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Diagnostic Accuracy of the RIPASA Score in Suspected Acute Appendicitis in Adults: A Cross-sectional Study Comparing it with Histopathological Findings from Bagalkot, India 成人疑似急性阑尾炎的RIPASA评分的诊断准确性:一项横断面研究,将其与印度巴加尔科特的组织病理学结果进行比较
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/65210:2932
C Shobha, G Sushrutha, Bhimanagouda V Goudar
Introduction: Acute appendicitis remains the most commonly occurring surgical emergency, with a prevalence rate of approximately 8% among individuals aged 10-30 years. The Raja Isteri Pengiran Anak Saleha for Appendicitis (RIPASA) scoring system appears to be an accurate, simple, and rapid parameter for predicting Acute Appendicitis (AA). Aim: To determine the validity and diagnostic efficiency of the RIPASA scoring system for acute appendicitis and compare it with histopathology. Materials and Methods: A cross-sectional study was conducted on patients admitted to Nijalingappa Medical College in Bagalkot, Karnataka, India, from January 2020 to June 2021. The study included patients of both genders above 18 years of age, presenting with right iliac fossa pain. Detailed history was obtained, and a thorough clinical examination was performed. Appropriate investigations were conducted, and the RIPASA score was calculated. Qualitative data were represented as frequency and percentage. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and diagnostic accuracy were calculated to assess the validity of the tool. An ROC curve was plotted to determine the area under the curve. Results: A total of 90 patients had RIPASA scores of ≥7.5, and the majority of them (75.6%) were under the age of 40 years, with a mean age of 39.9 years. The male-to-female ratio was 48.9:51.1, approximately 0.95. The sensitivity, specificity, and diagnostic accuracy of the RIPASA scoring system were 82%, 100%, and 82%, respectively. Conclusion: The RIPASA scoring system demonstrates good applicability and efficiency in diagnosing acute appendicitis. It is easily accessible and non-invasive, thereby reducing the cost of radiological investigations and unnecessary economic burden.
简介:急性阑尾炎仍然是最常见的外科急诊,在10-30岁的人群中患病率约为8%。Raja Isteri Pengiran Anak Saleha for Appendicitis (RIPASA)评分系统是预测急性阑尾炎(Acute Appendicitis, AA)的一个准确、简单、快速的参数。目的:探讨RIPASA评分系统对急性阑尾炎的有效性和诊断效率,并与组织病理学进行比较。材料与方法:对2020年1月至2021年6月在印度卡纳塔克邦巴加尔科特Nijalingappa医学院住院的患者进行了一项横断面研究。该研究包括18岁以上的男女患者,表现为右髂窝疼痛。获得了详细的病史,并进行了彻底的临床检查。进行了适当的调查,并计算了RIPASA评分。定性数据用频率和百分比表示。计算敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和诊断准确性,以评估该工具的有效性。绘制ROC曲线以确定曲线下的面积。结果:共有90例患者RIPASA评分≥7.5分,其中大多数(75.6%)年龄在40岁以下,平均年龄为39.9岁。男女比例为48.9:51.1,约为0.95。RIPASA评分系统的敏感性、特异性和诊断准确性分别为82%、100%和82%。结论:RIPASA评分系统对急性阑尾炎的诊断具有较好的适用性和有效性。它易于获取和非侵入性,从而减少了放射检查的成本和不必要的经济负担。
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引用次数: 0
Outcome of Limberg Flap Reconstruction in the Management of Pilonidal Sinus Disease: A Retrospective Study 林堡皮瓣重建治疗毛窦疾病的疗效回顾性研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/60931.2930
S Pradeep, V Kalaivani, K Anupama Pujar, Bhavyadeep Korrapati
Introduction: Pilonidal Sinus Disease (PSD) is a tract or cavity commonly seen in the sacrococcygeal region, usually containing a tuft of hair. It is mostly observed in drivers who have excessive hair in the natal cleft region. Although several surgical procedures have been described for the management of PSD, none have been universally accepted as the gold standard. Limberg flap reconstruction, following wide excision, offers a tension-free repair using a well-vascularised flap. This technique flattens the natal cleft, avoiding a midline scar and reducing the chance of recurrence. Aim: The aim of this study was to determine the outcomes of Limberg flap reconstruction in sacrococcygeal PSD. Materials and Methods: A retrospective descriptive study was conducted in the Department of General Surgery at M S Ramaiah Medical College, Bangalore, Karnataka, India. The study duration was six years, from January 2011 to January 2017. The study included a total of 40 patients aged between 15-70 years, with Tezel type III sacrococcygeal Pilonidal Disease (PND), who underwent the Limberg flap procedure. Data was collected and analysed from January to June 2021. Outcome measures such as duration of hospital stay, time required to return to work, and procedure-related complications associated with procedure were analysed and entered into an Excel sheet. Results: The mean age of the study participants was 18.02±6.87 years. Out of the 40 patients, 4 (10%) developed complications. Superficial wound infection was observed in 1 (2.5%) patient, which healed within two weeks. Minimal flap necrosis was observed in 2 (5%) patients, who underwent debridement and dressings on an outpatient basis. The wounds healed within three to four weeks. Recurrence was reported in 1 (2.5%) patient. The mean time to return to work was 18.7±4.88 days. Conclusion: Limberg flap reconstruction for sacrococcygeal PSD is a simple technique with a lower complication rate, faster return to normal activity, and a low recurrence rate.
