Original Research Article
Introduction: The conversion from laparoscopic cholecystectomy to open cholecystectomy results in a significant change in out-come for the patient because of the higher rate of postoperative complications and the longer hospital stay in addition to the effect and the long-term sequel of the cause of conversion itself as in bile duct injury. Material and Methods: A prospective study was carried out in Department of Surgery, N.C Medical College and Hospital over a period of 1 year patients undergoing laparoscopic cholecystectomy. Full details of patients were recorded in the proforma. Out of 240 laparoscopic cholecystectomy performed during this duration 16 needed conversions. Result: Adhesions (85.7% versus 31.2%, P<0.001), bleeding (28.5% versus 8.7%, P<0.01), and stone spillage (28.5% versus 7.9%, p=0.04) were significantly more frequent in the conversion group. However, unclear anatomy, thick gall bladder wall, and bile spillage had no significant relationship with conversion of laparoscopic to open cholecystectomy. Conclusion: We found that a thickened gallbladder wall and a contracted gallbladder on ultrasound, male gender, age above 40, and acute cholecystitis were risk factors for conversion of laparoscopic cholecystectomy to open surgery.
Congenital Unilateral Renal Agenesis: Prevalence, Prenatal Diagnosis
Ezza.Lemrabott, Kamal, Aboulfateh, Nessiba Abdelkader, K.Mohammedsaoud, N.Mamouni, S. Errarhay, C.Bouchikhi, A.Banani
EAS J Med Surg, 2021; 3(5): 93-96
Congenital anomalies of the kidney and urinary tract are common findings on fetal ultrasound. To review the antenatal sonographic findings and postnatal follow-up of fetuses with renal agenesis and normal amniotic fluid volume. Prenatal ultrasonography seems to be highly reliable in diagnosing these anomalies. Prognosis is favorable in the absence of additional extra urinary. Malformations, We report the case of a 30-year-old woman, second gesture, on 31 weeks of pregnant; referred for the management of suspected renal agenesis unilateral ;obstetrical ultrasound showing an empty right renal pelvis, left kidney seen.
Ossifying fibromas are true neoplasms that involve maxillofacial and craniofacial regions. The posterior mandibular region is the most common site for occurrence in maxillomandibular region. These lesions are asymptomatic, well defined radiologically, and show characteristic features histologically. The treatment plan includes enucleation of smaller lesions and resection and reconstruction of larger lesions. We report a case of large ossifying fibroma of mandible in a 13-year-old female child that was resected and reconstructed with vascularised fibula flap.
Brain abscess has been considered a rare infection; it is characterized by a collection of pus in the brain parenchyma. Different studies talk about the management and medical treatment with antibiotic regimens (at the beginning of therapy, the antibiotic is chosen empirically), among the most used are vancomycin, third-generation cephalosporins, clindamycin, trimethoprim-sulfamethoxazole, aztreonam, metronidazole, fluoroquinolone, and fluconazole when it is a fungal-type infection, and linezolid has shown promising results. Surgical management depends on the size, location, and characteristics of the brain abscess; it is suggested in the literature for small brain abscess do the aspiration and eradicates the purulent material, and in a big abscess (> 2.5cm) performs craniotomy and resection. A decrease in the degree of mortality related to brain abscess has been reported. That is why this study is presented, carried out over three years (2018 -2021) showing the results obtained, as well as the frequency of patients with brain abscess treated in the service of neurosurgery, of the Regional Hospital “Lic. Adolfo López Mateos”, in Mexico City. A series of cases is presented showing the evaluation and diagnosis protocol used in Neurosurgery and the clinical-epidemiological characteristics that the patients gave.
Abstract: Background: Detrimental effects of homocysteine on endothelial function are well documented. Plasma Homocysteine (Hcy) levels are elevated in type 2 diabetic patients as well as in pre-diabetic individuals with insulin resistance. In such individuals, plasma Hcy concentration is influenced by the insulin concentration and anti-diabetic therapy such as metformin, glitazones or insulin that can alter the plasma plasma homocysteine. Objective: To find out the Clinical & Demographic Profile with Serum Homocysteine Level among Type II Diabetic Patients and IGT Patients with Normal People. Methods: This was a cross-sectional observational study. Total 120 subjects were selected and allocated into three groups, equal number (n=40) in each group. This study was conducted in Mymensingh Medical College Hospital, Mymensingh, Bangladesh from June, 2019 to May, 2020. Results: The study showed that the mean age of the patients and their BMI were almost similar among the three groups, male female ratio was about 2.5:1. The ccorrelation analysis of different clinical & demographic profile with serum Homocysteine. The correlation between glycemic status and Serum Homocysteine levels of participants, which differ considerably, so that, Pearson correlation & Spearman correlation showed statistically significant difference. Hcy was positively associated with FBG (r=0.296, p<0.001), 2hPG (r=0.078, p=0.004). Similarly positive significant correlation was found with TC (r=7.655, p<0.001), TG (r=13.52, p=<0.05) and HDL-C (r=1.165, p<0.05). Present study showed that levels of Hcy were significantly higher in the type 2 DM group than those in normoglycemic group (19.86 μmol/L vs. 8.72 μmol/L, p<0.001). Similarly levels of Hcy were significantly higher in the IGT group than those in normoglycemic group (17.28 μmol/L vs. 8.72 μmol/l, p<0.001). The mean values of the serum Homocysteine level of Group -1 and Group – 2 showed statistical significant differences ..................
Abstract: The aim of this cross-sectional study to assess on management of surgical site infection at the Islami Bank Medical College Hospital. A total of 1256 respondents were selected for the study. At last January 2016 to march 2021 their socio-economic condition, demographic characteristics, opinion and level about surgical site infection were mainly investigated. The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites that is not normally present within the body. Infection may cause no symptoms and be subclinical, or it may cause symptoms and be clinically apparent.
Abstract: Among patients with symptoms suggestive of a Urinary tract infection (UTI) which includes dysuria and frequency, the diagnosis can be confirmed by sending a clean-catch specimen for culture and for urinalysis. One suggested exception recommended by most experts is a symptomatic young woman with pyuria detected by urinalysis dipstick who has apparently uncomplicated cystitis. It has been proposed that the findings are sufficiently diagnostic that an empiric course and usually three days of antimicrobial therapy can be initiated without performing a urine culture. Children who are toilet trained can provide clean voided urine samples. Clean voided bag urine samples are acceptable for urinalysis in infants and children between two months and two years of age who have unexplained fever and do not appear ill enough to require immediate antimicrobial therapy. If the sample suggests infection, then a catheterized urine specimen should be obtained for confirmatory testing and urine culture. Suprapubic aspiration and transurethral bladder catheterization are invasive but are the only valid ways to collect urine for culture in febrile young infants under two months of age and older infants and children with unexplained fever who are younger than two years of age and ill enough to merit immediate antimicrobial therapy. The use of portable ultrasound to visualize the bladder increases the success rate for both suprapubic aspiration and transurethral bladder catheterization. In this review article, we will cover urine sampling, procedure, culture, and dipstick as a tool of UTI analysis in both adults and children.