International Academic Research Journal of Surgery最新文献

{"title":"A Rare Case of Synovial Sarcoma with Bone Metastasis Mimicking Multiple Myeloma – Challenges of Management in a Nigerian Resource Constrained Setting","authors":"Nkpozi Mo, Eyichukwu . G, Ayogu . Bo","doi":"10.47310/iarjs.2022.v02i02.004","DOIUrl":"https://doi.org/10.47310/iarjs.2022.v02i02.004","url":null,"abstract":"Background: Synovial sarcoma (SS), a rare carcinoma of soft tissues (including ligaments and muscles) around the big joints of the body, poses significant diagnostic and management challenges in low and middle income countries especially if it presented when metastasis had occurred. When there is metastasis to the bones, it mimics multiple myeloma on radiological skeletal survey. The objective of this report is to draw attention to this rare carcinoma which, usually, presents as a small painless nodule within the first three decades of life. We report this rare case of SS in a middle aged Nigerian lady who presented initially at National Orthopaedic Hospital (NOHE) with chronic severe right hip pain in which the initial radiological skeletal survey strongly suggested multiple myeloma. Definitive diagnosis and management of this case of synovial sarcoma was very challenging to the patient and managing unit. Conclusion: Early diagnosis of SS is critical at which point surgical excision or radiotherapy may be the preferred treatment option to achieve a favorable outcome. When metastasis is extensive, chemotherapy becomes the therapy of choice and it does not come cheap or easily available.","PeriodicalId":299013,"journal":{"name":"International Academic Research Journal of Surgery","volume":"2019 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124026733","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}

{"title":"Arterio-Venous Brain Malformation Rupture during Pregnancy, About a Case","authors":"Asma Abidi, Abdelziz El Hadlousi, Noussaiba Nabil, Mouhcine Doumiri, M. Amor, W. Maazouzi","doi":"10.47310/iarjs.2022.v02i02.003","DOIUrl":"https://doi.org/10.47310/iarjs.2022.v02i02.003","url":null,"abstract":"AVMs are abnormalities of the intracranial vessels that constitute a connection between the arterial and venous systems and lack an intervening capillary bed. Hemorrhagic presentation of AVM is associated with significant morbidity and mortality; it is an independent predictor of future hemorrhage. AVM rupture is one of the most frequent and important causes of hemorrhagic stroke during pregnancy and puerperium. Whether the risks of AVM rupture increases during pregnancy and puerperium is controversial, but maternal physiological changes in hemodynamics, blood volume, and hormonal effects on the vessel walls could potentially increase the risk of hemorrhage from AVMs during pregnancy and in the postpartum period. For AVM during pregnancy and puerperium, previous studies have demonstrated histologic changes in arteries and arterioles of pregnant women, thought to be mediated by progesterone; the changes included fragmentation of reticular fibers and loss of normal corrugation of elastic fibers, which might play a role in the increased risk for AVM hemorrhage during pregnancy. However, there is insufficient evidence to guide management decisions for ruptured AVMs during pregnancy, and further well-designed, multicenter, perspective clinical trials are needed. We report the case of a young woman, who had an emergency ceasarean surgery for a headeck and consciousness disorder witch evoked eclampsia, while in fact; she had a rupture of arteriovenous malformation following the rupture of a cerebral Arterio-venous malformation in cerebral imaging.","PeriodicalId":299013,"journal":{"name":"International Academic Research Journal of Surgery","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114554125","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}

{"title":"Advantages of Two Clips Laparoscopic Cholecystectomy (TCLC) and Conventional Laparoscopic Cholecystectomy (CLC): A Comparative Study","authors":"Anshuk Attri, Parul Sharma, UK Chandel, Bhavash Devkaran, A. Kaundal, K. Syal","doi":"10.47310/iarjs.2022.v02i02.002","DOIUrl":"https://doi.org/10.47310/iarjs.2022.v02i02.002","url":null,"abstract":"Background: Laparoscopic cholecystectomy (LC) is the most commonly done, minimally invasive surgical procedure. Advanced energy sources, such as the harmonic scalpel, though expensive, may provide the advantage of shorter operating time by reducing smoke, bloodless dissection in the GB bed, lower risk of bleeding from the cystic artery due to secure vessel sealing, and avoiding the use of a larger number of titanium clips. Thus, a study was undertaken to compare the advantages of Two Clips Laparoscopic Cholecystectomy (TCLC) over conventional laparoscopic cholecystectomy (CLC). Material and Methods: This prospective randomized study was conducted in the Department of Surgery IGMC, Shimla over a period of 1 year starting from 1st july 2019 to 30th june 2020. In this study 100 consecutive patients of symptomatic cholelithiasis confirmed by USG reporting were participated and randomized into 2 groups of 50 each. Group 1 patients underwent CLC and Group 2 patients underwent TCLC. Outcomes were measured in terms of operative time, intra operative stone spillage, intra operative blood loss, amount of CO2 used , post operative pain , conversion into open cholecystectomy and post operative complications. Results: In the present study among 100 patients, 19 were males and 81 were females. Among them,5 males and 45 females underwent CLC using electrocautery while 14 males and 36 females underwent TCLC.Mean age of males were 47.60 ± 3.36 years and females were 45.20 ± 15.82 years in CLC group and mean age of males were 45.36 ± 14.53 and females were 45.25 ± 15.97 in TCLC group. Present study showed that there was significant less Operative Time, Less Mean CO2 used, less Approx. Blood Loss, less Average pain score at 6 and 24 hours, less Average Length of hospital stay, less Intra Op. Stone spillage, less Use of Drain and Post op. Complications in TCLC as compared to CLC but there was no significant difference in Conversion to Open Cholecystectomy in both groups. Conclusion: Study concluded that TCLC had advantage over CLC in terms of operative time ,intra operative stone spillage , intra operative blood loss , amount of CO2 used , post operative pain and post operative complications","PeriodicalId":299013,"journal":{"name":"International Academic Research Journal of Surgery","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131136036","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}

