Pub Date : 2023-03-01DOI: 10.4103/jmedsci.jmedsci_11_22
Arnab Das, Kunal Tiwari, S. Sharma, Shalendra Singh, S. Patnaik, Nimish Gaur
Background: Among the regional anesthesia techniques used for postoperative analgesia for lower abdominal surgeries, epidural analgesia (EA) has been the gold standard and time-tested technique, but complications and contraindications for the same warrant the need for other equally good analgesic techniques. Aim: The present study compared posterior transversus abdominis plane (TAP) block to EA for postoperative analgesic efficacy in patients undergoing lower abdominal surgeries. Methods: Prospective, observational study in patients undergoing lower abdominal surgeries under general anesthesia. Patients received ultrasound-guided (USG) 20 ml 0.2% ropivacaine each side in TAP block (Group A, n = 50) or 10 ml of 0.2% ropivacaine was administered in epidural (Group B; n = 50) before extubation. The Visual analog scale (VAS) score, hemodynamic parameters, and ill effects were recorded. Results: The blood pressure was significantly lower in first 6 h of block in Group B. VAS score was significantly lower in Group A in first 6 h of surgery. It was observed that a significantly higher number of patients in the Group B required rescue analgesic and at higher dosages. Postoperative nausea and vomiting were found in 32% of Group B and 22% of Group A patients. Conclusion: TAP block has almost no complications, keeps the patient more hemodynamically stable, and offers a better early postoperative analgesia when compared to EA in patients undergoing lower abdominal surgeries.
背景:在用于下腹部手术术后镇痛的区域麻醉技术中，硬膜外镇痛(EA)一直是金标准和经过时间考验的技术，但其并发症和禁忌症证明需要其他同样好的镇痛技术。目的:比较后腹横面阻滞与EA对下腹部手术患者术后镇痛效果的影响。方法:对全麻下腹部手术患者进行前瞻性观察性研究。患者在超声引导下(USG)在TAP阻滞中每侧给予0.2%罗哌卡因20 ml (A组，n = 50)或硬膜外给予0.2%罗哌卡因10 ml (B组;N = 50)拔管前。记录视觉模拟评分(VAS)、血流动力学参数及不良反应。结果:b组患者手术前6小时血压明显降低，A组患者手术前6小时VAS评分明显降低。我们观察到，B组患者需要更高剂量的抢救性镇痛药的人数明显增加。术后恶心呕吐发生率为32%，A组为22%。结论:与EA相比，TAP阻滞几乎没有并发症，使患者血流动力学更稳定，并能提供更好的术后早期镇痛。
{"title":"Ultrasound-guided posterior transversus abdominis plane block versus epidural analgesia for postoperative pain relief in lower abdominal surgeries","authors":"Arnab Das, Kunal Tiwari, S. Sharma, Shalendra Singh, S. Patnaik, Nimish Gaur","doi":"10.4103/jmedsci.jmedsci_11_22","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_11_22","url":null,"abstract":"Background: Among the regional anesthesia techniques used for postoperative analgesia for lower abdominal surgeries, epidural analgesia (EA) has been the gold standard and time-tested technique, but complications and contraindications for the same warrant the need for other equally good analgesic techniques. Aim: The present study compared posterior transversus abdominis plane (TAP) block to EA for postoperative analgesic efficacy in patients undergoing lower abdominal surgeries. Methods: Prospective, observational study in patients undergoing lower abdominal surgeries under general anesthesia. Patients received ultrasound-guided (USG) 20 ml 0.2% ropivacaine each side in TAP block (Group A, n = 50) or 10 ml of 0.2% ropivacaine was administered in epidural (Group B; n = 50) before extubation. The Visual analog scale (VAS) score, hemodynamic parameters, and ill effects were recorded. Results: The blood pressure was significantly lower in first 6 h of block in Group B. VAS score was significantly lower in Group A in first 6 h of surgery. It was observed that a significantly higher number of patients in the Group B required rescue analgesic and at higher dosages. Postoperative nausea and vomiting were found in 32% of Group B and 22% of Group A patients. Conclusion: TAP block has almost no complications, keeps the patient more hemodynamically stable, and offers a better early postoperative analgesia when compared to EA in patients undergoing lower abdominal surgeries.","PeriodicalId":39900,"journal":{"name":"Journal of Medical Sciences (Taiwan)","volume":"43 1","pages":"74 - 78"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45019276","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 : 2023-03-01DOI: 10.4103/jmedsci.jmedsci_356_21
Mu‐Hsien Yu, Chia-Teng Chang, Yi-Hsin Lin, Kuo-Min Su
Leiomyomatosis peritonealisis disseminata (LPD) is a rare benign tumor characterized by the dissemination of smooth muscle-like cell nodules within the peritoneal cavity. Diagnosing LPD is challenging for clinicians due to its nonspecific clinical presentation and its dissemination throughout the peritoneal cavity, which mimics intra-abdominal malignancy. In the present study, we present the case of a 47-year-old woman with severe abdominal pain and fever initially diagnosed with intra-abdominal abscess or peritoneal carcinomatosis. Exploratory laparotomy was performed to resect several leiomyoma-like tumors in the subperitoneal space. LPD was confirmed histopathologically.
