Pub Date : 2023-09-01DOI: 10.1016/j.ijso.2023.100661
L.V. Simhachalam Kutikuppala, Siva Santosh K. Pentapati, Venkataramana Kandi, Snehasish Mishra, Ranjan K. Mohapatra, Aroop Mohanty, Ranjit Sah
{"title":"Surgical intervention to treat neglected tropical diseases (NTDs): Caring for the neglected","authors":"L.V. Simhachalam Kutikuppala, Siva Santosh K. Pentapati, Venkataramana Kandi, Snehasish Mishra, Ranjan K. Mohapatra, Aroop Mohanty, Ranjit Sah","doi":"10.1016/j.ijso.2023.100661","DOIUrl":"10.1016/j.ijso.2023.100661","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"58 ","pages":"Article 100661"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45475325","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 : 2023-09-01DOI: 10.1016/j.ijso.2023.100678
Van Thuong Pham , Ngoc Son Vu , Huu Doan Hoang , Minh-Tung Do
Purpose
Several home made glove ports for single-incision laparoscopic cholecystectomy (SILC) has been proposed but no comparison in surgical outcomes with conventional laparoscopic cholecystectomy (CLC) was made. Therefore, we aimed to compare the outcomes of SILC using a totally homemade glove port versus CLC.
Methods
This cross-sectional study compared the surgical outcomes between 90 patients, who underwent SILC and 123 patients who underwent CLC. Patients with acute cholecystitis grade 3 according to the Tokyo Guidelines 2018, body mass index ≥30, and previous abdominal surgeries were excluded. Totally homemade glove port was made of a small and a big rubber ring and a surgical glove to creat the wound retractor. Trocars were inserted into the glove's fingers.
Results
The proportion of patients with acute cholecystitis was lower in the SILC group (7.78%) than in CLC (21.79%). Intraoperative complication rate, the prevalence of additional trocar or conversion to open surgery, success rate, and postoperative complication rate were similar between the two groups. However, SILC showed a significantly longer operative time (62.9 ± 25.1 verus 50.4 ± 20.7 min) and lower postoperative pain than CLC. The discrepancy in operative time was more likely to be remarkable in acute cholecystitis (50.43 min) compared with symptomatic cholelithiasis (14.28 min).
Conclusions
The SILC using a totally homemade glove port is feasible and safe compared with the CLC. However, in the case of acute cholecystitis, SILC should be indicated with caution because of the longer operative time than CLC.
{"title":"Single-incision laparoscopic cholecystectomy using totally homemade glove port versus conventional laparoscopic approach: A cross-sectional study in a developing country","authors":"Van Thuong Pham , Ngoc Son Vu , Huu Doan Hoang , Minh-Tung Do","doi":"10.1016/j.ijso.2023.100678","DOIUrl":"https://doi.org/10.1016/j.ijso.2023.100678","url":null,"abstract":"<div><h3>Purpose</h3><p>Several home made glove ports for single-incision laparoscopic cholecystectomy (SILC) has been proposed but no comparison in surgical outcomes with conventional laparoscopic cholecystectomy (CLC) was made. Therefore, we aimed to compare the outcomes of SILC using a totally homemade glove port versus CLC.</p></div><div><h3>Methods</h3><p>This cross-sectional study compared the surgical outcomes between 90 patients, who underwent SILC and 123 patients who underwent CLC. Patients with acute cholecystitis grade 3 according to the Tokyo Guidelines 2018, body mass index ≥30, and previous abdominal surgeries were excluded. Totally homemade glove port was made of a small and a big rubber ring and a surgical glove to creat the wound retractor. Trocars were inserted into the glove's fingers.</p></div><div><h3>Results</h3><p>The proportion of patients with acute cholecystitis was lower in the SILC group (7.78%) than in CLC (21.79%). Intraoperative complication rate, the prevalence of additional trocar or conversion to open surgery, success rate, and postoperative complication rate were similar between the two groups. However, SILC showed a significantly longer operative time (62.9 ± 25.1 verus 50.4 ± 20.7 min) and lower postoperative pain than CLC. The discrepancy in operative time was more likely to be remarkable in acute cholecystitis (50.43 min) compared with symptomatic cholelithiasis (14.28 min).</p></div><div><h3>Conclusions</h3><p>The SILC using a totally homemade glove port is feasible and safe compared with the CLC. However, in the case of acute cholecystitis, SILC should be indicated with caution because of the longer operative time than CLC.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"58 ","pages":"Article 100678"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49868855","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 : 2023-09-01DOI: 10.1016/j.ijso.2023.100656
Quach Van Kien , Quynh Lien Dam , Quang Hieu Tong , Quang Thai Pham , Đuc An Thai , Vu Hong Tuan
Introduction and importance
Ectopic pregnancy can occur in many locations such as the fallopian tube, cervical, ovary or the abdomen. Splenic ectopic pregnancy (SEP) which is rarely reported in the literature, is a very dangerous condition because the spleen capsule is very thin and the spleen parenchyma is rich in blood vessels.
