scholarly journals Evaluation of results of laparoscopic cholecystectomy after cholecystostomy for acute calculous cholecystitis

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Tuấn Ngọc Nguyễn ◽  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conversion Rate ◽  
Cross Sectional Study ◽  
High Rate ◽  
Cross Sectional ◽  
Female Ratio ◽  
Gallbladder Drainage ◽  
Acute Calculous Cholecystitis ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Calculous Cholecystitis

Tóm tắt Đặt vấn đề: Xác định tỷ lệ phẫu thuật nội soi (PTNS) thành công và một số yếu tố liên quan của PTNS cắt túi mật (TM) sau dẫn lưu túi mật (DLTM) qua da xuyên gan hoặc DLTM qua da trong viêm túi mật cấp (VTMC) do sỏi. Phương pháp nghiên cứu: Nghiên cứu cắt ngang người bệnh (NB) được PTNS cắt TM sau DLTM do VTMC do sỏi tại Bệnh viện Trưng Vương từ tháng 01/2013 đến tháng 6/2019. Kết quả: 72 NB được DLTM, 35 nam, 37 nữ, tỉ lệ nam/nữ 0,94. Tuổi trung bình là 57,8 ± 14,3. DLTM thành công 100%. Tỉ lệ chuyển mổ mở của PTNS cắt TM sau DLTM là 1,4 % (1 NB). Kết luận: DLTM trong VTMC do sỏi là kỹ thuật dễ thực hiện, an toàn, tỉ lệ thành công cao (100%), không có tai biến, và biến chứng nghiêm trọng. PTNS cắt TM sau DLTM thành công cao (98,6%), tỉ lệ chuyển mổ mở thấp, tai biến, biến chứng không đáng kể. DLTM là phương pháp điều trị tạm thời hiệu quả để chuẩn bị cho PTNS cắt TM sau đó. Abstract Introduction: Identification of successful rate of laparoscopic cholecystectomy (LC) and analysis of factors related to results of LC for post-percutaneous transhepatic gallbladder drainage or percutaneous gallbladder drainage (PTGBD) in acute calculous cholecystitis (ACC). Materials and Methods: Cross-sectional study. The patients with cholecystostomy due to ACC underwent LC at Trung Vuong hospital from January 2013 to June 2019 enrolled. Results: 72 patients had PTGBD including 35 male and 37 female, male/ female ratio was 0.94. The mean age was 57.8 ± 14.3 years old. The success rate of PTGBD was 100%. The LC has performed successfully for PTGBD and conversion rate to open surgery was 1,4% (1 patient). Conclusion: PTGBD for ACC is a feasilble and safe technique, high rate of success (100%) without any serious accidents and complications. LC after PTGBD has conducted successfully at high rate (98,6%), very low conversion rate and minimal complications. PTGBD is an effective temporary management for preparation of subsequent laparoscopic cholecystectomy Keywords: Cholecystitis, Percutaneous Transhepatic Gallbladder Drainage.

scholarly journals Surgical outcome of percutaneous transhepatic gallbladder drainage in acute cholecystitis: Ten years’ experience at a tertiary care centre

2021 ◽  
Author(s):  
Szabolcs Ábrahám ◽  
Illés Tóth ◽  
Ria Benkő ◽  
Mária Matuz ◽  
Gabriella Kovács ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Acute Cholecystitis ◽  
Conversion Rate ◽  
Clinical Success ◽  
Definitive Treatment ◽  
Success Rates ◽  
Female Ratio ◽  
Gallbladder Drainage ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Grade Iii

Abstract Background Percutaneous transhepatic gallbladder drainage (PTGBD) plays an important role in the treatment of elderly patients and/or patients in poor health with acute cholecystitis (AC). The primary aim of this study is to determine how these factors influence the clinical outcome of PTGBD. Moreover, we assessed the timing and results of subsequent cholecystectomies. Patients and Methods We retrospectively examined the results of 162 patients undergoing PTGBD between 2010 and 2020 (male–female ratio: 51.23% vs. 48.77%; mean age: 71.43 ± 13.22 years). Patient’s performance status and intervention outcomes were assessed with clinical success rates (CSR) and in-hospital mortality. The conversion rate (CR) of possible urgent or delayed, elective laparoscopic cholecystectomies (LC) after PTGBD were analysed. Results PTGBD was the definitive treatment in 42.18% of patients, while it was a bridging therapy prior to cholecystectomy (CCY) for the other patients. CSR was 87.97%, it was only 64.29% in grade III AC. In 9.87% of the cases, urgent LC was necessary after PTGBD, and its conversion rate was approximately equal to that of elective LC (18.18 vs. 17.46%, respectively, p = 0.2217). Overall, the post-PTGBD in-hospital mortality was 11.72%, while the same figure was 0% for grade I AC, 7.41% for grade II and 40.91% for grade III. Based on logistic regression analyses, in-hospital mortality (OR 6.07; CI 1.79–20.56), clinical progression (OR 7.62; CI 2.64–22.05) and the need for emergency CCY (OR 14.75; CI 3.07–70.81) were mostly determined by AC severity grade. Conclusion PTGBD is an easy-to-perform intervention with promising clinical success rates in the treatment of acute cholecystitis. After PTGBD, the level of gallbladder inflammation played a decisive role in the course of AC. In a severe, grade III inflammation, we have to consider low CSR and high mortality.

