scholarly journals Comparison between Outcome of Wedge Excision of Perforation Site and Trimming of Perforation Margin Followed by Primary Repair in the Management of Ileal Perforation

2017 ◽  
Vol 29 (2) ◽  
pp. 17-20
Author(s):  
Md Aziz Ullah ◽  
Soma Rahman
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Primary Repair ◽  
Ileal Perforation ◽  
Duration Of Hospital Stay ◽  
Perforation Site ◽  
Group I ◽  
Nonspecific Ulcer ◽  
The Mean ◽  
Group Ii

The aim of this study is to compare between the outcome of wedge excision of perforation site and trimming of perforation margin followed by primary repair in the management of ileal perforation in selected patients. This is an observational study with data from department of Surgery, Sir Salimullah Medical College and Mitford Hospital during February, 2007 to July, 2010. The study included 108 patients of ileal perforation of 15-67 years of age. All patients were treated by primary repair after either wedge excision of perforation site (Group I) or trimming of perforation margin (Group II). Perforation due to typhoid is common in both groups. Abdominal pain, fever, abdominal distention, constipation and vomiting were more frequent in both groups of patients. Signs of peritonitis were observed almost all the patients. Pneumoperitoneum was found 77.8% in group I and 66.7% in group II in X-ray. In ultrasonography ascitis and distended bowel loop was found 44.4% in group I and 66.7% in group II. Typhoid, tuberculosis, nonspecific ulcer and chronic nonspecific ulcer were found in histopathology. Post-operative complications were more in group II. Anastomotic leakage was found 18.5% in group I and 38.9% in group II. Prolonged ileus was observed 16.7% in group I and 33.3% in group II. Anastomotic leakage and Prolonged ileus difference were statistically significant (p<0.05). The mean duration of hospital stay was significantly (p<0.05) higher in group II, where the mean(±SD) duration of hospital stay was 14.2±7.2 days in group I and 18.1±8.9 days in group II. Mortality was observed 9.3% only in group II. So Wedge excision followed by primary repair is better in terms of post operative mortality and morbidity in the management of ileal perforation in selected patients.Medicine Today 2017 Vol.29(2): 17-20

scholarly journals Percutaneous endoscopic treatment of benign and malignant renal pelvis carcinoma: A single-center experience

2020 ◽  
Author(s):  
Xin Zhang ◽  
Wu Xiu Han ◽  
Sheng Yan Li ◽  
Hao Yuan Chen ◽  
Zhe Yu Tang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Renal Pelvis ◽  
Operation Time ◽  
Laser Evaporation ◽  
Pathological Grade ◽  
Group I ◽  
Grade Ii ◽  
The Mean ◽  
Group Ii

Abstract Background Percutaneous nephrolithotomy (PCNL) is a safe and efficient treatment for intro-renal diseases, most of which are calculus disease. In this study, we carried out percutaneous endoscopic nephron-sparing ablation for renal carcinoma in carefully selected patients. Our aim was to evaluate whether percutaneous endoscopic nephron-sparing operation was feasible for patients with renal cell carcinoma.Methods A total of 15 patients with renal pelvis carcinoma were treated with laser evaporation under percutaneous endoscopy between January 2015 and September 2019 ( group I ). Another 13 patients who received standard radical nephroureterectomy were recruited as the control group (group II). We recorded demographic data of the patients, the indication for surgery, tumor pathological grade, size and side of tumor, and the intraoperative and postoperative outcome, including the duration of surgery, length of hospital stay, and complication rate, as well as progression-free survival (PFS).Results In both groups, all of the patients received flexible ureteroscopy. In group I, 14 patients had transitional renal cell carcinoma (UCC), four had pathological grade I, nine had grade II, and one had hemangiopericytoma. In group II, all patients had UCC, five had pathological grade I, and eight had grade II. In group I, the mean operation time was 118 min (65–236 min), the mean blood loss was 110 ml (55–220 ml), and the mean hospital stay was 9 days (7–12 days). During follow-up, two patients died and two had recurrence; among them, one had systematic bone metastasis. The PFS rate was 66.7% (10/15). In group II, the mean operation time was 265 min (185–436 min), the mean blood loss was 133 ml (85–240 ml), and the mean hospital stay was 13 days (9–16 days). During the follow-up, two patients died and there was no local or systematic metastasis. The PFS rate was 84.6% (11/13). There was no significant difference in blood loss between the groups. However, the operation time and mean hospital stay were significantly shorter in group I compared with that in group II ( P < 0.05). But the PFS rate was significantly higher in group II than in group I (P < 0.05).Conclusions This study shows that laser evaporation under percutaneous endoscopy for renal pelvis carcinoma is a safe, effective, and technically feasible procedure for treating benign and malignant renal pelvis carcinoma.