Presentation of case
A 40-year-old woman, gravida 2, Para 2, had not menstruated for 37 days, presented in the emergency department with a chief complaint of vaginal bleeding and mild hypogastric pain for 1 week. Her serum Beta-human gonadotropin (β-HCG) level was 34279 IU/L. Abdominal ultrasound demonstrated a homogeneous echogenic structure in the upper pole parenchyma of the spleen, measuring 46 × 48 mm in diameter, containing the gestational sac and embryonal heart rate. Magnetic resonance imaging revealed a mass located in the upper pole of the spleen. Partial splenectomy was successfully and safely performed.
Clinical discussion
Surgical treatment of SEP is indicated for symptomatic or having a fetal heart rate or an elevated β-HCG level >30000 IU/L. The surgical methods are total splenectomy, laparoscopically injecting Methotrexate. This is the first case of partial splenectomy in the treatment of SEP.
Conclusion
Diagnosis of splenic ectopic pregnancy is mainly based on clinical and abdominal ultrasound. MRI may be indicated in cases when the patient arrives early and helps to identify the location of the lesion. Partial splenectomy is indicated when the ectopic pregnancy mass is located at one splenic pole.
{"title":"Emergency partial splenectomy for splenic ectopic pregnancy: A rare case report","authors":"Quach Van Kien , Quynh Lien Dam , Quang Hieu Tong , Quang Thai Pham , Đuc An Thai , Vu Hong Tuan","doi":"10.1016/j.ijso.2023.100656","DOIUrl":"10.1016/j.ijso.2023.100656","url":null,"abstract":"<div><h3>Introduction and importance</h3><p>Ectopic pregnancy can occur in many locations such as the fallopian tube, cervical, ovary or the abdomen. Splenic ectopic pregnancy (SEP) which is rarely reported in the literature, is a very dangerous condition because the spleen capsule is very thin and the spleen parenchyma is rich in blood vessels.</p></div><div><h3>Presentation of case</h3><p>A 40-year-old woman, gravida 2, Para 2, had not menstruated for 37 days, presented in the emergency department with a chief complaint of vaginal bleeding and mild hypogastric pain for 1 week. Her serum Beta-human gonadotropin (β-HCG) level was 34279 IU/L. Abdominal ultrasound demonstrated a homogeneous echogenic structure in the upper pole parenchyma of the spleen, measuring 46 × 48 mm in diameter, containing the gestational sac and embryonal heart rate. Magnetic resonance imaging revealed a mass located in the upper pole of the spleen. Partial splenectomy was successfully and safely performed.</p></div><div><h3>Clinical discussion</h3><p>Surgical treatment of SEP is indicated for symptomatic or having a fetal heart rate or an elevated β-HCG level >30000 IU/L. The surgical methods are total splenectomy, laparoscopically injecting Methotrexate. This is the first case of partial splenectomy in the treatment of SEP.</p></div><div><h3>Conclusion</h3><p>Diagnosis of splenic ectopic pregnancy is mainly based on clinical and abdominal ultrasound. MRI may be indicated in cases when the patient arrives early and helps to identify the location of the lesion. Partial splenectomy is indicated when the ectopic pregnancy mass is located at one splenic pole.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"58 ","pages":"Article 100656"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48794651","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 : 2023-09-01DOI: 10.1016/j.ijso.2023.100665
Hilmi Muhammad , Paramita Ayu Saraswati , Adrian Fakhri Ismiarto , Yoyos Dias Ismiarto
Background
In pediatric patients with developmental dysplasia of the hip (DDH), leg discrepancy may occur from treatment complications or from the treatment itself. Surgeons should be mindful that performing osteotomies with the purpose of providing better pelvic joint fit comes with risks of unequal bone growth. This article aimed to systematically review the reported leg length discrepancy (LLD) as a potential complication from osteotomy procedures in surgical treatment of pediatric patients with DDH.
