Journal of Clinical Surgery and Research最新文献

{"title":"Proposed Pathogenesis for a Subgroup of Patients with Neurogenic Thoracic Outlet Syndrome","authors":"F. Gharagozloo","doi":"10.31579/2768-2757/045","DOIUrl":"https://doi.org/10.31579/2768-2757/045","url":null,"abstract":"Most patients with Neurogenic Thoracic Outlet Syndrome (TOS) have upper extremity pain and paresthesia with normal neurologic examination and objective tests. The purpose of this study was to determine the pathologic nature of the resected first ribs in a subgroup of patients TOS who experienced resolution of symptoms postoperatively. Methods: In a retrospective study, we compared normal human cadaver first ribs (control, C) with first ribs from patients with proven NTOS (N). Ribs were examined for anatomic features. Preoperative and postoperative dynamic Magnetic Resonance Angiograms (MRA) of the affected and contralateral upper extremities were examined. Results: There were 41 first ribs from patients with DNTOS and 12 normal first ribs from human cadavers. In all patients (100%) with DNTOS there was a bony tubercle which corresponded to the area of subclavian vein groove in the normal ribs. Conclusion: A bony tubercle at the site of the subclavian vein groove in patients with DNTOS may be the pathologic entity which causes extrinsic compression of the subclavian vein at rest. The neurologic symptoms resolve following disarticulation and resection of the medial aspect of the first rib. In a subgroup of patients, NTOS may be the manifestation of venous ischemia of the nerves of the upper extremity as opposed to nerve compression. Type of Research: Single-center retrospective cohort study. Key Findings: A bony tubercle at the site of the subclavian vein groove in a subgroup of patients affected with DNTOS is the pathologic entity which causes extrinsic compression of the subclavian vein at rest. In these patients the neurologic symptoms resolve following disarticulation and resection of the medial aspect of the first rib. Take Home Message: A subgroup of patients with Disputed Neurogenic Thoracic Outlet Syndrome may have neurologic symptoms caused by venous ischemia of the upper extremity which is caused by extrinsic compression of the subclavian vein by a bony tubercle on the first rib at the costo-sternal joint. Table of Content Summary: This retrospective study compared normal human cadaver first ribs with first ribs from patients with proven NTOS (N). Proof of NTOS was symptom resolution following resection of the medial aspect of the first rib. The study suggests that in a subgroup of patients with Disputed Neurogenic Thoracic Outlet Syndrome, neurologic symptoms caused by venous ischemia of the upper extremity which is caused by extrinsic compression of the subclavian vein by a bony tubercle on the first rib at the costo-sternal joint","PeriodicalId":433748,"journal":{"name":"Journal of Clinical Surgery and Research","volume":"17 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":"122176189","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":"Necrotizing Fasciitis- A Lethal Soft Tissue Infection: Review Article","authors":"Agrawal Srikant","doi":"10.31579/2768-2757/049","DOIUrl":"https://doi.org/10.31579/2768-2757/049","url":null,"abstract":"Background: Necrotizing Fasciitis is a rapidly progressive soft tissue infection that is almost fatal without prompt treatment. This review highlights about the basic approach to the diagnosis and treatment of NF. Description: Various nomenclatures have been used to describe necrotizing soft tissue infections. These infections are classified on the basis of the microbes involved, depth of invasion and anatomical sites involved. Diabetes is the most common risk factor for NF. The masquerading cutaneous manifestations make the diagnosis of NF a challenge. Laboratory parameters, imaging techniques and scoring systems have been designed to aid in early diagnosis. Conclusion: High index of clinical suspicion is needed to make prompt diagnosis of NF. Urgent aggressive surgical debridement with antimicrobial therapy limits the morbidity and mortality associated with NF.","PeriodicalId":433748,"journal":{"name":"Journal of Clinical Surgery and Research","volume":"6 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":"114800497","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":"Neonatal Sepsis and Associated Factor among Neonate Admitted in Nicu at Hiwot Fana Specialized University Hospital Harar Town, Eastern, Ethiopia 2020","authors":"Gosaye Teklehaymanot