简介:毛窦病(PSD)是一种常见于骶尾骨区域的通道或腔,通常含有一束毛。这主要发生在先天性唇裂区域头发过多的司机身上。虽然有几种外科手术方法被描述用于治疗PSD,但没有一种被普遍接受为黄金标准。Limberg皮瓣重建,在广泛切除后,使用血管通畅的皮瓣提供无张力修复。这项技术使先天的唇裂变平,避免了中线疤痕,减少了复发的机会。目的:本研究的目的是确定林堡皮瓣重建骶尾骨PSD的结果。材料和方法:在印度卡纳塔克邦班加罗尔的M S Ramaiah医学院普外科进行了一项回顾性描述性研究。研究时间为6年,从2011年1月至2017年1月。该研究共纳入40例年龄在15-70岁之间,患有Tezel III型骶尾椎Pilonidal Disease (PND)的患者,他们接受了Limberg皮瓣手术。数据收集和分析从2021年1月到6月。结果测量指标,如住院时间、恢复工作所需的时间以及与手术相关的手术相关并发症被分析并输入到Excel表格中。结果:研究参与者的平均年龄为18.02±6.87岁。40例患者中,4例(10%)出现并发症。创面感染1例(2.5%),2周内愈合。2例(5%)患者在门诊基础上进行清创和敷料治疗,观察到轻度皮瓣坏死。伤口在三到四周内愈合。复发1例(2.5%)。平均恢复工作时间为18.7±4.88天。结论:Limberg皮瓣重建骶尾骨PSD方法简单,并发症发生率低,恢复活动快,复发率低。
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引用次数: 0
Mylohyoid Bridging of the Mandible and its Clinical Importance in Dry Mandibles: A Cross-sectional Study 下颌骨舌骨桥接及其在干性下颌骨中的临床意义:一项横断面研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/53104.2860
P. Samanta, A. Priya
Introduction: Mylohyoid Bridging (MB) is a hyperostotic variation in the mandible. On the inner aspect of the ramus of the mandible, the Mylohyoid Groove (MG) is observed. The content of this groove is the mylohyoid nerve and vessels. The mylohyoid bridging can compress these neurovascular structures. Aim: To determine the incidence of mylohyoid bridging and to determine, whether it is complete/incomplete or proximal/distal or unilateral/bilateral. Materials and Methods: The present cross-sectional study was conducted in the Department of Anatomy, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India, in July 2022. The study was conducted on 60 dried human mandibles (120 sides). The mandibles were collected from the Department of Anatomy. The mandibles were observed for the presence of a mylohyoid bridge on the inner aspect of its ramus on both sides. Results were expressed using descriptive statistics and were expressed in terms of frequency and percentage. Results: Mylohyoid bridge was observed in three out of 120 (2.5%) mylohyoid grooves. All the observed mylohyoid bridges were incomplete types (one each of proximal type, intermediate type, and distal type). In one of the mandible, a triangular bony spicule was noted at the proximal end of the mylohyoid groove, in a close approximation of the mandibular foramen on the right-side, whereas in one of the mandible, the mylohyoid groove was very deep, and communication between the mylohyoid groove and mandibular canal was noted. Conclusion: Knowledge regarding mylohyoid bridging will help in the successful administration of inferior alveolar nerve block.
简介:Mylohyoid Bridging (MB)是一种下颌骨骨质增生变异。在下颌骨分支的内侧,可以观察到Mylohyoid Groove (MG)。这个沟的内容是脊骨舌骨神经和血管。髓舌骨桥可以压迫这些神经血管结构。目的:确定髓舌骨桥接的发生率,并确定其是否完全/不完全或近端/远端或单侧/双侧。材料和方法:本横断面研究于2022年7月在印度北方邦大诺伊达Sharda大学医学科学与研究学院解剖系进行。研究对象为60个干燥的人下颌骨(120侧)。下颌骨来自解剖学系。观察下颌骨两侧分支内侧的下颌舌骨桥。结果用描述性统计表示,并以频率和百分比表示。结果:120个骨舌骨沟中有3个(2.5%)出现骨舌骨桥。所有观察到的下颌舌骨桥均为不完全型(近端型、中间型和远端型各1个)。在其中一个下颌骨,在下颌舌骨沟的近端发现了一个三角形的骨针状体,与右侧的下颌孔非常接近,而在另一个下颌骨,下颌舌骨沟非常深,并且在下颌舌骨沟和下颌管之间发现了交通。结论:掌握下颌舌骨桥的相关知识有助于下牙槽神经阻滞的成功实施。
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引用次数: 0
Association between American College of Radiology Thyroid Imaging Reporting and Data System and Bethesda Scoring System in Assessment of Thyroid Nodule: A Prospective Cross-sectional Study 美国放射学会甲状腺影像学报告和数据系统与Bethesda评分系统在甲状腺结节评估中的相关性:一项前瞻性横断面研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/55447.2853
Rithi Melissa Dsilva, HB Suresh, C. Jayaprakash
Introduction: In view of increased detection of incidental thyroid nodules on ultrasonography, there is a need for standardising the reporting system of thyroid nodules for better patient management. Aim: To assess concordance between two classification systems of thyroid nodules: American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TIRADS) 2017 criteria on sonography and Bethesda categories on cytology. Materials and Methods: A prospective, cross-sectional validation study was conducted in Department of Radiology in collaboration with the Department of Pathology at a tertiary care hospital in Dakshina Kannada district, Karnataka, India, over a period of 12 months between October 2017 to September 2018. A total of 175 thyroid nodules detected on Ultrasonography (USG) were categorised based on ACR TIRADS 2017 criteria. Ultrasound guided Fine Needle Aspiration Cytology (FNAC) was performed on the nodules and were scored on the basis of Bethesda categories. Nodules were categorized into benign and malignant under TIRADS and Bethesda and their concordance was assessed. Sensitivity, specificity, positive and negative predictive value were assessed. Pearsons Chi-square test statistical method and kappa values were used in analysis. Results: Solid composition, hypoechoic echotexture, taller than wide shape, irregular margin and microcalcification descriptors of ACR TIRADS 2017 system were features more in favour of a malignant nodule. With FNAC as gold standard, TIRADS had a sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of 91.7 %, 86.3%, 63.5%, 97.6% and 87.4% respectively (p-value <0.001). Conclusion: The stratification of risk among thyroid nodules as benign or malignant using ACR TIRADS 2017 criteria yielded good result in our study. With careful examination of nodules, TIRADS can be used to select appropriate nodules for further evaluation with cytology.