scholarly journals Short-Time Intermittent Preexposure of Living Human Donors to Hyperoxia Improves Renal Function in Early Posttransplant Period: A Double-Blind Randomized Clinical Trial

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Kamran Montazeri ◽  
Mohammadali Vakily ◽  
Azim Honarmand ◽  
Parviz Kashefi ◽  
Mohammadreza Safavi ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Hospital Stay ◽  
Urine Output ◽  
Human Study ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Duration Of Hospital Stay ◽  
Group I ◽  
Group Ii

The purpose of this human study was to investigate the effect of oxygen pretreatment in living kidney donors on early renal function of transplanted kidney. Sixty living kidney donor individuals were assigned to receive either 8–10 L/min oxygen (Group I) by a non-rebreather mask with reservoir bag intermittently for one hour at four times (20, 16, 12, and 1 hours before transplantation) or air (Group II). After kidney transplantation, urine output, blood urea nitrogen (BUN), serum creatinine, need to additional diuretics (NTADs) in the first 24 hours after transplantation, delayed graft function (DGF), the creatinine clearance (CrCL) on 10th day, and duration of hospital stay from the first posttransplant day till normalization of renal function was recorded and compared in two groups. Mean CrCL in posttransplant day 10, NTAD after 24 hours of transplantation, and urine output during 6 hours after operation were significantly better in Group I compared with Group II (). Also, DGF during the first week after operation and duration of hospital stay was less in Group I compared with Group II. Intermittent exposure of human living kidney donor to hyperoxic environment may improve renal function following kidney transplantation.

scholarly journals Impact of Spleen Size on Outcomes in Laparoscopic Splenectomy in Children

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Cetin Ali Karadag ◽  
Basak Erginel ◽  
Ozgur Kuzdan ◽  
Nihat Sever ◽  
Melih Akın ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Splenectomy ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Time Rate ◽  
Open Procedure ◽  
Group I ◽  
Longitudinal Length ◽  
The Mean ◽  
Group Ii

Background. The aim of our study is to compare the efficacy of laparoscopic splenectomy (LS) between enlarged spleens and normal sized spleens.Methods. From June 2006 to September 2012, 50 patients underwent LS. The patients consisted of 24 girls and 26 boys with the mean age of 8.64 years (1–18). The patients are divided into two groups according to spleen’s longitudinal length on the ultrasonography. Group I consisted of the normal sized spleens; Group II consisted of spleens that are exceeding the upper limit. Groups are compared in terms of number of ports, operative time, rate of conversion to open procedure, and length of hospital stay.Results. The mean number of ports was 3.27 and 3.46, the mean length of the operation was 116.36 min and 132.17 min, rate of conversion to open procedure was 9.09% and 10.25%, and the mean length of hospital stay was 3.36 days and 3.23 days, respectively, in Group I and Group II. Although there is an increase in the number of the ports, the operative time, rate of conversion to open procedure, and the length of hospital stay, the difference was not significant between groups (P>0.05).Conclusion. LS is safe and effective in enlarged spleens as well as normal sized spleens.

scholarly journals Which Criterion for Wound Drain Removal is Better Following Posterior 1-Level or 2-Level Lumbar Fusion With Instrumentation: Time Driven or Output Driven?

2021 ◽  
pp. 219256822110137
Author(s):  
Hang Shi ◽  
Zhi-Hao Huang ◽  
Yong Huang ◽  
Lei Zhu ◽  
Zan-Li Jiang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Lumbar Fusion ◽  
Demographic Characteristics ◽  
Total Blood ◽  
Duration Of Hospital Stay ◽  
Drain Removal ◽  
Group I ◽  
Wound Drain ◽  
Group Ii

