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Clinical Characteristics and Management of Renal Trauma: A Single-centre Observational Study 肾外伤的临床特点和处理:一项单中心观察性研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/57478.2857
VEnkAtA RAngA SwAmy, D. Reddy, Raja Sekhar Guddeti, Mutyasri Pedapathnapu
Introduction: The management of renal trauma includes operative and non operative approach based on clinical profile of patient. However, management of the high-grade renal trauma remains controversial. Aim: To evaluate mode of renal injury, staging and its management outcomes. Materials and Methods: This prospective, observational study included 49 patients (>15 years of age) who presented with abdominal trauma. Computed tomography was performed for grading of renal trauma. The patients were stratified based on whether they underwent open renal surgery or conservative management for their renal injury. Demographic characteristics and a detailed history of renal injuries were recorded. The patients were evaluated based on the rate of renal preservation and complications at 6-month follow-up. Results: The mean age was 32.10 years and majority of the patients were males (87.76%). Blunt trauma (95.92%) was most frequently reported. According to American Association for the Surgery of Trauma (AAST), 8 (16.33%) patients were categorized in grade I, 17 (34.69%) patients in grade II, 8 (16.33%) patients in grade III, 12 (24.49%) patients in grade IV, and 4 (8.16%) patients in grade V. Microscopic haematuria (42.86%) was the most common clinical presentation. The majority of the patients were managed conservatively (89.8%). Only two belonging to grade 4 and three from grade 5 were managed operatively due to haemodynamic instability. Rib fractures (n=10) were the most frequently associated injury, and Urinary Tract Infection (UTI) (n=8) was the most common complication, followed by persistent haematuria (n=3), and hypertension (n=3). All patients with grades I to III showed 100% renal preservation rate with conservative management. However, patients with grades IV and V showed renal preservation rate of 83.33% and 50%, respectively. Conclusion: Conservative treatment is a preferred choice of treatment in the most of the renal trauma. The present study reported high renal preservation rate in low-grade renal injuries, which were managed conservatively. However, there is still need of surgical treatment in high grade haemodynamically unstable patients.
导读:肾外伤的治疗根据患者的临床情况分为手术治疗和非手术治疗。然而,高级别肾外伤的处理仍然存在争议。目的:探讨肾损伤的模式、分期及治疗效果。材料和方法:这项前瞻性观察性研究纳入了49例(年龄0 ~ 15岁)腹部外伤患者。采用计算机断层扫描对肾损伤进行分级。根据患者是否接受开放肾手术或保守治疗对其肾损伤进行分层。记录患者的人口学特征和肾损伤的详细病史。在6个月的随访中,根据肾脏保存率和并发症对患者进行评估。结果:患者平均年龄32.10岁,男性居多(87.76%)。最常见的是钝挫伤(95.92%)。根据美国创伤外科协会(AAST)的数据,8例(16.33%)患者为I级,17例(34.69%)为II级,8例(16.33%)为III级,12例(24.49%)为IV级,4例(8.16%)为v级。镜下血尿(42.86%)是最常见的临床表现。大多数患者采用保守治疗(89.8%)。由于血流动力学不稳定,只有2例属于4级和3例来自5级的患者进行了手术治疗。肋骨骨折(n=10)是最常见的相关损伤,尿路感染(n=8)是最常见的并发症,其次是持续血尿(n=3)和高血压(n=3)。所有I ~ III级患者在保守治疗下肾脏保存率均为100%。IV级和V级患者的肾脏保存率分别为83.33%和50%。结论:保守治疗是大多数肾外伤的首选治疗方法。本研究报告了低级别肾损伤的高肾保存率,并对其进行了保守处理。然而,对于高度血流动力学不稳定的患者,仍然需要手术治疗。
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引用次数: 0
Effectiveness of Foam Sclerotherapy in Treatment of Symptomatic Haemorrhoidal Diseases at a Tertiary Care Hospital, Agra, Uttar Pradesh, India: A Prospective Interventional Study 泡沫硬化疗法在印度北方邦阿格拉三级医院治疗症状性痔疮疾病的有效性:一项前瞻性介入研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/59502.2869
P. Agrawal, A. Saxena, Prakhar Verma, A. Yadav, Radhika Sahni, Z. Parkar, Nitish Jain, Anam Fatima
