Impact of Early Intravenous Haemostatic Drugs on Brain Haemorrhage Patients and Their Image Segmentation Based on RGB-D Images

Cerebral haemorrhage is a serious subtype of stroke, with most patients experiencing short-term haematoma enlargement leading to worsening neurological symptoms and death. The main hemostatic agents currently used for cerebral haemorrhage are antifibrinolytics and recombinant coagulation factor VIIa. However, there is no clinical evidence that patients with cerebral haemorrhage can benefit from hemostatic treatment. We provide an overview of the mechanisms of haematoma expansion in cerebral haemorrhage and the progress of research on commonly used hemostatic drugs. To improve the semantic segmentation accuracy of cerebral haemorrhage, a segmentation method based on RGB-D images is proposed. Firstly, the parallax map was obtained based on a semiglobal stereo matching algorithm and fused with RGB images to form a four-channel RGB-D image to build a sample library. Secondly, the networks were trained with 2 different learning rate adjustment strategies for 2 different structures of convolutional neural networks. Finally, the trained networks were tested and compared for analysis. The 146 head CT images from the Chinese intracranial haemorrhage image database were divided into a training set and a test set using the random number table method. The validation set was divided into four methods: manual segmentation, algorithmic segmentation, the exact Tada formula, and the traditional Tada formula to measure the haematoma volume. The manual segmentation was used as the “gold standard,” and the other three algorithms were tested for consistency. The results showed that the algorithmic segmentation had the lowest percentage error of 15.54 (8.41, 23.18) % compared to the Tada formula method.

COMPLICATIONS OF INTRA ABDOMINAL DRAINS: A SINGLE CENTER EXPERIENCE

Objective: To compare frequency of intra-abdominal complications in drainage and non-drainage group among patents who underwent intra-abdominal surgeries. Study Design: Comparative prospective study. Place and Duration of Study: Department of Surgery, Pakistan Ordinance Factory, Wah Cantt, from Mar 2018 to Jul 2018. Methodology: There were 32 patients, 16 in each group. Patients were selected through the process of consecutive sampling. Patients were randomly divided into two groups (random number table method); group A patients underwent intra-abdominal drain while group B was non-drainage group. Patients were followed up for 7 days and observed for complications. Results: Total 32 patients were included in the study. There were 14 (43.8%) males and 18 (56.3%) females. Mean age of patients was 43.2 ± 9.5 years. Drain group showed significantly low anastomosis leakage (p=0.02), wound infection (p=0.05), mortality (p=0.04), pulmonary complications (p=0.05) and bleeding (p=0.03) as compared to the non-drain group. Conclusion: Intra-abdominal drains are associated with several complications. Anastomosis leakage is the most common complication following pulmonary complications and bleeding. However, drains help in early detection of complications and timely management of such complications leads to better outcome of a surgical procedure.

THE EFFECT OF DIFFERENT COMBINATIONS OF CALCIUM HYDROXIDE FOR MANAGEMENT OF POST-OPERATIVE PAIN IN ACUTE APICAL PERIODONTITIS

Objective: To find the effect of different combinations of Calcium Hydroxide for the management of post-operative pain in acute apical periodontitis. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Operative Dentistry Armed Forces Institute of Dentistry, Rawalpindi. from Jun to Nov 2019. Methodology: A total of 282 patients presenting with acute apical periodontitis in their mandibular posterior teeth were selected for this study and were randomly divided into three equal groups with the help of scientific random number table. Group-A patients were given intracanal dressing of Calcium Hydroxide mixed with Chlorhexidine, group-B patients were given intracanal dressing of Calcium Hydroxide mixed with Saline and group-C patients were given intracanal dressing of Calcium Hydroxide mixed with Dexamethasone. Endodontic therapy was initiated after application of rubber dam, following pulpectomy and disinfection with frequent irrigation, canals were prepared and intra-canal dressings were placed according to the allotted group and the cavity was restored till the next appointment. Post-operative pain was recorded at 24 hours, 48 hours and one week using the visual analogue scale. Results: The three intra-canal combinations of Calcium Hydroxide used in the study were found to be equally effective in reducing pain. Overall, the result between the three groups after 24 hours proved to be insignificant (p=0.40), after 48 hours (p=0.84) and 1 week (p=0.45) were also insignificant. Conclusion: Calcium Hydroxide mixed with Saline, Chlorhexidine and Dexamethasone are all effective for pain reduction with dexamethasone being the most effective.

