Pub Date : 2022-06-01DOI: 10.32457/ijmss.v9i2.1847
A. Quiroga-Garza, A. K. Flores-González, J. T. Guerrero-Zertuche, L. A. Álvarez-Lozada, B. A. Fernandez-Reyes, Rodrigo Enrique Elizondo Omaña
Introduction: The trachea is a semiflexible tube of 1.5 to 2 cm in width and 10 to 13 cm in length. Its deviation might be caused by not only diverse thoracic but also abdominal pathologies, which may compromise the airway. We present a case of a severe tracheal deviation due to an abdominal pathology causing displacement of mediastinal structures. Clinical Case: A 78-year-old woman presents with difficulty breathing. History of chronic bedridden and frequently constipated, last stool 5 days prior. On physical examination, cachectic complexion, dry mucous membranes, breathing superficially with scarce wheezing, SatO2 82% on room air. Abdomen distended with an absence of bowel sounds. Chest x-rays show severe tracheal deviation and abdominal x-ray with coffee bean sign. A laparotomy evidences a large sigmoid volvulus. A sigmoidectomy and descending colon colostomy is performed. Room air oxygen saturation improved after extubation to 96%. Conclusion: Desaturation and tracheal deviation were caused by a large sigmoid volvulus. Although these pathologies were thoracic, clinicians should suspect different underlying pathologies, in this case, abdominal.
{"title":"Respiratory distress and tracheal deviation secondary to sigmoid volvulus","authors":"A. Quiroga-Garza, A. K. Flores-González, J. T. Guerrero-Zertuche, L. A. Álvarez-Lozada, B. A. Fernandez-Reyes, Rodrigo Enrique Elizondo Omaña","doi":"10.32457/ijmss.v9i2.1847","DOIUrl":"https://doi.org/10.32457/ijmss.v9i2.1847","url":null,"abstract":"Introduction: The trachea is a semiflexible tube of 1.5 to 2 cm in width and 10 to 13 cm in length. Its deviation might be caused by not only diverse thoracic but also abdominal pathologies, which may compromise the airway. We present a case of a severe tracheal deviation due to an abdominal pathology causing displacement of mediastinal structures. Clinical Case: A 78-year-old woman presents with difficulty breathing. History of chronic bedridden and frequently constipated, last stool 5 days prior. On physical examination, cachectic complexion, dry mucous membranes, breathing superficially with scarce wheezing, SatO2 82% on room air. Abdomen distended with an absence of bowel sounds. Chest x-rays show severe tracheal deviation and abdominal x-ray with coffee bean sign. A laparotomy evidences a large sigmoid volvulus. A sigmoidectomy and descending colon colostomy is performed. Room air oxygen saturation improved after extubation to 96%. Conclusion: Desaturation and tracheal deviation were caused by a large sigmoid volvulus. Although these pathologies were thoracic, clinicians should suspect different underlying pathologies, in this case, abdominal.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77201429","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 : 2022-06-01DOI: 10.32457/ijmss.v9i2.1884
M. E. De la O-Cavazos, Manuel de la O Escamilla, Alberto Gómez-Orozco, L. A. Álvarez-Lozada, Marco Antonio Flores-Heredia
COVID-19 typically courses with mild clinical manifestations; however, a pediatric patient might get severe sequelae and complications when there is an infection. There is no information about liver complications due to COVID-19 in children in Mexico. This case report will set a precedent about timely diagnosis for hepatitis as a complication for COVID-19 disease in young patients in Mexico. Clinical case: A 12-years-old man has intermittent generalized abdominal pain misdiagnosed and treated for irritable bowel syndrome 3 days prior. The abdominal pain stayed, and a day after the patient vomited 3 times (each one after every meal). The patient started with orangish urine, weakness, fatigue and hyporexia 1 day prior to admission. The day of the admittance, a COVID-19 RT-PCR test was performed, giving a positive result. Once he was admitted, laboratory tests were made, showing an increase of liver enzyme levels, showing liver disease as a complication for the viral infection. Conclusion: Pediatrics patients might get Hepatitis due to COVID-19. In a patient with abdominal pain or other liver disease symptoms while coursing with the virus or even after the infection, further investigation must be made.
