scholarly journals Simultaneous saline irrigation during retrograde rigid ureteroscopic lasertripsy for the prevention of proximal calculus migration

2013 ◽  
Vol 7 (1-2) ◽  
pp. 65 ◽  
Author(s):  
Lu Sun ◽  
Fang-li Peng
Keyword(s):  
Operative Time ◽  
Upper Urinary Tract ◽  
Excretory Urography ◽  
Ureteral Stones ◽  
Saline Irrigation ◽  
Irrigation Method ◽  
Group I ◽  
Significant Difference ◽  
Stone Migration ◽  
Group Ii

Objective: To analyze the clinical efficacy of Simultaneous saline irrigation method in treating upper-mid ureteral stone migration and overall efficiency during ureteroscopic lasertripsy. Methods: We prospectively evaluated 78 patients with a total of 95 upper-mid ureteral stones, which were treated with holmium: YAG lasertripsy. These patients were randomized into two groups. In group I (39 cases with 44 ureteral stones), conventional ureteroscopic lasertripsy was performed in like manner. While in group II (39 cases with 51 ureteral stones), the Simultaneous saline irrigation method was used during lasertripsy. There was no significant difference between the groups with regards to stone site, size or state of the upper urinary tract by spiral computed tomography or excretory urography. Data were analyzed regarding stone migration, lengths of time, and ureteral clearing for various stages of each procedure. Results: One patients (2%) occurred upward stone migration in group II, while in group I it occurred in eight patients (20%).The operative time in group I ranged between 35 to 55 minutes (mean, 44.8±5.3), while in group II it ranged between 40 to 69 minutes (mean, 50.4±3), The operative time was no significant difference between the groups  (p<0.05). Ureteral perforation, urinoma, and urosepsis were not seen in both groups. Conclusion：Simultaneous saline irrigation method demonstrated a statistically significant advantage over the conventional methods. Operation can be performed persistently under clear vision, and the calculus can not be moved upwards, the fragmentation easily to be flushed out. Our data suggest that this method is simple，safe and effective in preventing proximal stone migration during ureteroscopic lasertripsy.

scholarly journals Do stone size and impaction influence therapeutic approach to proximal ureteral stones?

2009 ◽  
Vol 66 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Slobodan Radulovic ◽  
Aleksandra Vuksanovic ◽  
Dragica Milenkovic-Petronic ◽  
Bozo Vavic
Keyword(s):  
Therapeutic Approach ◽  
Ureteral Stone ◽  
Treatment Success ◽  
Ureteral Stones ◽  
Stone Size ◽  
Extracorporeal Shock Wave ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Proximal Ureteral Stone

Background/Aim. Primary therapeutic approach to lumbar ureteral stones is still contraversial. The aim of the study was to investigate the influence of stone impaction and size on the effectiveness of proximal ureteral stone lithotripsy. Methods. A total of 123 patients with proximal ureteral stones were investigated in this prospective study performed in a 10- month period. The patients were divided into the group I - 86 patients treated with extracorporeal shock wave lithotripsy (ESWL) and the group II - 37 patients treated with 'Swiss' Lithoclast. In the group I, 49 stones (57%) were classified as impacted, while 20 stones (23.3%) were larger than 100 mm2. In the group II, 26 stones (70.3%) were impacted, and 11 stones (29.7%) were larger than 100 mm2. Stones were defined as impacted by the radiographic, echosonographic as well as endoscopic findings in the group II of patients. Stone size was presented in mm2. Chemical composition of stones were almost the same in both groups of the patients. Results. Generally, there was no statistically significant difference in the treatment success between the groups. However, stones larger than 100 mm2 were statistically more successfully treated endoscopically, while there was no statistical difference in the treatment success of impacted stones between these two groups. Conclusion. ESWL can by considered as primary first therapeutic approach in treatment of all proximal ureteral stones except for stones larger than 100 mm2 that should primarily be treated endoscopically.

scholarly journals Contact Pneumatic Ureterolithotripsy Using LMA StoneBreaker Lithotriptor and Search for Opportunities to Increase Effectiveness

Health of Man ◽  
2021 ◽  
pp. 26-31
Author(s):  
Serhii Vozianov ◽  
Vasyl Chernenko ◽  
Volodymyr Savchuk ◽  
Dmytro Chernenko ◽  
Serhii Sokolenko ◽  
...  
Keyword(s):  
Mineral Composition ◽  
Intraoperative Complications ◽  
Ureteral Stones ◽  
Modified Technique ◽  
Group I ◽  
Minimum Number ◽  
Stone Migration ◽  
Group Ii ◽  
Standard Contact ◽  
Group 1

