Pub Date : 2023-07-01DOI: 10.21608/svuijm.2023.208584.1580
Mostafa Zain, S. Shehata, A. Khairi, M. El-Sawaf, Mohamed Abouheba
Background: Laparoscopic pyeloplasty in children gained more and more popularity over the past two decades. However, it remains technically challenging with the most steps of the procedure are ureteric spatulation, DJ insertion, and intracorporeal anastomosis. Many modifications have been proposed to address these issues. In this article, we present our surgical approach to laparoscopic transperitoneal modified dismembered pyeloplasty highlighting some tips to make it easy. Objectives : This study was conducted to evaluate the outcomes of laparoscopic management of ureteropelvic junction obstruction children. Patients and Methods: This was a prospective study carried out on patients who presented with UPJO to our center from May 2019 to October 2021. All the cases underwent laparoscopic transperitoneal modified dismembered pyeloplasty where complete dismembering is deferred after the ureteropelvic anastomosis to prevent ureteral torsion and to use the redundant pelvis as a handle for ureteric manipulation. We used 3 simple techniques for antegrade insertion of DJ. Results: The study included 25 patients (19 males and 6 females) The mean age at operation was 30.88 ± 27.48 months. The mean time needed for the anastomosis was 80 minutes while the mean total operative time was 155 minutes. No conversion was needed. Apart from 2 cases, all other patients showed significant improvement of the degree of hydronephrosis and renal split function. Conclusion: The described modifications facilitated performing the procedure rendering laparoscopic pyeloplasty to be a less demanding and much easier procedure than the conventional technique.
{"title":"Modified Dismembered Technique of Laparoscopic Transperitoneal Pyeloplasty in Children","authors":"Mostafa Zain, S. Shehata, A. Khairi, M. El-Sawaf, Mohamed Abouheba","doi":"10.21608/svuijm.2023.208584.1580","DOIUrl":"https://doi.org/10.21608/svuijm.2023.208584.1580","url":null,"abstract":"Background: Laparoscopic pyeloplasty in children gained more and more popularity over the past two decades. However, it remains technically challenging with the most steps of the procedure are ureteric spatulation, DJ insertion, and intracorporeal anastomosis. Many modifications have been proposed to address these issues. In this article, we present our surgical approach to laparoscopic transperitoneal modified dismembered pyeloplasty highlighting some tips to make it easy. Objectives : This study was conducted to evaluate the outcomes of laparoscopic management of ureteropelvic junction obstruction children. Patients and Methods: This was a prospective study carried out on patients who presented with UPJO to our center from May 2019 to October 2021. All the cases underwent laparoscopic transperitoneal modified dismembered pyeloplasty where complete dismembering is deferred after the ureteropelvic anastomosis to prevent ureteral torsion and to use the redundant pelvis as a handle for ureteric manipulation. We used 3 simple techniques for antegrade insertion of DJ. Results: The study included 25 patients (19 males and 6 females) The mean age at operation was 30.88 ± 27.48 months. The mean time needed for the anastomosis was 80 minutes while the mean total operative time was 155 minutes. No conversion was needed. Apart from 2 cases, all other patients showed significant improvement of the degree of hydronephrosis and renal split function. Conclusion: The described modifications facilitated performing the procedure rendering laparoscopic pyeloplasty to be a less demanding and much easier procedure than the conventional technique.","PeriodicalId":34789,"journal":{"name":"SVU International Journal of Medical Sciences","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85120772","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 : 2023-07-01DOI: 10.21608/svuijm.2023.215175.1601
S. Simanjuntak, Erwin Pradian, Ricky Aditya
Background: Overdoses with cardiovascular-active drugs are associated with significant morbidity and mortality. Intoxications involving multiple antiarrhythmic agents have been documented in several case reports, yet an instance of intentional overdose with three varieties of antiarrhythmics concomitant with simvastatin has not been previously reported. We report a rare case of severe toxicity from combined overdose of verapamil, atenolol, propafenone, and simvastatin, leading to resistant hypotension and total AV block. Case report: A 25-year-old male patient was brought to the Emergency Department (ED) with decreased consciousness and vomiting following a suicide attempt. He had a documented medical history of depression but had not previously attempted suicide. Laboratory findings indicated metabolic acidosis, severe hypoxemia, acute kidney injury (AKI) and elevated liver enzymes. Prompt resuscitation measures, including high-dose inotropic infusions and intensive care unit (ICU) admission, were initiated. Hemodialysis led to significant improvement, and successful extubation was achieved on the second day of ICU care. Through aggressive medical intervention, the patient's hemodynamic status normalized, negating the need for a pacemaker. He was extubated on ICU day two and discharged on day eight. Conclusion: This case underscores the clinical challenges associated with polypharmacy overdoses, their potential cardiac complications, and the crucial importance of aggressive and early intervention strategies.