The Effect of Intraperitoneal Administration of Dexamethasone on Abdominal Pain and Shoulder Pain after Selected Cholecystectomy by Laparoscopic Method

Introduction: Laparoscopic cholecystectomy is the standard treatment of cholecystitis. In comparison to open surgery, it has advantages such as a shorter recovery period and a shorter hospital stay. One of the side effects of this treatment is abdominal and shoulder pain after surgery. The purpose of this study was to see how intraperitoneal dexamethasone affects abdominal and shoulder pain following laparoscopic cholecystectomy. Methods and materials: This study included 70 patients aged 18-70 years who were candidate for laparoscopic elective cholecystectomy. Using a random number table, patients were separated into two equal groups. In the first group, after laparoscopy and before trocar removal, 20 cc of ringer serum containing 8 mg dexamethasone was sprayed in the diaphragm and peritoneal cavity, and in the second group, 20 cc ringer was sprayed. Visual analog scale (VAS) pain score was used to assess post operation pain. Results: From 6 o'clock on, there was a substantial difference in abdominal pain between the two groups, with the control group experiencing higher pain. From 12 o'clock onwards, there was a strong association between shoulder discomfort in the two groups, and patients in the control group experienced more pain. Furthermore, the control group received more opioids. Patients in the control group experienced higher nausea and vomiting starting 12 hours after surgery. Conclusion: After laparoscopic surgery, dexamethasone can relieve abdominal and shoulder discomfort, as well as nausea and vomiting, and it can also reduce the need for opioids. Dexamethasone appears to be effective in minimizing postoperative complications. Keywords: Postoperative Pain, Intraperitoneal, Dexamethasone, Laparoscopy

Efficacy of Endoscopic Posterior Nasal Neurectomy in Treating Eosinophilic Chronic Rhinosinusitis

<b><i>Objectives:</i></b> Recent guidelines have revealed that eosinophilic chronic rhinosinusitis (ECRS) exhibits a strong tendency for recurrence after surgery and impairs quality of life. Neuropeptides play an important neuroimmunological role. The aim of this study was to determine the efficacy of posterior nasal neurectomy (PNN) for the treatment of ECRS by inhibiting type 2 cytokine expression. <b><i>Methods:</i></b> Forty-six patients were divided into group A and group B according to a random number table. Group A underwent conventional functional endoscopic sinusitis surgery (FESS) combined with PNN, and group B underwent conventional FESS alone. The subjective and objective symptoms included a 10-cm visual analog scale (VAS), 22-item SinoNasal Outcome Test (SNOT-22) score, nasal speculum Lund-Kennedy score, and paranasal sinus computed tomography (CT) Lund-Mackay score at the 1-year postoperative follow-up. <b><i>Results:</i></b> Postoperative VAS (10.33 ± 2.18 vs. 8.38 ± 2.11, <i>p</i> &#x3c; 0.01) and Lund-Kennedy score (1.95 ± 1.32 vs. 3.14 ± 1.35, <i>p</i> &#x3c; 0.01) were significantly improved. The rhinorrhea score (1.76 ± 0.83 vs. 2.90 ± 1.14, <i>p</i> &#x3c; 0.001) in the VAS and the discharge (0.43 ± 0.51, vs. 0.95 ± 0.67, <i>p</i> &#x3c; 0.01) and edema (0.57 ± 0.60 vs. 0.95 ± 0.59, <i>p</i> &#x3c; 0.05) scores in the Lund-Kennedy score were observed to have improved significantly in group A compared with those in group B. <b><i>Conclusions:</i></b> FESS combined with PNN suppresses edema symptoms, which might significantly decrease the surgical recurrence rate of ECRS in the long term.

