scholarly journals TO ANALYSE PATIENT OF POST CHOLECYSTECTOMY SYMPTOMS AFTER CHOLECYSTECTOMY

2020 ◽  
pp. 72-73
Author(s):  
Jitendra K. Mangtani ◽  
Ketan Patel ◽  
Anshul Mathur ◽  
Heet Amlani ◽  
Vartika Gupta ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Common Cause ◽  
Abdominal Symptoms ◽  
Common Causes ◽  
Cbd Stone ◽  
Oddi Dysfunction ◽  
Upper Abdominal

Introduction: Post-cholecystectomy syndrome (PCS) comprise of a group of abdominal symptoms that occur after cholecystectomy. Post cholecystectomy syndrome is defined as group of heterogeneous symptoms. It is consists of upper abdominal pain, vomiting and dyspepsia, which occur after cholecystectomy. Although, this term is not accurate, as it comprises biliary and non-biliary disorders, possibly not related to cholecystectomy. AIM : To analyse the clinical evaluation for post cholecystectomy Symptoms. Objectives : To identify the causes for post cholecystectomy symptoms.To identify pre-operative factors (h/o ERCP, attacks of cholecystitis) associated with post cholecystectomy symptoms. Materials & Methods : A Prospective clinical hospital based study was done in 100 patients at tertiary care referral hospital in the department of general surgery. All cases of post- cholecystectomy who had clinical symptoms of PCS Cases in which on follow up USG and LFT were done. Result: In our study 100 patients were taken who developed PCS after cholecystectomy. Among all patients, 16% patient developed PCS due to biliary etiology. Among 16% patients most common cause is recurrent CBD stone (6%) and second most common causes is retained CBD Stone (3%) & spincter Of Oddi dysfunction (3%). Discussion : This analysis provides a qualitative overview of etiologies of abdominal symptoms after cholecystectomy. Based on the etiologies of persistent and incident symptoms after cholecystectomy provided in this review, we identified the cause of long-term symptoms after cholecystectomy. Conclusion : In our study, PCS developed mainly due to non-biliary etiology considered 84% and biliary etiology considered only 16%. Female has higher risk to developing post cholecystectomy symptoms compared to male after cholecystectomy.

Endaural Atticotomy for pars flaccida Cholesteatoma

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P55-P55
Author(s):  
John P Leonetti ◽  
Sam J Marzo ◽  
Matthew L Kircher
Keyword(s):  
Clinical Symptoms ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Long Term Results ◽  
Pars Flaccida ◽  
Academic Medical

Objective To present our long-term results using an endaural atticotomy approach for the management of 361 cases of pars flaccida cholesteatoma. Methods This is a retrospective chart review of 361 cases of attic cholesteatoma that were surgically managed at our tertiary care, academic medical center between 7/88 – 7/07. Results 361 of the 2068 cholesteatomas treated at our institution were surgically managed with an endaural atticotomy approach. There were 201 females and 160 males who ranged in age from 17–77 years. The most common clinical symptoms were aural fullness, hearing loss, and otorrhea. Ossiculoplasty was necessary in 170 of 361 or 47% of the patients. Hearing levels were maintained or improved in 297 patients or 82%. Cholesteatoma recurred in 29 of 361 patients (8%) and 24 of these 29 patients failed to return for otoscopic evaluation and PE tube replacement. The mean follow-up was 7.7 years. Conclusions The endaural approach for pars flaccida cholesteatoma is an option for limited retraction cholesteatomas in patients who will reliably be seen for ventilation tube replacement.

scholarly journals Endoscopically controlled surgery with open hemilaminectomy for the treatment of intradural extramedullary tumors: an operative technique and short-term outcomes of 20 consecutive cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically controlled surgery with open hemilaminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically controlled surgery with open hemilaminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short-term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically controlled surgery with open hemilaminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

Nephrocalcinosis, Renal Dysfunction, and Calculi in Patients With Primary Hypoparathyroidism on Long-Term Conventional Therapy

2020 ◽  
Vol 105 (4) ◽  
pp. e1215-e1224 ◽  
Author(s):  
Soma Saha ◽  
Devasenathipathy Kandasamy ◽  
Raju Sharma ◽  
Chandrasekhar Bal ◽  
Vishnubhatla Sreenivas ◽  
...  
Keyword(s):  
Renal Dysfunction ◽  
Conventional Therapy ◽  
Care Center ◽  
Tertiary Care ◽  
Fractional Excretion ◽  
Renal Calculi ◽  
Serum Total Calcium ◽  
Calcium Phosphorus