Introduction: Haemorrhoids is a very common condition in patients presenting to surgery Outpatient Department (OPD) with complaints of bleeding per rectum. Injection Foam Sclerotherapy has been established as a safe, simple and effective non surgical modality in treatment of symptomatic grade 1 and 2 haemorrhoids. Aim: To evaluate the effectiveness of foam sclerotherapy as a treatment modality in patients suffering with symptomatic Grade I and II Haemorrhoidal diseases. Materials and Methods: This prospective interventional study was conducted in General Surgery department of FH Medical College and Hospital, Agra, Uttar Pradesh, India between April 2021 to September 2021. A total of 42 patients with complaints of bleeding per rectum, and who were diagnosed as a case of Grade I or II internal haemorrhoids were included. 3% Polidocanol was used as the sclerosing agent for sclerotherapy. Effectiveness of sclerotherapy was evaluated, parameters assessed were bleeding per rectum, pain and pruritis with regular follow-ups of the patients at specific intervals. Results: Among 42 patients 29 (69.05%) patients had grade I haemorrhoids while 13 (30.95%) presented as a case of grade II haemorrhoidal disease. Among the patients with grade I haemorrhoids, 82.76% (24/29) were treated successfully after a single session of foam sclerotherapy while 53.85% (7/13) of the patients with grade II haemorrhoids were symptomatically relieved after a single session. The success rate after 2nd session of sclerotherapy was 100% (29/29) in patients diagnosed as a case of grade I haemorrhoids comparing it to 69.23% (9/13) in those with grade II haemorrhoids. The overall cure rate for either grade of haemorrhoid after three sessions of therapy was 95.24% (40/42). Conclusion: This study reflects that 3% polidocanol when used as a sclerosant agent was found to be cheap, safe and effective, and first line treatment modality in grade I and II haemorrhoids that can be done on outpatient basis with minimal complication.
简介:痔疮是一种非常常见的情况,患者提出的手术门诊部(OPD)的每直肠出血的投诉。注射泡沫硬化疗法是一种安全、简单、有效的非手术治疗症状性1级和2级痔疮的方法。目的:评价泡沫硬化治疗有症状的一、二级痔疮患者的疗效。材料与方法:本前瞻性介入研究于2021年4月至2021年9月在印度北方邦阿格拉FH医学院和医院普外科进行。共纳入42例直肠出血主诉,诊断为1级或2级内痔的患者。采用3%聚多坎醇作为硬化剂进行硬化治疗。评估硬化疗法的有效性,评估参数为直肠出血、疼痛和瘙痒,并在特定时间间隔定期随访患者。结果:42例患者中29例(69.05%)为I级痔疮,13例(30.95%)为II级痔疮。在I级痔疮患者中,82.76%(24/29)的患者通过一次泡沫硬化治疗成功,而53.85%(7/13)的患者通过一次泡沫硬化治疗症状缓解。II级痔疮患者第二次硬化治疗的成功率为69.23%(9/13),而I级痔疮患者第二次硬化治疗的成功率为100%(29/29)。三次治疗后,两级痔疮的总治愈率为95.24%(40/42)。结论:本研究表明,3%聚多卡因醇作为一种廉价、安全、有效的硬化剂,是一、二级痔疮的一线治疗方式,可在门诊进行,并发症少。
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引用次数: 0
Abnormal Behaviour of Introducing Ring in Penis and its Fatal Consequences: A Case Series 阴茎引入环的异常行为及其致命后果:一个案例系列
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/60484.2892
Dhrubajyoti Maulik, Debjit Nandi
This case series is about four incidences where the patients had introduced rings around the penis. The duration of the presentation ranged from eight to ninety-six hours. All patients had different degrees of injury and clinical presentation and were managed accordingly. Help of one metallic electrical cutter and two non hospital staff were required while removing those rings and same method was used in all cases. At the time of discharge, one patient was found to have degloved penile skin, others showed sloughed-out skin at the base of the penis. Late presenters had lower Erection Hard Score (EHS) but all had normal voiding of urine at the time of discharge. One patient was known to have schizophrenia. Other patients had no history of mental disorders and psychiatric evaluation was also done during hospital stay. Penile strangulation needs urgent medical attention and the removal of the rings as early as possible. Duration of strangulation and type of object plays a vital role in determining the grade of injury and complications.