Methods
This systematic review followed the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines. The study protocol was registered on the International Prospective Register of Systematic Reviews. A comprehensive search was performed on PubMed (MEDLINE), Scopus, the Cochrane Library and Europe PubMed Central in March 2022. Studies reporting outcomes of leg length discrepancy after osteotomy was performed were the main inclusion criteria. Quality and risk of bias assessment were performed by individual reviewers.
Results
From existing literatures, a total of eight studies were included in the review. From the data extracted, a total of 94 cases of DDH reported various LLD from 836 published cases with mean incidence of 11.2%. According to the patients’ age when the operation was performed, LLD of 2.20 cm was reported from the youngest patient operated on at 1.6 years old and LLD of 1.50 cm from the oldest patient operated on at 18 years old. The median LLD across the included studies was 1.30 cm. Limitations to this systematic review include study risk of bias, LLD reporting inconsistencies and assumptions when extracting the data which might have caused abnormal data distribution. Since no agreement exists regarding how much discrepancy between limb lengths is considered pathological, reports of cases and management of LLD vary widely. These results underline the importance of creating specific criteria to classify LLD severity and recommend appropriate treatment. WC:298.
{"title":"Leg length discrepancy complications from osteotomy procedures in pediatric developmental dysplasia of the hip: A systematic review","authors":"Hilmi Muhammad , Paramita Ayu Saraswati , Adrian Fakhri Ismiarto , Yoyos Dias Ismiarto","doi":"10.1016/j.ijso.2023.100665","DOIUrl":"10.1016/j.ijso.2023.100665","url":null,"abstract":"<div><h3>Background</h3><p>In pediatric patients with developmental dysplasia of the hip (DDH), leg discrepancy may occur from treatment complications or from the treatment itself. Surgeons should be mindful that performing osteotomies with the purpose of providing better pelvic joint fit comes with risks of unequal bone growth. This article aimed to systematically review the reported leg length discrepancy (LLD) as a potential complication from osteotomy procedures in surgical treatment of pediatric patients with DDH.</p></div><div><h3>Methods</h3><p>This systematic review followed the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines. The study protocol was registered on the International Prospective Register of Systematic Reviews. A comprehensive search was performed on PubMed (MEDLINE), Scopus, the Cochrane Library and Europe PubMed Central in March 2022. Studies reporting outcomes of leg length discrepancy after osteotomy was performed were the main inclusion criteria. Quality and risk of bias assessment were performed by individual reviewers.</p></div><div><h3>Results</h3><p>From existing literatures, a total of eight studies were included in the review. From the data extracted, a total of 94 cases of DDH reported various LLD from 836 published cases with mean incidence of 11.2%. According to the patients’ age when the operation was performed, LLD of 2.20 cm was reported from the youngest patient operated on at 1.6 years old and LLD of 1.50 cm from the oldest patient operated on at 18 years old. The median LLD across the included studies was 1.30 cm. Limitations to this systematic review include study risk of bias, LLD reporting inconsistencies and assumptions when extracting the data which might have caused abnormal data distribution. Since no agreement exists regarding how much discrepancy between limb lengths is considered pathological, reports of cases and management of LLD vary widely. These results underline the importance of creating specific criteria to classify LLD severity and recommend appropriate treatment. WC:298.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"58 ","pages":"Article 100665"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47794258","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 : 2023-09-01DOI: 10.1016/j.ijso.2023.100675
Samar J. Mkhayel, Sarine V. Sarkis
Introduction and Importance
Malignant hyperthermia (MH) is a hypermetabolic reaction caused by exposure to halogenated volatile anesthetics or succinylcholine. Symptoms include unexplained elevations in end-tidal carbon dioxide and body temperature, muscle rigidity, hemodynamic instability, and electrolyte disturbances. Delayed diagnosis and treatment end up with detrimental consequences.