{"title":"Acute Hepatitis in a Pediatric Patient with COVID -19 : Case Report","authors":"M. E. De la O-Cavazos, Manuel de la O Escamilla, Alberto Gómez-Orozco, L. A. Álvarez-Lozada, Marco Antonio Flores-Heredia","doi":"10.32457/ijmss.v9i2.1884","DOIUrl":"https://doi.org/10.32457/ijmss.v9i2.1884","url":null,"abstract":"COVID-19 typically courses with mild clinical manifestations; however, a pediatric patient might get severe sequelae and complications when there is an infection. There is no information about liver complications due to COVID-19 in children in Mexico. This case report will set a precedent about timely diagnosis for hepatitis as a complication for COVID-19 disease in young patients in Mexico. Clinical case: A 12-years-old man has intermittent generalized abdominal pain misdiagnosed and treated for irritable bowel syndrome 3 days prior. The abdominal pain stayed, and a day after the patient vomited 3 times (each one after every meal). The patient started with orangish urine, weakness, fatigue and hyporexia 1 day prior to admission. The day of the admittance, a COVID-19 RT-PCR test was performed, giving a positive result. Once he was admitted, laboratory tests were made, showing an increase of liver enzyme levels, showing liver disease as a complication for the viral infection. Conclusion: Pediatrics patients might get Hepatitis due to COVID-19. In a patient with abdominal pain or other liver disease symptoms while coursing with the virus or even after the infection, further investigation must be made.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89132387","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 : 2022-06-01DOI: 10.32457/ijmss.v9i2.1871
Carlos Mena Canata, Enrique Pérez Girala, T. Liu, Raúl Andrés Tornaco Maidana, Rodrigo González Insfrán
The alteration of the senses of taste and smell in relation to COVID-19 is a widely known phenomenon; however, this alteration has not been exhaustively characterized in the international literature. The following study is proposed with the aim of describing the alterations in the senses of taste and smell in relation to COVID-19 by means of their subjective evaluation. The nature of the study is observational, descriptive and cross-sectional, and was applied to patients who sought medical attention via remote consultations carried out on virtual platforms of the Service of Otorhinolaryngology and Head and Neck Surgery of the Clínicas Hospital, San Lorenzo, between the months of March and October of 2021. We included 440 patients aged 31.3 ± 9.9 years (18 to 60 years), 308 (70%) female, 388 (88%) from urban areas, with evidence of infection by SARS-CoV-2 by RT-PCR in 260 (59%), predominantly without comorbidities 232 (53%), with fever as the most frequently reported symptom 352 (80%), treated more frequently with NSAIDs 208 (47%) and/or Paracetamol 216 (49%). Both taste and smell alterations in patients who have had COVID-19 have been shown to appear more frequently 1 to 7 days after the onset of symptoms (207 for smell, 184 for taste), occurring more frequently with a total decrease of both senses (anosmia 302 and ageusia 216), recovering completely in most cases (214 and 216) and within a period of 1 to 4 weeks (140 and 130).