这个系列的病例是关于四个病人在阴茎周围植入环的病例。报告的持续时间从8小时到96小时不等。所有患者均有不同程度的损伤和临床表现,并进行相应的处理。拆除这些环时需要一名金属电动切割器和两名非医院工作人员的帮助,所有情况下都使用了相同的方法。出院时,一名患者阴茎皮肤脱落,其他患者阴茎底部皮肤脱落。迟到者勃起硬评分(EHS)较低,但出院时排尿正常。其中一名患者患有精神分裂症。其他患者无精神病史,住院期间也进行了精神病学评估。阴茎勒死需要紧急医疗护理,并尽早取出环。勒死的时间和物体类型在决定损伤程度和并发症方面起着至关重要的作用。
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引用次数: 0
Variations of Cystic Artery Supplying the Gallbladder and its Surgical Importance: A Cadaveric Study from Tamil Nadu, India 供应胆囊的囊性动脉的变异及其外科意义:来自印度泰米尔纳德邦的尸体研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/59640.2875
K. Sangameswaran
Introduction: Symptomatic cholelithiasis is usually treated by cholecystectomy. Cystic Artery (CA) should be ligated prior to removal of gallbladder during cholecystectomy. CA arises from Right Hepatic Artery (RHA) posterolateral to common hepatic duct inside Calot’s triangle but variations of CA are very common. If surgeons fail to identify these variations during cholecystectomy, this artery is more prone to iatrogenic injury leading the profuse bleeding. Aim: To study the variations of CA in terms of its origin, number, length, course and its relation with the biliary ductal system and Calot’s triangle. Materials and Methods: The present cross-sectional study was conducted in the department of Anatomy, Government Tiruvannamalai Medical College, Tamil Nadu, India from August 2019 to July 2022. Forty adult cadaveric liver specimens with intact vasculature of gallbladder were dissected and the variations of CA were noted. Length of CA was measured by using Vernier caliper, and it’s descriptive statistics like range, mean, Standard Deviation (SD) were evaluated by using Microsoft excel 2019 software. Results: The CA arose from RHA in 33 (82.5%), from replaced RHA in 2 (5%), from Left Hepatic Artery (LHA) in 2 (5%), from Proper Hepatic Artery (PHA) in 2 (5%), and from Common Hepatic Artery (CHA) in 1 (2.5%) specimens. Its mean length ±SD was 2.6±0.35 cm. CA was single in 39 specimens (97.5%) (38 single CA inside Calot’s triangle, one single CA was outside of Calot’s triangle). Double cystic arteries were seen in only one specimen (2.5%) and forming compound type of relation with Calot’s triangle (one CA was outside of Calot’s triangle and the other one was inside of that triangle) in it. CA was superomedial to Cystic Duct (CD) in 34 (85%) specimens. This artery was passing anterior and posterior to common hepatic duct in 6 (15%) and 2 (5%) specimens, respectively. Conclusion: The overall prevalence of variations in different parameters of CA in the present study was found to be high as 35%.