The objective: to evaluate the effectiveness of portable pneumatic contact lithotripter LMA StoneBreaker in endoscopic contact ureterolithotripsy of ureteral stones of different localization depending on their density and search for opportunities to increase it. Materials and methods. Contact pneumatic ureterolithotripsy was performed in 89 patients (49 men, 40 women), 39 (43.8%) patients (I group) underwent standard contact pneumoureterolithotripsy, and 50 (56.2%) patients (11 group) – modified (with prior fixation of the stone in the ureter loop Dormia), which allowed urethrolithotripsy in situ and prevented the migration of stones and their fragments proximally. The number of strokes required to initiate fragmentation, complete fragmentation, and total ureterolithotripcy time for stones of different localization and density were determined. The integrity of the stones was determined by computed tomography in units of Haunsfield (HU). The mineral composition of stone fragments after their removal was diagnosed by X-ray diffraction analysis. The effectiveness of the applied methods was evaluated in groups of patients by complete (100%) removal of stone fragments from the ureter and by the number of cases of retrograde migration of stones into the renal cavity. Results. No intraoperative complications were observed. The number of strokes for the initial and complete disintegration of the stone, regardless of the method of ureterolithotripsy and their localization, depended on their density, ie its mineral composition. The minimum number of strokes for start and complete fragmentation of the stone was recorded in patients with a stone density of 480+54 HU and diagnosed as phosphates. Oxalate and uric acid stones, as well as their combinations (density 1310–1580 HU) required the maximum number of blows. Stone migration was noted in 8 (8.99%) patients. Thanks to intraoperative stone fixation was able to reduce the average time of lithotripsy (from 15,65±6.9 min to 12.3±6,15 min) and reduce the frequency of retrograde stone migration from 15.4% (in 6 patients of group 1) to 4% (2 patients of ІI group). The dependence of lithotripsy efficiency on stone localization is established. It was highest in patients with stones of the lower third of the ureter (95% in patients of group 1 and 100% of patients in group II) and with low density (480–840 HU). The lowest efficacy was observed in patients whose stones were localized in the upper third of the ureter (66.3% in group I and 90% in group II) and had a high density (more than 1200 HU). Due to the fixation of the stone with modified pneumoureterolithotripsy, the overall effectiveness of the method increased from 84.6% to 96%. Conclusions. Traneurethral contact pneumoureterolithotrysis using a portable pneumatic lithotripter LMA Stonebreaker – is effective, safe, minimally costly and easy to use. The effectiveness of contact pneumatic ureterolithotripsy depends on the location and density of the stone. The number of strokes required for the initial and complete fragmentation of the stone directly depends on the density of the stone and does not depend on its location and method of performing pneumoureterolithotripsy. The use of a modified technique with fixation of the stone in the ureter during the process of lithotripsy reduces the time of the operation and increases its effectiveness.

scholarly journals Comparison of surgical and audiological outcomes of endoscopic and microscopic approach in stapes surgery

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Secaattin Gülşen ◽  
Erkan Karataş
Keyword(s):  
Operative Time ◽  
Stapes Surgery ◽  
Chorda Tympani Nerve ◽  
Microscopic Approach ◽  
Creative Commons ◽  
Group I ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group Ii ◽  
Open Access Article

Objective: The main objectives of the present study were to compare the surgical and audiological outcomes of endoscopic and microscopic approach in stapes surgery. Methods: Sixty-one patients who underwent the stapes surgery with the endoscopic and microscopic approach between January 2012-November 2018 were included in the study. Patients were divided into two groups as a Group-I (endoscopic) and Group-II (microscopic). The audiometric measurements, duration of surgery, intraoperative findings and complications were recorded and evaluated retrospectively. Results: Mean operative time for the Group-I and II was 45.1±8.4 minutes and 48.7±5.6 minutes, respectively (p>0.05). The preoperative and postoperative average air-bone gap in the Group-I was 27.8±7.2 dB and 8.7±3.4 dB and these values in Group-II were 30.2±5.1 dB and 7.4±4.8 dB, respectively (p<0.001). The requirement of chorda tympani nerve manipulation and scutum curettage were significantly less in Group-I as compared Group-II (p<0.05). Dysgeusia and postoperative pain were observed significantly higher ratios in Group-II relative to Group-I (p<0.05). There was no significant difference between endoscopic and microscopic approach in stapes surgery in terms of difficulty of prosthesis insertion (p>0.05). Conclusion: Endoscopic stapes surgery provides comparable audiological outcomes, shorter operative times, fewer complications rates, and more minimally invasive surgery, relative to the microscopic approach. doi: https://doi.org/10.12669/pjms.35.5.439 How to cite this:Gulsen S, Karatas E. Comparison of surgical and audiological outcomes of endoscopic and microscopic approach in stapes surgery. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.439 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Impact of hemodialysis on the wellbeing of chronic kidney diseases patients: a pre-post analysis

