Pub Date : 2019-06-30DOI: 10.33762/BSURG.2019.162889
T. Hamdan
{"title":"SEE IT, SAY IT, AND SORT IT","authors":"T. Hamdan","doi":"10.33762/BSURG.2019.162889","DOIUrl":"https://doi.org/10.33762/BSURG.2019.162889","url":null,"abstract":"","PeriodicalId":52765,"journal":{"name":"Basrah Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43904990","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 : 2019-06-30DOI: 10.33762/bsurg.2019.163873
Ahmed Abdulnab
{"title":"THE EFFECT OF LIMITED VERSUS EXTENDED AXILLARY LYMPH NODES DISSECTION IN THE DEVELOPMENT OF POST-MASTECTOMY MORBIDITY","authors":"Ahmed Abdulnab","doi":"10.33762/bsurg.2019.163873","DOIUrl":"https://doi.org/10.33762/bsurg.2019.163873","url":null,"abstract":"","PeriodicalId":52765,"journal":{"name":"Basrah Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45906190","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 : 2019-06-30DOI: 10.33762/BSURG.2019.163759
A. Ahmed, Muhanad Abass A Zahra, Haider Saeed
Strut graft is an important, commonly used method to increase nasal tip projection and rotation. This study discuss its benefit by prospective analysis of a group of patients in which strut graft was used and compare it with a control group using digitalized photographs. The aim of this study is to evaluate the benefit of columellar strut graft and its effect on nasal projection and rotation using digital images. Thirty two patients were treated with external rhinoplasty. Using their photographs, we analyzed the projection and rotation of the nose before and after operation. The patients were classified into two groups: group A included 18 patients who have strut and group B included 14 patients without strut. The analysis of the photos of the two groups was done with a computer program. By using Goode method, nasal tip projection decreases from 0.63 to 0.62 for patients using the strut, while in patients without strut nasal tip projection decreases from 0.64 to 0.61. Nasal tip rotation slightly increased in patients with strut graft from 99 to 99.5 degrees, while in those without the graft, nasal tip rotation markedly increased from 95 to 103 degrees. In conclusion, external rhinoplasty decreases nasal tip projection and the use of strut graft is unnecessary in increasing nasal tip projection but it helps in preserving the projection and slightly increasing nasal tip rotation.
{"title":"COLUMELLAR STRUT GRAFT IN TIP RHINOPLASTY, IS IT OF BENEFIT?","authors":"A. Ahmed, Muhanad Abass A Zahra, Haider Saeed","doi":"10.33762/BSURG.2019.163759","DOIUrl":"https://doi.org/10.33762/BSURG.2019.163759","url":null,"abstract":"Strut graft is an important, commonly used method to increase nasal tip projection and rotation. This study discuss its benefit by prospective analysis of a group of patients in which strut graft was used and compare it with a control group using digitalized photographs. The aim of this study is to evaluate the benefit of columellar strut graft and its effect on nasal projection and rotation using digital images. Thirty two patients were treated with external rhinoplasty. Using their photographs, we analyzed the projection and rotation of the nose before and after operation. The patients were classified into two groups: group A included 18 patients who have strut and group B included 14 patients without strut. The analysis of the photos of the two groups was done with a computer program. By using Goode method, nasal tip projection decreases from 0.63 to 0.62 for patients using the strut, while in patients without strut nasal tip projection decreases from 0.64 to 0.61. Nasal tip rotation slightly increased in patients with strut graft from 99 to 99.5 degrees, while in those without the graft, nasal tip rotation markedly increased from 95 to 103 degrees. In conclusion, external rhinoplasty decreases nasal tip projection and the use of strut graft is unnecessary in increasing nasal tip projection but it helps in preserving the projection and slightly increasing nasal tip rotation.","PeriodicalId":52765,"journal":{"name":"Basrah Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43811239","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 : 2019-06-30DOI: 10.33762/bsurg.2019.163871
Ghadban Al-Ebadi, A. Jabbar
{"title":"BILE LEAK FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY, A PROSPECTIVE STUDY","authors":"Ghadban Al-Ebadi, A. Jabbar","doi":"10.33762/bsurg.2019.163871","DOIUrl":"https://doi.org/10.33762/bsurg.2019.163871","url":null,"abstract":"","PeriodicalId":52765,"journal":{"name":"Basrah Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43912689","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 : 2019-06-30DOI: 10.33762/BSURG.2019.163877
J. Salman, S. Asfar
