’s multifunction operative dissector in laparoscopic hemihepatectomy

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02311-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Jingwei Cai ◽

Guixing Jiang ◽

Yuelong Liang ◽

Yangyang Xie ◽

Junhao Zheng ◽

...

Keyword(s):

Blood Loss ◽

Operative Time ◽

Harmonic Scalpel ◽

Peak Level ◽

Bile Leakage ◽

Liver Parenchyma ◽

Control Group ◽

Case Group ◽

Intraoperative Blood Loss ◽

And Control

Abstract Objectives This study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH). Methods We designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January 2016 to May 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. Results The case group had significantly less intraoperative blood loss in milliliters (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate, and others were comparable between the two groups. There was no perioperative mortality. Conclusions We demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

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THE PERIPHERAL BLOOD FILM

Journal of Clinical Pathology ◽

10.1136/jcp.21.6.788-b ◽

1968 ◽

Vol 21 (6) ◽

pp. 788-788

Author(s):

A. G. Signy

Keyword(s):

Peripheral Blood ◽

Blood Film ◽

Peripheral Blood Film

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Levosimendan administration is not associated with increased risk of bleeding and blood transfusion requirement in patients undergoing off-pump coronary artery bypass grafting: a retrospective study from single center

Perfusion ◽

10.1177/02676591211049022 ◽

2021 ◽

pp. 026765912110490

Author(s):

Li-hong Wang ◽

Xiao-hong Wang ◽

Jie-chao Tan ◽

Li-xian He ◽

Run-qiao Fu ◽

...

Keyword(s):

Blood Transfusion ◽

Transfusion Requirement ◽

Artery Bypass ◽

Postoperative Bleeding ◽

Control Group ◽

Chest Drainage ◽

Off Pump ◽

Blood Transfusion Requirement ◽

Pump Coronary Artery Bypass ◽

And Control

Background: Levosimendan (LEVO) is a positive inotropic drug which could increase myocardial contractility and reduce the mortality rate in cardiac surgical patients. However, Whether LEVO is associated with postoperative bleeding and blood transfusion in cardiac surgical patients is controversial. Therefore, the current study was designed to investigate the impact of LEVO administration on bleeding and blood transfusion requirement in off-pump coronary artery bypass grafting (OPCAB) patients. Methods: In a retrospective analysis, a total of 292 patients, aged 40–87 years, undergoing elective OPCAB between January 2019 and July 2019, were divided into LEVO group ( n = 151) and Control group ( n = 141). Patients in LEVO group continuously received LEVO at a rate of 0.1–0.2 μg kg−1 min−1 after anesthesia induction until 24 hours after OPCAB or patients in Control group received no LEVO. The primary outcome was postoperative chest drainage volume. The secondary outcomes were reoperation for postoperative bleeding, transfusion requirement of red blood cells (RBCs), fresh frozen plasma (FFP) and platelet concentrate (PC), etc. Comparisons of two groups were performed with the Student’s t-test or Wilcoxon-Mann-Whitney test. Results: There was no significant difference with respect to chest drainage volume ((956.29 ± 555.45) ml vs (1003.19 ± 572.25) ml, p = 0.478) and the incidence of reoperation for postoperative bleeding (1.32% vs 1.42%, p = 0.945) between LEVO group and Control group. The transfusion incidence and volume of allogeneic RBCs, FFP, and PC were comparable between two groups. Conclusions: LEVO administration was neither associated with more postoperative blood loss nor increased allogeneic blood transfusion requirement in OPCAB patients.

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In Vivo Therapeutic Effect of Triclabendazole + Levamisole on Hydatid Cyst in Rats

International Journal of Medical Parasitology and Epidemiology Sciences ◽

10.34172/ijmpes.2020.06 ◽

2020 ◽

Vol 1 (1) ◽

pp. 18-20

Author(s):

Peyman Sadeghi ◽

Yagoob Garedaghi ◽

Mirhadi Khayatnouri ◽

Hosein Hashemzade Farhang ◽

Ramin Kaffash Elahi

Keyword(s):

Hydatid Cyst ◽

Close Contact ◽

Control Group ◽

Case Group ◽

Hydatid Cysts ◽

Group 3 ◽

The Mean ◽

Group 2 ◽

And Control

Introduction: Hydatidosis is a global disease and one of the most dangerous zoonotic diseases which is found in areas where humans, dogs, and herbivores are in close contact with each other. Methods: In this study, a total of 64 rats were divided into control and case groups, and then 3000 protoscolices were injected into the peritoneal cavity. After 2 months, rats in the case group were given triclabendazole + levamisole at a dose of 6 mg + 4.41 mg/mL orally for 60 days, respectively. Then, after 6 months of infection, the rats of the control and case groups were killed by anesthesia and then an autopsy was performed and the viscera were carefully examined for hydatid cyst infection. Results: The results showed that in the control group, 3 cysts were observed in the liver, 10 in the kidney, and 88 in the lung. The mean number of hydatid cysts in this group was determined to be 33.6. In the case group, 2 cysts were observed in the liver, 6 in the kidney, and 64 in the lungs. The mean number of hydatid cysts in the viscera was 24 in the case group. Conclusions: Statistical analysis of the results obtained from the case and control groups showed that the therapeutic efficacy of triclabendazole + levamisole was 31%, which is not enough to treat cases of hydatid cyst.

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The Relationship between Smoking and Sublingual Varices in the Elderly

Oman Medical Journal ◽

10.5001/omj.2021.94 ◽

2021 ◽

Vol 36 (4) ◽

pp. e288-e288

Author(s):

Niusha Barzideh ◽

Arezoo Alaee ◽

Arash Azizi

Keyword(s):

Older Adults ◽

Cigarette Smoking ◽

Elderly Patients ◽

Varicose Veins ◽

The Elderly ◽

Control Group ◽

Case Group ◽

Chi Square ◽

Number Of Patients ◽

And Control

Objectives: We investigated the existence of any connection between smoking and sublingual varices (SLV) in the older population. Methods: This case-control study was conducted in 2019 on adults > 65 years old at Kahrizak Charity Nursing Home, Alborz, Iran. We conducted clinical examination and inspection of 222 elderly patients. Both the case group and control group contained the same number of patients (n = 111). SLV were classified as grade 0 (few or none visible) and grade 1 (moderate or severe). The case group included patients with SLV and the control group consisted of those older adults without SLV and who were matched with the case group based on age, gender, blood pressure, denture wearing, and varicose veins in their legs. Cigarette smoking habits were investigated in both groups. Smokers were considered those who smoked at least one cigarette per day for more than six months. Chi-square and odds ratio (OR) were used to statistically analyze the exposure of participants to smoking in both groups. Results: Among 222 participants, 21.6% and 5.4% were smokers in the case and control groups, respectively. The results of our data analysis revealed that SLV were significantly associated with smoking (p < 0.001, OR = 4). Conclusions: Elderly patients with SLV are more likely to be cigarette smokers. Therefore, cigarette smoking cessation programs are recommended for older adults in society.

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