Effect of Xiaoyutang Combined with Intraperitoneal Heat Perfusion Chemotherapy on Immune Function, Circulating mir, Prognosis, and Survival of Postoperative Patients with Colorectal Cancer

Objective. To explore the effects of Xiaoyutang combined with intraperitoneal heat perfusion chemotherapy on immune function, circulating Mir, and prognosis and survival of postoperative patients with colorectal cancer. Methods. A total of 96 patients with colorectal cancer who were treated in our hospital from May 2018 to August 2019 and followed up to August 2021 were selected as the study subjects. The patients were randomly divided into a control group and study group by a 1 : 1 random number table method, 48 cases in each group. Patients in the control group were given intraperitoneal thermal perfusion chemotherapy after surgery, and patients in the research group were treated with Xiaoyutang on this basis. The treatment cycle was 21 days, and all patients were treated for 3 consecutive cycles. The therapeutic efficacy, immune function (CD3+, CD4+, and CD4+/CD8+), circulating mir (mir-29a, mir-145, and mir-92a), prognosis, and survival of the two groups were compared. Results. After 3 cycles of treatment, ORR and DCR in the study group were higher than those in the control group (60.42% vs. 37.50%) and 85.42% vs. 66.67%, respectively, with statistical significance ( P < 0.05 ). There were statistically significant differences in CD3+, CD4+, CD4+/CD8+, mir-29a, mir-145, and mir-92a time points and intergroup and intergroup interactions between the two groups ( P < 0.05 ); the levels of CD3+, CD4+, and CD4+/CD8+ in the study group were higher than those in the control group after 1, 2, and 3 cycles of treatment ( P < 0.05 ); the expressions of mir-29a, mir-145, and mir-92a were significantly lower than those in the control group ( P < 0.05 ). By the end of follow-up, 3 cases were lost to follow-up in the study group and 5 cases in the control group. The recurrence rate and mortality of the study group were lower than those of the control group at 1- and 2-year follow-up ( P > 0.05 ), and the mean survival time of patients in the study group was higher than that in the control group; the differences were statistically significant ( χ 2 = 5.151 , P = 0.023 ). Conclusion. Xiaoyutang combined with peritoneal heat perfusion chemotherapy has a good postoperative effect on patients with colorectal cancer, which can effectively improve the immune function and circulating Mir of patients with colorectal cancer, reduce tumor recurrence, and improve the prognosis of patients.

A comparison of Lidocaine and Ketamine for prevention withdrawal from injection of Rocuronium.

Aim : To make comparison of the effects of lidocaine and ketamine in preventing withdrawal moments linked with IV injection of rocuronium . Methods: About sixty candidates (ASA I & II) were chosen for this case research and categorized into two groups via aid of random number table in such a manner that each group contained 30 individuals. Candidates belonging to group A were administered ketamine in the dosage of 0.5mg/kg that was diluted in 2ml whereas group B candidates were administered 2ml of 1% lidocaine. On the dorsum of the hand, 20 gauge cannula will be inserted intravenously and candidate will be administered midazolamin doage of 0.02mg/kg intravenously for five minutes before coming into in the Operation theatre. After arrival of candidate , non-invasive routine monitoring of the candidates will be carried out and free fluid flow fluid via cannula will be assured by gravity with aid of IV fluid as normal saline. At room temperature, the syringes will be placed. Administration of drugs will be carried out via the injection port of intravenously cannula with a free fluid flow intravenously. Results: In case of ketamine , the prevalence withdrawal movements was recorded as 43.3% and lidocaine as 40%. In case of both research groups, the mean withdrawal scores were similar (P value two tailed = 1.0 (>0.05). Two candidates among these individuals i-e one from each groups depicted generalized response (3.3%). No noteworthy difference was recorded in case of lidocaine and ketamine for preventing withdrawal moments after administration of injection of rocuronium. Conclusion: Equal effectiveness of lidocaine 1% and Ketamine 0.5mg/kg 2ml (20mg) was recorded in deducing withdrawal moments after administration of injection of rocuronium intravenously . Keywords: Lidocaine, ketamine, withdrawal movements