症状性胆石症通常通过胆囊切除术治疗。胆囊切除术中,胆囊动脉(CA)在切除胆囊前应结扎。CA起源于卡洛三角内的肝总管后外侧的右肝动脉(RHA),但CA的变化很常见。如果外科医生在胆囊切除术中未能识别这些变异,则该动脉更容易发生医源性损伤,导致大量出血。目的:探讨胆总管病变的起源、数量、长度、走行及其与胆道系统和卡洛三角的关系。材料与方法:本横断面研究于2019年8月至2022年7月在印度泰米尔纳德邦政府Tiruvannamalai医学院解剖系进行。本文解剖了40例胆囊血管完整的成人尸体肝脏标本,观察了CA的变化。使用游标卡尺测量CA长度,并使用Microsoft excel 2019软件评估其描述性统计量如range、mean、Standard Deviation (SD)。结果:CA来源于RHA 33例(82.5%),替代RHA 2例(5%),左肝动脉(LHA) 2例(5%),肝固有动脉(PHA) 2例(5%),肝总动脉(CHA) 1例(2.5%)。平均长度±SD为2.6±0.35 cm。39例(97.5%)单发CA,其中38例单发CA位于Calot三角内,1例单发CA位于Calot三角外。双囊性动脉仅见于1例(2.5%),与卡洛三角呈复合型关系(1例在卡洛三角外,1例在卡洛三角内)。34例(85%)CA位于囊管上内侧。该动脉分别在6例(15%)和2例(5%)标本中通过肝总管的前后。结论:本研究中CA不同参数变异的总体发生率高达35%。
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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。
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引用次数: 0
Variations in Renal Arteries- A Cadaveric Study in Telangana, India 肾动脉的变异——印度特伦加纳的一项尸体研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/60529.2886
P. Sirikonda, .. Mariya, R. Sugavasi, R. Katikireddi
Introduction: Regarding the disorders associated with multiple renal arteries, they are of specific interest to urologists, nephrologists, surgeons, and radiologists. Aim: To identify the presence of multiple renal arteries in the human cadavers. Materials and Methods: An observational cadaveric study was conducted on 50 formalin-fixed human cadavers in Osmania Medical College, Hyderabad, Telangana, India, from May 2017 to July 2022. Dissection procedure was followed according to standard techniques. Variations and patterns of renal arteries were observed. Descriptive statistics were used and results were expressed in terms of frequency (N) and percentages (%). Results: Out of 50 cadavers, variations in the renal artery were seen in eight cadavers. Four cadavers showed double renal arteries (one right side and three left side). Three cadavers showed early division and one cadaver which has shown double Right Renal Artery (RRA) also showed Early Division of RRA (ED of RRA) and one cadaver showed an Accessory Renal Artery (ARA) on the left side. Conclusion: Variations observed were mainly double renal arteries, early division of the renal arteries, and ARA. This kind of different pattern of variations may play an important role in renal transplants and any surgeries involving the renal arteries.
简介:关于与多肾动脉相关的疾病,泌尿科医生、肾病科医生、外科医生和放射科医生对此特别感兴趣。目的:鉴别人尸体中存在的多肾动脉。材料与方法:于2017年5月至2022年7月在印度特伦甘纳邦海得拉巴的Osmania医学院对50具福尔马林固定的人体尸体进行了观察性尸体研究。按照标准技术进行解剖。观察肾动脉的变化和形态。采用描述性统计,结果以频率(N)和百分比(%)表示。结果:50具尸体中,8具出现肾动脉变异。4具尸体显示双肾动脉(右侧1条,左侧3条)。3具尸体显示早期分裂,1具尸体显示双右肾动脉(RRA)也显示早期分裂(RRA的ED), 1具尸体显示左侧副肾动脉(ARA)。结论:主要以双肾动脉、早期肾动脉分裂、ARA为主。这种不同的变异模式可能在肾移植和任何涉及肾动脉的手术中发挥重要作用。
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引用次数: 0
Anatomical Variations of Branching Pattern of the Arch of Aorta: A Cadaveric Cross-sectional Study 主动脉弓分支形态的解剖学变异:尸体横断面研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/65112.2923
Gautam Shyam, Anjanjyoti Rajkonwar, Deepsikha Thengal, Giriraj Kusre
Introduction: The arch of the aorta normally gives off three major branches from its convex surface. Variations in the branching pattern of the Aortic Arch (AA) are not uncommon. Knowledge of these variations is crucial during aortic instrumentation and thoracic or neck surgeries. Aim: This study aimed to investigate the anatomical variations in the branching pattern of the AA in perinatal and adult cadavers. Materials and Methods: A cross-sectional cadaveric study was conducted in the Department of Anatomy, at Assam Medical College and Hospital, Dibrugarh, from August 2018 to July 2021. The study included cadavers of various ages and both genders (N=46). Perinatal cadavers received from the Obstetrics and Gynecology department were also included. The thoracic cavity was opened by cutting through the costochondral junctions and reflecting the sternum. Fibrofatty tissue was removed to expose the branches of the AA, which were then examined and classified. Variations were observed, and the results were expressed in terms of frequency and percentages. Results: A classical branching pattern (Type-A) was observed in 89.1% of cadavers. Five cadavers (10.9%), comprising four males and one female, exhibited branching patterns different from the classical pattern. Among them, Type-C variation was noted in 4 (8.7%) cadavers, and Type-D variation was found in 1 (2.2%) male cadaver. Conclusion: Having a good understanding of the variations in the branching pattern of the arch of the aorta can be beneficial for surgeons performing complex vascular surgery.