{"title":"Subjective assessment of taste and smell disfunction in patients with COVID-19 in Paraguay","authors":"Carlos Mena Canata, Enrique Pérez Girala, T. Liu, Raúl Andrés Tornaco Maidana, Rodrigo González Insfrán","doi":"10.32457/ijmss.v9i2.1871","DOIUrl":"https://doi.org/10.32457/ijmss.v9i2.1871","url":null,"abstract":"The alteration of the senses of taste and smell in relation to COVID-19 is a widely known phenomenon; however, this alteration has not been exhaustively characterized in the international literature. The following study is proposed with the aim of describing the alterations in the senses of taste and smell in relation to COVID-19 by means of their subjective evaluation. The nature of the study is observational, descriptive and cross-sectional, and was applied to patients who sought medical attention via remote consultations carried out on virtual platforms of the Service of Otorhinolaryngology and Head and Neck Surgery of the Clínicas Hospital, San Lorenzo, between the months of March and October of 2021. We included 440 patients aged 31.3 ± 9.9 years (18 to 60 years), 308 (70%) female, 388 (88%) from urban areas, with evidence of infection by SARS-CoV-2 by RT-PCR in 260 (59%), predominantly without comorbidities 232 (53%), with fever as the most frequently reported symptom 352 (80%), treated more frequently with NSAIDs 208 (47%) and/or Paracetamol 216 (49%). Both taste and smell alterations in patients who have had COVID-19 have been shown to appear more frequently 1 to 7 days after the onset of symptoms (207 for smell, 184 for taste), occurring more frequently with a total decrease of both senses (anosmia 302 and ageusia 216), recovering completely in most cases (214 and 216) and within a period of 1 to 4 weeks (140 and 130).","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81805525","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}
Cisplatin, the first platinum compound approved for cancer treatment, is widely used in the treatment of various cancers including hepatocellular carcinoma (HCC). HCC incidence rates rise globally. Epithelial mesenchymal transition (EMT) is implicated in cancer invasion and metastasis, which are associated with increased mortality. Cisplatin dose might influence cancer invasion and metastatic behavior of the cells. The aim of the study was to investigate the effect of low-dose cisplatin treatment on EMT- related changes in HepG2 cells. Following treatment with 4 µM cisplatin, HepG2 cells were evaluated morphologically. Gene expression of E-cadherin, Vimentin, Snail1 was assessed by quantitative PCR. Immunofluorescence analyses of NA-K ATPase were performed. Although the low-dose cisplatin treated cells exhibited a more stretched morphology, no statistical difference was detected in gene expression of E-cadherin, Vimentin, Snail1 and immunofluorescence of NA-K ATPase. Findings on low-dose cisplatin effects in HepG2 might contribute to the knowledge of antineoplastic inefficacy by further understanding the molecular mechanisms of drug action.
{"title":"Low-dose cisplatin exposure and SNAIL, Vimentin, E-cadherin expression in HEPG2 cell line","authors":"Yaprak Dönmez Çakıl, Zeynep Akbulut, Ranan Gülhan Aktaş, Zeynep Gunes Ozunal","doi":"10.32457/ijmss.v9i2.1864","DOIUrl":"https://doi.org/10.32457/ijmss.v9i2.1864","url":null,"abstract":"Cisplatin, the first platinum compound approved for cancer treatment, is widely used in the treatment of various cancers including hepatocellular carcinoma (HCC). HCC incidence rates rise globally. Epithelial mesenchymal transition (EMT) is implicated in cancer invasion and metastasis, which are associated with increased mortality. Cisplatin dose might influence cancer invasion and metastatic behavior of the cells. The aim of the study was to investigate the effect of low-dose cisplatin treatment on EMT- related changes in HepG2 cells. Following treatment with 4 µM cisplatin, HepG2 cells were evaluated morphologically. Gene expression of E-cadherin, Vimentin, Snail1 was assessed by quantitative PCR. Immunofluorescence analyses of NA-K ATPase were performed. Although the low-dose cisplatin treated cells exhibited a more stretched morphology, no statistical difference was detected in gene expression of E-cadherin, Vimentin, Snail1 and immunofluorescence of NA-K ATPase. Findings on low-dose cisplatin effects in HepG2 might contribute to the knowledge of antineoplastic inefficacy by further understanding the molecular mechanisms of drug action.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76359583","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 : 2022-06-01DOI: 10.32457/ijmss.v9i2.1883
Jesús Nicolás Larco Coloma, Nicolás Larco Noboa
Thyroid pathology is the morphofunctional evolution of the thyroid glands that leads to different types of clinical pictures. Within it is subclinical hypothyroidism, which is a biochemical alteration due to the elevation of thyroid-stimulating hormone (TSH) between 4.5 to 10 mUI that can occur with or without symptoms of multifactorial origin. The worldwide prevalence is 4-10% and Latin America 15-25%. 90% of patients with this pathology do not require treatment, but in turn there is an overmedicalization and underdiagnosis of it. This bibliographic review analyzes from its morphofunctional changes towards clinical criteria for a comprehensive approach to subclinical hypothyroidism, where we have an individualization by its comorbidities, age group, diagnostic algorithm, follow-up and differentiated treatment according to recent studies within this pathology. Therefore, an adequate diagnosis, follow-up and treatment provides a better lifestyle for patients.