{"title":"Severe Toxicity Following Combined Overdose of Verapamil, Atenolol, Propafenone, and Simvastatin in a Suicidal Attempt: A case study","authors":"S. Simanjuntak, Erwin Pradian, Ricky Aditya","doi":"10.21608/svuijm.2023.215175.1601","DOIUrl":"https://doi.org/10.21608/svuijm.2023.215175.1601","url":null,"abstract":"Background: Overdoses with cardiovascular-active drugs are associated with significant morbidity and mortality. Intoxications involving multiple antiarrhythmic agents have been documented in several case reports, yet an instance of intentional overdose with three varieties of antiarrhythmics concomitant with simvastatin has not been previously reported. We report a rare case of severe toxicity from combined overdose of verapamil, atenolol, propafenone, and simvastatin, leading to resistant hypotension and total AV block. Case report: A 25-year-old male patient was brought to the Emergency Department (ED) with decreased consciousness and vomiting following a suicide attempt. He had a documented medical history of depression but had not previously attempted suicide. Laboratory findings indicated metabolic acidosis, severe hypoxemia, acute kidney injury (AKI) and elevated liver enzymes. Prompt resuscitation measures, including high-dose inotropic infusions and intensive care unit (ICU) admission, were initiated. Hemodialysis led to significant improvement, and successful extubation was achieved on the second day of ICU care. Through aggressive medical intervention, the patient's hemodynamic status normalized, negating the need for a pacemaker. He was extubated on ICU day two and discharged on day eight. Conclusion: This case underscores the clinical challenges associated with polypharmacy overdoses, their potential cardiac complications, and the crucial importance of aggressive and early intervention strategies.","PeriodicalId":34789,"journal":{"name":"SVU International Journal of Medical Sciences","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83493662","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 : 2023-07-01DOI: 10.21608/svuijm.2023.188757.1498
R. Saleh, B. Eldeeb
{"title":"Post-COVID-19 pulmonary changes: A retrospective study of 72 patients based upon chest computed tomography findings","authors":"R. Saleh, B. Eldeeb","doi":"10.21608/svuijm.2023.188757.1498","DOIUrl":"https://doi.org/10.21608/svuijm.2023.188757.1498","url":null,"abstract":"","PeriodicalId":34789,"journal":{"name":"SVU International Journal of Medical Sciences","volume":"124 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87958540","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 : 2023-06-19DOI: 10.21608/svuijm.2023.213737.1597
Mostafa Ahmed AbdelRahman Mahmoud, W. Hassanein, Ahmed Saleh Abo El Kassem, M. Zaki
Background : Coronary artery bypass graft surgery (CABG) is considered the most performed cardiac surgery nowadays. The outcome of CABG surgery has been linked to several aspects. Above all is graft patency which is a crucial element contributing to success of the surgery. Early graft failure following CABG has been recorded in up to 12% of grafts (left IMA 7%; saphenous vein graft 8%). Objectives: The aim of the present study was to determine the efficacy and feasibility of the endovascular visualization to detect anastomotic errors. Patients and methods: The study included 40 patients who presented with CAD and were candidates for coronary artery bypass grafting (CABG). All anastomoses were assessed using 1.9 mm telescope and endovascular visualisation score was recorded followed by routine assessment of grafts quality using transient time flow meter. Results: In this prospective cross-sectional study, we included a total of forty patients who underwent CABG which enabled intraoperative assessment of the quality of 70 venous grafts. There is a statistically significant correlation between the endovascular visual score and the mean flow across the OM and RCA grafts. For the Diagonal grafts , the correlation was less evident due to the small sample number. Conclusion: Coronary angioscopy is a simple and safe procedure and provides clinically relevant information. It provides immediate control of anastomotic quality and it can assist in the assessment of the native coronary artery. Together with transient time flowmeter, it provides a new alternative for the quality control of CABG surgery.