{"title":"MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XVI: HARMS LINKED TO DRUGS ADMINISTERED DURING ANESTHESIA","authors":"J. Salman, S. Asfar","doi":"10.33762/BSURG.2019.163877","DOIUrl":"https://doi.org/10.33762/BSURG.2019.163877","url":null,"abstract":"","PeriodicalId":52765,"journal":{"name":"Basrah Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47296365","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 : 2019-05-31DOI: 10.33762/BSURG.2019.163874
A. Y. Alwajeeh
Nodular goiter is one of the most common presentation of thyroid gland diseases. The risk of development of thyroid cancer is relatively rare (1%) of all types of tumors, however, it is the most common endocrine malignancy, and usually presented as multinodular goiter. Fine needle aspiration cytology (FNAC) considered as the golden tool in the diagnosis of thyroid nodule though, it still has false negative rate which is variable depending on the experience and the technique being used. This means that even if the FNAC done prior to surgery shows negative finding, this doesn't exclude the presence of carcinoma, especially in multinodular goiter where it is possible not to sample the involved area. In this prospective study which was done in Almawanee Teaching Hospital between 2012-2018, 69 patients with Multinodular goiter where considered for the risk of harboring an incidental malignancy. The results of patients with multinodular goiter of benign origin was 57 patients (82.86%) while multinodular goiter which has an incidental malignancy was 12 patients (17.14%). Conclusion: due to relatively high risk of malignancy in multinodular goiter especially with non-compliance for follow-up from patients and risk of missing incidental malignancy by FNAC in multinodular goiter, it is preferable to do total or near total thyroidectomy.
{"title":"MULTINODULAR GOITER AND RISK OF MALIGNANCY, SURGERY OR FOLLOW UP ?","authors":"A. Y. Alwajeeh","doi":"10.33762/BSURG.2019.163874","DOIUrl":"https://doi.org/10.33762/BSURG.2019.163874","url":null,"abstract":"Nodular goiter is one of the most common presentation of thyroid gland diseases. The risk of development of thyroid cancer is relatively rare (1%) of all types of tumors, however, it is the most common endocrine malignancy, and usually presented as multinodular goiter. Fine needle aspiration cytology (FNAC) considered as the golden tool in the diagnosis of thyroid nodule though, it still has false negative rate which is variable depending on the experience and the technique being used. This means that even if the FNAC done prior to surgery shows negative finding, this doesn't exclude the presence of carcinoma, especially in multinodular goiter where it is possible not to sample the involved area. In this prospective study which was done in Almawanee Teaching Hospital between 2012-2018, 69 patients with Multinodular goiter where considered for the risk of harboring an incidental malignancy. The results of patients with multinodular goiter of benign origin was 57 patients (82.86%) while multinodular goiter which has an incidental malignancy was 12 patients (17.14%). Conclusion: due to relatively high risk of malignancy in multinodular goiter especially with non-compliance for follow-up from patients and risk of missing incidental malignancy by FNAC in multinodular goiter, it is preferable to do total or near total thyroidectomy.","PeriodicalId":52765,"journal":{"name":"Basrah Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43410921","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 : 2019-05-31DOI: 10.33762/BSURG.2019.163876
J. Hameed
Fingertip amputation is the most common injury of the upper limb. The goals of treating it are; covering the defect, achieve sensibility, preserving the length of the finger by using durable coverage, obtaining the satisfactory aesthetic appearance and allow the patient for faster return to work. This study aimed to evaluate the use of bilateral V-Y rotation advancement flaps for the management of fingertip amputations with exposed bones and to assess the functional and aesthetic outcome. Between January 2017 and August 2018, bilateral V-Y rotation advancement flaps was performed on eleven male patients, average age 32 years, whose fingertip amputation with variable planes and zones. Patients were followed-up for at least 6-12 months. Twenty two flaps were made on 11 fingers, there was no partial or total flap loss. Patients had neither cold intolerance nor scar hypersensitivity, no obvious hook nail deformity apart of one patient. Because flap have neurovascular bundle inside it, so no change in sensation or perfusion occur postoperatively. In conclusion, the V-Y rotation advancement flap is simple, single stage operation that is optimum for surgical reconstruction of any fingertip injury. It provides a good contour, finger pulp coverage and acceptable appearance.