{"title":"Approach to Subclinical Hypothyroidism in Adults","authors":"Jesús Nicolás Larco Coloma, Nicolás Larco Noboa","doi":"10.32457/ijmss.v9i2.1883","DOIUrl":"https://doi.org/10.32457/ijmss.v9i2.1883","url":null,"abstract":"Thyroid pathology is the morphofunctional evolution of the thyroid glands that leads to different types of clinical pictures. Within it is subclinical hypothyroidism, which is a biochemical alteration due to the elevation of thyroid-stimulating hormone (TSH) between 4.5 to 10 mUI that can occur with or without symptoms of multifactorial origin. The worldwide prevalence is 4-10% and Latin America 15-25%. 90% of patients with this pathology do not require treatment, but in turn there is an overmedicalization and underdiagnosis of it. This bibliographic review analyzes from its morphofunctional changes towards clinical criteria for a comprehensive approach to subclinical hypothyroidism, where we have an individualization by its comorbidities, age group, diagnostic algorithm, follow-up and differentiated treatment according to recent studies within this pathology. Therefore, an adequate diagnosis, follow-up and treatment provides a better lifestyle for patients.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80798927","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}
{"title":"Vol. 9 No. 2 (2022): June 2022","authors":"","doi":"10.32457/ijmss.v9i2","DOIUrl":"https://doi.org/10.32457/ijmss.v9i2","url":null,"abstract":"no aplica","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88572767","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}
P. Agrawal, M. Girish, A. Ramanathan, M. Sudhakaran, S. Murali
Abstract Background Compartment syndrome, a potential limb-threatening condition in acute traumatic situations following different modalities of injury, may lead to irreversible damage or even life risk later. Its differential time-bound clinical presentation with added observer bias on available invasive and noninvasive diagnostic modalities influences the decision-making and undue delay for early intervention toward limb salvage procedure. Results Thirty-two patients were included in our study with mean age of 36; males (18; 56.3%) were more injured than females (14; 43.8%) and left limb (17; 53.1%) was more involved than right (15; 46.9%). Mean calf muscle measurement of total injured limb with relation to immediate time was 39.9 cm, after 1 hour was 40.69 cm, after 2 hours was 41.06 cm, and after 3 hours was 41.40 cm; 95% confidence interval was found to be statistically significant. Three patients (9%) underwent emergency decompression fasciotomy, with an average mean of 41.4 cm for injured limbs against 38.5 cm in control limb. Conclusion Compartment syndrome is an acute emergency with potential irreversible damage when undiagnosed. Bias on diagnosis evolves around observer skills and clinical invasive and noninvasive methods, with differential statistical results pertaining to its decision-making for emergency fasciotomy.