{"title":"Leiomyomatosis peritonealisis disseminata resembling intra-abdominal malignancy","authors":"Mu‐Hsien Yu, Chia-Teng Chang, Yi-Hsin Lin, Kuo-Min Su","doi":"10.4103/jmedsci.jmedsci_356_21","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_356_21","url":null,"abstract":"Leiomyomatosis peritonealisis disseminata (LPD) is a rare benign tumor characterized by the dissemination of smooth muscle-like cell nodules within the peritoneal cavity. Diagnosing LPD is challenging for clinicians due to its nonspecific clinical presentation and its dissemination throughout the peritoneal cavity, which mimics intra-abdominal malignancy. In the present study, we present the case of a 47-year-old woman with severe abdominal pain and fever initially diagnosed with intra-abdominal abscess or peritoneal carcinomatosis. Exploratory laparotomy was performed to resect several leiomyoma-like tumors in the subperitoneal space. LPD was confirmed histopathologically.","PeriodicalId":39900,"journal":{"name":"Journal of Medical Sciences (Taiwan)","volume":"43 1","pages":"87 - 89"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45529137","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 : 2023-03-01DOI: 10.4103/jmedsci.jmedsci_304_21
Yu‐Xuan Jiang, P. Hsu, Chien-Sung Tsai, Chih-Yuan Lin
Vasoplegic syndrome (VS) is characterized by low systemic vascular resistance paired with relatively preserved cardiac output that may result in increased morbidity and mortality rate after open-heart surgery utilizing cardiopulmonary bypass. We report a case of a 61-year-old male who underwent redo open-heart surgery due to a paravalvular leak of the previous implanted mitral bioprosthesis and severe tricuspid regurgitation. The patient experienced the VS in the intensive care unit after the operation. He was resuscitated by vasopressors and recovered uneventfully.
{"title":"Vasoplegic syndrome after cardiopulmonary bypass for paravalvular leak of mitral bioprosthesis","authors":"Yu‐Xuan Jiang, P. Hsu, Chien-Sung Tsai, Chih-Yuan Lin","doi":"10.4103/jmedsci.jmedsci_304_21","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_304_21","url":null,"abstract":"Vasoplegic syndrome (VS) is characterized by low systemic vascular resistance paired with relatively preserved cardiac output that may result in increased morbidity and mortality rate after open-heart surgery utilizing cardiopulmonary bypass. We report a case of a 61-year-old male who underwent redo open-heart surgery due to a paravalvular leak of the previous implanted mitral bioprosthesis and severe tricuspid regurgitation. The patient experienced the VS in the intensive care unit after the operation. He was resuscitated by vasopressors and recovered uneventfully.","PeriodicalId":39900,"journal":{"name":"Journal of Medical Sciences (Taiwan)","volume":"43 1","pages":"84 - 86"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44117157","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}
Delusional infestation has been described since 1894. The variety of treatments of delusional infestation has been administered in different atypical antipsychotic agents. Here, we present a case of first treatment with lurasidone on the delusional infestation in a 68-year-old female with vascular dementia, and the literature reviews of the related delusion infestation management.