{"title":"Revival of Endovascular Visual Assessment of Anastomotic Patency in Coronary Artery Bypass Graft Surgery","authors":"Mostafa Ahmed AbdelRahman Mahmoud, W. Hassanein, Ahmed Saleh Abo El Kassem, M. Zaki","doi":"10.21608/svuijm.2023.213737.1597","DOIUrl":"https://doi.org/10.21608/svuijm.2023.213737.1597","url":null,"abstract":"Background : Coronary artery bypass graft surgery (CABG) is considered the most performed cardiac surgery nowadays. The outcome of CABG surgery has been linked to several aspects. Above all is graft patency which is a crucial element contributing to success of the surgery. Early graft failure following CABG has been recorded in up to 12% of grafts (left IMA 7%; saphenous vein graft 8%). Objectives: The aim of the present study was to determine the efficacy and feasibility of the endovascular visualization to detect anastomotic errors. Patients and methods: The study included 40 patients who presented with CAD and were candidates for coronary artery bypass grafting (CABG). All anastomoses were assessed using 1.9 mm telescope and endovascular visualisation score was recorded followed by routine assessment of grafts quality using transient time flow meter. Results: In this prospective cross-sectional study, we included a total of forty patients who underwent CABG which enabled intraoperative assessment of the quality of 70 venous grafts. There is a statistically significant correlation between the endovascular visual score and the mean flow across the OM and RCA grafts. For the Diagonal grafts , the correlation was less evident due to the small sample number. Conclusion: Coronary angioscopy is a simple and safe procedure and provides clinically relevant information. It provides immediate control of anastomotic quality and it can assist in the assessment of the native coronary artery. Together with transient time flowmeter, it provides a new alternative for the quality control of CABG surgery.","PeriodicalId":34789,"journal":{"name":"SVU International Journal of Medical Sciences","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90204011","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 : 2023-04-06DOI: 10.21608/svuijm.2023.199049.1550
M. Hussien, H. A. Dardeer, M. Ali, A. Nafady
{"title":"Diagnostic Value of Upper and Lower Endoscopy in Assessment of Patients with Microcytic Hypochromic Anaemia without Site-specific Gastrointestinal Manifestations","authors":"M. Hussien, H. A. Dardeer, M. Ali, A. Nafady","doi":"10.21608/svuijm.2023.199049.1550","DOIUrl":"https://doi.org/10.21608/svuijm.2023.199049.1550","url":null,"abstract":"","PeriodicalId":34789,"journal":{"name":"SVU International Journal of Medical Sciences","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88021612","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 : 2023-01-19DOI: 10.21608/svuijm.2023.173817.1456
Siphesihle Mbatha, V. Ramloutan, C. Aldous
{"title":"The high prevalence of muscle invasive disease among bladder cancer patients attending a regional hospital in Durban, South Africa","authors":"Siphesihle Mbatha, V. Ramloutan, C. Aldous","doi":"10.21608/svuijm.2023.173817.1456","DOIUrl":"https://doi.org/10.21608/svuijm.2023.173817.1456","url":null,"abstract":"","PeriodicalId":34789,"journal":{"name":"SVU International Journal of Medical Sciences","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84421108","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 : 2023-01-10DOI: 10.21608/svuijm.2023.183640.1482
Islam A. Shaboob, A. Dawood
Background: Surgical stress is aggravated by anesthesia especially opioid-based anesthesia. Epidural anesthesia (EA) was previously found to modulate the immune response. Bupivacaine (BUP) may suffice as anesthetic but adjuvant might increase this and possibly may modulate the stress response Objectives: Evaluation of the effects of dexmedetomidine (DEX), fentanyl (FEN), or tramadol (TRM) as adjuvants to BUP-EA on anesthetic outcomes and serum levels of interleukin (IL)-6, IL-1β and Tumor necrosis factor-α (TNF - α) during varicose vein surgery. Patients and methods : 120 patients received single-shoot BUP 0.5% EA alone or with 25, 50 and 100 µg of DEX, FEN and TRM, respectively. Blood samples were obtained at start (T1) and end of surgery (T2) and 24-h postoperative (PO) (T3) for ELISA estimations of cytokines' levels. Study outcomes include the effect of adjuvants on anesthetic outcome and serum cytokines. Results : Adjuvants significantly fastened