主动脉弓通常从其凸起的表面上分出三个主要分支。主动脉弓(AA)分支模式的变化并不罕见。了解这些变异在主动脉内固定和胸颈部手术中是至关重要的。目的:本研究旨在探讨围产儿和成体尸体AA分支形态的解剖学差异。材料和方法:2018年8月至2021年7月,在迪布鲁加尔阿萨姆邦医学院和医院解剖学系进行了横断面尸体研究。该研究包括不同年龄和性别的尸体(N=46)。从妇产科收到的围产期尸体也包括在内。胸腔通过肋软骨连接处切开,反射胸骨。去除纤维脂肪组织,暴露AA的分支,然后对其进行检查和分类。观察到变化,结果以频率和百分比表示。结果:89.1%的尸体有典型的分支模式(A型)。5具尸体(10.9%),包括4名男性和1名女性,表现出与经典模式不同的分支模式。其中,4例(8.7%)男性尸体出现c型变异,1例(2.2%)男性尸体出现d型变异。结论:掌握主动脉弓分支形态的变化规律,有助于外科医生进行复杂血管手术。
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引用次数: 0
Morphological Variations of the Tricipital Aponeurosis and Its Clinical Significance: A Cross-sectional Cadaveric Study 三头肌腱膜的形态学变化及其临床意义:横断面尸体研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/60566.2925
B Anisha, S Syamly, SV Uma
Introduction: The radial nerve is commonly injured during posterior approach humerus surgeries, making it crucial for surgeons to identify and preserve the nerve. The tricipital aponeurosis (TA) serves as a reliable landmark for identifying the radial nerve during these procedures. Aim: This study aimed to investigate the different shapes and patterns of the TA and their relationship with the radial nerve, as well as their clinical significance. Materials and Methods: A cross-sectional observational cadaveric study was conducted in the Department of Anatomy, Dr. Chandramma Dayanand Sagar Institute of Medical Education and Research (CDSIMER), a unit of Dayanand Sagar University (DSU), Bengaluru, Karnataka, India, from January 2022 to April 2022. A total of 40 arms from 20 adult cadavers obtained from CDSIMER were examined. The TA was assessed to record variations in its shape and classified accordingly. The distance of the radial nerve from the point of confluence was measured for different types. Vernier calipers were used for all measurements. The collected data was analysed using the Statistical Package for the Social Sciences (SPSS) version 16.0, and paired two-tailed Student's t-test was performed. Results: The classical type A was observed in 32 (80%) of the specimens. The mean distance of the radial nerve from the point of confluence of the TA was 30.58±4.29 mm on the right side and 31.27±4.48 mm on the left side, with a p-value of 0.621. Conclusion: Knowledge of the different shapes of the TA and its distance from the radial nerve can assist surgeons in creating a safe zone during various procedures, thereby preventing radial nerve injuries.