{"title":"Lurasidone treatment for delusional infestation in a patient with dementia","authors":"Yu-Ning Her, Hsin-An Chang, Fang Wan, Nian-Sheng Tzeng","doi":"10.4103/jmedsci.jmedsci_410_20","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_410_20","url":null,"abstract":"Delusional infestation has been described since 1894. The variety of treatments of delusional infestation has been administered in different atypical antipsychotic agents. Here, we present a case of first treatment with lurasidone on the delusional infestation in a 68-year-old female with vascular dementia, and the literature reviews of the related delusion infestation management.","PeriodicalId":39900,"journal":{"name":"Journal of Medical Sciences (Taiwan)","volume":"43 1","pages":"79 - 83"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49112698","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}
Background: Surgical intervention is important for acute appendicitis. Perforated appendicitis leads to more complications and is more difficult to manage. Studies differentiating ruptured from nonruptured appendicitis are controversial. Aim: Early identification of perforated appendicitis is important for first-line medical practitioners. Our study aimed to provide more indicators to evaluate the risk of perforation before surgery. Methods: This retrospective study included 116 patients who underwent an appendectomy at the Tri-Service General Hospital between 2014 and 2018 with pathological diagnosis. Based on the surgical records, the patients were classified into two groups: simple (nonperforation) and complicated (perforation). Results: The patients (68 boys, 48 girls) were all under 18 years of age. Simple appendicitis was diagnosed in 87 patients and perforated appendicitis in 29 patients. Analysis revealed significant differences in blood C-reactive protein (CRP) levels between the two groups. The highest Youden's index was at a CRP level of 1.755 mg/dL. Positive findings were obtained for suppurative change as well as chylous ascites. Conclusion: Elevated CRP level was found to be a useful biomarker in predicting perforated appendicitis, excluding other general factors in pediatric patients. Suppurative change and chylous ascites could serve as indicators for the possibility of perforation during surgery.
{"title":"C-reactive protein as a potential effective predictor of perforated appendicitis in pediatric patients","authors":"Chia-Wei Chang, Shyi-Jou Chen, Der-shiun Wang, Chih-Hsiung Hsu, Wan-Fu Hsu","doi":"10.4103/jmedsci.jmedsci_349_21","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_349_21","url":null,"abstract":"Background: Surgical intervention is important for acute appendicitis. Perforated appendicitis leads to more complications and is more difficult to manage. Studies differentiating ruptured from nonruptured appendicitis are controversial. Aim: Early identification of perforated appendicitis is important for first-line medical practitioners. Our study aimed to provide more indicators to evaluate the risk of perforation before surgery. Methods: This retrospective study included 116 patients who underwent an appendectomy at the Tri-Service General Hospital between 2014 and 2018 with pathological diagnosis. Based on the surgical records, the patients were classified into two groups: simple (nonperforation) and complicated (perforation). Results: The patients (68 boys, 48 girls) were all under 18 years of age. Simple appendicitis was diagnosed in 87 patients and perforated appendicitis in 29 patients. Analysis revealed significant differences in blood C-reactive protein (CRP) levels between the two groups. The highest Youden's index was at a CRP level of 1.755 mg/dL. Positive findings were obtained for suppurative change as well as chylous ascites. Conclusion: Elevated CRP level was found to be a useful biomarker in predicting perforated appendicitis, excluding other general factors in pediatric patients. Suppurative change and chylous ascites could serve as indicators for the possibility of perforation during surgery.","PeriodicalId":39900,"journal":{"name":"Journal of Medical Sciences (Taiwan)","volume":"43 1","pages":"51 - 55"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49301415","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 : 2023-03-01DOI: 10.4103/jmedsci.jmedsci_38_22
C. Lin, Meng-Hung Shih, C. Tsao
Intrauterine devices (IUDs) are one of the most popular reversible contraception methods. However, if an event related to them is unanticipated, or if they are not located when missing, it can be dangerous. We present a case of chronic lower abdomen pain and recurrent urinary tract infection ongoing for 1.5 years. Despite the patient undergoing laparoscopic uterine myomectomy, her symptoms had not improved. The patient visited a genitourinary clinic for lower urinary tract symptoms and accepted cystoscopy and electrohydraulic lithotomy. Incidentally, a part of an IUD was found in the calculus. This case highlights the need for careful diagnosis and for locating missing IUDs to avoid serious complications.