Case presentation
A 19-year-old healthy patient with a negative surgical history for anesthesia complications presented for an elective otolaryngology surgery. Following a smooth induction of general anesthesia and while maintained on sevoflurane, the patient started having elevation in end-tidal carbon dioxide and body temperature followed by hemodynamic instability. MH reaction was suspected. Dantrolene was directly administered intravenously along with cold physiologic saline. Consequently, body temperature as well as end tidal CO2 gradually decreased; the patient improved hemodynamically. The surgery was completed, and the patient was transferred to the intensive care unit for continuity of care.
Clinical discussion
MH is challenging for both anesthesia and surgical teams as well as for hospitals in general. Although symptoms are non-specific, the diagnosis of MH reaction and the subsequent initiation of treatment with dantrolene should be prompt. As such, hospitals should be logistically prepared for such scenarios. Furthermore, the treating medical team should be trained in advance in order to avoid any possible delay that might result in catastrophic consequences on the patient.
Conclusion
Early recognition and initiation of treatment are important for survival in MH. This can be achieved by proper staff education along with logistical preparedness.
{"title":"Malignant hyperthermia in a young man: A case report","authors":"Samar J. Mkhayel, Sarine V. Sarkis","doi":"10.1016/j.ijso.2023.100675","DOIUrl":"10.1016/j.ijso.2023.100675","url":null,"abstract":"<div><h3>Introduction and Importance</h3><p>Malignant hyperthermia (MH) is a hypermetabolic reaction caused by exposure to halogenated volatile anesthetics or succinylcholine. Symptoms include unexplained elevations in end-tidal carbon dioxide and body temperature, muscle rigidity, hemodynamic instability, and electrolyte disturbances. Delayed diagnosis and treatment end up with detrimental consequences.</p></div><div><h3>Case presentation</h3><p>A 19-year-old healthy patient with a negative surgical history for anesthesia complications presented for an elective otolaryngology surgery. Following a smooth induction of general anesthesia and while maintained on sevoflurane, the patient started having elevation in end-tidal carbon dioxide and body temperature followed by hemodynamic instability. MH reaction was suspected. Dantrolene was directly administered intravenously along with cold physiologic saline. Consequently, body temperature as well as end tidal CO2 gradually decreased; the patient improved hemodynamically. The surgery was completed, and the patient was transferred to the intensive care unit for continuity of care.</p></div><div><h3>Clinical discussion</h3><p>MH is challenging for both anesthesia and surgical teams as well as for hospitals in general. Although symptoms are non-specific, the diagnosis of MH reaction and the subsequent initiation of treatment with dantrolene should be prompt. As such, hospitals should be logistically prepared for such scenarios. Furthermore, the treating medical team should be trained in advance in order to avoid any possible delay that might result in catastrophic consequences on the patient.</p></div><div><h3>Conclusion</h3><p>Early recognition and initiation of treatment are important for survival in MH. This can be achieved by proper staff education along with logistical preparedness.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"58 ","pages":"Article 100675"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41810385","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 : 2023-09-01DOI: 10.1016/j.ijso.2023.100663
Huda Muhaddien Muhammad , Rezheen J. Rashid , Snur Othman , Nahidah Hamah Ameen Ahmed , Rawa M. Ali , Ari M. Abdullah , Hadeel Adnan Yasseen , Fakher Abdullah , Fahmi H. Kakamad
Introduction and importance
Leiomyomas can affect 20–30% of women of reproductive age and are commonly observed in the uterus. Their occurrence in the vagina is exceedingly rare, representing the least common presentation among all locations. Herein, we report a case of vaginal leiomyomas in a 48-year-old lady.
Case presentation
A 48-year-old female presented to our gynecology clinic complaining of feeling a mass within her vagina. Physical examination revealed a round, smooth mass in the anterior vaginal wall with a normal-looking cervix. Ultrasound examination showed an enlarged anteverted uterus with an endometrial thickness of 14 mm and an endometrial polyp of 15 × 7mm arising from the left upper anterolateral wall. Magnetic resonance imaging demonstrated a well-defined, fusiform, submucosal vaginal mass originating from the anterior vaginal wall, measuring 37× 22 × 36 mm. Hysteroscopy was performed, and the uterine and vaginal masses were resected. The masses were confirmed to be conventional leiomyomas.
