Pub Date : 2023-02-14DOI: 10.23958/ijirms/vol08-i02/1613
L. Nunziata, S. Ambrosino, M. Volpicelli, M. Capasso, L. Caliendo
The aneurysms of sinus of Valsalva are rare cardiac anomalies, which may be either acquired or congenital. A congenital lack of continuity between the aortic media and annulus fibrosus may initiate aneurysm formation. Acquired aneurysms may result from trauma, endocarditis, syphilis, Behcet, atherosclerosis and senile-type dilatation. We report a case of a 38-year-old man who presented with aneurysm of the right sinus of Valsalva with fistula between it and the right ventricular outflow and pulmonary trunk dilatation diagnosed by transthoracic echocardiography (TTE), chest computed tomography (CT) scan and transesophageal ecocardiography (TEE). We describe this case which has been successfully-treated because the concomitant presence of an aneurysm of the right Valsalva sinus, a fistula between it and the right ventricular outflow and pulmonary trunk dilatation represents an extremely rare and poorly described event in the literature.
{"title":"Aneurysm of Right Sinus of Valsalva: A Particular Case Report and Brief Review of Literature","authors":"L. Nunziata, S. Ambrosino, M. Volpicelli, M. Capasso, L. Caliendo","doi":"10.23958/ijirms/vol08-i02/1613","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i02/1613","url":null,"abstract":"The aneurysms of sinus of Valsalva are rare cardiac anomalies, which may be either acquired or congenital. A congenital lack of continuity between the aortic media and annulus fibrosus may initiate aneurysm formation. Acquired aneurysms may result from trauma, endocarditis, syphilis, Behcet, atherosclerosis and senile-type dilatation. We report a case of a 38-year-old man who presented with aneurysm of the right sinus of Valsalva with fistula between it and the right ventricular outflow and pulmonary trunk dilatation diagnosed by transthoracic echocardiography (TTE), chest computed tomography (CT) scan and transesophageal ecocardiography (TEE). We describe this case which has been successfully-treated because the concomitant presence of an aneurysm of the right Valsalva sinus, a fistula between it and the right ventricular outflow and pulmonary trunk dilatation represents an extremely rare and poorly described event in the literature.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90650642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-12DOI: 10.23958/ijirms/vol08-i02/1625
Joshua Hyman, B. Doolittle
Objective: The COVID-19 pandemic has greatly impacted the residency experience, yet few qualitative studies have engaged residents for their perspectives. Our aim in this investigation was to better understand what effect the COVID-19 pandemic has had on resident learning climate and well-being and to determine how perspectives on the residency experience have changed over time. Methods: We conducted interviews from May 2020 through February 2021 with residents from the internal medicine, pediatrics, and internal medicine-pediatrics residency programs from a single, university-affiliated hospital. Validated instruments were used to quantify participants’ level of satisfaction and burnout. A snowball sampling technique was used for recruitment. We employed thematic content analysis using a grounded theory-based approach. Results: Of the 56 residents invited to participate, 37 (66.1%) elected to do so. The first 15 interviews were completed between May 2020 and July 2020 (early COVID-19), with 22 interviews completed between December 2020 and February 2021 (late COVID-19). The residents interviewed during the late COVID-19 block were less likely to meet criteria for satisfaction (p<0.01) and thriving (p<0.05) and were more likely to endorse feeling burned out (p<0.002) compared to their peers in the early COVID-19 cohort. Four key themes emerged: changes to training and education, changes to well-being, changes to the practice of medicine, and changes to perspectives on residency. Conclusions: Residents described how the COVID-19 pandemic has contributed to a diminished sense of well-being as well as poorer clinical training. Further study should be done to determine what measures can be taken to help attenuate COVID-19-related burnout and educational compromise.