{"title":"EVALUTION OF BILATERAL V-Y ROTATION ADVANCEMENT FLAPS FOR TREATMENT OF FINGERTIP AMPUTATION","authors":"J. Hameed","doi":"10.33762/BSURG.2019.163876","DOIUrl":"https://doi.org/10.33762/BSURG.2019.163876","url":null,"abstract":"Fingertip amputation is the most common injury of the upper limb. The goals of treating it are; covering the defect, achieve sensibility, preserving the length of the finger by using durable coverage, obtaining the satisfactory aesthetic appearance and allow the patient for faster return to work. This study aimed to evaluate the use of bilateral V-Y rotation advancement flaps for the management of fingertip amputations with exposed bones and to assess the functional and aesthetic outcome. Between January 2017 and August 2018, bilateral V-Y rotation advancement flaps was performed on eleven male patients, average age 32 years, whose fingertip amputation with variable planes and zones. Patients were followed-up for at least 6-12 months. Twenty two flaps were made on 11 fingers, there was no partial or total flap loss. Patients had neither cold intolerance nor scar hypersensitivity, no obvious hook nail deformity apart of one patient. Because flap have neurovascular bundle inside it, so no change in sensation or perfusion occur postoperatively. In conclusion, the V-Y rotation advancement flap is simple, single stage operation that is optimum for surgical reconstruction of any fingertip injury. It provides a good contour, finger pulp coverage and acceptable appearance.","PeriodicalId":52765,"journal":{"name":"Basrah Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45638579","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 : 2019-05-31DOI: 10.33762/BSURG.2019.163867
F. Warid, Maha Elshafei
The aim of this study is to describe a technique for intraoperative examination of macula and posterior capsule during phacoemulsification surgery in eyes with dense cataract. This work was done in Ophthalmology Department, Hamad Medical Corporation, Doha-Qatar on 36 patients (42 Eyes) with dense cataract and obscured fundus view. No data were recorded for macular status, and preoperative macular assessment was not conclusive by Ophthalmoscopy, B-Scan Ultrasound, and Optical Coherence Tomography (OCT). All patients were consented for cataract surgery plus additional vitreoretinal surgical procedure if indicated. Fundus examination done during phacoemulsification by translimbal insertion of endo-light probe after Irrigation/Aspiration step prior to lens implantation, capsular-bag expanded by viscoelastic to accommodate probe insert. Posterior capsule status checked by Endolight using microscope lens system only, macula checked by endolight with a vitreoretinal viewing lens system. Forty-two eyes (25 right and 17 left), (27 males, 15 females) in 39 patients were studied. The mean age was 59 years (47-78 years). Fourteen patients (18 eyes) were diabetics. Preoperative Visual Acuity of ≤ 6/60 was recorded in all patients. Cataract Density was graded by fundus visualization and in all cases, only shadow of optic disc and/or major vessels could be seen. Concurrent intravitreal injections was done in eight eyes (19%): seven of them were having Diabetic Macular Edema, and one has hemorrhagic Choroidal Neovascular Membrane (CNVM) due to age related macular degeneration. No complication was recorded in relation to Endoillumination. Posterior Capsule visualization was improved significantly and intracapsular lens implantation was done in all cases In conclusion, translimbal endo-illumination technique improved view to both Macula and posterior capsule during phacoemulsification with subsequent early surgical decision according to endolight findings. No extra incision required.