Zewde","doi":"10.31579/2768-2757/048","DOIUrl":"https://doi.org/10.31579/2768-2757/048","url":null,"abstract":"Background:Neonatal sepsis is a condition defined as a clinical syndrome characterized by signs and symptoms of infection in an infant 28 days of life or younger. Neonatal sepsis is one of the major causes of neonatal morbidity and mortality especially in developing countries. Socio-demographic, maternal, neonatal and medical factors were associated with risk of infection. The clinical signs and symptoms of neonatal Sepsis are nonspecific and the confirmation of diagnosis is challenging and time consuming. Therefore, the diagnostic approach should be depends up on consideration of risk factors. Objective: This study aimed to assess the prevalence and factors associated with neonatal sepsis among neonates admitted to neonatal intensive care unit at Hiwot Fana Specialize Hospital Harar, Ethiopia 2020. Methods: Retrospective cross sectional registered data based study was conducted from February 7- February 25/2020 G.C. A total of 292 neonates cards was selected systematically from neonates admitted to Hiwot Fana specialize hospital at NICU. Data was collected using data extraction tool and checked for completeness and consistency then entered in to SPSS windows version 20.0 for analysis. Bivariate logistic and multivariate regression analysis was used to check existence of association of each independent variable with the outcome variable and Variables significant in bi-variate analysis (P< 0.25) was entered to a multivariate logistic regression model and statistical significance was declared at P < 0.05. Odds ratios along with 95% Confidence interval were used to measure strength and to assess the presence of statistically significant association between independent variables and outcome variable. Result: The prevalence of Neonatal Sepsis was 52.7%. From these 92.2% and 7.8% 0f Neonates developed Early and Late Neonatal sepsis respectively. Among them 59.7% were males. The study found that, Rural residence, delivery place, Meconium stained amniotic fluid, ANC follow up, Gestational age, birth asphyxia and 5th minute APGAR score <7 were significantly associated with neonatal sepsis. Conclusion: The prevalence of neonatal sepsis was 52.7%. Rural residence, Hospital delivery, Meconium-stained Amniotic Fluid, ANC follow up, Gestational Age <37 weeks, birth asphyxia and 5th minute APGAR score <7 were found to statistically significant with Neonatal sepsis.","PeriodicalId":433748,"journal":{"name":"Journal of Clinical Surgery and Research","volume":"8 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":"128892951","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":"Distal Ulna Giant Cell Tumor: A Case Report","authors":"Clevio Desouza","doi":"10.31579/2768-2757/047","DOIUrl":"https://doi.org/10.31579/2768-2757/047","url":null,"abstract":"Introduction:Long bone giant cell tumors have been documented in the literature in a large number of cases. A patient with a large giant cell tumor in the distal ulna is described. With a reported prevalence of 0.5 to 6%, this is extremely rare. Case Presentation:A 16-year-old male presented to the orthopedic OPD with pain and swelling in the wrist. A diagnosis of distal ulna giant cell tumor was made after a histological examination. Intralesional curettage, phenol treatment, and bone grafting were used to treat the malignancy. Conclusion:If a giant cell tumor is detected early and treated aggressively, it has an excellent prognosis. It is critical to be aware of unusual cancer localizations in order to make an accurate diagnosis.","PeriodicalId":433748,"journal":{"name":"Journal of Clinical Surgery and Research","volume":"98 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":"124810802","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":"Are MRI Findings Different in HIV Positive Tuberculosis Spine Patients","authors":"Clevio Desouza","doi":"10.31579/2768-2757/046","DOIUrl":"https://doi.org/10.31579/2768-2757/046","url":null,"abstract":"Background: Tuberculosis of the spine is a serious manifestation of the disease that causes debilitating injury. In HIV positive patients the incidence of skeletal tuberculosis increases to 60%. The MRI has become the gold standard for diagnosis and preoperative planning in spinal TB. The objective of this study was to assess the impact of HIV status on MRI findings in spinal tuberculosis patients at a tertiary public hospital in Pune, India. Methods: This was retrospective study of spinal TB patients admitted to a tertiary public