MRI with multiple sequences should be incorporated for tumor volume delineation and they provide a clear boundary between the tumor and normal tissue with critical structures nearby.
Duplication cysts of small bowel seldom present in newborns and usually represent the development of complications. In utero complications may lead to mesenteric vascular accidents and thus resulting in intestinal atresias. We report three neonates with duplication cyst of small bowel causing localized intestinal volvulus, leading to small bowel intestinal atresia/stenosis. The neonates underwent excision of the duplication cyst and resection anastomosis of the small bowel. Post-operative recovery was uneventful in all three of them.
Phosphodiesterase 5 inhibitors (PDE5Is) and low-energy shock wave therapy (LESWT) have created a revolution in the treatment of erectile dysfunction (ED). However, they are not able to restore the actual changes in the penis. An emerging new therapy called platelet-rich plasma (PRP) is believed to be more beneficial in treating ED. The objective of this study is to evaluate and compare the efficacy of LESWT and PRP in treating ED. A total of sixty participants of pathological ED was included in the study and divided into two groups. Group A received the LESWT, whereas Group B received the PRP. The benefits were measured by the International Index of Erectile Function (IIEF), an erection hardness score (EHS) and Self-Esteem And Relationship (SEAR) questionnaires. The results of this analysis demonstrated a larger effect in treatment group B in percentage terms, but there were no statistical differences in the two groups. In the near future, PCP may be a new modality for treating ED, especially PDE5I non-respondents with organic ED. However, more extensive preclinical and applied research needs to be conducted.
Aim: To compare the number of attempts at creating pneumoperitoneum for laparoscopic cholecystectomy using direct trocar versus veress needle insertion techniques. Design: Randomized controlled trial Place and Duration of Study: Department of Surgery, Allama Iqbal Memorial Hospital Sialkot and Govt. Sardar Begum Teaching Hospital, Sialkot from 27th September 2017 to 26th September 2020. Methodology: Six hundred and eight patients of both male and female patients, having uncomplicated cholelithiasis were selected. All participants were randomized into two equal groups, Group A (direct trocarInsertion) and the Group B (veress needle insertion). All trocars and veress needle used were disposable, with a safety shield. All procedures were carried out by the single experienced surgeons and his team. Data was noted, regarding age, sex, body mass index (BMI) and the number of attempts to create the successful pneumoperitoneum. Results: The number of attempts to create successful pneumoperitoneum in DTI group was significantly feweras compared to VNI group (p=0.026) but we found no statisticallysignificant difference between age, gender, and body mass index. Conclusion: The direct trocar insertion is a safe alternative to veress needle insertion in laparoscopic cholecystectomy because it requires fewernumber of attempts for successful creation of pneumoperitoneum as compared to the veress needle. Key words: Laparoscopic cholecystectomy, Veress needle insertion, Direct trocar insertion, Pneumoperitoneum
<p><strong>Background and Objective:</strong> Thyroid imaging reporting and data system (TI-RADS) is developed to determine the risk of malignancy in patients with thyroid nodules. The aim of this study was to determine the diagnostic accuracy of TI-RADS classification for diagnosing malignant thyroid nodules taking Fine needle aspiration cytology (FNAC) as a gold standard in the local population.</p>
<p><strong>Methods:</strong> In this cross-sectional validation study, 201 patients presenting with thyroid nodules at the Department of Radiology, Bakhtawar Amin Hospital Multan, Pakistan from July 2020 to December 2020 were included. In all patients, thyroid nodules were evaluated on grey scale (B-mode) modality. TI-RADS score was calculated for each patient. Patients with TI-RADS score 4 and 5 were labelled as having malignant nodules. After that FNAC samples were taken and sent for histopathologic evaluation of thyroid nodules. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of TI-RADS taking FNAC as a gold standard were determined.</p>
<p><strong>Results:</strong> The mean age of the patients was 47.8 ± 4.5 years; there were 129 (67.2%) women and 72 (35.82%) men. There were 42 patients who tested true positive and 36 patients tested false positive and 12 patients were false negative and 111 patients true negative. The TIRADS sensitivity was 77.8%, specificity was 75.5%, PPV was 53.8%, and NPV 90.2%. the diagnostic accuracy was 76.1%.</p>
<p><strong>Conclusion: </strong>Differentiating benign thyroid nodules from malignant using the TI-RADS score has a high diagnostic accuracy. Our study results support the TIRADS as a first-line imaging evaluation for diagnosis of thyroid malignancy.</p>
Abstract
Objective: To compare the outcome in terms of mean time to disappearance of cough, wheezing, crackles and length of hospital stay in patients treated with sodium chloride 3% with sodium chloride 0.9% as nebulisation diluent in children for suffering from bronchiolitis.
Methods: The prospective study was conducted at the Department of Paediatric Medicine Sheikh Zayed Hospital, Lahore, Pakistan, from November 2014 to April 2015, and comprised children aged between 6 weeks and 24 months having bronchiolitis. Group A received 3% sodium chloride and Group B received 0.9% of the same solution. Duration of cough, wheezing, crackles and duration of stay at hospital were compared between the groups. Data was analysed using SPSS 17.
Results: Of the 100 patients, there were 50(50%) in Group A with a mean age of 7.17±4.46, and as many in Group B with a mean age of 6.6±3.74. Overall, there were 55(55%) boys and 45(45%) girls. Mean cough and wheezing remission time as well as length of hospital stay was significantly different between the groups (p<0.05).
Conclusion: In children having bronchiolitis, 3% saline as nebuliser solution was found to be more effective than 0.9% saline solution.
Key Words: 3% saline solution, Bronchiolitis, Wheezing, Crepitations, Hospital stay.
Aim: To compare the outcomes in term of complication of Veress Needle Insertion (VNI) to Direct Trocar Insertion (DTI) for creation of pneumoperitoneum in laparoscopic cholecystectomy.
Design: Randomized controlled trial
Place and Duration of Study: The current analysis was conducted at Khawaja Muhammad Safdar Medical College Surgical Department, Allama Iqbal Memorial Hospital and Govt. Sardar Begum Teaching Hospital, Sialkot from September 27, 2017, to September 26, 2020.
Methodology: A total of six hundred and eight (n=608) patients, having age 30 to 75 years planned for laparoscopic cholecystectomy were included in this study. Patients were randomly divided into two groups, Group A (Direct Trocar Insertion), Group B (Veress Needle Insertion). Both groups had age and sex matched males and female. All trocars and veress needle used were disposable, with a safety shield. The primary outcome of our study was to compare the complications to assess the safety levels, while total time taken by the procedure and mean time for laparoscopic entry were the secondary end points. The collected data was analyzed by using software SPSS version 22. Chi-square test was used to check the significance of variance. P-value less than 0.05 remained the statistically significant.
Results: The complication rate in VNI group were significantly greater than the DTI group (p < 0.01), the duration of surgery between the two groups was not significantly different (p > 0.05), but we found statistically significant difference in mean laparoscope insertion time (DTI 3.4+ 1.4 versus VNI 4.8+ 0.7 minutes, p < 0.001).
Conclusion: From the results of our study, it can be concluded that the direct trocar insertion is a safe alternative to veress needle insertion in laparoscopic cholecystectomy as it is associated with fewer complications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.