{"title":"A Comparative Study of Single Clip Laparoscopic Cholecystectomy (SCLC) and Conventional Laparoscopic Cholecystectomy (CLC)","authors":"Anshuk Attri, Parul Sharma, UK Chandel, Bhavash Devkaran, A. Kaundal, K. Syal","doi":"10.47310/iarjs.2022.v02i02.001","DOIUrl":"https://doi.org/10.47310/iarjs.2022.v02i02.001","url":null,"abstract":"Background: Theoretical benefits for use of one clip laparoscopic cholecystectomy are Less operative time, Less bleeding, Early post operative recovery, Cost factor , Less spillage of stones, Less chances of converting into open cholecystectomy , Less pain post operatively and Less amount of CO2 used. Thus, a study was undertaken to compare the advantages of Single clip laparoscopic cholecystectomy (SCLC) over conventional laparoscopic cholecystectomy (CLC). Material and Methods: This prospective randomized study was conducted in the Department of Surgery IGMC, Shimla over a period of 1 year starting from 1st july 2019 to 30th june 2020. In this study 100 consecutive patients of symptomatic cholelithiasis confirmed by USG reporting were participated and randomized into 2 groups of 50 each. Group 1 patients underwent CLC and Group 2 patients underwent SCLC. Outcomes were measured in terms of operative time, intra operative stone spillage, intra operative blood loss, amount of CO2 used , post operative pain , conversion into open cholecystectomy and post operative complications. Results: Out of 100 patients 15 were males and 85 were females. Among them, 5 males and 45 females underwent CLC using electrocautery while 10 males and 40 females underwent SCLC. Mean age of males were 47.60 ± 3.36 and females were 45.20 ± 15.82 in CLC group and mean age of males were 48.50 ± 14.49 and females were 46.73 ± 16.16 in SCLC group . Present study showed that there was significant less Operative Time, Less Mean CO2 used, less Approx. Blood Loss, less Average pain score at 6 and 24 hours, less Average Length of hospital stay, less Intra Op. Stone spillage, less Use of Drain and Post op. Complications in SCLC as compared to CLC but there was no significant difference in Conversion to Open Cholecystectomy in both groups. Conclusion: Study showed clear cut benefits of SCLC over CLC in terms of operative time , intra operative stone spillage , intra operative blood loss , amount of CO2 used , post operative pain and post operative complications","PeriodicalId":299013,"journal":{"name":"International Academic Research Journal of Surgery","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123872823","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}

{"title":"The Role of Focused Assessment with Sonography for Trauma (FAST) in Children with Stable Hemodynamics after Blunt Abdominal Trauma:the Spleen and Hepatic Rupture Case Series","authors":"M. Muamar, Suwardi .","doi":"10.47310/iarjs.2022.v02i02.006","DOIUrl":"https://doi.org/10.47310/iarjs.2022.v02i02.006","url":null,"abstract":"Introduction: The most prevalent type of abdominal trauma in children is blunt abdominal trauma (BAT). Traffic accidents and falls are the most prevalent causes of trauma. In this case, a CT scan is the gold standard for detecting BAT. However, there are several limits to this examination, particularly in terms of availability, cost, and radiation exposure. In BAT, FAST assists in the detection of intraabdominal free fluid. Case Description: Three pediatric patients with stable hemodynamics underwent BAT in this case series. All three patients were below 17 years old and had stomach discomfort due to a traffic accident. All three patients tested positive for FAST. Then, a contrast CT scan of the abdomen revealed a splenic rupture in the three patients and a splenic rupture and liver rupture in one of them. All the patients were hemodynamically stable before being treated with symptomatic medicines in a conservative (non-surgical) manner. All of the patients had satisfactory outcomes and could return home without undergoing surgery. Conclusion: Both FAST and CT scans do not affect therapeutic care, that were conservative management in these patients with stable hemodynamics. As a result, FAST may be a less expensive examination alternative, reducing radiation exposure and lowering the risk of cancer in children in the future.","PeriodicalId":299013,"journal":{"name":"International Academic Research Journal of Surgery","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114229038","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}