scholarly journals Clinicopathological profile and treatment outcomes of patients presenting with epistaxis: a hospital-based cross-sectional study in Southern railway headquarters hospital, Chennai

2021 ◽  
Vol 7 (10) ◽  
pp. 1624
Author(s):  
Thirupathi K. ◽  
A. P. Preetham ◽  
Musarrat Feshan
Keyword(s):  
Nasal Septum ◽  
Cross Sectional Study ◽  
Nasal Packing ◽  
High Rate ◽  
Sectional Study ◽  
Deviated Nasal Septum ◽  
Cross Sectional ◽  
Female Ratio ◽  
Clinicopathological Profile ◽  
The Right

<p class="abstract"><strong>Background:</strong> Epistaxis (nose-bleed) is one of the commonest emergencies presenting to an otolaryngological emergency that affects up to sixty per cent of the population in their lifetime; in this, six per cent needs medical care.</p><p class="abstract"><strong>Methods: </strong>Hospital-based cross-sectional study carried between October 2018 to January 2020 in the department of ENT at Southern Railway Headquarters Hospitals, Perambur, Chennai.</p><p class="abstract"><strong>Results: </strong>The mean age of the subjects was 47.76±23.01. Females were less affected compared to males with 1.68:1 male: female ratio. The results of ENT examination/anterior rhinoscopic examination revealed that all 153 (100%) subjects had anterior epistaxis and 5 (3.27%) had posterior epistaxis. 143 (93.46%) had deviated nasal septum. Diagnostic nasal endoscopy revealed that 90 (58.82%) had deviated nasal septum to the left, and 55 (35.94%) had to the right. The majority of subjects, i.e., 86 (56.21%), were managed conservatively, followed by 52 (33.99%), 5 (3.27%), and 1 (0.65%) patient were given treatment with anterior nasal packing, anterior and posterior nasal packing, and cauterization respectively. Whereas 9 (5.88%) subjects needed a surgical mode of treatment to manage their epistaxis.</p><p class="abstract"><strong>Conclusions:</strong> Findings revealed that the incidence was high in elderly individuals, with male preponderance over females. Anterior epistaxis more commonly occurred in comparison to posterior epistaxis. Our research supports the conservative management methods’ credibility in the epistaxis treatment. The practice of simple nasal packing is the commonest conservative approach that has a high rate of success. As a result, this method will be the best choice for epistaxis management.</p>

scholarly journals Comparison of emergency cholecystectomy and delayed cholecystectomy after percutaneous transhepatic gallbladder drainage in patients with acute cholecystitis: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Shao-Zhuo Huang ◽  
Hao-Qi Chen ◽  
Wei-Xin Liao ◽  
Wen-Ying Zhou ◽  
Jie-Huan Chen ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Blood Loss ◽  
Acute Cholecystitis ◽  
Conversion Rate ◽  
Operative Time ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Intraoperative Blood Loss ◽  
Gallbladder Drainage ◽  
Percutaneous Transhepatic Gallbladder Drainage

Abstract Laparoscopic cholecystectomy and percutaneous transhepatic gallbladder drainage (PTGBD) are common treatments for patients with acute cholecystitis. However, the safety and efficacy of emergency laparoscopic cholecystectomy (ELC) and delayed laparoscopic cholecystectomy (DLC) after PTGBD in patients with acute cholecystitis remain unclear. The PubMed, EMBASE, and Cochrane Library databases were searched through October 2019. The quality of the included nonrandomized studies was assessed using the Methodological Index for Nonrandomized Studies (MINORS). The meta-analysis was performed using STATA version 14.2. A random-effects model was used to calculate the outcomes. A total of fifteen studies involving 1780 patients with acute cholecystitis were included in the meta-analysis. DLC after PTGBD was associated with a shorter operative time (SMD − 0.51; 95% CI − 0.89 to − 0.13; P = 0.008), a lower conversion rate (RR 0.43; 95% CI 0.26 to 0.69; P = 0.001), less intraoperative blood loss (SMD − 0.59; 95% CI − 0.96 to − 0.22; P = 0.002) and longer time of total hospital stay compared to ELC (SMD 0.91; 95% CI 0.57–1.24; P < 0.001). There was no difference in the postoperative complications (RR 0.68; 95% CI 0.48–0.97; P = 0.035), biliary leakage (RR 0.65; 95% CI 0.34–1.22; P = 0.175) or mortality (RR 1.04; 95% CI 0.39–2.80; P = 0.933). Compared to ELC, DLC after PTGBD had the advantages of a shorter operative time, a lower conversion rate and less intraoperative blood loss.

