scholarly journals Ultrasound-Guided Block of the Axillary Nerve: A Prospective, Randomized, Single-Blind Study Comparing Interfascial and Perivascular Injections

2019 ◽  
Vol 4 (22;4) ◽  
pp. 369-375
Author(s):  
Young Hoon Kim
Keyword(s):  
Management Practice ◽  
Randomized Study ◽  
Axillary Nerve ◽  
University Hospital ◽  
Time Interval ◽  
Ultrasound Guided ◽  
Interventional Pain Management ◽  
A New Technique ◽  
Posterior Circumflex Humeral Artery

Background: The ultrasound-guided block of the axillary nerve may be complicated in cases in which the posterior circumflex humeral artery (PCHA) follows an abnormal course. Objectives: To develop a new technique that does not rely on direct visualization of the PCHA or the axillary nerve, and to compare interfascial injection and conventional perivascular injection for a block of the axillary nerve. Study Design: A prospective randomized study. Setting: An interventional pain-management practice in a university hospital. Methods: A total of 56 patients received ultrasound-guided block of the axillary nerve with either interfascial injection (IF Group) or perivascular injection with nerve stimulation (PV Group). The primary outcome was procedure duration, defined as the time interval from when the transducer contacted the skin to when the needle was removed from the skin. Results: The mean procedure time was significantly shorter in the IF Group than in the PV Group (64 seconds [SD 28.3] vs. 135 seconds [50.3], difference of −71.4 seconds; 95% confidence interval, −93.2 to −49.5) (P < 0.001). There were no differences in secondary outcomes, including the quality of blocks, between the 2 groups. Limitations: The practitioner was not blinded to the group to which the patients belonged. Conclusions: Ultrasound-guided block of the axillary nerve with interfascial injection can be performed without placing the needle near the PCHA. Key words: Block of axillary nerve, ultrasound-guided block, posterior circumflex humeral artery, interfascial injection

scholarly journals Analysis of socio-demographic and microbiological profile of vaginal discharge in patients attending Kathmandu University Hospital, Nepal

2015 ◽  
Vol 14 (4) ◽  
pp. 323-326
Author(s):  
Abha Shrestha ◽  
Nuche Ratna Tuladhar ◽  
Chander Dev Chawla
Keyword(s):  
Vaginal Discharge ◽  
Public Awareness ◽  
Randomized Study ◽  
Medical Science ◽  
University Hospital ◽  
Factors Affecting ◽  
Microbiological Profile ◽  
Appropriate Treatment ◽  
Socio Demographic Factors

Background: Vaginal discharge and associated vaginal symptoms is very common amongst women of South East Asia, hence it is necessary to make accurate diagnosis and also for appropriate treatment by identifying the causative microorganisms. Objectives: To analyze the socio-demographic and microbiological profile of vaginal discharge. Methodology: This is a prospective, non-randomized study performed in one hundred and ninety three patients attending in Department of Obstetrics and Gynecology in Kathmandu University Hospital, Dhulikhel, Nepal. The patients with vaginal discharge and age of ?16 years included. Vaginal discharge was taken from the posterior and lateral fornices. The swab was cultured on blood, chocolate and Mac Conkey’s agar and incubated at 37°C for 24-48 hours. Fungus when isolated was subcultured onto Sabouraud dextrose agar. The data were analyzed using the SPSS 11.5 software. Result: The frequency of vaginal discharge was 1.67%. Most of the patients fell within 16-25 years. 50.3% patients were illiterate whereas only 3.1% was having master degree. 50.3% patients were having class V socioeconomic status where as only 2.6% had class I status. Housewife accounted for 67.9% whereas other occupation (petty business) accounted for only 5.2%. Most of the patients with vaginal discharge were from Newar and Tamang ethnic group. Bacterial vaginosis was isolated in 36.3% and normal flora accounted for 20.7%. Conclusion: There is still lack of awareness about the vaginal discharge be it abnormal discharge or physiological leucorrhea and related problems. So, it is worthwhile to create public awareness and also to find out the socio-demographic factors affecting the pattern of microbiological flora variation in vaginal discharge, as it gives us the clue regarding the use of appropriate antimicrobial therapy and the changes that can be made to the quality of life of the women.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.323-326

scholarly journals Ultrasound-Guided Quadrilateral Space Block for the Diagnosis of Quadrilateral Syndrome

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Hamilton Chen ◽  
Vincent Reginald Narvaez
Keyword(s):  
Gold Standard ◽  
Mr Angiography ◽  
External Rotation ◽  
Axillary Nerve ◽  
Imaging Studies ◽  
Ultrasound Guided ◽  
Diagnostic Block ◽  
Diagnostic Modalities ◽  
No Gold Standard ◽  
Posterior Circumflex Humeral Artery