Abstract Context There are concerns about the long-term safety of conventional therapy on renal health in patients with hypoparathyroidism. Careful audit of these would help comparisons with upcoming parathyroid hormone therapy. Objective We investigated nephrocalcinosis, renal dysfunction, and calculi, their predictors and progression over long-term follow-up in patients with primary hypoparathyroidism (PH). Design and Setting An observational study at a tertiary care center was conducted. Participants and Methods A total of 165 PH patients receiving conventional therapy were evaluated by radiographs, ultrasonography, and computed tomography. Their glomerular filtration rate (GFR) was measured by Tc-99m-diethylenetriamine penta-acetic acid clearance. Clinical characteristics, serum total calcium, phosphorus, creatinine, hypercalciuria, and fractional excretion of phosphorus (FEPh) at presentation and during follow-up were analyzed as possible predictors of renal complications. Controls were 165 apparently healthy individuals. Results Nephrocalcinosis was present in 6.7% of PH patients but not in controls. Patients younger than 15 years at presentation and with higher serum calcium-phosphorus product were at higher risk. Nephrocalcinosis showed no significant association with cataract and intracranial calcification. Prevalence of renal calculi was comparable between hypoparathyroid patients and controls (5% vs 3.6%, P = .58). Fourteen percent of patients had a GFR less than 60 mL/min/1.73 m2. Increased FEPh during follow-up was the significant predictor of low GFR. Nephrocalcinosis developed in 9% of patients over 10 years of conventional therapy. Conclusion A total of 6.7% of PH patients had nephrocalcinosis, and 14% showed renal dysfunction. Prevalence of renal calculi was similar in patients and controls. Nine percent of patients developed nephrocalcinosis over 10 years of conventional therapy.

scholarly journals Endoscopically-controlled surgery with open hemi-laminectomy for the treatment of intradural extramedullary tumors: An operative technique and short-term outcomes of 20 consecutive cases

2020 ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically-controlled surgery with open hemi-laminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically-controlled surgery with open hemi-laminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically-controlled surgery with open hemi-laminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

Vestibular migraine: Long-term follow-up of clinical symptoms and vestibulo-cochlear findings

Neurology ◽  
2012 ◽  
Vol 79 (15) ◽  
pp. 1607-1614 ◽  
Author(s):  
A. Radtke ◽  
M. von Brevern ◽  
H. Neuhauser ◽  
T. Hottenrott ◽  
T. Lempert
Keyword(s):  
Clinical Symptoms ◽  
Vestibular Migraine ◽  
Long Term Follow Up

scholarly journals A rare case of duodenal diaphragm in an adult during ERCP treatment for choledocholithiasis

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Liying Wu ◽  
Guofa Jia ◽  
Yiheng Hu ◽  
Liangsong Zhu ◽  
Shuhai Wang
Keyword(s):  
Acute Cholangitis ◽  
Clinical Manifestations ◽  
Endoscopic Retrograde ◽  
Case Summary ◽  
Inflammatory Drugs ◽  
Cbd Stone ◽  
Duodenal Diaphragm ◽  
Upper Abdominal ◽  
Endoscopic Balloon

Abstract Background Duodenal Diaphragm in adults is very uncommon, caused by congenital and acquired changes. It is reported that acquired duodenal diaphragm is related to the long-term use of nonsteroidal anti-inflammatory drugs. Case summary We report an adult presentation of duodenal diaphragm in a 77-year-old woman, suffered from acute cholangitis and choledocholithiasis. She was performed endoscopic retrograde cholangiopancreatography (ERCP) procedure to remove the stone in common bile duct (CBD). After the stenosis ring dilated by endoscopic balloon dilatation, ERCP procedure was applied, and the CBD stone was removed successfully. Conclusion Duodenal diaphragm is difficult to diagnose in clinic. Although the patient in this case had relatively mild symptoms of incomplete upper hemi-abdominal obstruction, these symptoms could be obscured by the emergency acute upper abdominal pain with fever as clinical manifestations of acute cholangitis.

scholarly journals P1826ASSESSMENT OF GROWTH PARAMETERS OF CHILDREN IN LONG TERM FOLLOW UP WITH DIFFERENT RELAPSING COURSE OF NEPHROTIC SYNDROME