STUDY ON THRIVE SCORE IN THE PROGNOSIS OF ISCHEMIC STROKE

2017 ◽  
pp. 22-24
Author(s):  
Thi Thao Nhi Tran ◽  
Dinh Toan Nguyen
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Regression Models ◽  
Cross Sectional Study ◽  
High Rate ◽  
Vascular Events ◽  
Cross Sectional ◽  
Key Words Ischemic Stroke ◽  
Outcome Mortality ◽  
Better Than

Background and Purpose: Stroke is the second cause of mortality and the leading cause of disability. Using the clinical scale to predict the outcome of the patient play an important role in clinical practice. The Totaled Health Risks in Vascular Events (THRIVE) score has shown broad utility, allowing prediction of clinical outcome and death. Methods: A cross-sectional study conducting on 102 patients with acute ischemic stroke using THRIVE score. The outcome of patient was assessed by mRankin in the day of 30 after stroke. Statistic analysis using SPSS 15.0. Results: There was 60.4% patient in the group with THRIVE score 0 – 2 points having a good outcome (mRS 0 - 2), patient group with THRIVE score 6 - 9 having a high rate of bad outcome and mortality. Having a positive correlation between THRIVE score on admission and mRankin score at the day 30 after stroke with r = 0.712. THRIVE score strongly predicts clinical outcome with ROC-AUC was 0.814 (95% CI 0.735 - 0.893, p<0.001), Se 69%, Sp 84% and the cut-off was 2. THRIVE score strongly predicts mortality with ROC-AUC was 0.856 (95% CI 0.756 - 0.956, p<0.01), Se 86%, Sp 77% and the cut-off was 3. Analysis of prognostic factors by multivariate regression models showed that THRIVE score was only independent prognostic factor for the outcome of post stroke patients. Conclusions: The THRIVE score is a simple-to-use tool to predict clinical outcome, mortality in patients with ischemic stroke. Despite its simplicity, the THRIVE score performs better than several other outcome prediction tools. Key words: Ischemic stroke, THRIVE, prognosis, outcome, mortality

scholarly journals Risk Factors, Pattern and Outcome of Motorcycle-associated Head Injury in Sokoto: An Analysis of 184 Cases

2021 ◽  
Author(s):  
Henry Olayere Obanife ◽  
Nasiru Jinjiri Ismail ◽  
Ali Lasseini ◽  
Bello B. Shehu ◽  
Ega J. Otorkpa
Keyword(s):  
Developing Countries ◽  
Head Injury ◽  
Road Traffic ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Incidence And Mortality ◽  
Male Female Ratio ◽  
Significant Negative Impact

Abstract Background Road traffic accident (RTA) is the eighth leading cause of death worldwide. Motorcycle-associated head injury is the leading cause of road traffic associated morbidity and mortality in developing countries. Even though the incidence and mortality of head injury from motor cycle crash is on the increase in developing countries, especially in the African continent, most of the studies published in the literature on this subject matter took place in the developed Western countries. Methods This is a retrospective cross-sectional study of data from patients managed in our institution between December 2014 and November 2016. Results One hundred and eighty-four patients were analyzed. None of the patients used safety helmet for protection. The mean age was 27.6 ± 17.2 years with male female ratio of 6.7:1. Lone crash by cyclists and collisions accounted for 66.8% and 33.1% of the cases, respectively. Passengers and riders comprised 75% of the patients, while 25% were vulnerable pedestrians. The most frequently abused substance by the patients was tramadol (65.52%). Severe head injury and pupillary abnormality were found in 23.9% and 45.5% of the patients, respectively. Cranial CT scan showed abnormalities in 40.2% of the patients. Surgery was done in 28.3% of the patients with mortality rate of 20.7%. Conclusions The use of motorcycle as a mean of transportation has caused significant negative impact on the society. Young people, who constitute the workforce, are majorly affected, and this invariably leads to a serious economic burden on the concerned families and communities.