{"title":"Dexmedetomidine overrides Fentanyl and Tramadol as Epidural Adjuvant for its advantageous Anesthetic Outcomes and Immunomodulatory effects","authors":"Islam A. Shaboob, A. Dawood","doi":"10.21608/svuijm.2023.183640.1482","DOIUrl":"https://doi.org/10.21608/svuijm.2023.183640.1482","url":null,"abstract":"Background: Surgical stress is aggravated by anesthesia especially opioid-based anesthesia. Epidural anesthesia (EA) was previously found to modulate the immune response. Bupivacaine (BUP) may suffice as anesthetic but adjuvant might increase this and possibly may modulate the stress response Objectives: Evaluation of the effects of dexmedetomidine (DEX), fentanyl (FEN), or tramadol (TRM) as adjuvants to BUP-EA on anesthetic outcomes and serum levels of interleukin (IL)-6, IL-1β and Tumor necrosis factor-α (TNF - α) during varicose vein surgery. Patients and methods : 120 patients received single-shoot BUP 0.5% EA alone or with 25, 50 and 100 µg of DEX, FEN and TRM, respectively. Blood samples were obtained at start (T1) and end of surgery (T2) and 24-h postoperative (PO) (T3) for ELISA estimations of cytokines' levels. Study outcomes include the effect of adjuvants on anesthetic outcome and serum cytokines. Results : Adjuvants significantly fastened","PeriodicalId":34789,"journal":{"name":"SVU International Journal of Medical Sciences","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80115863","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 : 2023-01-01DOI: 10.21608/svuijm.2022.145271.1324
R. Agrawal, A. Baghel, Harshul Patidar, P. Akhani
Background: Medical students are the most affected psychologicallyduring COVID-19 pandemic in India. Psychological impact (depression, anxiety and stress) were mild to severe in nature. Objectives: Objective of the current study is the assessmentof psychological impact of COVID-19pandemic on medical students of Madhya Pradesh, India. Patients and methods : A cross section web based online survey was used for data collection in different medical colleges of Madhya Pradesh. Socio-demographic, COVID-19 related questionnaires and DASS (Depression, anxiety and stress) scale wereused for determining the degree of depression, anxiety and stress among medical students. Data was analyzed statically using SPSS 22 and Chi-Square test. Results: A total of 717 medical students of different medical colleges of Madhya Pradesh participate in this survey. Psychological impact (depression, anxiety and stress score)was observed in 34 to 47 % ranging from mild to severe in nature.Depression and anxiety was found in 46.7% of patients and stress in 34.3%.Female participants have more psychological impact than male. Conclusions : COVID-19 pandemic significantly impact the mental health of the medical students.
{"title":"Psychological impact of COVID-19 pandemic on medical students of Madhya Pradesh, India","authors":"R. Agrawal, A. Baghel, Harshul Patidar, P. Akhani","doi":"10.21608/svuijm.2022.145271.1324","DOIUrl":"https://doi.org/10.21608/svuijm.2022.145271.1324","url":null,"abstract":"Background: Medical students are the most affected psychologicallyduring COVID-19 pandemic in India. Psychological impact (depression, anxiety and stress) were mild to severe in nature. Objectives: Objective of the current study is the assessmentof psychological impact of COVID-19pandemic on medical students of Madhya Pradesh, India. Patients and methods : A cross section web based online survey was used for data collection in different medical colleges of Madhya Pradesh. Socio-demographic, COVID-19 related questionnaires and DASS (Depression, anxiety and stress) scale wereused for determining the degree of depression, anxiety and stress among medical students. Data was analyzed statically using SPSS 22 and Chi-Square test. Results: A total of 717 medical students of different medical colleges of Madhya Pradesh participate in this survey. Psychological impact (depression, anxiety and stress score)was observed in 34 to 47 % ranging from mild to severe in nature.Depression and anxiety was found in 46.7% of patients and stress in 34.3%.Female participants have more psychological impact than male. Conclusions : COVID-19 pandemic significantly impact the mental health of the medical students.","PeriodicalId":34789,"journal":{"name":"SVU International Journal of Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75310531","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 : 2023-01-01DOI: 10.21608/svuijm.2022.172130.1442
Shymaa Sayed Salem, Khaled Hussein, M. Badawy, G. Gad, A. Rashad
{"title":"The effects of biphasic positive airway pressure in patients with chronic obstructive pulmonary disease: A comparative study","authors":"Shymaa Sayed Salem, Khaled Hussein, M. Badawy, G. Gad, A. Rashad","doi":"10.21608/svuijm.2022.172130.1442","DOIUrl":"https://doi.org/10.21608/svuijm.2022.172130.1442","url":null,"abstract":"","PeriodicalId":34789,"journal":{"name":"SVU International Journal of Medical Sciences","volume":"52 58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80415288","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":"Malignant Melanoma – A Single Institutional Analysis On Real World Data","authors":"Sakthi Usha Devi J, Prasanna Srinivasa Rao H, Balamurugan T.D, Muhammed Owaise J","doi":"10.21608/svuijm.2023.199868.1552","DOIUrl":"https://doi.org/10.21608/svuijm.2023.199868.1552","url":null,"abstract":"","PeriodicalId":34789,"journal":{"name":"SVU International Journal of Medical Sciences","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88111546","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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