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Um-e-Kalsoom ◽  
Sabiha Khan ◽  
Israr Ahmad
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Perceived Social Support ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
The Impact

Abstract Background Hemodialysis may have serious psychological impact upon patients suffering from chronic kidney diseases. The aim of the present study is to investigate the impact of hemodialysis on the wellbeing of individuals with chronic kidney diseases (CKD). Result A sample consists of (N = 100) CKD patients referred from neurology ward of Leady Reading Hospital Peshawar. Data was collected from both male (50%) and female (50%) in 2017. Participants were divided into two groups on the basis of pre-set criteria. In group I, individuals with 4–5 stage of CKD referred first time for dialysis treatment were recruited. Group II comprised of CKD patients with 1–3 stage. Demographic data sheet, Pakistan Anxiety and Depression, WHO Quality of Life scale, and Perceived Social support scale (PSS) were used to test the hypotheses. Paired sample t test was use to see the difference between pre- and post-analysis of depression, anxiety, QOL, and PSS in group I (experimental group). Results suggests significant difference on depression (p > .001), anxiety (p > .001), and QOL (p > .001), while no significant difference was reported on perceived social support (p <.673). Findings also indicate no significant difference between group I and group II on QOL depression, anxiety, and PSS. Conclusion The findings concluded that patients under hemodialysis treatment suffered from depression, anxiety, and poor quality of life.

Role of Cord Blood Carboxyhemoglobin in Detecting Significant Hyperbilirubinemia in Term Neonates with ABO Alloimmunization

2021 ◽  
Author(s):  
Mahir Tıraş ◽  
Emrah Can ◽  
Şahin Hamilçıkan
Keyword(s):  
Cord Blood ◽  
Total Serum ◽  
Healthy Controls ◽  
Term Neonates ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Positive Direct ◽  
Severe Hyperbilirubinemia

Objective This study aimed to assess whether cord blood carboxyhemoglobin (COHb) levels in jaundiced term neonates with and without a positive direct Coombs test (DCT) and in healthy controls could be used as a predictor of severe hyperbilirubinemia. The percentage of cord blood COHb should be higher among neonates with Coombs-positive ABO hemolytic disease than among those with Coombs-negative ABO incompatibility and higher than that of ABO-compatible control neonates. Study Design This cross-sectional descriptive study of 198 term neonates comprised three subgroups: group I featured 68 DCT-positive ABO-incompatible neonates (ABO + DCT), group II featured 60 DCT-negative ABO-incompatible neonates with hyperbilirubinemia (ABO–DCT), and group III featured 70 healthy controls. COHb was determined by an OSM3 hemoximeter. Results Group I differed from groups II and III for cord blood bilirubin, cord blood hemoglobin, and cord blood hematocrit. Groups I and II had higher mean total serum bilirubin (TSB) levels than group III, while there was no difference in the mean TSB levels between groups I and II. There was no significant difference between the COHb group means for groups I, II, and III (p = 0.98). The area under the receiver operating characteristic curve calculated for group I/group III and group II/group III were found to be 0.62 and 0.54, respectively. Conclusion COHb levels did not prove to be superior to the DCT for predicting the risk of developing severe hyperbilirubinemia in term neonates. Key Points

scholarly journals Experimental Study on a Prediction Model of the Shrinkage and Creep of Recycled Aggregate Concrete

2019 ◽  
Vol 9 (20) ◽  
pp. 4322 ◽  
Author(s):  
Lv ◽  
Liu ◽  
Zhu ◽  
Bai ◽  
Qi
Keyword(s):  
Substitution Rate ◽  
Recycled Aggregate Concrete ◽  
Recycled Aggregate ◽  
Creep Model ◽  
Aggregate Concrete ◽  
Ordinary Concrete ◽  
Group I ◽  
Significant Difference ◽  
Shrinkage And Creep ◽  
Group Ii