Clinical discussion
The diagnosis is seldom established preoperatively and the preferred therapeutic approach for treating vaginal leiomyoma is surgical removal via the vaginal route. However, in the case of large tumors, the abdominoperineal route may be necessary.
Conclusion
Vaginal leiomyoma is a rare tumor with approximately 300 reported cases worldwide. It can be asymptomatic or cause to feel it within the vagina. Besides the necessity of surgical resection, colporrhaphy as a reconstructive surgery may be required.
{"title":"Vaginal leiomyoma: A case report","authors":"Huda Muhaddien Muhammad , Rezheen J. Rashid , Snur Othman , Nahidah Hamah Ameen Ahmed , Rawa M. Ali , Ari M. Abdullah , Hadeel Adnan Yasseen , Fakher Abdullah , Fahmi H. Kakamad","doi":"10.1016/j.ijso.2023.100663","DOIUrl":"10.1016/j.ijso.2023.100663","url":null,"abstract":"<div><h3>Introduction and importance</h3><p>Leiomyomas can affect 20–30% of women of reproductive age and are commonly observed in the uterus. Their occurrence in the vagina is exceedingly rare, representing the least common presentation among all locations. Herein, we report a case of vaginal leiomyomas in a 48-year-old lady.</p></div><div><h3>Case presentation</h3><p>A 48-year-old female presented to our gynecology clinic complaining of feeling a mass within her vagina. Physical examination revealed a round, smooth mass in the anterior vaginal wall with a normal-looking cervix. Ultrasound examination showed an enlarged anteverted uterus with an endometrial thickness of 14 mm and an endometrial polyp of 15 × 7mm arising from the left upper anterolateral wall. Magnetic resonance imaging demonstrated a well-defined, fusiform, submucosal vaginal mass originating from the anterior vaginal wall, measuring 37× 22 × 36 mm. Hysteroscopy was performed, and the uterine and vaginal masses were resected. The masses were confirmed to be conventional leiomyomas.</p></div><div><h3>Clinical discussion</h3><p>The diagnosis is seldom established preoperatively and the preferred therapeutic approach for treating vaginal leiomyoma is surgical removal via the vaginal route. However, in the case of large tumors, the abdominoperineal route may be necessary.</p></div><div><h3>Conclusion</h3><p>Vaginal leiomyoma is a rare tumor with approximately 300 reported cases worldwide. It can be asymptomatic or cause to feel it within the vagina. Besides the necessity of surgical resection, colporrhaphy as a reconstructive surgery may be required.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"58 ","pages":"Article 100663"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43181823","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}
Pain is one of the most significant problems, and its uncontrolled management can lead to complications such as increased blood pressure, myocardial ischemia, etc. An effective approach to control postoperative pain is preemptive pain management with a combination of drugs prior to surgery. The present study aims to compare the level of postoperative abdominal pain in patients receiving pregabalin and famotidine versus pregabalin and diphenhydramine.
Materials and methods
In this double-blind clinical trial, a total of 34 candidates for abdominal surgery (laparotomy) with ASA physical status classification of 1 or 2 were enrolled from the patients referring to (XXX). They were divided into two groups of 17 (Group A: pregabalin and famotidine, Group B: pregabalin and diphenhydramine). The drugs were administered to the patients 2 h before the surgery. The patients' pain levels were measured using the Visual Analog Scale (VAS) at the recovery stage after complete consciousness and at 6, 12, and 24 h postoperatively. Additionally, the amount of analgesic consumed within the first 24 h after the surgery was recorded and compared between the two groups.
Results
The average pain intensity score at 6 h postoperatively was (6 ± 0.2) in patients who received pregabalin and diphenhydramine, and (7.1 ± 0.1) in patients who received pregabalin and famotidine (p = 0.002). The average pain intensity score at 12 h postoperatively was (6.1 ± 0.3) in patients who received pregabalin and famotidine, and (5.6 ± 0.2) in patients who received pregabalin and diphenhydramine (p = 0.021). Furthermore, the average pain intensity score at 24 h postoperatively was (5.2 ± 0.2) in patients who received pregabalin and famotidine, and (4.2 ± 0.2) in patients who received pregabalin and diphenhydramine (p = 0.014). The results demonstrated that the pain intensity score decreased in all four measured time intervals in the overall patient population (p < 0.001), and this reduction was significantly different between the two groups (p = 0.002), with the final average pain score being lower in the group receiving pregabalin and diphenhydramine compared to the other group.