Study Design: Case-control study. Objectives: To compare the outcomes of 2 different criteria (time driven and output driven) for wound drain removal and identify which one is better. Methods: 743 patients who underwent posterior lumbar fusion with instrumentation involving 1 or 2 motion segments were enrolled in this study. Based on the different criteria for drain removal, the patients were divided into 2 groups. The drains were discontinued by time driven (postoperative day 2) in group I and output driven (<50 ml per day) in group II. Demographic characteristics, perioperative parameters and clinical outcomes were compared between the 2 groups. Results: The demographic characteristics in both groups were comparable. The postoperative drain output, total blood loss, postoperative timing of ambulation, and postoperative duration of hospital stay in group I were lower than those in group II ( P < 0.001). There was a higher proportion of patients requiring postoperative blood transfusion in group II, but not to a level of statistical significance ( P = 0.054). There was no statistical significant difference in the incidence of surgical site infection (SSI) or symptomatic spinal epidural hematoma (SEH) between the 2 groups ( P > 0.05). Conclusions: This study reveals that there are more benefits of wound drain removal by time driven than that by output driven for patients undergoing posterior 1-level or 2-level lumbar fusion with instrumentation, including less postoperative drain output, less total blood loss, earlier postoperative timing of ambulation and less postoperative duration of hospital stay without increasing the incidence of postoperative SSI or symptomatic SEH.

Pediatric Referrals to Psychiatry: I. Comparison of Referrals and Nonreferrals

1977 ◽  
Vol 7 (3) ◽  
pp. 241-247 ◽  
Author(s):  
Arthur P. Froese
Keyword(s):  
Hospital Stay ◽  
Psychiatric Diagnosis ◽  
Psychiatric Evaluation ◽  
Discharge Diagnosis ◽  
Sex Distribution ◽  
Duration Of Hospital Stay ◽  
Group I ◽  
Group Ii

Age, sex and duration of hospital stay of 220 patients consecutively referred to psychiatry (Group I) and of their fellow 2065 nonreferred patients (Group II) were compared. Overall, Group I was significantly older, remained in hospital longer, and included more girls than boys, whereas Group II included slightly more boys than girls. Separation of Group II into those whose primary discharge diagnosis was psychiatric or nonpsychiatric revealed that mean age and duration of hospital stay of the former were almost identical, and the sex distribution was similar, to those of Group I. These findings suggest that children referred for psychiatric evaluation differ from their nonreferred fellows discharged with a nonpsychiatric diagnosis but not from nonreferred fellows discharged with a psychiatric diagnosis.

scholarly journals Role of Continuous Low Pressure Suction in Management of Traumatic Haemothorax and/or Haemopneumothorax: Experiences at NIDCH and CMH Dhaka

2015 ◽  
Vol 10 (2) ◽  
pp. 21-26 ◽  
Author(s):  
Md Neazul Islam Majumdar ◽  
AKM Razzaque ◽  
Md Shahinur Rahman ◽  
Anwarul Anam Kibria ◽  
Rokshana Rahman ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Chest Tube ◽  
Chest Trauma ◽  
Low Pressure ◽  
Chest Tube Drainage ◽  
Tube Drainage ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Pressure Suction

Introduction: The number of chest trauma patients has rapidly increased in this 21st century of high speed travel, violence, natural and manmade disasters. Most of the patients present with haemothorax and/or haemopneumothorax. Drainage of haemothorax and/or haemopnumothorax by tube thoracostomy is the main stay of treatment. Even timely insertion of chest tube sometimes fails to drain haemothorax adequately and results in clotted haemothorax for which surgical management is needed. Application of continuous low pressure suction through chest tube hastens evacuation of blood and reduces incidence of clotted haemothorax and thoracotomy.Objective: The aim of this study is to find out the effectiveness of continuous low pressure suction in evacuation of blood and air from pleural cavity, in early re-expansion of lung and reduction of clotted haemothorax in comparison with simple chest tube drainage.Methods: This randomized controlled clinical trial was conducted at Combined Military Hospital (CMH) Dhaka and National Institute of Diseases of the Chest and Hospital (NIDCH), Mohakali, Dhaka from April 2012 to March 2013. A total of 60 patients with blunt and penetrating chest trauma fulfilling the selection criteria enrolled in this study. Patients were allocated into two groups. Patients who received continuous low pressure suction on their chest tubes were leveled as group-I and patients who received only chest tube drainage were leveled as group-II. Data were collected by interview, observation, clinical examination and investigation results. Data were processed and analyzed by using statistical test.Results: The mean chest tube duration was 7.13±2.1 days with a range from 5-16 days in group-I as compared to 11.83±5.26 days with a range from 6-28 days in group-II. The mean duration of hospital stay was 8.97±2.28 days with a range from 6-18 days in group-I as opposed to 13.47±5.53 days with a range from 8-32 days in group-II. In group-I 96.7% patients achieved full lung re-expansion while 3.3% patients had clotted haemothorax for which they underwent thoracotomy and evacuation of clot. In group-II who was on simple chest tube drainage, 76.7% patients achieved full lung re-expansion and 23.3% patient had clotted haemothorax and required thoracotomy.Conclusion: Continuous low pressure suction is a useful device in the management of traumatic haemothorax and/or haemopneumothorax. It reduces morbidity, hospital stay and cost of thoracic surgery.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014