在肱骨后入路手术中,桡神经常受到损伤,因此识别和保存桡神经对外科医生来说至关重要。在这些手术中,肱三头腱膜(TA)是识别桡神经的可靠标志。目的:探讨TA的不同形状、形态及其与桡神经的关系及临床意义。材料和方法:横断面观察性尸体研究于2022年1月至2022年4月在印度卡纳塔克邦邦班加罗尔Dayanand Sagar大学(DSU)的Chandramma Dayanand Sagar博士医学教育与研究所(CDSIMER)解剖学系进行。从CDSIMER获得的20具成人尸体共40只手臂进行了检查。评估TA以记录其形状的变化并相应分类。测量不同类型的桡神经离汇合点的距离。所有测量均使用游标卡尺。收集的数据使用SPSS 16.0版本进行分析,并进行配对双尾Student's t检验。结果:经典A型32例(80%)。桡神经距TA汇合点的平均距离右侧30.58±4.29 mm,左侧31.27±4.48 mm, p值为0.621。结论:了解TA的不同形状及其与桡神经的距离可以帮助外科医生在各种手术过程中创建安全区,从而防止桡神经损伤。
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引用次数: 0
Morphometric Analysis of Lateral Ventricles of the Brain using Magnetic Resonance Imaging and Dissection Method: A Cross-sectional Study 脑侧脑室的磁共振成像及解剖方法的形态计量学分析:一项横断面研究
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/65902.2928
Pradipta Ray Choudhury, Prabahita Baruah, Sushant Agarwal, Riturag Thakuria, Bikash Sandalya, Krishna Kanta Biswas
Introduction: The lateral ventricle, which is the largest among all ventricles of the brain, can be divided into the frontal horn, body, posterior horn, and inferior horn. Various methodologies may produce different results in measuring the length of the lateral ventricle. Aim: To determine whether there are any differences in the lengths of the lateral ventricle when measured using formalin-fixed brain specimens and Magnetic Resonance Imaging (MRI) scans. Materials and Methods: This cross-sectional study was conducted from April 2014 to March 2019 in the Department of Anatomy at Silchar Medical College and Hospital, Assam, India. A total of 127 formalin-fixed cadaveric brain specimens were used to measure the lengths of different parts of the lateral ventricle using a Vernier Calliper. Additionally, MRI scans of 35 patients were used to measure the same lengths. The mean values of the lateral ventricle lengths measured in formalin-fixed brain specimens and MRI scans were compared using Student’s t-test to determine statistical significance. Furthermore, variations in the lengths of the lateral ventricle according to age and gender were also measured using MRI. Results: Among the 127 brain specimens, 78 were from male brains and 49 were from female brains. Out of the 35 MRI scans, 23 were from male cases and 12 were from female cases. The average length of the frontal horn, body, and inferior horn was found to be greater in MRI scans (34.83 mm, 54.37 mm, and 51.09 mm, respectively) compared to the dissection method in cadavers (30.64 mm, 35.49 mm, and 42.29 mm, respectively). All parts of the lateral ventricle measured in MRI scans were found to have greater lengths in males, although the difference was not statistically significant. Conclusion: A significant difference was observed when comparing the lengths of the lateral ventricle measured in MRI scans and formalin-fixed cadaveric brain specimens.
简介:侧脑室是大脑所有脑室中最大的,可分为额角、体角、后角和下角。在测量侧脑室长度时,不同的方法可能产生不同的结果。目的:探讨使用福尔马林固定脑标本和磁共振成像(MRI)扫描测量侧脑室长度是否存在差异。材料与方法:本横断面研究于2014年4月至2019年3月在印度阿萨姆邦Silchar医学院和医院解剖学系进行。用游标卡尺测量了127个经福尔马林固定的尸体脑标本侧脑室不同部位的长度。此外,35名患者的核磁共振扫描被用来测量相同的长度。使用学生t检验比较福尔马林固定脑标本和MRI扫描测量的侧脑室长度的平均值,以确定统计学意义。此外,根据年龄和性别,侧脑室长度的变化也使用MRI测量。结果:127例脑标本中,男性78例,女性49例。在35个MRI扫描中,23个来自男性病例,12个来自女性病例。与尸体解剖方法(分别为30.64 mm、35.49 mm和42.29 mm)相比,MRI扫描发现前角、体和下角的平均长度更大(分别为34.83 mm、54.37 mm和51.09 mm)。MRI扫描中测量的侧脑室的所有部分都发现男性的长度更大,尽管差异没有统计学意义。结论:MRI扫描测量的侧脑室长度与福尔马林固定的尸体脑标本的长度有显著差异。
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引用次数: 0
Missed Double-J Ureteric Stent Presenting as a Large Stone Burden: A Case Report 输尿管双j型支架漏诊表现为巨大结石负担1例
Pub Date : 2023-01-01 DOI: 10.7860/ijars/2023/63521.2935
Guru Thangiah Arun, Faaz Salah Gomha, Sheik Akbar Hussein, Nasser Jassim Al Maslamani
Ureteric stenting using a Double-J Stent (DJS) is one of the commonly used urological management techniques to ensure adequate drainage from the renal pelvis to the bladder. However, DJS placements are known to be associated with various consequences and complications. Hereby, the authors present a case of a 46-year-old male who presented to the Emergency Department with left flank pain and haematuria that had persisted for one week. The patient had previously undergone ureteric stenting one year prior for the management of a left ureteric calculus. Unfortunately, he had not returned for follow-up due to the Coronavirus Disease 2019 (COVID-19) pandemic. X-ray of the Kidney, Ureter, and Bladder (KUB) and Computed Tomography (CT) of the KUB revealed a missed left ureteral stent that was completely encrusted and associated with the highest stone burden. This stent was causing obstruction of the left renal pelvis-calyceal system and thinning of the left renal parenchyma. The patient also had a co-existing staghorn calculus and urinary tract infection. After completing a course of antibiotics, the encrusted ureteral stent was surgically removed using cystolitholapaxy with pneumatic lithotripsy, ureteral lithoclast, and percutaneous nephrolithotomy. A new DJS was placed to maintain drainage through the ureter. The patient had no complications during the follow-up period. Authors reported a case of a missed DJS with the highest stone burden within a year to highlight the importance of patient and family education. Authors recommended implementing electronic follow-up systems for patients who undergo ureteric stenting to prevent lost to follow-up, minimise long-term complications, and ensure patient safety.