Conclusion
The results of this study indicate that the use of drugs such as diphenhydramine and pregabalin as preemptive medications can be effective in controlling postoperative abdominal pain and reducing the consumption of analgesics in patients after abdominal surgery.
{"title":"Comparison of the effects of pregabalin and famotidine with pregabalin and diphenhydramine on postoperative abdominal pain","authors":"Masoud Saadat Fakhr , Parnian Motamed Chaboki , Hemin Ashayeri , Pouria Sahranavard , Somayeh Mohammadipanah , Mahnaz Narimani Zamanabadi","doi":"10.1016/j.ijso.2023.100674","DOIUrl":"10.1016/j.ijso.2023.100674","url":null,"abstract":"<div><h3>Objectives</h3><p>Pain is one of the most significant problems, and its uncontrolled management can lead to complications such as increased blood pressure, myocardial ischemia, etc. An effective approach to control postoperative pain is preemptive pain management with a combination of drugs prior to surgery. The present study aims to compare the level of postoperative abdominal pain in patients receiving pregabalin and famotidine versus pregabalin and diphenhydramine.</p></div><div><h3>Materials and methods</h3><p>In this double-blind clinical trial, a total of 34 candidates for abdominal surgery (laparotomy) with ASA physical status classification of 1 or 2 were enrolled from the patients referring to (XXX). They were divided into two groups of 17 (Group A: pregabalin and famotidine, Group B: pregabalin and diphenhydramine). The drugs were administered to the patients 2 h before the surgery. The patients' pain levels were measured using the Visual Analog Scale (VAS) at the recovery stage after complete consciousness and at 6, 12, and 24 h postoperatively. Additionally, the amount of analgesic consumed within the first 24 h after the surgery was recorded and compared between the two groups.</p></div><div><h3>Results</h3><p>The average pain intensity score at 6 h postoperatively was (6 ± 0.2) in patients who received pregabalin and diphenhydramine, and (7.1 ± 0.1) in patients who received pregabalin and famotidine (p = 0.002). The average pain intensity score at 12 h postoperatively was (6.1 ± 0.3) in patients who received pregabalin and famotidine, and (5.6 ± 0.2) in patients who received pregabalin and diphenhydramine (p = 0.021). Furthermore, the average pain intensity score at 24 h postoperatively was (5.2 ± 0.2) in patients who received pregabalin and famotidine, and (4.2 ± 0.2) in patients who received pregabalin and diphenhydramine (p = 0.014). The results demonstrated that the pain intensity score decreased in all four measured time intervals in the overall patient population (p < 0.001), and this reduction was significantly different between the two groups (p = 0.002), with the final average pain score being lower in the group receiving pregabalin and diphenhydramine compared to the other group.</p></div><div><h3>Conclusion</h3><p>The results of this study indicate that the use of drugs such as diphenhydramine and pregabalin as preemptive medications can be effective in controlling postoperative abdominal pain and reducing the consumption of analgesics in patients after abdominal surgery.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"58 ","pages":"Article 100674"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45413415","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 : 2023-09-01DOI: 10.1016/j.ijso.2023.100670
Ranjan K. Mohapatra, Snehasish Mishra, Lucia Pintilie, Lawrence Sena Tuglo
{"title":"Potentially pandemic MERS-CoV constantly circulating in the Middle East threatens the globe: Preparedness and prevention with commentaries on the ‘one health’ model","authors":"Ranjan K. Mohapatra, Snehasish Mishra, Lucia Pintilie, Lawrence Sena Tuglo","doi":"10.1016/j.ijso.2023.100670","DOIUrl":"10.1016/j.ijso.2023.100670","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"58 ","pages":"Article 100670"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41686198","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 : 2023-09-01DOI: 10.1016/j.ijso.2023.100662
Michael J. Warn , Austin R. Swisher , Alexandra Pitco , Zahan Ghyaz , Ross Vitek , Neharika Khurana
Introduction and Importance
Diaphragmatic hernias are the herniation of abdominal contents through the diaphragm into the thorax and are categorized as congenital or acquired. Most commonly, acquired diaphragmatic hernia is preceded by blunt or penetrating trauma to the abdomen with the former occurring more frequently. In less than 1% of cases, acquired diaphragmatic hernias can occur spontaneously, which can be recognized incidentally on imaging or by patients presenting with non-specific symptoms. Without prompt diagnosis, patients are at risk for incarceration and strangulation of the herniated contents, resulting in bowel necrosis.