{"title":"The migrated intrauterine contraceptive device presented as a vesical stone","authors":"C. Lin, Meng-Hung Shih, C. Tsao","doi":"10.4103/jmedsci.jmedsci_38_22","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_38_22","url":null,"abstract":"Intrauterine devices (IUDs) are one of the most popular reversible contraception methods. However, if an event related to them is unanticipated, or if they are not located when missing, it can be dangerous. We present a case of chronic lower abdomen pain and recurrent urinary tract infection ongoing for 1.5 years. Despite the patient undergoing laparoscopic uterine myomectomy, her symptoms had not improved. The patient visited a genitourinary clinic for lower urinary tract symptoms and accepted cystoscopy and electrohydraulic lithotomy. Incidentally, a part of an IUD was found in the calculus. This case highlights the need for careful diagnosis and for locating missing IUDs to avoid serious complications.","PeriodicalId":39900,"journal":{"name":"Journal of Medical Sciences (Taiwan)","volume":"43 1","pages":"93 - 96"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45990878","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}
Vid Velikić, Mosad Zineldin, Ivana Dabovic, F. Mokhtar
{"title":"The Effect of Integrated Cognitive Behavioral Therapy on Clinical Decision Making for Patients with Depression and Anxiety","authors":"Vid Velikić, Mosad Zineldin, Ivana Dabovic, F. Mokhtar","doi":"10.3923/jms.2023.38.44","DOIUrl":"https://doi.org/10.3923/jms.2023.38.44","url":null,"abstract":"","PeriodicalId":39900,"journal":{"name":"Journal of Medical Sciences (Taiwan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46038086","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}
Misbah Salam, M. Rana, P. Baral, M. Rahman, Shehreen Ahmed, Rubiya Rahman, Nusaiba Jahan, Tanoy Mazumder, M. Islam, M. Hussain
{"title":"Glipizide has Low Influences on Lipid Index and Major Organs Weight Variation and Considerable Anxiolytic Properties: An in vivo Investigation","authors":"Misbah Salam, M. Rana, P. Baral, M. Rahman, Shehreen Ahmed, Rubiya Rahman, Nusaiba Jahan, Tanoy Mazumder, M. Islam, M. Hussain","doi":"10.3923/jms.2023.7.17","DOIUrl":"https://doi.org/10.3923/jms.2023.7.17","url":null,"abstract":"","PeriodicalId":39900,"journal":{"name":"Journal of Medical Sciences (Taiwan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45793662","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}
A. Kayode, S. Adrish, A. Muhammad, R. Amin, D. Muhammad, Z. Rida, G. O. Alabi, G. F. Okumede, O. Kayode
{"title":"Therapeutic Uses of Medical Cannabis: An Overview of its Functions in Disease Management","authors":"A. Kayode, S. Adrish, A. Muhammad, R. Amin, D. Muhammad, Z. Rida, G. O. Alabi, G. F. Okumede, O. Kayode","doi":"10.3923/jms.2023.32.39","DOIUrl":"https://doi.org/10.3923/jms.2023.32.39","url":null,"abstract":"","PeriodicalId":39900,"journal":{"name":"Journal of Medical Sciences (Taiwan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48020109","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}
A. Omar, Adel Taha, Praveen C Sivadasan, Mohamed Abdelmonem Khalil, Tamer Elmetwally Farhat
{"title":"Nosocomial Diarrhea in Intensive Care Units: A Mortality-Based Bacteriological Study","authors":"A. Omar, Adel Taha, Praveen C Sivadasan, Mohamed Abdelmonem Khalil, Tamer Elmetwally Farhat","doi":"10.3923/jms.2023.32.37","DOIUrl":"https://doi.org/10.3923/jms.2023.32.37","url":null,"abstract":"","PeriodicalId":39900,"journal":{"name":"Journal of Medical Sciences (Taiwan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48454365","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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