{"title":"TRANSLIMBAL INTRAOCULAR ENDOILLUMINATION DURING CATARACT SURGERY","authors":"F. Warid, Maha Elshafei","doi":"10.33762/BSURG.2019.163867","DOIUrl":"https://doi.org/10.33762/BSURG.2019.163867","url":null,"abstract":"The aim of this study is to describe a technique for intraoperative examination of macula and posterior capsule during phacoemulsification surgery in eyes with dense cataract. This work was done in Ophthalmology Department, Hamad Medical Corporation, Doha-Qatar on 36 patients (42 Eyes) with dense cataract and obscured fundus view. No data were recorded for macular status, and preoperative macular assessment was not conclusive by Ophthalmoscopy, B-Scan Ultrasound, and Optical Coherence Tomography (OCT). All patients were consented for cataract surgery plus additional vitreoretinal surgical procedure if indicated. Fundus examination done during phacoemulsification by translimbal insertion of endo-light probe after Irrigation/Aspiration step prior to lens implantation, capsular-bag expanded by viscoelastic to accommodate probe insert. Posterior capsule status checked by Endolight using microscope lens system only, macula checked by endolight with a vitreoretinal viewing lens system. Forty-two eyes (25 right and 17 left), (27 males, 15 females) in 39 patients were studied. The mean age was 59 years (47-78 years). Fourteen patients (18 eyes) were diabetics. Preoperative Visual Acuity of ≤ 6/60 was recorded in all patients. Cataract Density was graded by fundus visualization and in all cases, only shadow of optic disc and/or major vessels could be seen. Concurrent intravitreal injections was done in eight eyes (19%): seven of them were having Diabetic Macular Edema, and one has hemorrhagic Choroidal Neovascular Membrane (CNVM) due to age related macular degeneration. No complication was recorded in relation to Endoillumination. Posterior Capsule visualization was improved significantly and intracapsular lens implantation was done in all cases In conclusion, translimbal endo-illumination technique improved view to both Macula and posterior capsule during phacoemulsification with subsequent early surgical decision according to endolight findings. No extra incision required.","PeriodicalId":52765,"journal":{"name":"Basrah Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45033263","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 : 2019-05-31DOI: 10.33762/BSURG.2019.163769
J. Salman, S. Salman, S. Asfar
Unexpected difficult endotracheal intubation remains the main concern of anesthesiologists. This study aimed to compare validity and role of 7 bedside techniques of assessment used in predicting difficult intubation. This prospective study included 80 patients scheduled for surgery. Before induction of anesthesia, bedside tests for predicting difficult intubation were done, these tests are: Prayer sign, Thyromental distance, Mallampati test, The inter incisor distance, Palm print test, Upper lip bite test, and Wilson scoring system. During induction of anesthesia, laryngoscopic view was evaluated. Values for each test were calculated and compared. The results showed that, the highest sensitivity (62.5%) was for Mallampati and thyromental distance but despite that, they differed in their specificity and predictive values. Upper lip bite was 12.5% sensitive but had one of the highest specificity alongside with Mallampati test. Thyromental distance was 34.7% specific. Mallampati classes of more than class I was strongly associated with difficult intubation. The mouth gap of more than 4 cm was marginally associated with difficult intubation. The predictor Wilson showed a significant association with difficult intubation if the score exceeded 3.5. The upper lip bite of more than class I was slightly associated with difficult intubation. In conclusion, Mallampati classification and thyromental distance are superior to other available tests to predict difficult intubation, performing these two tests alone is relatively adequate to predict intubation difficulty.
{"title":"VALIDITY OF CERTAIN BEDSIDE TESTS IN PREDICTING DIFFICULT ENDOTRACHEAL INTUBATION","authors":"J. Salman, S. Salman, S. Asfar","doi":"10.33762/BSURG.2019.163769","DOIUrl":"https://doi.org/10.33762/BSURG.2019.163769","url":null,"abstract":"Unexpected difficult endotracheal intubation remains the main concern of anesthesiologists. This study aimed to compare validity and role of 7 bedside techniques of assessment used in predicting difficult intubation. This prospective study included 80 patients scheduled for surgery. Before induction of anesthesia, bedside tests for predicting difficult intubation were done, these tests are: Prayer sign, Thyromental distance, Mallampati test, The inter incisor distance, Palm print test, Upper lip bite test, and Wilson scoring system. During induction of anesthesia, laryngoscopic view was evaluated. Values for each test were calculated and compared. The results showed that, the highest sensitivity (62.5%) was for Mallampati and thyromental distance but despite that, they differed in their specificity and predictive values. Upper lip bite was 12.5% sensitive but had one of the highest specificity alongside with Mallampati test. Thyromental distance was 34.7% specific. Mallampati classes of more than class I was strongly associated with difficult intubation. The mouth gap of more than 4 cm was marginally associated with difficult intubation. The predictor Wilson showed a significant association with difficult intubation if the score exceeded 3.5. The upper lip bite of more than class I was slightly associated with difficult intubation. In conclusion, Mallampati classification and thyromental distance are superior to other available tests to predict difficult intubation, performing these two tests alone is relatively adequate to predict intubation difficulty.","PeriodicalId":52765,"journal":{"name":"Basrah Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43872009","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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