输尿管内放置双j型支架(DJS)是一种常用的泌尿外科治疗技术,以确保从肾盂到膀胱的充分引流。然而,dj的位置与各种后果和并发症有关。在此,作者提出一个病例46岁的男性谁提出了左侧疼痛和血尿,持续了一个星期急诊科。患者曾接受输尿管支架置入一年前的管理左输尿管结石。不幸的是,由于2019冠状病毒病(COVID-19)大流行,他没有回来接受随访。肾、输尿管和膀胱x线片(KUB)和KUB的计算机断层扫描(CT)显示遗漏的左侧输尿管支架完全包覆,并伴有最高的结石负担。该支架导致左肾盆腔-肾盏系统阻塞,左肾实质变薄。患者同时患有鹿角结石和尿路感染。完成一个疗程的抗生素治疗后,采用气压碎石、输尿管碎石和经皮肾镜取石术联合膀胱碎石术取出结痂的输尿管支架。放置一个新的dj以保持输尿管引流。随访期间无并发症发生。作者报告了一年内结石负担最高的dj失诊病例,以强调患者和家庭教育的重要性。作者建议对输尿管支架植入术患者实施电子随访系统,以防止丢失随访,减少长期并发症,并确保患者安全。
{"title":"Missed Double-J Ureteric Stent Presenting as a Large Stone Burden: A Case Report","authors":"Guru Thangiah Arun, Faaz Salah Gomha, Sheik Akbar Hussein, Nasser Jassim Al Maslamani","doi":"10.7860/ijars/2023/63521.2935","DOIUrl":"https://doi.org/10.7860/ijars/2023/63521.2935","url":null,"abstract":"Ureteric stenting using a Double-J Stent (DJS) is one of the commonly used urological management techniques to ensure adequate drainage from the renal pelvis to the bladder. However, DJS placements are known to be associated with various consequences and complications. Hereby, the authors present a case of a 46-year-old male who presented to the Emergency Department with left flank pain and haematuria that had persisted for one week. The patient had previously undergone ureteric stenting one year prior for the management of a left ureteric calculus. Unfortunately, he had not returned for follow-up due to the Coronavirus Disease 2019 (COVID-19) pandemic. X-ray of the Kidney, Ureter, and Bladder (KUB) and Computed Tomography (CT) of the KUB revealed a missed left ureteral stent that was completely encrusted and associated with the highest stone burden. This stent was causing obstruction of the left renal pelvis-calyceal system and thinning of the left renal parenchyma. The patient also had a co-existing staghorn calculus and urinary tract infection. After completing a course of antibiotics, the encrusted ureteral stent was surgically removed using cystolitholapaxy with pneumatic lithotripsy, ureteral lithoclast, and percutaneous nephrolithotomy. A new DJS was placed to maintain drainage through the ureter. The patient had no complications during the follow-up period. Authors reported a case of a missed DJS with the highest stone burden within a year to highlight the importance of patient and family education. Authors recommended implementing electronic follow-up systems for patients who undergo ureteric stenting to prevent lost to follow-up, minimise long-term complications, and ensure patient safety.","PeriodicalId":56235,"journal":{"name":"International Journal of Anatomy Radiology and Surgery","volume":"31 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":"135445021","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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