背景筋膜室综合征是急性创伤情况下不同形式损伤后的一种潜在肢体威胁疾病，可能导致不可逆损伤甚至生命危险。其不同的时间限制临床表现，加上对现有侵入性和非侵入性诊断方式的观察者偏见，影响了对肢体保留手术早期干预的决策和不当延误。结果32例患者入组，平均年龄36岁;男性(18;56.3%)受伤率高于女性(14;43.8%)和左肢(17;53.1%)参与多于正确(15;46.9%)。小腿总损伤肢体肌肉测量值与即刻相关的平均值为39.9 cm, 1小时后为40.69 cm, 2小时后为41.06 cm, 3小时后为41.40 cm;95%置信区间有统计学意义。3例(9%)患者接受了紧急减压筋膜切开术，损伤肢体平均为41.4 cm，而对照组平均为38.5 cm。结论筋膜室综合征是一种急性急症，若不及时诊断，可能造成不可逆的损害。诊断偏差围绕观察者技能和临床侵入性和非侵入性方法而发展，与急诊筋膜切开术决策相关的差异统计结果。
{"title":"Compartment Syndrome and Its Validation in Skeletal Injuries","authors":"P. Agrawal, M. Girish, A. Ramanathan, M. Sudhakaran, S. Murali","doi":"10.1055/s-0043-1761415","DOIUrl":"https://doi.org/10.1055/s-0043-1761415","url":null,"abstract":"Abstract Background Compartment syndrome, a potential limb-threatening condition in acute traumatic situations following different modalities of injury, may lead to irreversible damage or even life risk later. Its differential time-bound clinical presentation with added observer bias on available invasive and noninvasive diagnostic modalities influences the decision-making and undue delay for early intervention toward limb salvage procedure. Results Thirty-two patients were included in our study with mean age of 36; males (18; 56.3%) were more injured than females (14; 43.8%) and left limb (17; 53.1%) was more involved than right (15; 46.9%). Mean calf muscle measurement of total injured limb with relation to immediate time was 39.9 cm, after 1 hour was 40.69 cm, after 2 hours was 41.06 cm, and after 3 hours was 41.40 cm; 95% confidence interval was found to be statistically significant. Three patients (9%) underwent emergency decompression fasciotomy, with an average mean of 41.4 cm for injured limbs against 38.5 cm in control limb. Conclusion Compartment syndrome is an acute emergency with potential irreversible damage when undiagnosed. Bias on diagnosis evolves around observer skills and clinical invasive and noninvasive methods, with differential statistical results pertaining to its decision-making for emergency fasciotomy.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78574442","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}
Abstract Introduction Hamstring graft use has been in the forefront of ligament reconstruction around the knee. With the increasing number of surgeries, the complications are equally on the rise. One of the detrimental factors for predicting the outcome is the diameter and length of the graft. We did an observational study to find out the relationship of patient factors with the morphometry of the graft. Materials and Methods Total 484 patients were included in the study. Preoperatively, the age, sex, height, weight, and activity levels of the patients were noted. They were categorized into two major groups: physically active and inactive. The intraoperative measurements of the grafts were recorded. Analysis of variance for comparing the means of multiple groups was used for statistical analysis. Results Among the total 484 patients, 407 were male and 77 were female. The semitendinosus graft diameter did not show any statistical significance to the age and weight of the patient. The mean graft diameter was highest in the 45 to 49-year age group. The average graft diameter in physically active group was 3.704 mm, and 3.503 mm in the inactive group. This and the height of the patient proved to have statistically significant relation with graft diameter. Conclusion Physical activity along with the height of the patient must be taken into due consideration before embarking upon ligament reconstruction with hamstring graft in mind, as these two are found to determine the diameter and length of the hamstring graft.