{"title":"The Impact of the COVID-19 Pandemic on the Residency Experience: A Qualitative Study","authors":"Joshua Hyman, B. Doolittle","doi":"10.23958/ijirms/vol08-i02/1625","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i02/1625","url":null,"abstract":"Objective: The COVID-19 pandemic has greatly impacted the residency experience, yet few qualitative studies have engaged residents for their perspectives. Our aim in this investigation was to better understand what effect the COVID-19 pandemic has had on resident learning climate and well-being and to determine how perspectives on the residency experience have changed over time. Methods: We conducted interviews from May 2020 through February 2021 with residents from the internal medicine, pediatrics, and internal medicine-pediatrics residency programs from a single, university-affiliated hospital. Validated instruments were used to quantify participants’ level of satisfaction and burnout. A snowball sampling technique was used for recruitment. We employed thematic content analysis using a grounded theory-based approach. Results: Of the 56 residents invited to participate, 37 (66.1%) elected to do so. The first 15 interviews were completed between May 2020 and July 2020 (early COVID-19), with 22 interviews completed between December 2020 and February 2021 (late COVID-19). The residents interviewed during the late COVID-19 block were less likely to meet criteria for satisfaction (p<0.01) and thriving (p<0.05) and were more likely to endorse feeling burned out (p<0.002) compared to their peers in the early COVID-19 cohort. Four key themes emerged: changes to training and education, changes to well-being, changes to the practice of medicine, and changes to perspectives on residency. Conclusions: Residents described how the COVID-19 pandemic has contributed to a diminished sense of well-being as well as poorer clinical training. Further study should be done to determine what measures can be taken to help attenuate COVID-19-related burnout and educational compromise.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75988967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-12DOI: 10.23958/ijirms/vol08-i02/1624
D. N. Kumar, D. R. Chopra, Dr. Ashish Jaiman, Dr. Simarjot Singh Sodhi, Deepanshu Mittal, Dr. Prashant Bajaj, Dr. Rohan Krishnan
Study Design: Prospective and Interventional Randomized Comparative Study. Duration of study: 18 months. Objective: 1. To estimate pain relief in a patient with primary degenerative osteoarthritis of knee after medial open wedge high tibial osteotomy (HTO) using visual analog scale(VAS). 2. To assess the change in femorotibial angle, weight bearing line deviation and tibial slope pre and post operatively. 3. To compare pre- and post-operative WOMAC (The Western Ontario and McMaster Universities Osteoarthritis Index) index. Methodology: This study is a prospective analysis of patients with the requisite inclusion criteria, done over 18 months in the Central Institute of Orthopaedics, VMMC & SJH, and New Delhi. It includes a total of 20 patients who were followed up for 6 months. After initial preoperative evaluation, they underwent medial open wedge HTO for primary degenerative osteoarthritis of knee. Post operatively, patients were assessed clinically, functionally and radiologically for the benefits & drawbacks of this technique. This study is used to compare the clinical, radiological and functional improvement using this technique in patients pre-operatively and post-operatively. Observation and Result: Based on our observation we conclude that the study suggest that medial open wedge HTO using TomoFixTM should be recommended for treatment of primary degenerative osteoarthritis of knee primarily involving the medial compartment of knee.