A retrospective analysis of congenital anomalies in congenital hypothyroidism

2020 ◽  
Vol 33 (9) ◽  
pp. 1147-1153
Author(s):  
Fatima Ali Mazahir ◽  
Manal Mustafa Khadora
Keyword(s):  
United Arab Emirates ◽  
Congenital Hypothyroidism ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
High Rate ◽  
Lingual Thyroid ◽  
Cross Sectional

AbstractObjectivesWe evaluated the spectrum of diseases accompanying congenital hypothyroidism (CH) in the United Arab Emirates and compared them with internationally studied patterns.MethodsThe presented retrospective cross-sectional study took place in two government tertiary care centres. In total, 204 patients with a confirmed diagnosis of CH and a minimum period of follow-up of 1 year were included. Patients with Down syndrome, infants born at <35 weeks of gestation, and babies with TORCH (Toxoplasma gondii, Other viruses [HIV, measles, etc.], Rubella, Cytomegalovirus, and Herpes simplex) infections were subsequently excluded from the study.ResultsOf the subjects with CH, 39% had associated extrathyroidal anomalies (ETAs); among these, 25% had a single anomaly. A significant proportion of Arab males were affected by CH as compared to other ethnic groups. Dyshormonogenesis was the commonest aetiological cause (55%) of CH. Males with an ectopic lingual thyroid gland had significant ETAs as compared to females of the same cohort. The most common ETAs were congenital heart disease (16%), followed by urogenital tract anomalies (14%).ConclusionsDetection of a high rate and variability of ETAs associated with CH necessitates the formulation of a structured screening programme including appropriate clinical, laboratory, and imaging tools to detect ETAs at an earlier stage.

scholarly journals Prevalence of Thinness among Santal Preschool Children Using New Body Mass Index Cut-Off Points

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Subal Das ◽  
Kaushik Bose
Keyword(s):  
Body Mass Index ◽  
Preschool Children ◽  
Nutritional Status ◽  
Body Mass ◽  
Cross Sectional Study ◽  
High Rate ◽  
Tribal Community ◽  
Community Based ◽  
Cross Sectional ◽  
Purulia District

A community-based cross-sectional study was undertaken to determine the prevalence of undernutrition using body mass index (BMI) among 2–6-year Santal preschool children of Purulia District, West Bengal, India. A total of 251 (116 boys and 135 girls) children from 12 villages were measured. Commonly used indicators, that is, weight, height, and BMI, were used to evaluate the nutritional status. More boys (59.5%) than girls (53.3%), based on BMI, were undernourished. Significant age differences in weight (F=44.29∗∗∗; df=3), height (F=58.48∗∗∗; df=3), and BMI (F=3.52∗∗∗; df=3) among boys were observed. Similarly, significant differences between ages in mean weight (F=56.27∗∗∗; df=3), height (F=64.76∗∗∗; df=3), and BMI (F=2.62∗∗∗; df=3) were observed among the girls. The present study revealed that the nutritional status of the preschool children of Santal tribal community of these villages was poor with very high rate of thinness in boys and girls (59.5% and 53.3%, resp.).

scholarly journals Self-Reported Efficacy of Cannabis and Other Complementary Medicine Modalities by Parkinson’s Disease Patients in Colorado

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Taylor Andrew Finseth ◽  
Jessica Louise Hedeman ◽  
Robert Preston Brown ◽  
Kristina I. Johnson ◽  
Matthew Sean Binder ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Support Groups ◽  
Legal Status ◽  
Cross Sectional Study ◽  
Recent Change ◽  
High Rate ◽  
Cross Sectional ◽  
Metro Area ◽  
Cam Use

Introduction. Complementary and alternative medicine (CAM) is frequently used by Parkinson’s disease (PD) patients. We sought to provide information on CAM use and efficacy in PD patients in the Denver metro area with particular attention to cannabis use given its recent change in legal status.Methods. Self-administered surveys on CAM use and efficacy were completed by PD patients identified in clinics and support groups across the Denver metro area between 2012 and 2013.Results. 207 patients (age69±11; 60% male) completed the survey. Responses to individual CAM therapy items showed that 85% of respondents used at least one form of CAM. The most frequently reported CAMs were vitamins (66%), prayer (59%), massage (45%), and relaxation (32%). Self-reported improvement related to the use of CAM was highest for massage, art therapy, music therapy, and cannabis. While only 4.3% of our survey responders reported use of cannabis, it ranked among the most effective CAM therapies.Conclusions. Overall, our cross-sectional study was notable for a high rate of CAM utilization amongst PD patients and high rates of self-reported efficacy across most CAM modalities. Cannabis was rarely used in our population but users reported high efficacy, mainly for nonmotor symptoms.

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