导言:鉴于超声检查对偶发甲状腺结节的检出率越来越高,有必要规范甲状腺结节的报告制度,以更好地管理患者。目的:评估两种甲状腺结节分类系统之间的一致性:美国放射学会(ACR)甲状腺影像学报告和数据系统(TIRADS) 2017年超声检查标准和细胞学Bethesda分类。材料和方法:在2017年10月至2018年9月的12个月期间,在印度卡纳塔克邦Dakshina Kannada地区一家三级保健医院的放射科与病理学部合作进行了一项前瞻性横断面验证研究。根据ACR TIRADS 2017标准对超声检查(USG)检测到的175个甲状腺结节进行分类。对结节行超声引导下细针穿刺细胞学检查(FNAC),并根据Bethesda分类进行评分。在TIRADS和Bethesda下将结节分为良性和恶性,并评估其一致性。评估敏感性、特异性、阳性和阴性预测值。分析采用皮尔逊卡方检验、统计学方法和kappa值。结果:ACR TIRADS 2017系统的实性组成、低回声、高过宽、边缘不规则、微钙化等特征更有利于恶性结节的诊断。以FNAC为金标准,TIRADS的敏感性、特异性、阳性预测值和阴性预测值分别为91.7%、86.3%、63.5%、97.6%和87.4% (p值<0.001)。结论:在我们的研究中,使用ACR TIRADS 2017标准对甲状腺结节进行良性或恶性风险分层获得了良好的结果。通过对结节的仔细检查,TIRADS可用于选择适当的结节进行进一步的细胞学评估。
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引用次数: 0
Luminal and Extraluminal Factors in Normal and Pathological Appendix- A Cadaveric Study from Central Kerala, India 正常和病理阑尾的腔内和腔外因素——印度喀拉拉邦中部的一项尸体研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/56903.2852
Palaniappan Gajapriya, Sathappan Sivaraj, MB Prasanna
Introduction: Appendicitis is the most common clinical entity among the acute abdominal emergencies. Variations in the position of appendix along with degree of inflammation makes the clinical presentation of the condition notoriously inconsistent. Anatomical knowledge about the organ is thereby mandatory for the clinical assessment and to make a confident diagnosis. Obstructive causes have been found to be responsible in 50-80% cases of acute appendicitis. The way in which the inflammatory process proceeds, still remains a topic of debate. Aim: To study the luminal and extraluminal factors in both normal and pathological appendices. Materials and Methods: This was a cross-sectional descriptive study on gross morphological parameters like frequency of various positions, blood supply of appendix, length of appendix and mesoappendix, gross luminal content conducted on 50 normal and 53 pathological appendices collected from the Departments of Forensic Medicine, Anatomy and Pathology in the Government Medical College, Kottayam, Kerala, India, for a period of one year from April 2013-March 2014. Data entered in the excel sheet was further analysed using Statistical Package for Social Sciences (SPSS) software. Continuous variables were summarised as mean and Standard Deviation (SD) and the significance between their mean variables were analysed using t-test. Results: The most common age group presenting with appendicitis was 15-30 years with male incidence more than female. Appendices were supplied by single artery in 64% and by dual arteries in 36% samples. The average length of normal appendix was 7.8±2.33 cm and pathological appendix was 6.05±1.83 cm. Total 34 (77%) of normal appendices and 9 (81.81%) of pathological appendices showed shortening in length of mesoappendix from the tip of appendix. Common positions in normal and pathological appendices were retrocaecal and pelvic respectively. The most common complication presented in this study was perforation (n=7). Appendices were fixed in 16 (32%) of normal and 12 (22.6%) of pathological appendices. Fixity and complication were commonly associated with retrocaecal position. Conclusion: Appendicitis was more common among the younger age groups. The positions of appendix had no role in initiating the appendicitis. But fixity in particular position played an important role in late presentation thereby favouring complications.