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sonia Sharma
Keyword(s):  
Nephrotic Syndrome ◽  
Growth Parameters ◽  
Tertiary Care ◽  
Age At Onset ◽  
Standard Deviation Score ◽  
Pediatric Nephrology ◽  
Group 2 ◽  
Nephrotic Children

Abstract Background and Aims Childhood Nephrotic syndrome has its peak onset in the age group 2-4 years, and that is also a period of significant height growth. Corticosteroids and chronic diseases are known to have long term effects on growth parameters of these children. Hence we assessed and compared the growth of children with Infrequent relapsing (IFRNS) and remission (R) as group 1, Frequent -relapsing (FR), and steroid - dependent (SD) as group 2 and steroid -resistant (SR) as group 3. Method This retrospective single center study collected data from medical records of children presented in a pediatric nephrology clinic in a tertiary care center in New Delhi. Nephrotic children, aged 1-18 years with regular follow up in the period of 2014 to 2019 were included. Basic demographic details including age at onset and age at last follow up in clinic, sex, anthropometry details at last follow up were recorded. We traced initial height at nephrotic syndrome onset to assess growth velocity but were unavailable at the moment so excluded from analysis. Also, children completed less than 1 year follow up, and compliance issues were excluded. Z scores (standard deviation score) for weight, height and BMI were calculated. Initial comparison of three groups as FR/SDNS, IFRNS/R and SRNS was done. But in the second comparison, we combined FR/SD and SR children in one group as Difficult nephrotic syndrome (DNS) group. Anova Kruskal-Wallis test was used to find significance in three groups in table 1. Subsequent analysis was done by the non-parametric statistic method Mann-Whitney Test to assess significance in subgroups of boys and girls. Results: 27 IFR/R nephrotic children, 36 FR/SD, and 15 SRNS were compared as in Table1. D-NS and IFRNS-R for boys and girls ratio (11; 16) & (18; 32) followed for a median period of 18 (max 46; 12), 24.6 (57.6; 12), and 32 (50;12) months respectively. Conclusion Linear growth (height) is the most affected parameters in children in SRNS and FR/SD nephrotic syndrome. Effect is more significant in girls then in boys as they showed improvement in . No difference in weight and BMI is seen on applied statistics in two groups.

scholarly journals Comparative study of post-partum intra uterine contraceptive device insertion and interval intra uterine contraceptive device insertion in a tertiary care hospital

2017 ◽  
Vol 6 (7) ◽  
pp. 2760
Author(s):  
Manimegalai R. ◽  
Suganthi R.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Family Health ◽  
Common Reason ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Medical College

Background: NFHS (National Family Health Survey) 2005-2006 in India revealed that the contraceptive prevalence rate is 53.5%. 10% of all pregnancies are mistimed and 11% of all pregnancies are unwanted in India. Objective of present study was to compare the benefits and complications of postpartum IUCD insertion (PPIUCD) over interval IUCD insertion in a tertiary care hospital.Methods: It is a retrospective study conducted in the Department of Obstetrics and Gynecology, Govt. Mohan Kumaramangalam Medical College, Salem from 2009-2014. The cases of interval IUCD for the year 2009-2014 and PPIUCD cases for the year 2012-2014 both vaginal insertion and intracaesarean insertion were taken for study. Complications, benefits and reasons for removal were compared between the two groups.Results: The total number of cases of IUCD insertion significantly increased after the introduction of PPIUCD programme in 2012. The acceptance of IUCD insertion was steadily increasing after the introduction of PPIUCD even though the follow up of PPIUCD cases was less (32%). The rate of removal in patients who came for follow up was less in PPIUCD group (18%) compared to interval IUCD cases (57%) when the reason was menorrhagia. The most common reason for removal was menorrhagia in interval IUCD patients. Abdominal pain was the most common reason for removal in PPIUCD patients. The rate of expulsion was higher in PPIUCD (6%) compared to interval IUCD patients (<1%). No cases of perforation and no cases of pregnancy in situ were reported in PPIUCD cases during the study period. Even though the rate of infection and missing strings were higher in PPIUCD patients when compared to interval IUCD patients who came for follow up the number of women with infection in PPIUCD patients is less and easily managed with appropriate antibiotics.Conclusions: In India PPIUCD insertion soon after delivery is a safe, effective, reversible and reliable method of long term contraception. Both vaginal and intracaesarean insertions are safe, efficacious and convenient even though there are few complications which are easily manageable. There are no incidences of perforations, pregnancy in situ, ectopic pregnancy and low rates of infection. Hence PPIUCD is a promising approach to decrease the fertility rate in the field of family planning.