Quadrilateral space syndrome (QSS) is a rare nerve entrapment disorder that occurs when the axillary nerve and posterior circumflex humeral artery (PCHA) become compressed in the quadrilateral space. QSS presents as vague posterolateral shoulder pain that is exacerbated upon the abduction and external rotation of the shoulder. Diagnosis of QSS is difficult because of the vague presentation of QSS. In addition, even though MRI and MR angiography can be used in QSS diagnosis, there is currently no “gold standard” diagnostic imaging studies for QSS. In this case report, we describe a novel ultrasound-guided technique for a diagnostic quadrilateral space block and present a case where the diagnostic block was used to diagnose QSS. We believe that a diagnostic block of the quadrilateral space is a useful adjunct in the evaluation of patients with suspected QSS, especially in cases where examination findings and other diagnostic modalities are indeterminate.

scholarly journals Contrast Runoff Correlates with the Clinical Outcome of Cervical Epidural Neuroplasty Using a Racz Catheter

2016 ◽  
Vol 7;19 (7;9) ◽  
pp. E1035-E1040
Author(s):  
Young Hoon Kim
Keyword(s):  
Rating Scale ◽  
Management Practice ◽  
Spinal Pain ◽  
Numeric Rating Scale ◽  
University Hospital ◽  
Control Group ◽  
Foraminal Stenosis ◽  
Total Pain ◽  
Spread Pattern ◽  
Interventional Pain Management

Background: Epidural neuroplasty using a Racz catheter has a therapeutic effect. Studies have found no correlation between foraminal stenosis and the outcome of epidural neuroplasty, which is thought to depend on contrast runoff. Objective: To examine the correlation between the contrast spread pattern and pain reduction in cervical epidural neuroplasty using a Racz catheter. Study Design: Retrospective study. Setting: An interventional pain-management practice in a university hospital. Methods: Fluoroscopic images were reviewed retrospectively. The spread of contrast from the neural foramen to a nerve root was called contrast runoff. If the contrast did not spread in this manner, then there was no contrast runoff. We defined successful epidural neuroplasty as a 50% or greater reduction from the pre-procedure numeric rating scale (NRS) score for total pain, and an at least 40% reduction in the neck pain and disability scale (NPDS) score. Results: This study reviewed 169 patients. Among the patients who had a contrast runoff pattern, the epidural neuroplasty was rated as successful in 96 (74.4%), 97 (75.2%), 86 (66.7%), and 79 (61.2%) cases one, 3, 6, and 12 months after the procedure, respectively. When there was no contrast runoff, the epidural neuroplasty was successful in 12 (30%), 12 (30%), 10 (25%), and 10 (25%) cases at one, 3, 6, and 12 months after the procedure (P < 0.001). Logistic regression of the contrast spread pattern and predicting successful epidural neuroplasty gave similar results. Patients with a contrast runoff pattern had odds ratios of 6.788, 7.073, 6.000, and 4.740 at one, 3, 6, and 12 months, respectively (P < 0.001). Limitations: This study lacked a control group, and the patients were not classified by their diagnosed disease, such as spinal stenosis, herniated nucleus pulposus, and post-spinal surgery syndrome. Conclusions: Cervical epidural neuroplasty with a contrast runoff pattern had a higher success rate. Contrast runoff should be observed during neuroplasty, even in the presence of foraminal stenosis. Key words: Cervical spinal pain, contrast, contrast runoff, epidural neuroplasty, percutaneous adhesiolysis, Racz catheter

scholarly journals Efficacy of Early Endoscopic Ultrasound-Guided Transluminal Drainage for Postoperative Pancreatic Fistula

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Nao Fujimori ◽  
Takashi Osoegawa ◽  
Akira Aso ◽  
Soichi Itaba ◽  
Yosuke Minoda ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Endoscopic Ultrasound ◽  
Disease Onset ◽  
Postoperative Pancreatic Fistula ◽  
University Hospital ◽  
Optimal Timing ◽  
Time Interval ◽  
Initial Operation ◽  
Ultrasound Guided ◽  
Patient Groups