阑尾炎是急腹症中最常见的临床疾病。阑尾位置的变化以及炎症的程度使得这种疾病的临床表现出出了名的不一致。因此,关于器官的解剖学知识对于临床评估和做出自信的诊断是强制性的。在50-80%的急性阑尾炎病例中发现梗阻性病因。炎症过程是如何进行的,仍然是一个争论的话题。目的:探讨正常阑尾和病理阑尾的腔内和腔外因素。材料与方法:2013年4月- 2014年3月,对印度喀拉拉邦Kottayam政府医学院法医学、解剖学和病理学院系采集的50条正常阑尾和53条病理阑尾进行了为期一年的横断面描述性研究,包括阑尾各部位出现频率、阑尾血供、阑尾及尾系膜长度、阑尾总腔内含量等大体形态学参数。输入到excel表格中的数据使用社会科学统计软件包(SPSS)软件进一步分析。连续变量总结为均值和标准差(SD),采用t检验分析其均值变量之间的显著性。结果:15 ~ 30岁为阑尾炎最常见的年龄组,男性发病率高于女性。64%的样本由单动脉供应阑尾,36%的样本由双动脉供应阑尾。正常阑尾平均长度为7.8±2.33 cm,病理阑尾平均长度为6.05±1.83 cm。正常阑尾34例(77%),病理阑尾9例(81.81%),尾系膜从阑尾尖端开始缩短。正常阑尾和病理阑尾的常见位置分别为盲肠后和盆腔。本研究中最常见的并发症是穿孔(n=7)。正常阑尾16例(32%),病理阑尾12例(22.6%)。固定和并发症通常与盲肠后位置有关。结论:阑尾炎以低龄人群多见。阑尾位置对阑尾炎的发生无影响。但特定位置的固定在晚期表现中起重要作用,从而有利于并发症的发生。
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引用次数: 0
Association between Main Pulmonary Artery Diameter and COVID-19 Severity- A Cross-sectional Study 肺动脉主动脉直径与COVID-19严重程度的相关性——一项横断面研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/59317.2911
Aysha Abna, A. Braggs, Soujanya Mynalli
Introduction: Long-term consequences of the Coronavirus Disease 2019 (COVID-19) pneumonia infection, like lung vessel thrombosis and pulmonary hypertension, require prompt diagnosis and management. Hence, measurement of Main Pulmonary Artery Diameter (MPAD) in patients with moderate to severe Computed Tomography (CT)-based severity scoring helps detect the possibility of complication early. In this study, Coronavirus Disease 2019 Reporting and Data System (CO-RADS) scoring for suspected patients were done. Aim: To measure MPAD in Reverse Transcription-Polymerase Chain Reaction (RT-PCR) COVID-19 positive (CO-RADS 6) and highly COVID-19 pneumonia suspicious patients (CO- RADS 4, 5) and then to associate with CT Severity Score (CTSS). Materials and Methods: This cross-sectional, retrospective study was conducted in the Department of Radiodiagnosis, Father Muller Medical College, Mangalore from January 2020 to January 2022. Total of 200 patients, including 141 males and 59 females, who were highly suspicious and positive for COVID-19 pneumonia were studied. CT findings were noted, and CTSS was calculated. This was used to categorise the study sample into mild, moderate, and severe categories. MPAD was then measured for the corresponding patients. The measurement was then associated with the COVID-19 CTSS scoring using the Chi-square test, and p-value<0.05 was considered significant. Results: Considering various parameters like age, gender, co- morbidities, and CTSS with MPAD, there was no statistically significant association between the former three parameters. Considering CTSS with MPAD, there were 72 mild, 92 moderate, and 36 severe cases. The study found a highly significant association between co-morbidities and CTSS (p-value=0.009) and a significant association between MPAD and the CTSS (p-value=0.024). Conclusion: MPAD could be used to predict the possibility of future complications like lung vessel thrombosis and pulmonary artery hypertension in patients highly suspicious and positive for COVID-19 pneumonia.
2019冠状病毒病(COVID-19)肺炎感染的长期后果,如肺血管血栓形成和肺动脉高压,需要及时诊断和治疗。因此,在进行中至重度CT严重程度评分的患者中测量主肺动脉直径(MPAD)有助于早期发现并发症的可能性。本研究对疑似患者进行2019冠状病毒病报告和数据系统(CO-RADS)评分。目的:测定逆转录聚合酶链反应(RT-PCR) COVID-19阳性(CO-RADS 6)和COVID-19肺炎高度可疑(CO-RADS 4、5)患者的MPAD水平,并与CT严重程度评分(CTSS)进行关联。材料和方法:本横断面回顾性研究于2020年1月至2022年1月在芒格洛尔父亲穆勒医学院放射诊断部进行。选取新冠肺炎高度可疑阳性患者200例,其中男性141例,女性59例。记录CT表现,计算CTSS。这被用来将研究样本分为轻度、中度和重度三类。然后测量相应患者的MPAD。然后使用卡方检验将测量结果与COVID-19 CTSS评分相关联,p值<0.05被认为是显著的。结果:考虑年龄、性别、合并症、CTSS合并MPAD等参数,前3个参数间无统计学意义的相关性。考虑合并MPAD的CTSS,轻度72例,中度92例,重度36例。该研究发现合并症与CTSS之间存在高度显著相关性(p值=0.009),MPAD与CTSS之间存在显著相关性(p值=0.024)。结论:MPAD可用于预测COVID-19肺炎高度可疑阳性患者未来发生肺血管血栓形成、肺动脉高压等并发症的可能性。
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引用次数: 0
Factors Affecting Wound Healing after Laparotomy at a Tertiary Care Hospital, Odisha, India: A Prospective Interventional Study 影响印度奥里萨邦三级医院剖腹手术后伤口愈合的因素:一项前瞻性介入研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/59903.2885
Sucheta Panigrahi, Sudarsan Sethy, Kishan Bhoi, Supreet Saurav, Manish Panigrahi
Introduction: Wound healing after the injury occurs after various phases and is affected by multiple factors. It plays a psychological role for the surgeon and patients, influencing morbidity and hospital stay. Factors like age, nutrition, use of steroids, type of incision, diabetes and infection plays an essential role in wound healing. Aim: To assess the factors influencing patients and affecting wound healing after laparotomy. Materials and Methods: This prospective interventional study was carried in the Department of General Surgery, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, India, between October 2019 and September 2021 on 100 patients undergoing laparotomy, admitted in the surgical ward. Data was collected regarding clinical history including co-morbid conditions (diabetes, hypertension, anaemia), general physical and systemic examination and relevant diagnostic investigations. The collected data was tabulated as mean±Standard Deviation (SD), frequency (n) and percentage (%) for proper analysis, represented in form of pie-charts and bar diagrams. Results: A total of 100 patients undergoing laparotomies were studied, with maximum participants in 61-70 years of age. Out of these, 40 patients were found to have delayed wound healing (mean age: 62.2 years), 10 (25%) were females and 30 (75%) were males. Wound infection was most common (n=38) factor for delayed healing followed by diabetes (16 patients out of 30 known diabetics), and consumption of alcohol (14 patients out of 24 known alcoholics) and smoking (20 out of 25 known chronic smokers). Conclusion: The incidence of delayed healing was higher in the present study with an increased incidence of wound infection. Clinical factors of low haemoglobin, low serum albumin, history of diabetes mellitus, alcohol and smoking, were observed to be associated with delayed wound healing along with physiological predisposing factors of increasing age and gender. These factors should be considered, and efforts can be made to manage these risk factors for proper care of patients.