研究设计:前瞻性和干预性随机比较研究。学习时间:18个月。目的:1。目的:应用视觉模拟量表(VAS)评估原发性退行性膝关节骨性关节炎患者内侧开楔形高位胫骨截骨术(HTO)后疼痛缓解情况。2. 观察术前、术后股骨胫骨角、负重线偏差及胫骨斜率的变化。3.比较手术前后WOMAC (Western Ontario and McMaster university Osteoarthritis Index)指数。方法:本研究是一项前瞻性分析，患者符合必要的纳入标准，在中央骨科研究所，VMMC & SJH和新德里完成了超过18个月。共包括20例患者，随访6个月。在最初的术前评估后，他们接受了内侧开楔形HTO治疗原发性膝关节退行性骨关节炎。术后，对患者进行临床、功能和放射学评估，以了解该技术的优缺点。本研究用于比较术前和术后使用该技术的患者的临床、放射学和功能改善。观察与结果:根据我们的观察，我们得出结论，该研究建议使用TomoFixTM进行内侧开楔形HTO治疗主要累及膝关节内侧室的原发性退行性膝关节骨性关节炎。
{"title":"Evaluation of Medial Open Wedge High Tibial Osteotomy in Osteoarthritis of Knee","authors":"D. N. Kumar, D. R. Chopra, Dr. Ashish Jaiman, Dr. Simarjot Singh Sodhi, Deepanshu Mittal, Dr. Prashant Bajaj, Dr. Rohan Krishnan","doi":"10.23958/ijirms/vol08-i02/1624","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i02/1624","url":null,"abstract":"Study Design: Prospective and Interventional Randomized Comparative Study. Duration of study: 18 months. Objective: 1. To estimate pain relief in a patient with primary degenerative osteoarthritis of knee after medial open wedge high tibial osteotomy (HTO) using visual analog scale(VAS). 2. To assess the change in femorotibial angle, weight bearing line deviation and tibial slope pre and post operatively. 3. To compare pre- and post-operative WOMAC (The Western Ontario and McMaster Universities Osteoarthritis Index) index. Methodology: This study is a prospective analysis of patients with the requisite inclusion criteria, done over 18 months in the Central Institute of Orthopaedics, VMMC & SJH, and New Delhi. It includes a total of 20 patients who were followed up for 6 months. After initial preoperative evaluation, they underwent medial open wedge HTO for primary degenerative osteoarthritis of knee. Post operatively, patients were assessed clinically, functionally and radiologically for the benefits & drawbacks of this technique. This study is used to compare the clinical, radiological and functional improvement using this technique in patients pre-operatively and post-operatively. Observation and Result: Based on our observation we conclude that the study suggest that medial open wedge HTO using TomoFixTM should be recommended for treatment of primary degenerative osteoarthritis of knee primarily involving the medial compartment of knee.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87895037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-12DOI: 10.23958/ijirms/vol08-i02/1615
K. Alrabiah
Multiple, hard, flesh-to-pink papules, plaques, and nodules, often seen on the extensor surfaces of the limbs, are characteristic of prurigo nodularis, a persistent skin condition. The itchy lesions may strike people of any age. It often occurs in tandem with another condition that causes constant itching, such atopic dermatitis or another dermatosis. The clinical symptoms are the primary indicators. However, there may be numerous instances when lichen simplex chronic us and hypertrophic lichen planus are indistinguishable from a clinical standpoint. Therefore, it is crucial to confirm the diagnosis by dermoscopy and histology. Many other therapy strategies are being used, including those using powerful antipruritics, immunomodulators, and neuromodulators. After a diagnosis has been made, treatment might take a long time, thus patient education and counseling are crucial to ensuring they stick with the plan. A subset of chronic prurigo, prurigo nodularis (PN) manifests as hyperkeratotic, very itchy papules and nodules that are often seen in a symmetrical pattern. PN develops with persistent pruritus in the setting of a wide variety of dermatological, systemic, neurological, or mental disorders. Although the specific pathophysiology of PN is not well understood, chronic scratching may be a primary cause. Topical steroids, capsaicin, calcineurin inhibitors, ultraviolet (UV) treatment, systemic injection of gabapentinoids, -opioid receptor antagonists, antidepressants, and immunosuppressants are the current gold standard in treating PN. Clinical trials are being conducted on cutting-edge therapeutic modalities such blockers of neurokinin-1, opioid, and interleukin-31 receptors.