{"title":"The Effect of Progesterone Levels Changes in the Blood on the Progressivity of Luminal a Breast Cancer","authors":"Uray Yessika Bianthi Sugiat Asli, W. Soewoto, Ida Bagus Budhi Surya A","doi":"10.47310/iarjs.2022.v02i02.007","DOIUrl":"https://doi.org/10.47310/iarjs.2022.v02i02.007","url":null,"abstract":"Objectives: Breast cancer is the most common type of cancer in Indonesia, accounting for 28% of all cancer diseases. This number increases annually (Departemen Kesehatan RI, Statistik morbiditas dan mortalitas di rumah sakit; 2005-2010). Breast cancer in women is associated with progesterone hormone, which is a female reproductive hormone (DeVita, V. T. et al., 2011). Both in-vivo and in-vitro researches on the effect of progesterone on breast cancer progression has been carried out in other studies. However, clinical research on this topic is rarely done. Therefore, the authors were interested in doing this research (Sobri, F. B. et al., 2018). Material and Methods: This was cross-sectional research. This was a follow-up study from research conducted five years ago in The Department of Surgical Oncology Dr. Moewardi Hospital Surakarta between March to May 2015. Subjects of this study were Luminal A breast cancer patients carried out for progesterone examination in the blood and assessed for TNM stage. Evaluation of progesterone levels in the blood and TNM stage were performed in November to December 2020. Statistical analysis: In this study data, bivariate and multivariate analyses were carried out. Logistic regression test for ordinal data was used for bivariate analysis, whereas Chi-square/Fisher exact test was performed for data with nominal dichotomy scale. Multivariate analysis was done using logistic regression with a significance p-value less than 0.05 in the bivariate analysis to determine the odds ratio. Data was significant if p less than 0.05. Results: Based on bivariate analysis with logistic regression test and multivariate analysis, progesterone levels in the blood of Luminal A breast cancer patients influence the breast cancer progression, with p-value = 0.037 on bivariate analysis and p-value = 0.031 on multivariate analysis. Increased progesterone levels in the blood of Luminal A breast cancer patients multiplied the risk of breast cancer progression by 12 times. Conclusions: This study showed that blood progesterone levels had a significant effect on the progression of Luminal A breast cancer patients..","PeriodicalId":299013,"journal":{"name":"International Academic Research Journal of Surgery","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126192431","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}

{"title":"Peripartum Management of Vonwildebrand Disease: A Case Report","authors":"El Hadloussi Abdelaziz, El Hamdouchi Hajar, A. Mohammed, N. Youness, A. Abidi, Jebli Salma, A. Tazi","doi":"10.47310/iarjs.2022.v02i02.005","DOIUrl":"https://doi.org/10.47310/iarjs.2022.v02i02.005","url":null,"abstract":"Understanding coagulation disorders is essential, especially for obstetricians and intensive care providers managing parturients, as these disorders can have significant consequences for the mother and child during the peripartum period. Von Willebrand-Jürgens syndrome or von Willebrand disease is the most common congenital bleeding disorder. It is subject to autosomal inheritance with variable penetrance and expressivity. The cause of the disease lies in quantitative (type 1, type 3) or qualitative (type 2) abnormalities of vonWillebrand factor (vWF). vWF has two important functions in coagulation. On the one hand, it circulates in plasma as a carrier protein for factor VIII and thus has a protective function; on the other hand, it is responsible for platelet adhesion to the subendothelium of injured vessels and platelet aggregation . The risk of bleeding varies according to the severity of the injury. The therapeutic management strategy depends on the type of disease. In this paper, we report the observation of two patients with von Willebrand disease who had vaginal deliveries.","PeriodicalId":299013,"journal":{"name":"International Academic Research Journal of Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123352075","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}