The significant difference between recycled aggregate and natural aggregate is the content of the attached mortar layer. With the increase of the replacement rate of recycled aggregate, the shrinkage and creep of recycled aggregate concrete is significantly increased. In this paper, 180-day shrinkage and creep tests of recycled aggregate concrete with different water–cement ratios were designed in order to analyze the effect of the substitution rate and water–cement ratio on shrinkage and creep properties. The results show that the shrinkage strain of recycled aggregate concrete with a substitution rate of 50% and 100% at 180 days is 26% and 48% higher than that of ordinary concrete, respectively, and the growth of group II is 22% and 47%, respectively. When the load was 180 days old, the creep coefficient of recycled aggregate concrete with a substitution rate of 50% and 100% in group I increased by 19.6% and 39.6%, respectively compared with ordinary concrete, and group II increased by 23.6% and 44.3%, respectively. Based on the difference of adhering mortar content, the creeping increase coefficient and shrinkage increase coefficient of the attached mortar were proposed, and a shrinkage and creep model of recycled aggregate concrete was established. When compared with the experimental results, the model calculation results met the accuracy requirements.

Immersive and Non-Immersive Virtual Reality Distraction on Pain Perception to Intraoral Injections

2021 ◽  
Vol 45 (6) ◽  
pp. 389-394
Author(s):  
Supriya Kumari ◽  
Rachana Bahuguna ◽  
Nishita Garg ◽  
Ramakrishna Yeluri
Keyword(s):  
Virtual Reality ◽  
Pain Perception ◽  
Dental Treatment ◽  
Immersive Virtual Reality ◽  
Dental Procedures ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Chi Square Analysis

Objective: To evaluate the efficacy of immersive VR (IVR) and non-immersive VR (NIVR) distraction on perceived pain during intraoral injections in children undergoing dental procedures. The objective was to introduce 3-dimensional nature of virtual reality during the provoking phase of dental treatment as a means of distraction in children. Study design: A total of 200 children were selected for the study, 100 for IVR group and 100 for NIVR group. After randomization, children were introduced to Oculus Go Standalone equipment; MCDAS (f), VAS, WBFRS and the treatment procedure using tell show do technique. Group I children were introduced to oculus go standalone headset with hand held controller to play temple run or roller coaster game while in group II, children watched cartoon movies of their choice. Pre-operative & post-operative MCDAS scores were obtained using MCDAS (f) questionnaire in local language. Post-operatively, VAS and WBFRS scores were also obtained. The data was analyzed using independent t-test and chi-square analysis. Results: Pre-operatively, the mean MCDAS scores were similar in both the groups viz. Group–I (29.20 ± 3.197) and Group–II (29.09 ± 3.803) and is statistically not significant. Post-operatively, the mean MCDAS scores were higher in non-immersive group (20.72 ± 2.822) as compared to immersive group (10.99 ± 2.227). VAS score was higher in non-immersive group (2.72 ± 0.99) as compared to immersive group (0.75 ± 0.88). WBFRS scores were higher in non-immersive group (2.78 ± 1.097) as compared to immersive group (0.82 ± 1.104). Conclusion: Three-dimensional virtual reality was found to be an effective means of distraction in children undergoing dental procedures and especially during the provoking phase. The significant difference obtained clearly indicates irrespective of immersiveness of virtual reality, anxiety had been decreased and on comparison the pain perception to intraoral injection is less in immersive virtual reality environment. Immersive VR distraction technique can serve as an adjunct to traditional behavior management strategies already available to the pediatric dentist.

Comparison of the Effects of Low Dose Methylprednisolone and Metoclopramide on Nausea and Vomiting and Respiratory Complications after Adenotonsillectomy

2021 ◽  
Vol 15 (9) ◽  
pp. 2753-2756
Author(s):  
Shahid Adalat Chaudhry ◽  
Madiha Zafar ◽  
Usman Zeeshan ◽  
Mubashar Iqbal ◽  
Arooj Fatima ◽  
...  
Keyword(s):  
Side Effects ◽  
Pain Score ◽  
Low Dose ◽  
Operative Time ◽  
Oral Intake ◽  
Respiratory Complications ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Mean Time