{"title":"Prurigo Nodularis: Literature Review","authors":"K. Alrabiah","doi":"10.23958/ijirms/vol08-i02/1615","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i02/1615","url":null,"abstract":"Multiple, hard, flesh-to-pink papules, plaques, and nodules, often seen on the extensor surfaces of the limbs, are characteristic of prurigo nodularis, a persistent skin condition. The itchy lesions may strike people of any age. It often occurs in tandem with another condition that causes constant itching, such atopic dermatitis or another dermatosis. The clinical symptoms are the primary indicators. However, there may be numerous instances when lichen simplex chronic us and hypertrophic lichen planus are indistinguishable from a clinical standpoint. Therefore, it is crucial to confirm the diagnosis by dermoscopy and histology. Many other therapy strategies are being used, including those using powerful antipruritics, immunomodulators, and neuromodulators. After a diagnosis has been made, treatment might take a long time, thus patient education and counseling are crucial to ensuring they stick with the plan. A subset of chronic prurigo, prurigo nodularis (PN) manifests as hyperkeratotic, very itchy papules and nodules that are often seen in a symmetrical pattern. PN develops with persistent pruritus in the setting of a wide variety of dermatological, systemic, neurological, or mental disorders. Although the specific pathophysiology of PN is not well understood, chronic scratching may be a primary cause. Topical steroids, capsaicin, calcineurin inhibitors, ultraviolet (UV) treatment, systemic injection of gabapentinoids, -opioid receptor antagonists, antidepressants, and immunosuppressants are the current gold standard in treating PN. Clinical trials are being conducted on cutting-edge therapeutic modalities such blockers of neurokinin-1, opioid, and interleukin-31 receptors.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"555 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78028788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-12DOI: 10.23958/ijirms/vol08-i02/1621
J. Fair, Caitlin Shi, Harshit Amin, Tharidu Gunawardena, Sarah Abernathy, Sai Kottapalli, Sophia Thompson, Thomas Amabile, Kush N. Shah, Curtis Caughey, Kirin Anand, A. Sahu, Grace Yi, James Bennett
Carpal Tunnel Syndrome (CTS) is a common disorder that affects the hand, caused by compression of the median nerve at the wrist. Despite its prevalence and impact on individuals, the underlying biological mechanisms of CTS remain poorly understood. Moreover, there is a lack of strategies for identifying individuals at risk for CTS in order to prevent its development. In recent years, the use of genome sequencing, genetic analysis, and genome-wide association studies (GWAS) has revealed several genetic factors that may be associated with CTS, including specific genes and gene loci. A Genetic Risk Score (GRS) that incorporates these findings could potentially be used to predict the likelihood of developing CTS and enable earlier identification and prevention of the condition. GWAS has already demonstrated a correlation between CTS severity and a GRS composed of 13 susceptibility loci. Further research on the development of a more comprehensive GRS for CTS could potentially reduce the overall burden of this disorder.
{"title":"Uncovering Carpal Tunnel Syndrome Risk through Genetics: A Path to Early Prevention","authors":"J. Fair, Caitlin Shi, Harshit Amin, Tharidu Gunawardena, Sarah Abernathy, Sai Kottapalli, Sophia Thompson, Thomas Amabile, Kush N. Shah, Curtis Caughey, Kirin Anand, A. Sahu, Grace Yi, James Bennett","doi":"10.23958/ijirms/vol08-i02/1621","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i02/1621","url":null,"abstract":"Carpal Tunnel Syndrome (CTS) is a common disorder that affects the hand, caused by compression of the median nerve at the wrist. Despite its prevalence and impact on individuals, the underlying biological mechanisms of CTS remain poorly understood. Moreover, there is a lack of strategies for identifying individuals at risk for CTS in order to prevent its development. In recent years, the use of genome sequencing, genetic analysis, and genome-wide association studies (GWAS) has revealed several genetic factors that may be associated with CTS, including specific genes and gene loci. A Genetic Risk Score (GRS) that incorporates these findings could potentially be used to predict the likelihood of developing CTS and enable earlier identification and prevention of the condition. GWAS has already demonstrated a correlation between CTS severity and a GRS composed of 13 susceptibility loci. Further research on the development of a more comprehensive GRS for CTS could potentially reduce the overall burden of this disorder.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82351811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-12DOI: 10.23958/ijirms/vol08-i02/1620
K. Bhat, Sohaib Ahmad
The emergence of variants of corona which are getting transmitted easily and are more virulent and fatal has made things more difficult and the need to know about the prognostic markers has taken a priority besides vaccination. All COVID-19 RT PCR positive patients were categorized into mild, moderate and severe category any time during hospital stay based on the WHO guidelines 2021. Comparison of all clinical and selected biochemical parameters (Ferritin, LDH, IL-6, TLC, NLR, albumin, D-dimer and procalcitonin) was done. The Aim of the study was to establish a cut off level of the biomarkers of COVID -19 which could determine the severity of the disease and act as prognostic factors too. These biochemical markers include NLR, serum D-dimer, CRP, IL-6, ferritin, LDH, albumin, procalcitonin, AST and ALT(p<0.001). A total of 240 patients who were RT-PCR positive were included in the study. Compared to patients with mild disease, those with moderate to severe disease had a significant higher levels of the markers except serum albumin(p<0.0001). Albumin was significantly lower in these patients. A significant association was also seen between these markers and the outcome of the disease. Those who expired or left against medical advice (LAMA) had a significant higher levels of D-dimer, IL-6, CRP, procalcitonin and LDH as compared to those who were cured. IL-6, D-dimer, LDH, CRP, Procalcitonin and albumin are really helpful in knowing the severity of the disease and in disease surveillance.