scholarly journals Cesarean scar defect and its association with clinical symptoms, uterine position and the number of cesarean sections

2020 ◽  
Vol 9 (10) ◽  
pp. 4091
Author(s):  
Madhangi V. B. ◽  
Ramany C.
Keyword(s):  
Clinical Symptoms ◽  
Transvaginal Ultrasound ◽  
Multiple Logistic Regression Analysis ◽  
Tertiary Care ◽  
Cesarean Sections ◽  
History Of ◽  
Caesarean Scar Defect ◽  
Relationship Of ◽  
The Relationship

Background: Caesarean scar defect (CSD), also called isthmocele or niche is a long-term complication, which can be asymptomatic or can give rise to chronic pelvic pain, dyspareunia and postmenstrual spotting. The objective of this study was to assess the association of CSD with clinical symptoms, position of the uterus and the number of caesarean sections.Methods: This was a prospective observational study done at a tertiary care teaching hospital from January 2019 to December 2019. The study included women with history of previous one or more caesarean sections with demonstrable CSD on transvaginal ultrasound. Various scar dimensions noted were width and depth of the scar. A deficiency ratio was calculated as a ratio of residual myometrium at the scar to the adjacent myometrium.Univariate analysis was done to assess the relationship of clinical symptoms with the defect parameters and number of previous caesarean sections. Multiple logistic regression analysis was done to find out the association between symptoms and number of previous caesarean sections with the scar defect dimensions.Results: The width, depth and deficiency ratio of the CSD were significantly higher in study subjects with a greater number of caesarean sections. Retroflexed uteri had larger CSD. There was no association of clinical features with the defect dimensions and the position of the uterus.Conclusions: CSD dimensions and deficiency ratio correlate with the number of previous caesarean sections and the position of the uterus. There was no association of clinical symptoms with the defect parameters.

scholarly journals Etiologies of Long-Term Postcholecystectomy Symptoms: A Systematic Review

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Carmen S. S. Latenstein ◽  
Sarah Z. Wennmacker ◽  
Judith J. de Jong ◽  
Cornelis J. H. M. van Laarhoven ◽  
Joost P. H. Drenth ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Strategies ◽  
Sphincter Of Oddi ◽  
Sphincter Of Oddi Dysfunction ◽  
Physiological Changes ◽  
Persistent Symptoms ◽  
Abdominal Symptoms ◽  
The Us ◽  
Oddi Dysfunction

Background. Cholecystectomy does not relieve abdominal symptoms in up to 40% of patients. With 700,000 cholecystectomies performed in the US, annually, about 280,000 patients are left with symptoms, making this a serious problem. We performed a systematic review to determine the different etiologies of long-term postcholecystectomy symptoms with the aim to provide guidance for clinicians treating these patients. Methods. A systematic search of the literature was performed using MEDLINE, EMBASE, and Web of Science. Articles describing at least one possible etiology of long-term symptoms after a laparoscopic cholecystectomy were included in this review. Long-term symptoms were defined as abdominal symptoms that were present at least four weeks after cholecystectomy, either persistent or incident. The etiologies of persistent and incident symptoms after LC and the mechanism or hypothesis behind the etiologies are provided. If available, the prevalence of the discussed etiology is provided. Results. The search strategy identified 3320 articles of which 130 articles were included. Etiologies for persistent symptoms were residual and newly formed gallstones (41 studies, prevalence ranged from 0.2 to 23%), coexistent diseases (64 studies, prevalence 1-65%), and psychological distress (13 studies, no prevalence provided). Etiologies for incident symptoms were surgical complications (21 studies, prevalence 1-3%) and physiological changes (39 studies, prevalence 16-58%). Sphincter of Oddi dysfunction (SOD) was reported as an etiology for both persistent and incident symptoms (21 studies, prevalence 3-40%). Conclusion. Long-term postcholecystectomy symptoms vary amongst patients, arise from different etiologies, and require specific diagnostic and treatment strategies. Most symptoms after cholecystectomy seem to be caused by coexistent diseases and physiological changes due to cholecystectomy. The outcome of this research is summarized in a decision tree to give clinical guidance on the treatment of patients with symptoms after cholecystectomy.

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