Case presentation
Here, we present the case of a 36-year-old male who presented with worsening 3-month history of dyspnea and palpitations. Initial clinical exam was notable for tachypnea and accessory muscle recruitment. Auscultation revealed bowel sounds in the right lung fields. Semi-upright chest radiograph uncovered a large right-sided pneumothorax containing portions of the stomach, liver, and numerous loops of bowel, with significant cardiomediastinal left shift. Surgical intervention for diaphragmatic hernia repair was promptly planned.
Clinical discussion
Spontaneous diaphragmatic hernia occurring secondary to a defect on the right side of the diaphragm without any history of trauma or surgery is an extraordinarily infrequent pathology. This subacute clinical presentation despite extensive anatomic involvement highlights the importance of thorough physical examination, with auscultation of bowel sounds in the thorax serving as a near pathognomonic finding for a spontaneous diaphragmatic hernia, including patients without a known history of acute trauma or previous surgery.
Conclusion
Surgical management of such rare hernias via abdominal, thoracic, or a combined approach coupled with pulmonary monitoring proves to be an effective treatment, and awareness of this case will aid in its identification and the ability to provide prompt intervention.
{"title":"Indolent presentation of a right-sided spontaneous diaphragmatic hernia: A case report and review of the literature","authors":"Michael J. Warn , Austin R. Swisher , Alexandra Pitco , Zahan Ghyaz , Ross Vitek , Neharika Khurana","doi":"10.1016/j.ijso.2023.100662","DOIUrl":"10.1016/j.ijso.2023.100662","url":null,"abstract":"<div><h3>Introduction and Importance</h3><p>Diaphragmatic hernias are the herniation of abdominal contents through the diaphragm into the thorax and are categorized as congenital or acquired. Most commonly, acquired diaphragmatic hernia is preceded by blunt or penetrating trauma to the abdomen with the former occurring more frequently. In less than 1% of cases, acquired diaphragmatic hernias can occur spontaneously, which can be recognized incidentally on imaging or by patients presenting with non-specific symptoms. Without prompt diagnosis, patients are at risk for incarceration and strangulation of the herniated contents, resulting in bowel necrosis.</p></div><div><h3>Case presentation</h3><p>Here, we present the case of a 36-year-old male who presented with worsening 3-month history of dyspnea and palpitations. Initial clinical exam was notable for tachypnea and accessory muscle recruitment. Auscultation revealed bowel sounds in the right lung fields. Semi-upright chest radiograph uncovered a large right-sided pneumothorax containing portions of the stomach, liver, and numerous loops of bowel, with significant cardiomediastinal left shift. Surgical intervention for diaphragmatic hernia repair was promptly planned.</p></div><div><h3>Clinical discussion</h3><p>Spontaneous diaphragmatic hernia occurring secondary to a defect on the right side of the diaphragm without any history of trauma or surgery is an extraordinarily infrequent pathology. This subacute clinical presentation despite extensive anatomic involvement highlights the importance of thorough physical examination, with auscultation of bowel sounds in the thorax serving as a near pathognomonic finding for a spontaneous diaphragmatic hernia, including patients without a known history of acute trauma or previous surgery.</p></div><div><h3>Conclusion</h3><p>Surgical management of such rare hernias via abdominal, thoracic, or a combined approach coupled with pulmonary monitoring proves to be an effective treatment, and awareness of this case will aid in its identification and the ability to provide prompt intervention.</p></div>","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"58 ","pages":"Article 100662"},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43421069","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 : 2023-09-01DOI: 10.1016/j.ijso.2023.100660
Eman Ali
{"title":"FDA approves first leadless dual-chamber pacing system; A breakthrough in therapy of bradycardia","authors":"Eman Ali","doi":"10.1016/j.ijso.2023.100660","DOIUrl":"https://doi.org/10.1016/j.ijso.2023.100660","url":null,"abstract":"","PeriodicalId":43872,"journal":{"name":"International Journal of Surgery Open","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54471030","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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