简介:创伤后伤口愈合发生在多个阶段,受多种因素影响。它对外科医生和患者都有心理作用,影响发病率和住院时间。年龄、营养、类固醇使用、切口类型、糖尿病和感染等因素在伤口愈合中起着至关重要的作用。目的:探讨影响剖腹手术患者及术后创面愈合的因素。材料与方法:这项前瞻性介入研究于2019年10月至2021年9月在印度奥里萨邦萨姆巴尔普尔Burla Veer Surendra Sai医学科学与研究所普通外科进行,研究对象是100名在外科病房接受剖腹手术的患者。收集有关临床病史的数据,包括合并症(糖尿病、高血压、贫血)、一般体格和全身检查以及相关的诊断调查。收集到的数据以均数±标准差(SD)、频率(n)和百分比(%)的形式制成表格,以饼状图和条形图的形式表示,便于分析。结果:共研究了100例剖腹手术患者,年龄在61-70岁之间。其中,40例患者发现伤口愈合延迟(平均年龄:62.2岁),10例(25%)为女性,30例(75%)为男性。伤口感染是延迟愈合最常见的因素(n=38),其次是糖尿病(30名已知糖尿病患者中有16名)、饮酒(24名已知酗酒者中有14名)和吸烟(25名已知慢性吸烟者中有20名)。结论:在本研究中,延迟愈合的发生率较高,伤口感染的发生率也较高。低血红蛋白、低血清白蛋白、糖尿病史、酒精和吸烟等临床因素与伤口愈合延迟有关,同时伴有年龄和性别增加的生理易感因素。应考虑这些因素,并努力管理这些风险因素,以便对患者进行适当护理。
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引用次数: 0
Morphometric Study of Sulci Tali and Calcanei and its Clinical Significance: A Cross-sectional Analytical Study 截骨沟和跟骨沟的形态计量学研究及其临床意义
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/60821.2933
Sulekha Mangesh Kolap, Siddhesh Prakash Prabhu, Uday Narayan Kudalkar
Introduction: Knowledge of the vascular anatomy of the talus and calcaneus, particularly the sinus tarsi in the foot, is important for orthopaedic and vascular surgeons performing surgical procedures. Aim: The aim of this study was to measure and compare the dimensions of the right and left tali and calcanei, as well as the right and left sulci tali and calcanei. Materials and Methods: A cross-sectional analytical study was conducted at the Department of Anatomy, Goa Medical College, Bambolim, Goa, India, from March 2020 to August 2022. The study included 62 calcanei (32 left, 30 right) and 50 tali (26 left, 24 right) of unspecified gender/age. Measurements of the length and width of the tali and calcanei, as well as the dimensions of the sulci tali and calcanei, were obtained using digital Vernier calipers. The number of vascular foramina was also recorded. Statistical analysis including mean, standard deviation (SD), and p-values was performed using Statistical Package for the Social Sciences (SPSS) software version 22.0. Results: The length of the right and left tali was measured as 50.85±3.44 mm and 51.87±3.86 mm, respectively (p-value=0.32), while the width of the right and left tali was measured as 36.92±4.0 mm and 38.51±2.65 mm, respectively (p-value=0.10). The length of the right and left sulcus tali was measured as 31.44±2.82 mm and 32.01±2.78 mm, respectively (p-value=0.47), with the width of the right and left sulcus tali measured as 10.08±3.47 mm and 10.9±3.45 mm, respectively (p-value=0.40), and the depth of the right and left sulcus tali measured as 4.65±0.82 mm and 5.01±1.33 mm, respectively (p-value=0.24). The length of the right and left calcanei was measured as 72.58±5.77 mm and 72.75±5.44 mm, respectively (p-value=0.90), with the width of the right and left calcanei measured as 28.56±2.52 mm and 27.76±2.42 mm, respectively (p-value=0.21). The length of the right and left sulcus calcanei was measured as 34.62±2.59 mm and 34.8±3.3 mm, respectively (p-value=0.81), with the width of the right and left sulcus calcanei measured as 10.85±2.12 mm and 10.69±2.07 mm, respectively (p-value=0.75), and the depth of the right and left sulcus calcanei measured as 2.64±0.77 mm and 2.93±0.83 mm, respectively (p-value=0.17). A total of 232 and 335 vascular foramina were found in the sulci tali on the right and left sides, respectively. A total of 172 and 168 vascular foramina were found in the sulci calcanei on the right and left sides, respectively. Conclusion: The dimensions of the left side were generally higher compared to the right for most of the measured variables. This study provides valuable insights for clinicians from a surgical perspective and in the context of fracture healing and foot rehabilitation procedures.