{"title":"Anthropometric Measurements of Hamstring Tendon Graft and Its Predictors in Ligament Reconstruction Surgeries of Knee: An Observational Study","authors":"T. Panigrahi, R. Maharaj, D. Nanda","doi":"10.1055/s-0043-1761414","DOIUrl":"https://doi.org/10.1055/s-0043-1761414","url":null,"abstract":"Abstract Introduction Hamstring graft use has been in the forefront of ligament reconstruction around the knee. With the increasing number of surgeries, the complications are equally on the rise. One of the detrimental factors for predicting the outcome is the diameter and length of the graft. We did an observational study to find out the relationship of patient factors with the morphometry of the graft. Materials and Methods Total 484 patients were included in the study. Preoperatively, the age, sex, height, weight, and activity levels of the patients were noted. They were categorized into two major groups: physically active and inactive. The intraoperative measurements of the grafts were recorded. Analysis of variance for comparing the means of multiple groups was used for statistical analysis. Results Among the total 484 patients, 407 were male and 77 were female. The semitendinosus graft diameter did not show any statistical significance to the age and weight of the patient. The mean graft diameter was highest in the 45 to 49-year age group. The average graft diameter in physically active group was 3.704 mm, and 3.503 mm in the inactive group. This and the height of the patient proved to have statistically significant relation with graft diameter. Conclusion Physical activity along with the height of the patient must be taken into due consideration before embarking upon ligament reconstruction with hamstring graft in mind, as these two are found to determine the diameter and length of the hamstring graft.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75078257","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}
C. Gaike, Girish Gadekar, Shraddha Kardile, M. Panat
Abstract Introduction Anterior cervical plating in anterior cervical discectomy and fusion (ACDF) has inherent drawbacks like plate loosening, screw pullout, breakage, trachea-esophageal irritation and fistula, increased operation time, and increased duration of hospital stay. Due to low profile and in-built screw fixation slots, Zero-profile (Zero-P) cages are becoming popular among spine surgeons since they are supposed to minimize drawbacks that are associated with anterior cervical plates. Aims In our study, we evaluated two different fixation methods: (1) anterior cervical plate plus titanium cage and (2) zero-P titanium cages with respect to duration of surgery, length of hospitalization, rate of fusion, and postoperative complications. Materials and Methods This was a comparative prospective observational study with a sample size of 30 patients. Patients with cervical compressive disease (radiculopathy/myelopathy or combined symptoms) who require ACDF and fit in inclusion criteria were divided in two groups: group A—anterior cervical plate and titanium cage and group B—Zero-P titanium. Statistical Analysis Used Mann–Whitney U test was used for the duration of stay, and Student's t -test was used for the duration of surgery. Results C4–5 level was most commonly involved followed by C5–C6 level and C3–C4 level. The mean duration of surgery in group A was 141.3 minutes and group B was 111.3 minutes. The mean duration of stay in group A was 4.40 days and group B was 2.0 days. Two patients in group A and one patient in group B had dysphagia. One each in both groups had developed hoarseness of voice after surgery. Two patients in group A and one in group B had persistent donor site pain till 6 weeks to 2 months. One patient each of both groups had cage subsidence. Almost all patients in both groups achieved fusion by 6 months. Conclusion ACDF with standalone Zero-P cage is equally good. Duration of surgery and duration of stay were shorter in standalone Zero-P cage group. We feel it is good for patients and healthcare since it reduces overall financial burden.