{"title":"Radiological Predictors for Difficult Single Incision Laparoscopic Cholecystectomy","authors":"A. Chaudhary, R. Chauhan, R. Jhobta","doi":"10.47310/iarjs.2022.v02i01.001","DOIUrl":"https://doi.org/10.47310/iarjs.2022.v02i01.001","url":null,"abstract":"Background: Single-incision laparoscopic cholecystectomy (SILC) has been developed to further minimize the invasiveness of laparoscopic cholecystectomy by reducing the number of incisions. Knowledge of preoperative clinical factors to predict difficult SILC may be used for the preoperative counselling of the patients regarding the successful outcome of the surgery as well as to predict the risk of conversion preoperatively for selected patients, prepare the patient psychologically and minimise the procedure related cost. Objective: The present study was conducted to know about radiological predictors for difficult SILC. Methods: The study was a hospital based prospective observational study where 50 patients undergoing elective laparoscopic cholecystectomy due to gall stone diseases were included in the study. Multiple logistic regression analysis was done to predict difficult single incision laparoscopic cholecystectomy. Results: Out of 50 patients 15 patients underwent difficult SILC, while 35 patients had undergone easy single incision laparoscopic cholecystectomy independent risk factors in multivariate logistic regression analysis for difficult SILC were: contracted or distended gall bladder on ultrasound, longer umbilicus to Calot’s triangle distance (UCD) on MRI. Conclusion: Radiological Factors associated with difficult SILC contracted or distended gall bladder on ultrasound and longer umbilicus to Calot’s triangle distance on MRI.","PeriodicalId":299013,"journal":{"name":"International Academic Research Journal of Surgery","volume":"33 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132326578","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}

{"title":"Incidence of perforation of gall bladder during laparoscopic cholecystectomy and its associated factors: A cross sectional study in a tertiary care hospital","authors":"U. Sharma, Manish Sharma","doi":"10.47310/iarjs.2022.v02i01.005","DOIUrl":"https://doi.org/10.47310/iarjs.2022.v02i01.005","url":null,"abstract":"Background: Present study was done to evaluate the incidence of perforation of gall bladder during laparoscopic cholecystectomy and its associated factors. Material and Methods: This prospective study was conducted in the Department of General Surgery, IGMC, Shimla. 100 consecutive patients of symptomatic gallstones with the documented gallstones undergoing laparoscopic cholecystectomy between July 2011 to March 2012 were included in the study and a study of gall bladder perforation was done. Results: Majority of patients in this study were females and were in age group of 31- 40 years. . Gall bladder perforation was present in 27.83% of patients. Gall bladder perforation was more common in males and in age group of 61- 70 years. Gall bladder perforation occurred during grasping in 44.4 % patients and during dissection from liver bed in 37.04% patients. Gall bladder perforation was more common in case of distended gallbladder with omental adhesions (9 out of 22 patients) and in patients with partly intrahepatic gallbladder (4 out of 8 patients). Conclusion: Gallbladder perforation is common intra-operative phenomenon, more common in males and in older age group. Perforation is more common in gallbladder having adhesion with omentum and if gallbladder is partly intra-hepatic.","PeriodicalId":299013,"journal":{"name":"International Academic Research Journal of Surgery","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125531520","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}

{"title":"The development of nomogram for predicting thyroid cancer in subject with single thyroid nodule in Bali, Indonesia","authors":"C. Aryanti, I. Sudarsa, P. Adiputra, I. Setiawan","doi":"10.47310/iarjs.2022.v02i01.007","DOIUrl":"https://doi.org/10.47310/iarjs.2022.v02i01.007","url":null,"abstract":"Background: There were many cases of thyroid cancer proven from histopathology test after lobectomy from single thyroid nodules, which were not being predicted in advanced. The challenge for the clinician is thus to predict the malignancy preoperative to prevent unnecessary second completion thyroidectomy. Objective: This study aimed to determine the cancer probability risk of a single thyroid nodule by using preoperative parameters. Methods: This cohort study was conducted in Sanglah General Hospital, from 2016 to 2021. All data was obtained by Cancer Registry and electronic medical records. There were nine variables that being analyzed in this study, such as age, gender, side, size, consistency, vascularization, node, and cytology. The data was pooled and analyzed in SPSS and R studio. Smart phone application was developed using Android studio. Data were analyzed by logistic regression multivariate analysis. Results: From 2016-2021, there were 198 subjects with single thyroid nodules underwent surgeries in Sanglah General Hospital, Denpasar, Bali, Indonesia. As many as 98 subjects were histopathology proven cancer (follicular, papillary) after surgery. From multivariate analysis, the only left significant variables were vascularization, calcification, age, consistency, and cytology. Further, nomogram was developed to plot the probability of cancer from significant variables. By using only cytology parameter, the cancer predictive value was only less than 10%. Even age and consistency parameter by physical examination gave a higher value of 30% predictive value. The ultrasound parameters, combining the presence of calcification and vascularization, had a good predictive value of 60%. Conclusion: The combination of the ultrasound characteristics, age and physical examination able to accurately predict thyroid cancer.","PeriodicalId":299013,"journal":{"name":"International Academic Research Journal of Surgery","volume":"207 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122516246","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}