导读:距骨和跟骨的血管解剖学知识,特别是足部跗骨窦的血管解剖学知识,对于骨科和血管外科医生进行外科手术是很重要的。目的:本研究的目的是测量和比较左右距和跟骨,以及左右距沟和跟骨的尺寸。材料和方法:2020年3月至2022年8月,在印度果阿邦邦邦邦果阿医学院解剖学系进行了一项横断面分析研究。该研究包括62名未指明性别/年龄的跟骨(32名左侧,30名右侧)和50名(26名左侧,24名右侧)。使用数字游标卡尺测量足趾和跟骨的长度和宽度,以及足沟和跟骨的尺寸。同时记录血管孔的数量。使用SPSS 22.0版社会科学统计软件包(Statistical Package for Social Sciences)进行统计分析,包括平均值、标准差(SD)和p值。结果:测得左右塔利长度分别为50.85±3.44 mm和51.87±3.86 mm (p值=0.32),测得左右塔利宽度分别为36.92±4.0 mm和38.51±2.65 mm (p值=0.10)。测得左右tal沟长度分别为31.44±2.82 mm和32.01±2.78 mm (p值=0.47),左右tal沟宽度分别为10.08±3.47 mm和10.9±3.45 mm (p值=0.40),左右tal沟深度分别为4.65±0.82 mm和5.01±1.33 mm (p值=0.24)。左右跟骨长度分别为72.58±5.77 mm和72.75±5.44 mm (p值=0.90),左右跟骨宽度分别为28.56±2.52 mm和27.76±2.42 mm (p值=0.21)。左、右跟沟长度分别为34.62±2.59 mm和34.8±3.3 mm (p值=0.81),左、右跟沟宽度分别为10.85±2.12 mm和10.69±2.07 mm (p值=0.75),左、右跟沟深度分别为2.64±0.77 mm和2.93±0.83 mm (p值=0.17)。在右侧和左侧沟内分别发现232和335个血管孔。跟骨沟两侧分别有172个和168个血管孔。结论:在大多数测量变量中,左侧的维度普遍高于右侧。本研究为临床医生从外科角度以及骨折愈合和足部康复过程提供了有价值的见解。
{"title":"Morphometric Study of Sulci Tali and Calcanei and its Clinical Significance: A Cross-sectional Analytical Study","authors":"Sulekha Mangesh Kolap, Siddhesh Prakash Prabhu, Uday Narayan Kudalkar","doi":"10.7860/ijars/2023/60821.2933","DOIUrl":"https://doi.org/10.7860/ijars/2023/60821.2933","url":null,"abstract":"Introduction: Knowledge of the vascular anatomy of the talus and calcaneus, particularly the sinus tarsi in the foot, is important for orthopaedic and vascular surgeons performing surgical procedures. Aim: The aim of this study was to measure and compare the dimensions of the right and left tali and calcanei, as well as the right and left sulci tali and calcanei. Materials and Methods: A cross-sectional analytical study was conducted at the Department of Anatomy, Goa Medical College, Bambolim, Goa, India, from March 2020 to August 2022. The study included 62 calcanei (32 left, 30 right) and 50 tali (26 left, 24 right) of unspecified gender/age. Measurements of the length and width of the tali and calcanei, as well as the dimensions of the sulci tali and calcanei, were obtained using digital Vernier calipers. The number of vascular foramina was also recorded. Statistical analysis including mean, standard deviation (SD), and p-values was performed using Statistical Package for the Social Sciences (SPSS) software version 22.0. Results: The length of the right and left tali was measured as 50.85±3.44 mm and 51.87±3.86 mm, respectively (p-value=0.32), while the width of the right and left tali was measured as 36.92±4.0 mm and 38.51±2.65 mm, respectively (p-value=0.10). The length of the right and left sulcus tali was measured as 31.44±2.82 mm and 32.01±2.78 mm, respectively (p-value=0.47), with the width of the right and left sulcus tali measured as 10.08±3.47 mm and 10.9±3.45 mm, respectively (p-value=0.40), and the depth of the right and left sulcus tali measured as 4.65±0.82 mm and 5.01±1.33 mm, respectively (p-value=0.24). The length of the right and left calcanei was measured as 72.58±5.77 mm and 72.75±5.44 mm, respectively (p-value=0.90), with the width of the right and left calcanei measured as 28.56±2.52 mm and 27.76±2.42 mm, respectively (p-value=0.21). The length of the right and left sulcus calcanei was measured as 34.62±2.59 mm and 34.8±3.3 mm, respectively (p-value=0.81), with the width of the right and left sulcus calcanei measured as 10.85±2.12 mm and 10.69±2.07 mm, respectively (p-value=0.75), and the depth of the right and left sulcus calcanei measured as 2.64±0.77 mm and 2.93±0.83 mm, respectively (p-value=0.17). A total of 232 and 335 vascular foramina were found in the sulci tali on the right and left sides, respectively. A total of 172 and 168 vascular foramina were found in the sulci calcanei on the right and left sides, respectively. Conclusion: The dimensions of the left side were generally higher compared to the right for most of the measured variables. This study provides valuable insights for clinicians from a surgical perspective and in the context of fracture healing and foot rehabilitation procedures.","PeriodicalId":56235,"journal":{"name":"International Journal of Anatomy Radiology and Surgery","volume":"364 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135445795","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}
引用次数: 0
Utility of Diffusion-Weighted MRI with ADC Values in the Characterisation of Endometrial Lesions: A Prospective Cohort Study 具有ADC值的弥散加权MRI在子宫内膜病变表征中的应用:一项前瞻性队列研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/62440.2926
Amandeep Singh, Parmeet Kaur, Amitojveer Singh, Gursangeet Singh, Arvinder Singh, Vijinder Arora
Introduction: Endometrial lesions are a diagnostic dilemma for both radiologists, as well as, gynecologists. Characterising these lesions is crucial for effective management. The Apparent Diffusion Coefficient (ADC) reflects the molecular translational movement of water molecules. Malignant tumours, with higher cellularity than benign tumours, exhibit decreased ADC values compared to benign lesions. Aim: This study aimed to evaluate the diagnostic accuracy of ADC in conjunction with Diffusion-weighted Images (DWI) for differentiating malignant and benign endometrial lesions. Materials and Methods: A prospective cohort study was conducted at the Outpatient Department (OPD) of Radiodiagnosis at Sri Guru Ram Das Charitable Hospital in Amritsar, Punjab, India. The study spanned one year and seven months, from February 2020 to October 2021. A total of 100 female patients across all age groups with clinically suspected gynecological complaints related to the endometrium were included. Magnetic Resonance Imaging (MRI) was used to the examine the patients with endometrial lesions, and the results were compared with histopathology. The ADC values of benign and malignant lesions were statistically analysed using Student's t-test. Statistical significance was defined as a p-value < 0.05. Results: The mean age of participants with benign lesions was lower than that of those with malignant lesions (53.47±8.75 years and 60.00±13.93 years, respectively). The 100 individuals were divided into two groups: group I included individuals with benign lesions (58%), and group II comprised patients with malignant lesions (42%). Conventional MRI demonstrated a sensitivity of 86.2%, specificity of 91.8%, Positive Predictive Value (PPV) of 91.6%, and Negative Predictive Value (NPV) of 100% in lesion detection and differentiation. Combining DWI and ADC value mapping at a high b-value (b=800) in MRI significantly increased sensitivity (92.1%), specificity (97.9%), PPV (97.9%), and NPV (92.3%). Conclusion: The addition of DWI and ADC values to conventional MRI significantly improved the ability to distinguish malignant endometrial lesions from benign ones. However, histopathology remains the gold standard investigation as MRI inference cannot differentiate low-grade endometrial carcinoma from hyperplasia.