To Explore the Haemostatic Effect of Compression Haemostasis Using an Ultrasonic Probe under the Guidance of Ultrasound after Radial Artery Puncture

Objective. To evaluate a new haemostasis method using an ultrasound probe to compress the radial artery and haemostasis under direct vision to replace traditional manual compression of the radial artery. Methods. According to a random number table, 240 patients with gastrointestinal tumours who had undergone arterial puncture were divided into Group A (120 cases) and Group B (120 cases). In Group A, patients were under the guidance of ultrasound to confirm the vascular port, determine the compression position of the ultrasound probe, observe the degree of vascular deformation, and press the radial artery puncture port with pressure to stop bleeding under direct vision. In Group B, traditional manual compression was used. All patients received 5 min of compression for haemostasis, and haemostasis conditions were recorded after compression and 24 hours postoperatively. Results. The incidence of bleeding, haematoma, and skin ecchymosis at the puncture site after 5 minutes of compression in Group A was lower than that in Group B ( P < 0.05 ). No significant difference was found between the two groups at 24 hours after the operation ( P > 0.05 ). Conclusion. The method using an ultrasound probe to guide radial artery compression to haemostasis is better than traditional manual compression when applied for compression haemostasis after removing the radial artery catheter.

Comparison of two different methods of establishment of canine urethroplasty model: an experimental trial

Background Graft substitute urethroplasty is recommended for patients with long segment anterior urethral stricture. The therapeutic effects of the grafts need to be validated on the animal models. Therefore the aim of this study was to compared the operative time, blood loss, intra- and post- operative complications of two different methods of establishment of canine urethroplasty model. Methods Twelve Beagle dogs were randomly separated into control and experimental group using a random number table. Six animals in the control group received the conventional urethroplasty, while the other 6 in the experimental group received the modified procedures. Tube cystostomy and urethroplasty were performed in the control group. The cystostomy not the tube cystostomy were performed in the experimental group, and the testes were simultaneously removed with the scrotum. Per- and postoperative outcomes, complications were evaluated. Results The urethroplasty were successfully performed for all dogs and all of these procedures were done by the same surgeon. The median operative time in the control and experimental groups was 186.8 min and 188.7 min respectively. The blood loss in the control and experimental groups was 40.8 ml and 45.8 ml respectively. No intraoperative complications occurred. 3 animals in the control group developed acute urinary retention after the accidental removal of suprapubic bladder tube and the cystostomy was done again. There was no occurrence of urinary retention in the experimental group. 4 animals in the control group developed the perineal hematoma, in which one animal had the urine leakage and incision infection. Perineal hematoma occurred in only one animal in the experimental group. Conclusion The occurrence of urinary retention and perineal hematoma decreased in the modified group, in which the cystostomy not the tube cystostomy were performed and the testes with the scrotum were simultaneously removed.

Effect of Continuous Nursing Model on Nursing Effect of Continuous Peritoneal Dialysis

Objective: To analyze and study the effect of continuous nursing mode for continuous peritoneal dialysis nursing. Methods: 40 patients with continuous peritoneal dialysis received in our hospital were randomly selected as the research object. The research time was from June 2018 to June 2020. The patients were divided into two groups by random number table method. The patients with routine nursing mode were named as the control group and the patients with continuous nursing mode were named as the observation group (20 cases in each group). The clinical nursing effects of different nursing modes are compared. Results: After nursing, the nursing compliance of the observation group was 95%, which was higher than 70% of the control group. There was significant difference between the two groups (P < 0.05). Comparing the blood routine related indexes of the two groups, the blood potassium, hemoglobin, serum creatinine and carbon dioxide binding force of the observation group were better than those of the control group (P < 0.05). The incidence of peritonitis and rehospitalization rate in half a year in the observation group were lower than those in the control group (P < 0.05). Conclusion: The continuous nursing model for patients undergoing continuous peritoneal dialysis can improve the treatment effect of patients, significantly improve the compliance of patients, significantly improve the serological indexes, promote the health of patients, reduce the incidence of peritonitis, and significantly reduce the rehospitalization rate in half a year. It has a broad prospect of clinical promotion.