冠状病毒变种的出现更容易传播，毒性和致命性更强，这使得事情变得更加困难，除了疫苗接种外，了解预后标志物的需求已成为优先事项。根据世界卫生组织2021年指南，所有COVID-19 RT PCR阳性患者在住院期间的任何时间都被分为轻度、中度和重度三类。比较所有临床及部分生化指标(铁蛋白、LDH、IL-6、TLC、NLR、白蛋白、d -二聚体、降钙素原)。该研究的目的是建立COVID -19生物标志物的临界值，这可以确定疾病的严重程度，也可以作为预后因素。这些生化指标包括NLR、血清d -二聚体、CRP、IL-6、铁蛋白、LDH、白蛋白、降钙素原、AST和ALT(p<0.001)。共纳入240例RT-PCR阳性患者。与轻度疾病患者相比，中度至重度疾病患者除血清白蛋白外其他标志物水平均显著升高(p<0.0001)。这些患者的白蛋白水平明显降低。这些标记物与疾病结果之间也存在显著关联。那些死亡或不遵医嘱离开的患者(LAMA)的d -二聚体、IL-6、CRP、降钙素原和LDH水平明显高于治愈者。IL-6, d -二聚体，LDH, CRP，原降钙素和白蛋白对了解疾病的严重程度和疾病监测非常有帮助。
{"title":"Biochemical Markers of COVID -19: Role in Diagnosis, Management and Predicting Severity of the Disease","authors":"K. Bhat, Sohaib Ahmad","doi":"10.23958/ijirms/vol08-i02/1620","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i02/1620","url":null,"abstract":"The emergence of variants of corona which are getting transmitted easily and are more virulent and fatal has made things more difficult and the need to know about the prognostic markers has taken a priority besides vaccination. All COVID-19 RT PCR positive patients were categorized into mild, moderate and severe category any time during hospital stay based on the WHO guidelines 2021. Comparison of all clinical and selected biochemical parameters (Ferritin, LDH, IL-6, TLC, NLR, albumin, D-dimer and procalcitonin) was done.\u0000The Aim of the study was to establish a cut off level of the biomarkers of COVID -19 which could determine the severity of the disease and act as prognostic factors too. These biochemical markers include NLR, serum D-dimer, CRP, IL-6, ferritin, LDH, albumin, procalcitonin, AST and ALT(p<0.001). A total of 240 patients who were RT-PCR positive were included in the study. Compared to patients with mild disease, those with moderate to severe disease had a significant higher levels of the markers except serum albumin(p<0.0001). Albumin was significantly lower in these patients. A significant association was also seen between these markers and the outcome of the disease. Those who expired or left against medical advice (LAMA) had a significant higher levels of D-dimer, IL-6, CRP, procalcitonin and LDH as compared to those who were cured. IL-6, D-dimer, LDH, CRP, Procalcitonin and albumin are really helpful in knowing the severity of the disease and in disease surveillance.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78783550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-11DOI: 10.23958/ijirms/vol08-i02/1627
Hart Fiekabo, Abhulimen Victor
Introduction: Renal Cell Carcinoma (RCC) accounts for 2% of global cancer diagnoses and deaths, its incidence is increasing globally. In Africa, the incidence of RCC is relatively low but many patients present late with advanced-stage disease and consequently, poorer prognosis. Anaesthetic care of these patients is important. Materials and Methods: This is a ten-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Ethical approval for the study was sought and gotten from the hospital’s ethical committee. The information gotten includes the type of anaesthesia and method of postoperative pain management. The data collected was analyzed and presented in a table. Results: 84% had general anaesthesia while 16% had regional anaesthesia, all the patients had multimodal method of pain management. Conclusion: Perioperative management for renal surgery varies significantly depending on the disease and patient groups, the anaesthetic must take into consideration the various surgical approaches and be prepared to assist the surgeon.