子宫内膜病变是一个两难的诊断放射科医生,以及,妇科医生。表征这些病变对有效治疗至关重要。表观扩散系数(ADC)反映了水分子的平移运动。恶性肿瘤比良性肿瘤具有更高的细胞密度,其ADC值也比良性肿瘤低。目的:本研究旨在评估ADC结合弥散加权图像(DWI)对子宫内膜良恶性病变的诊断准确性。材料和方法:在印度旁遮普省阿姆利则的Sri Guru Ram Das慈善医院放射诊断门诊部(OPD)进行了一项前瞻性队列研究。该研究历时一年零七个月,从2020年2月到2021年10月。共有100名不同年龄组的女性患者,临床怀疑与子宫内膜有关的妇科疾病。应用磁共振成像(MRI)对子宫内膜病变患者进行检查,并与组织病理学结果进行比较。良、恶性病变的ADC值采用Student’st检验进行统计学分析。统计显著性定义为p值<0.05. 结果:良性病变参与者的平均年龄低于恶性病变参与者(分别为53.47±8.75岁和60.00±13.93岁)。100例患者被分为两组:I组为良性病变患者(58%),II组为恶性病变患者(42%)。常规MRI对病变的检测和鉴别敏感性为86.2%,特异性为91.8%,阳性预测值(Positive Predictive Value, PPV)为91.6%,阴性预测值(Negative Predictive Value, NPV)为100%。MRI高b值(b=800) DWI与ADC值作图结合,可显著提高敏感性(92.1%)、特异性(97.9%)、PPV(97.9%)和NPV(92.3%)。结论:在常规MRI基础上增加DWI和ADC值可显著提高子宫内膜良恶性病变的鉴别能力。然而,组织病理学仍然是金标准调查,因为MRI推断不能区分低级别子宫内膜癌和增生。
{"title":"Utility of Diffusion-Weighted MRI with ADC Values in the Characterisation of Endometrial Lesions: A Prospective Cohort Study","authors":"Amandeep Singh, Parmeet Kaur, Amitojveer Singh, Gursangeet Singh, Arvinder Singh, Vijinder Arora","doi":"10.7860/ijars/2023/62440.2926","DOIUrl":"https://doi.org/10.7860/ijars/2023/62440.2926","url":null,"abstract":"Introduction: Endometrial lesions are a diagnostic dilemma for both radiologists, as well as, gynecologists. Characterising these lesions is crucial for effective management. The Apparent Diffusion Coefficient (ADC) reflects the molecular translational movement of water molecules. Malignant tumours, with higher cellularity than benign tumours, exhibit decreased ADC values compared to benign lesions. Aim: This study aimed to evaluate the diagnostic accuracy of ADC in conjunction with Diffusion-weighted Images (DWI) for differentiating malignant and benign endometrial lesions. Materials and Methods: A prospective cohort study was conducted at the Outpatient Department (OPD) of Radiodiagnosis at Sri Guru Ram Das Charitable Hospital in Amritsar, Punjab, India. The study spanned one year and seven months, from February 2020 to October 2021. A total of 100 female patients across all age groups with clinically suspected gynecological complaints related to the endometrium were included. Magnetic Resonance Imaging (MRI) was used to the examine the patients with endometrial lesions, and the results were compared with histopathology. The ADC values of benign and malignant lesions were statistically analysed using Student's t-test. Statistical significance was defined as a p-value < 0.05. Results: The mean age of participants with benign lesions was lower than that of those with malignant lesions (53.47±8.75 years and 60.00±13.93 years, respectively). The 100 individuals were divided into two groups: group I included individuals with benign lesions (58%), and group II comprised patients with malignant lesions (42%). Conventional MRI demonstrated a sensitivity of 86.2%, specificity of 91.8%, Positive Predictive Value (PPV) of 91.6%, and Negative Predictive Value (NPV) of 100% in lesion detection and differentiation. Combining DWI and ADC value mapping at a high b-value (b=800) in MRI significantly increased sensitivity (92.1%), specificity (97.9%), PPV (97.9%), and NPV (92.3%). Conclusion: The addition of DWI and ADC values to conventional MRI significantly improved the ability to distinguish malignant endometrial lesions from benign ones. However, histopathology remains the gold standard investigation as MRI inference cannot differentiate low-grade endometrial carcinoma from hyperplasia.","PeriodicalId":56235,"journal":{"name":"International Journal of Anatomy Radiology and Surgery","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135446653","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}
引用次数: 0
Morphometric Study of Different Orbital Dimensions in Dry Skull in Eastern India- A Cross-sectional Study 印度东部干颅骨不同眶径的形态计量学研究-横断面研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/55329.2878
P. Chakraborty, Alipta Bhattacharya, Anamika Ghosh, A. Bhattacharya, A. K. Ghosal