scholarly journals Can antibiotic preference affect bleeding in percutaneous nephrolithotomy? Retrospective comparative study of two commonly used antibiotics

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Ali Akkoç ◽  
Cemil Aydın ◽  
Murat Uçar ◽  
Murat Topçuoğlu
Keyword(s):  
Body Mass Index ◽  
Blood Transfusion ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Stone Size ◽  
Postoperative Fever ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Retrospective Comparative Study

Objective: Bleeding is one of the most common and alarming complication of percutaneous nephrolithotomy (PCNL). In this study, we aimed to compare the effects of ciprofloxacin and cefuroxime on the bleeding in PCNL procedures. Methods: The study was a retrospective analysis of 97 patients who underwent PCNL between February 2011 and June 2017. We just included the patients who had single tract lower pole PCNL for more objective evaluation of bleeding in the study. The patients were divided into two groups as ciprofloxacin group (Group-I, n:40) and cefuroxime group (Group-II, n:56) according to the type of antibiotic used in the operation. Patient age, gender, body mass index, stone size, preoperative INR, preoperative and postoperative platelet counts and difference, operative time, need for blood transfusion, postoperative fever, hospital stay, postoperative hemoglobin and hematocrit drop were analyzed. Results: There was no statistically significant difference in patients’ gender distribution, body mass index, preoperative INR, preoperative and postoperative platelet counts, preoperative and postoperative platelet difference, duration of operation, hospital stay, postoperative fever and need for postoperative blood transfusion between two antibiotic groups (p > 0.05). Mean patient age was 42,75±16,97 in Group-I and 35,54±14,71 in Group-II (p < 0.05). The mean stone size of Group-I and Group-II were 27,23±7,05 mm and 30,59±8,20, respectively (p < 0.05). The mean postoperative hemoglobin and hematocrit drop were significantly higher in Group-I than in Group-II. The mean hemoglobin drop was 1,73±0,95 for Group-I and 1,28±0,67 for Group-II (p < 0.05). The mean hematocrit drop was 5,17±2,76 for Group-I and 3,80±1,99 for Group-II (p < 0.05). Conclusion: On the basis of the results of the initial study, the antibiotic preference in patients undergoing surgery may be one of the bleeding factors during and after PCNL. doi: https://doi.org/10.12669/pjms.36.4.1977 How to cite this:Akkoc A, Aydin C, Ucar M, Topcuoglu M. Can antibiotic preference affect bleeding in percutaneous nephrolithotomy? Retrospective comparative study of two commonly used antibiotics. Pak J Med Sci. 2020;36(4):---------.  doi: https://doi.org/10.12669/pjms.36.4.1977 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Assessment of Acute Kidney Injury in Patients Undergoing Elective Coronary Angiography and Percutaneous Coronary Intervention

2012 ◽  
Vol 5 (1) ◽  
pp. 37-43
Author(s):  
ABMM Alam ◽  
M Moniruzzaman ◽  
MB Alam ◽  
N Islam ◽  
F Khatoon ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Contrast Media ◽  
Creatinine Level ◽  
Ace Inhibitor ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Group I ◽  
Percutaneous Coronary ◽  
The Mean ◽  
Group Ii