{"title":"Anaesthetic Considerations in Managing Renal cell Carcinoma in a Resource-Poor Setting","authors":"Hart Fiekabo, Abhulimen Victor","doi":"10.23958/ijirms/vol08-i02/1627","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i02/1627","url":null,"abstract":"Introduction: Renal Cell Carcinoma (RCC) accounts for 2% of global cancer diagnoses and deaths, its incidence is increasing globally. In Africa, the incidence of RCC is relatively low but many patients present late with advanced-stage disease and consequently, poorer prognosis. Anaesthetic care of these patients is important. Materials and Methods: This is a ten-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Ethical approval for the study was sought and gotten from the hospital’s ethical committee. The information gotten includes the type of anaesthesia and method of postoperative pain management. The data collected was analyzed and presented in a table. Results: 84% had general anaesthesia while 16% had regional anaesthesia, all the patients had multimodal method of pain management. Conclusion: Perioperative management for renal surgery varies significantly depending on the disease and patient groups, the anaesthetic must take into consideration the various surgical approaches and be prepared to assist the surgeon.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80870640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-11DOI: 10.23958/ijirms/vol08-i02/1622
Enebeli Victor, Abhulimen Victor
Background: Polydactyly is a common congenital abnormality of the hands and feet characterized by more than five fingers and toes. Polydactyly is amongst the commonest inherited skeletal conditions. Polydactyly can be familial or sporadic. Methods: This article presents a case of familial postaxial polydactyly in a male neonate involving all four limbs seen in our hospital. The mother has history of postaxial polydactyly in both upper limbs consisting only of soft tissue unlike the index patient who has well developed bone on the extra digit. Conclusion: Polydactyly is easily diagnosed at birth however earlier diagnosis during the early antenatal period provides an opportunity for counselling, investigation for syndromic associations or familial gene transmission and planning treatment.
{"title":"Familial Post-Axial Polydactyly of all Limbs in a Neonate","authors":"Enebeli Victor, Abhulimen Victor","doi":"10.23958/ijirms/vol08-i02/1622","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i02/1622","url":null,"abstract":"Background: Polydactyly is a common congenital abnormality of the hands and feet characterized by more than five fingers and toes. Polydactyly is amongst the commonest inherited skeletal conditions. Polydactyly can be familial or sporadic. Methods: This article presents a case of familial postaxial polydactyly in a male neonate involving all four limbs seen in our hospital. The mother has history of postaxial polydactyly in both upper limbs consisting only of soft tissue unlike the index patient who has well developed bone on the extra digit. Conclusion: Polydactyly is easily diagnosed at birth however earlier diagnosis during the early antenatal period provides an opportunity for counselling, investigation for syndromic associations or familial gene transmission and planning treatment.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77260235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-07DOI: 10.23958/ijirms/vol08-i02/1623
Vilton Zimmermann de Souza, Emilly Schoenberger, Roberto Francisco Wesoloski, G. Garcia, Rosalen Rosalen da Silva, R. Manfro
Bone augmentations for installation of dental implants are often necessary and often decreases patient acceptance of treatment due to increased morbidity. In this clinical case, we report the procedure of subperiosteal tunneling (tunnel technique) combining in situ xenogeneic graft, of slow absorption bovine origin, for horizontal augmentation in the mandible. Bone grafts, horizontal and vertical, are extremely important procedures for oral rehabilitation in implant dentistry, thus enabling the re-establishment of an adequate framework for the installation of implants with correct positioning, restoring function and aesthetics to our patients. The most commonly used therapy consists of raising a more invasive flap to expose the bone tissue and performing associated grafting techniques. However, in well-indicated cases, we have this tool at our disposal, where we can treat our patients with minimally invasive techniques, such as subperiosteal tunneling, with very favorable clinical results. The main advantage of this approach, in addition to the minimally invasive technique, is the preservation of the periosteum and blood supply to the flap, which may contribute to increased favorable wound healing and a reduced risk of flap dehiscence and membrane exposure. This tunnel approach to guided bone regeneration in horizontal bone gains, specifically adapted and filled with xenogeneic bone, resulted in a significant gain in bone volume in thickness, which allowed implant placement (average increase of 5.0mm observed on tomography). As for morbidity, the patient reported a better postoperative period in the reconstruction surgery compared to the implant installation surgery, measured by the visual analogue scale (VAS).