Introduction: Existing data regarding the relative position of the various bony landmarks of the orbit suggest that the position of these landmarks may vary depending on the racial population studied. The present study will provide useful baseline orbital morphometric data in Eastern Indian population. Aim: To study the morphometric data of the different orbital dimensions, fissures and foramens of dry skulls in Eastern Indian region. Materials and Methods: This cross-sectional study was done in the department of Anatomy, of a Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India from January 2016 to June 2020. Total 101 adult dry skulls (71 male and 30 female) collected from the departments of Anatomy of four medical colleges were included in the study. Orbital height, breadth, index, distance between Supraorbital Notch/foramen (SON) to Superior Orbital Fissure distance (SOF), the Anterior Lacrimal Crest (ALC) to Posterior Lacrimal Crest (PLC), ALC to the medial border of the optic canal, orbital floor and lateral wall were measured. Results: Based on Orbital Index (OI) 39.12% skulls were found to be in mesoseme, 50.5% in microseme and 10.4% in megaseme category, both genders taken together. The mean SON to SOF distance was 42.48 mm in males and 41.52 mm in females. Mean Infraorbital Foramen (IF) to Inferior Orbital Fissure (IOF) distance was 22.4 mm in males and 22.26 mm in females. Average Frontozygomatic Suture (FZ) to Inferior Orbital Fissure (IOF) was 24.35 mm whereas it was 32.97 mm for the ALC to Optic canal (OC) distance. Conclusion: Most of the skulls studies belonged to the microseme category. Orbital height and breadth were significantly higher in males compared to females.
关于眼眶各种骨标记的相对位置的现有数据表明,这些标记的位置可能因所研究的种族人口而异。本研究将为东印度人口提供有用的基线眼窝形态测量数据。目的:研究印度东部地区干颅骨不同眶径、裂隙、孔的形态计量学资料。材料和方法:本横断面研究于2016年1月至2020年6月在印度西孟加拉邦加尔各答的研究生医学教育与研究所解剖学系完成。本研究共收集4所医学院解剖学系101例成人干颅骨(男71例,女30例)。测量眼眶高度、宽度、指数、眶上切迹/孔距(SON)至眶上裂距(SOF)、泪前嵴距(ALC)、泪后嵴距(PLC)、ALC距视神经管内侧缘、眶底及眶外壁。结果:根据眼眶指数(OI), 39.12%的颅骨属于中位,50.5%属于微位,10.4%属于大位。男性的平均SON - SOF距离为42.48 mm,女性为41.52 mm。平均眶下孔(IF)至眶下裂(IOF)距离男性为22.4 mm,女性为22.26 mm。额颧缝距眶下裂(IOF)平均为24.35 mm, ALC距视神经管(OC)平均为32.97 mm。结论:多数颅骨研究属于微粒体范畴。男性眼眶高度和宽度明显高于女性。
{"title":"Morphometric Study of Different Orbital Dimensions in Dry Skull in Eastern India- A Cross-sectional Study","authors":"P. Chakraborty, Alipta Bhattacharya, Anamika Ghosh, A. Bhattacharya, A. K. Ghosal","doi":"10.7860/ijars/2023/55329.2878","DOIUrl":"https://doi.org/10.7860/ijars/2023/55329.2878","url":null,"abstract":"Introduction: Existing data regarding the relative position of the various bony landmarks of the orbit suggest that the position of these landmarks may vary depending on the racial population studied. The present study will provide useful baseline orbital morphometric data in Eastern Indian population. Aim: To study the morphometric data of the different orbital dimensions, fissures and foramens of dry skulls in Eastern Indian region. Materials and Methods: This cross-sectional study was done in the department of Anatomy, of a Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India from January 2016 to June 2020. Total 101 adult dry skulls (71 male and 30 female) collected from the departments of Anatomy of four medical colleges were included in the study. Orbital height, breadth, index, distance between Supraorbital Notch/foramen (SON) to Superior Orbital Fissure distance (SOF), the Anterior Lacrimal Crest (ALC) to Posterior Lacrimal Crest (PLC), ALC to the medial border of the optic canal, orbital floor and lateral wall were measured. Results: Based on Orbital Index (OI) 39.12% skulls were found to be in mesoseme, 50.5% in microseme and 10.4% in megaseme category, both genders taken together. The mean SON to SOF distance was 42.48 mm in males and 41.52 mm in females. Mean Infraorbital Foramen (IF) to Inferior Orbital Fissure (IOF) distance was 22.4 mm in males and 22.26 mm in females. Average Frontozygomatic Suture (FZ) to Inferior Orbital Fissure (IOF) was 24.35 mm whereas it was 32.97 mm for the ALC to Optic canal (OC) distance. Conclusion: Most of the skulls studies belonged to the microseme category. Orbital height and breadth were significantly higher in males compared to females.","PeriodicalId":56235,"journal":{"name":"International Journal of Anatomy Radiology and Surgery","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71263193","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}
引用次数: 0
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International Journal of Anatomy Radiology and Surgery
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