{"title":"Anterior Cervical Discectomy and Fusion—Can a Standalone Zero-Profile Titanium Cage a Better Alternative Option to Traditional Cervical Plate-Titanium Cage Combination?: A Prospective Observational Study","authors":"C. Gaike, Girish Gadekar, Shraddha Kardile, M. Panat","doi":"10.1055/s-0042-1743447","DOIUrl":"https://doi.org/10.1055/s-0042-1743447","url":null,"abstract":"Abstract Introduction Anterior cervical plating in anterior cervical discectomy and fusion (ACDF) has inherent drawbacks like plate loosening, screw pullout, breakage, trachea-esophageal irritation and fistula, increased operation time, and increased duration of hospital stay. Due to low profile and in-built screw fixation slots, Zero-profile (Zero-P) cages are becoming popular among spine surgeons since they are supposed to minimize drawbacks that are associated with anterior cervical plates. Aims In our study, we evaluated two different fixation methods: (1) anterior cervical plate plus titanium cage and (2) zero-P titanium cages with respect to duration of surgery, length of hospitalization, rate of fusion, and postoperative complications. Materials and Methods This was a comparative prospective observational study with a sample size of 30 patients. Patients with cervical compressive disease (radiculopathy/myelopathy or combined symptoms) who require ACDF and fit in inclusion criteria were divided in two groups: group A—anterior cervical plate and titanium cage and group B—Zero-P titanium. Statistical Analysis Used Mann–Whitney U test was used for the duration of stay, and Student's t -test was used for the duration of surgery. Results C4–5 level was most commonly involved followed by C5–C6 level and C3–C4 level. The mean duration of surgery in group A was 141.3 minutes and group B was 111.3 minutes. The mean duration of stay in group A was 4.40 days and group B was 2.0 days. Two patients in group A and one patient in group B had dysphagia. One each in both groups had developed hoarseness of voice after surgery. Two patients in group A and one in group B had persistent donor site pain till 6 weeks to 2 months. One patient each of both groups had cage subsidence. Almost all patients in both groups achieved fusion by 6 months. Conclusion ACDF with standalone Zero-P cage is equally good. Duration of surgery and duration of stay were shorter in standalone Zero-P cage group. We feel it is good for patients and healthcare since it reduces overall financial burden.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"18 1","pages":"012 - 017"},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79127254","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}
Abstract Background Hypoxemic respiratory failure may require high flow O 2 therapy (>15 L/m), which can be delivered using a high-flow nasal cannula (HFNC) device. There are three variables: FiO 2 , flow, and temperature that can be controlled while using HFNC. This study was planned to assess the degree of comfort level of patients at two different temperature settings. Methods A prospective interventional cross-over study was performed on 40 hypoxemic respiratory failure patients, who were on HFNC. Primary outcome was to assess patient comfort during HFNC therapy at two different temperatures (31 and 37°C), at the flow of 60 L/m for 30 minutes at each temperature setting, leaving FiO 2 unchanged. After 30 minutes of each temperature setting, the comfort level was assessed using 11 score visual numerical scale (ranging from 0 to 10) together with other vital parameters. Result Patients were found to be more comfortable at temperature settings of 31°C than at 37°C ( p -value < 0.05%). Also, an increase in blood pressure was observed at 37°C after completion of 30 minutes, which was statistically significant but not clinically significant. Conclusion Starting HFNC therapy at lower temperature gives better patient acceptance and reduces chances of failure due to discomfort.
{"title":"Effect of Two Different Temperature Settings on Patient Comfort Level during Respiratory Therapy by High-Flow Nasal Cannula","authors":"M. Kumari, R. Taneja, Niharika Grover, Megha Soni","doi":"10.1055/s-0042-1745746","DOIUrl":"https://doi.org/10.1055/s-0042-1745746","url":null,"abstract":"Abstract Background Hypoxemic respiratory failure may require high flow O 2 therapy (>15 L/m), which can be delivered using a high-flow nasal cannula (HFNC) device. There are three variables: FiO 2 , flow, and temperature that can be controlled while using HFNC. This study was planned to assess the degree of comfort level of patients at two different temperature settings. Methods A prospective interventional cross-over study was performed on 40 hypoxemic respiratory failure patients, who were on HFNC. Primary outcome was to assess patient comfort during HFNC therapy at two different temperatures (31 and 37°C), at the flow of 60 L/m for 30 minutes at each temperature setting, leaving FiO 2 unchanged. After 30 minutes of each temperature setting, the comfort level was assessed using 11 score visual numerical scale (ranging from 0 to 10) together with other vital parameters. Result Patients were found to be more comfortable at temperature settings of 31°C than at 37°C ( p -value < 0.05%). Also, an increase in blood pressure was observed at 37°C after completion of 30 minutes, which was statistically significant but not clinically significant. Conclusion Starting HFNC therapy at lower temperature gives better patient acceptance and reduces chances of failure due to discomfort.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"308 1","pages":"006 - 011"},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77219792","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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