Background: CIN has gained increased attention in the clinical setting, particularly during cardiac intervention but also in many other radiological procedures in which iodinated contrast media are used. There is at present good clinical evidence from well-controlled randomized studies that CIN is a common cause of acute renal dysfunction.Methodology: This was a prospective study conducted among the patients who underwent coronary angiography and percutaneous coronary intervention in the Department of Cardiology, Dhaka Medical College Hospital during January 2010 to December 2010. A total of 111 patients age range from 25 to 75 years were included in the study. Serum creatinine level at baseline and at the end of 48 hours was done in all these patients. Study population was divided into two groups according to development of acute kidney injury (AKI). Group-I = AKI, Group II = Not developed AKI. Results: AKI developed 11.7% of the study patient. DM and Preexisting renal insufficiency were significantly higher in group I patients. HTN was (61.5% Vs 44.9%) higher in group I but not significantly. History of ACE inhibitor/ARB, NSAID intake and LVEF <40% were significantly higher in group I patients. The mean±SD volume of CM (Contrast Media) were 156.9±44.8 ml and 115.4±30.0 ml in group I and group II respectively, which was significant. The mean±SD of serum creatinine after 48-72 hours of CAG/PCI was 1.4±0.37 mg/dl and 1.1±0.2 mg/dl in group I and group II respectively. The serum creatinine level increased significantly (p<0.05) after 48-72 hours of CAG/PCI in group I. In group II, S. creatinine level increased but not significant (p>0.05). Impaired renal function was found 76.9% and 2.0% in group I and group II respectively. DM, HTN, preexisting renal insufficiency, ACE inhibitor/ARB, NSAIDs, contrast volume (>150 ml), eGFR (<60 ml/min/ 1.73m2) and LVEF (<40%) are significantly (p0.05) associated for CIN development.Conclusion: CIN is an iatrogenic but preventable disorder results from the administration of contract media. Although rare in the general population, CIN occurs frequently in patients with underlying renal dysfunction and diabetes. In patients with pre angiographic normal renal function, the prevalence is low but in pre-existing renal impairment it may pose a serious threat. Thus risk factors are synergistic in their ability to predispose to the development of CIN. A careful risk-benefit analysis must always be performed prior to the administration of contrast media to patients at risk for CIN. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12227 Cardiovasc. j. 2012; 5(1): 37-43

EVALUATION OF LONGO’S HEMORRHOIDECTOMY AT HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 79-85
Author(s):  
Van Lieu Nguyen ◽  
Doan Van Phu Nguyen ◽  
Thanh Phuc Nguyen
Keyword(s):  
Hospital Stay ◽  
Perioperative Complications ◽  
University Hospital ◽  
Anal Pain ◽  
Stapled Hemorrhoidectomy ◽  
Fourth Degree ◽  
Duration Of Hospital Stay ◽  
The Mean ◽  
Good For

Introduction: Since Longo First described it in 1998, Stapled Hemorrhoidectomy has been emerging as the procedure of choice for symtomatic hemorrhoid. Several studies have shown it to be a safe, effective and relative complication free procedure. The aim of this study was to determine the suitability of (SH) as a day cas procedure at Hue University Hospital. Methods: From Decembre 2009 to April 2012, 384 patients with third- degree and fourth-degree hemorrhoids who underwent Stapled Hemorrhoidectomy were included in this study. Parameters recorded included postoperative complications, analegic requirements, duration of hospital stay and patient satisfaction. Follow-up was performed at 1 month and 3 months post-operative. Results: Of the 384 patients that underwent a Stapled Hemorrhoidectomy 252 (65,7%) were male and 132 (34,3%) were female. The mean age was 47,5 years (range 17-76 years. Duration of hospital stay: The mean day was 2,82 ± 1,15 days (range 1-6 days). There were no perioperative complications. There was one case postoperative complication: hemorrhage; Follow-up after surgery: 286 (74,4%) patients had less anal pain, 78 (20,3%) patients had moderate anal pain, 3 (0,8%) patients had urinary retention; Follow-up after one month: good for 325 (84,6%) patients, average for 59 (15,4%) patients; Follow-up after three months: good for 362 (94,3%) patients, average for 22 (5,7%) patients. Conclusion: Our present study shows that Stapled Hemorrhoidectomy is a safe, reduced postoperative pain, shorter hospital stay and a faster return to unrestricted daily activity

scholarly journals A prospective study on effectiveness of drotaverine in acceleration of labor

2019 ◽  
Vol 2 (3) ◽  
pp. 137-141
Author(s):  
Padma Raj Dhungana ◽  
Rajesh Adhikari ◽  
Prem Raj Pageni ◽  
Apsara Koirala ◽  
Anand Nepal
Keyword(s):  
Prospective Study ◽  
Drug Administration ◽  
Active Phase ◽  
Delivery Mode ◽  
Normal Delivery ◽  
Group I ◽  
Vacuum Delivery ◽  
Drotaverine Hydrochloride ◽  
The Mean ◽  
Group Ii

Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome.  

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