Objective: The aim of this study is to compare the effects of low dose methylprednisolone and metoclopramide on nausea, vomiting and respiratory complications after adenotonsillectomy. Study Design: Retrospective study Place and Duration: The study was conducted in Divisional Headquarter Teaching Hospital, Mirpur AJK for duration of six months from December 2020 to May 2021. Methods: Total 150 patients of both genders underwent adenotonsillectomy presented in this study. Patients were aged between 3-15 years. Detailed demographics of enrolled cases age, sex and weight were recorded after taking informed written consent. Patients were equally divided into two groups. Group I had 75 patients and received 1 mg/kg IV methylpredinosolone and group II received 0.15 mg/kg metoclopramide among 75 patients. Post-operative effects on PONV were assessed and compared among both groups in terms of oral intake time, vomiting episodes, respiratory complications and side effects. Mean pain score was calculated by VAS. Complete data was analyzed by SPSS 23.0 version. Results: There were 40 (53.3%) females and 35 (46.7%) males in group I with mean age 9.43±1.44 years while in group II 42 (56%) were females and 33 (44%) were male patients with mean age 8.04±3.36 years. Mean weight of the patients in group I was 23.08±4.61 kg and in group II mean body weight was 22.11±6.84 kg. Mean operative time in group I was 27.41±8.53 min and in group II mean time was 28.17±6.34 min. Post-operative frequency of vomiting and nausea was lower in group I 14 (18.7%) and 16 (21.3%) as compared to group II 21 (28%) and 24 (34%). Low pain score was found in group I 1.71±6.11 as compared to group II 3.02±4.09. Time to oral intake was higher in group II 2.98±3.48 hours as compared to group I 1.09±7.51 hours. Rate of respiratory complications and side effects were significantly higher in group II. Conclusion: We concluded in this study that the use of methylpredinosolone was effective among patients those underwent for adenotonsillectomy in terms of post-operative frequency of PONV, pain, respiratory complications and side effects. Except this low dose of methylpredinosolone were effective in earlier tolerance of oral intake. Keywords: Adenotonsillectomy, Metoclopramide, Methylpredinosolone, Oral Intake

Effect of using smart phones on balance functions

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
N Hazzaa ◽  
DM Hassan ◽  
Sh Mahmoud
Keyword(s):  
Healthy Subjects ◽  
Smart Phone ◽  
Balance Function ◽  
Visual Fatigue ◽  
Vestibular Disorder ◽  
Dynamic Posturography ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Composite Scores

Abstract Objective To investigate the effect of visual fatigue caused by smart phone on the balance function. Subjects and Methods Forty subjects divided into 2 groups were included in the present study . Group I, twenty normal healthy subjects with mean age of 28.8 years. Group II, twenty subjects with a clinical diagnosis of peripheral vestibular disorder with mean age of 38.85years. They were subjected to a computer vision syndrome questionnaire (CVS-Q) , occulomotor tests of videonystagmography (VNG) and sensory organization test (SOT) of computerized dynamic posturography (CDP) before and after visual fatigue induction. Results Significant differences existed between C5, 6 and composite scores in group I and in C4 and composite scores in group II after visual fatigue induction. However, there was no significant difference between occulomotor tests in both groups after visual fatigue induction. Conclusions The smart phone use can affect the balance function in healthy subjects and augment the deficit in those with balance problem. Reducing visual fatigue should be considered through various procedures as taking proper rest, adjusting the brightness of screen, avoid any wrong posture and using filters if possible.

Comparison of a PGA Sheet with a Commercial ePTFE Sheet as a Staple-Line Reinforcement in Lung Surgery

2007 ◽  
Vol 342-343 ◽  
pp. 849-852
Author(s):  
Keon Hyeon Jo ◽  
Seok Whan Moon ◽  
Young Du Kim ◽  
Young Jo Sa ◽  
Si Young Choi ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Polyglycolic Acid ◽  
Lung Surgery ◽  
Resection Margins ◽  
Air Leakage ◽  
Staple Line Reinforcement ◽  
Group I ◽  
Significant Difference ◽  
Similar Threshold ◽  
Group Ii

To prevent prolonged air leakage after lung surgery, we developed a biodegradable polyglycolic acid (PGA) sheet and compared it with an expanded polytetrafluoethylene (ePTFE). Eighteen adult mongrel dogs were used in this experiment. The airway pressures at which air first leaked at the stapled resection margins were measured immediately after surgery in group I (N=5), 2 days after surgery in group II (N=5), and 7 days after surgery in group IIII (N=5), Based on the presence of SLR, there were 3 subgroups in each group: there was no SLR in subgroup a; ePTFE in subgroup b; PGA sheet in subgroup c. The histologic examination was performed 2 months after surgery (N=3). In group I, there was a significant difference in air leakage pressures (mm Hg) between no reinforcement and SLR. We observed the same results in group II and III with statistical significance. However, there was no significant difference between the reinforcement groups. The histologic findings demonstrated more severe adhesions and biodegradation in the dogs in which the PGA sheet was used. Our PGA sheet was considered a useful reinforcement material, because it had a similar threshold for air leakage with the ePTFE with excellent biodegradation.

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