Background. Endoscopic ultrasound-guided transluminal drainage (EUS-TD) is generally performed 4 weeks after disease onset for evacuating pancreatic fluid collections. However, the optimal timing for conducting the procedure in those diagnosed with postoperative pancreatic fistula (POPF) has not been established. We aimed to elucidate the efficacy and safety of early EUS-TD procedures for treating POPF. Methods. We retrospectively reviewed patients diagnosed with POPF who underwent EUS-TD in the Kyushu University Hospital between 2008 and 2019. Clinical features were comparatively analyzed between the two patient groups who underwent either early (≤15 days postoperatively) or late (>15 days postoperatively) EUS-TD. Factors prolonging hospital stay were also analyzed using Cox proportional hazard models. Results. Thirty patients (median age, 64.5 years) were enrolled. The most common initial operation was distal pancreatectomy with splenectomy (60.0%). Median size of POPF was 69.5 (range, 38–145) mm, and median time interval between surgery and EUS-TD was 17.5 (range, 3–232) days. Totally, 47% patients underwent early EUS-TD. Rates of technical success, clinical success, and complications were 100%, 97%, and 6.9%, respectively. No recurrence of POPF occurred during a median follow-up period of 14 months. Clinical characteristics and outcomes were comparable between the early and late drainage patient groups, except for the rates of infection and nonencapsulation of POPF, which were significantly higher in the early drainage group. Performing simultaneous internal and external drainage (hazard ratio (HR): 0.31; 95% confidence interval (CI): 0.11–0.93, p = 0.04 ) and conducting ≥2 treatment sessions (HR: 0.26; 95% CI: 0.08–0.84, p = 0.02 ) were significantly associated with prolonged hospitalization after EUS-TD. Conclusions. EUS-TD is a safe and effective method for managing POPF, regardless of when it is performed in the postoperative period. Once infected POPF occurs, clinicians should not hesitate to perform EUS-TD even within 15 days of the initial operation.

Symptomatic vascular complications after vascular closure device use following diagnostic and interventional catheterisation

VASA ◽  
2004 ◽  
Vol 33 (2) ◽  
pp. 78-81 ◽  
Author(s):  
Thalhammer ◽  
Aschwanden ◽  
Jeanneret ◽  
Labs ◽  
Jäger
Keyword(s):  
Current Literature ◽  
Vascular Complications ◽  
University Hospital ◽  
Closure Device ◽  
Ultrasound Guided ◽  
Vascular Closure Device ◽  
Device Use ◽  
Arterial Stenoses ◽  
The University ◽  
Stenotic Lesions

Background: Haemostatic puncture closure devices for rapid and effective hemostasis after arterial catheterisation are a comfortable alternative to manual compression. Implanting a collagen plug against the vessel wall may become responsible for other kind of vascular injuries i.e. thrombotic or stenotic lesions and peripheral embolisation. The aim of this paper is to report our clinically relevant vascular complications after Angio-Seal® and to discuss the results in the light of the current literature. Patients and methods: We report the symptomatic vascular complications in 17 of 7376 patients undergoing diagnostic or therapeutic catheterisation between May 2000 and March 2003 at the University Hospital Basel. Results: Most patients presented with ischaemic symptoms, arterial stenoses or occlusions and thrombotic lesions (n = 14), whereas pseudoaneurysms were extremely rare (n = 3). Most patients with ischaemic lesions underwent vascular surgery and all patients with a pseudoaneurysm were successfully treated by ultrasound-guided compression. Conclusions: Severe vascular complications after Angio-Seal® are rare, consistent with the current literature. There may be a shift from pseudoaneurysms to ischaemic lesions.

Statistical Management of Food Production Processes

2020 ◽  
pp. 30-35
Author(s):  
N.A. Jurk ◽  
Keyword(s):  
Production Process ◽  
Control Chart ◽  
Food Production ◽  
Time Interval ◽  
Bakery Products ◽  
Shewhart Control ◽  
Manufactured Products ◽  
Mnemonic Technique ◽  
The Stability

The article presents scientific research in the field of statistical controllability of the food production process using the example of bakery products for a certain time interval using statistical methods of quality management. During quality control of finished products, defects in bakery products were identified, while the initial data were recorded in the developed form of a checklist for registering defects. It has been established that the most common defect is packaging leakage. For the subsequent statistical assessment of the stability of the production process and further analysis of the causes of the identified defect, a Shewhart control chart (p-card by an alternative feature) was used, which allows you to control the quality of manufactured products by the number of defects detected. Analyzing the control chart, it was concluded that studied process is conditionally stable, and the emerging defects are random. At the last stage of the research, the Ishikawa causal diagram was used, developed using the 6M mnemonic technique, in order to identify the most significant causes that affect the occurrence of the considered defect in bakery products. A more detailed study will allow the enterprise to produce food products that meet the established requirements.

EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

2017 ◽  
pp. 103-106
Author(s):  
Minh Duc Pham
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
University Hospital ◽  
Early Results ◽  
Sils Port ◽  
The Mean ◽  
A New Technique

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy

Sign in / Sign up

Export Citation Format

Share Document