{"title":"Horizontal Bone Augmentation in the Mandible by Subperiosteal Tunneling Technique: Case Report","authors":"Vilton Zimmermann de Souza, Emilly Schoenberger, Roberto Francisco Wesoloski, G. Garcia, Rosalen Rosalen da Silva, R. Manfro","doi":"10.23958/ijirms/vol08-i02/1623","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i02/1623","url":null,"abstract":"Bone augmentations for installation of dental implants are often necessary and often decreases patient acceptance of treatment due to increased morbidity. In this clinical case, we report the procedure of subperiosteal tunneling (tunnel technique) combining in situ xenogeneic graft, of slow absorption bovine origin, for horizontal augmentation in the mandible. Bone grafts, horizontal and vertical, are extremely important procedures for oral rehabilitation in implant dentistry, thus enabling the re-establishment of an adequate framework for the installation of implants with correct positioning, restoring function and aesthetics to our patients. The most commonly used therapy consists of raising a more invasive flap to expose the bone tissue and performing associated grafting techniques. However, in well-indicated cases, we have this tool at our disposal, where we can treat our patients with minimally invasive techniques, such as subperiosteal tunneling, with very favorable clinical results. The main advantage of this approach, in addition to the minimally invasive technique, is the preservation of the periosteum and blood supply to the flap, which may contribute to increased favorable wound healing and a reduced risk of flap dehiscence and membrane exposure. This tunnel approach to guided bone regeneration in horizontal bone gains, specifically adapted and filled with xenogeneic bone, resulted in a significant gain in bone volume in thickness, which allowed implant placement (average increase of 5.0mm observed on tomography). As for morbidity, the patient reported a better postoperative period in the reconstruction surgery compared to the implant installation surgery, measured by the visual analogue scale (VAS).","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"5 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90242100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-06DOI: 10.23958/ijirms/vol08-i02/1607
Silvia Bonassisa, C. I. Aquino, Alessandro Libretti, R. Amadori, V. Remorgida, D. Surico
Human Herpesvirus 6 (HHV-6) is often associated with asymptomatic infections, but in immunocompetent adults is relatively rare. A 24-years old pregnant woman at 16 weeks of gestation presented a meningoencephalitis caused by HHV-6, confirmed by MRI (Magnetic Resonance Imaging) and cerebrospinal fluid (CSF) sample. Acyclovir treatment (750 mg IV for 3 times/die) was started but after hours the patient started a spontaneous labor arose which determined a late miscarriage at 16+5 weeks of gestation without evidence of intra-amniotic infection or chorioamnionitis. The patient was discharged after 3 weeks in good health and without neurological sequalae. The exact role of HHV-6 in the development of late miscarriage and its incidence in late abortions is currently unknown.
{"title":"Late Miscarriage and HHV-6 Meningoencephalitis: A Case Report","authors":"Silvia Bonassisa, C. I. Aquino, Alessandro Libretti, R. Amadori, V. Remorgida, D. Surico","doi":"10.23958/ijirms/vol08-i02/1607","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i02/1607","url":null,"abstract":"Human Herpesvirus 6 (HHV-6) is often associated with asymptomatic infections, but in immunocompetent adults is relatively rare. A 24-years old pregnant woman at 16 weeks of gestation presented a meningoencephalitis caused by HHV-6, confirmed by MRI (Magnetic Resonance Imaging) and cerebrospinal fluid (CSF) sample. Acyclovir treatment (750 mg IV for 3 times/die) was started but after hours the patient started a spontaneous labor arose which determined a late miscarriage at 16+5 weeks of gestation without evidence of intra-amniotic infection or chorioamnionitis. The patient was discharged after 3 weeks in good health and without neurological sequalae. The exact role of HHV-6 in the development of late miscarriage and its incidence in late abortions is currently unknown.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"os-48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87359505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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