hospital in Pune, India. Fifty patients with histopathological confirmation of spinal tuberculosis, HIV status and available MRI scans from 2017-2020 were identified. HIV status was positive in 16 and negative in 34. Males were predominant (27:23). Site, extent of disease, type of lesion, abscess volume, kyphotic deformity and skip lesions were reported. Results: There is no statistical difference in age and sex of the patients. The average abscess size in HIV positive group is more (9.63 sq.cm) as compare to (2.29 sq. cm) non HIV group. Average numbers of vertebrae involved in both groups are almost same (2.4:2.26). Average kyphotic angle is significantly more in non HIV group as compare to HIV group (10.8:15.38). skip lesions were more common in HIV group (6 out of 10 as compare to 6 out of 20). There was a positive correlation between abscess size and CD4 count in HIV patients. Conclusion: HIV negative patients have greater tubercular destruction as measured by resultant kyphosis. There is no difference in the incidence of location, type of vertebral involvement and number of vertebrae involved. Skip lesions were more common in HIV positive patients in our study. HIV positive patients show greater epidural abscess volume and are showing correlation with CD4 count.","PeriodicalId":433748,"journal":{"name":"Journal of Clinical Surgery and Research","volume":"38 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":"133473456","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":"Association between osteoporosis Knowledge and Food Habits in Female University Students of Lahore","authors":"Saeed Taj Din, Masooma Fareed Thind","doi":"10.31579/2768-2757/042","DOIUrl":"https://doi.org/10.31579/2768-2757/042","url":null,"abstract":"Background: Osteoporosis is a general metabolic disorder which causes many musculoskeletal issues and reduces the quality of life in the elderly population which usually progresses at the age between 30 to 40 years in both males and females. Recent studies suggested some of the associated factors like age, low bone mineral density, sex family history of fracture, less dietary intake of vitamin D, and abnormal thyroid function, these factors are the leading cause of osteoporosis especially in females. It is also indicated that along with other associated factors poor living style, malnutrition and the bad food habits leads to form osteoporosis which contributes in the loss of bone mass in post-menopausal stage of women Objective: To determine the association between osteoporosis knowledge and food habits in female university students of Lahore. Methodology: After the approval from the research committee of University an analytical cross sectional study was conducted using the Osteoporosis knowledge assessment tool (OKAT) &Adolescent food habits checklist tool (AFHC) to collect data from 138 students. The collection of data was carried by online Google forms because the university was closed due to the pandemic situation. Results: Mean knowledge score was found 9.9 with SD 4.8. Majority of the participants were found having average Knowledge good Knowledge (33.3% and 32.6%). Mean AFHC score was found 12.1 with SD±4.5. Increasing score indicates higher good food habits’ value and r value indicates that there is association between osteoporosis knowledge and food habits. Conclusion: This study concluded that there is a strong positive correlation between osteoporosis knowledge and food habits.","PeriodicalId":433748,"journal":{"name":"Journal of Clinical Surgery and Research","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126482846","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":"Hemorrhagic Shock Caused by Mesenteric Injury - Ski Pediatric Blunt Abdominal Trauma case report","authors":"K. Karavdić, A. Firdus, L. Kapetanović-Zametica, D. Anić, N. Kulenović-Spahović, N. Begic, S. Begić","doi":"10.31579/2768-2757/040","DOIUrl":"https://doi.org/10.31579/2768-2757/040","url":null,"abstract":"Trauma is the leading cause of pediatric mortality and abdominal injury is a significant contributor to morbidity. Abdominal trauma in the population of injured children, is the third leading cause of death in this population, after head and thoracic injuries. It is the most common cause of death owing to unrecognized injury. They most often occur in traffic accidents, games and sports. The clinical presentation depends on the severity of the injury, the injured organ and the associated injuries. Mesenteric injury from blunt abdominal trauma is uncommon and can be difficult to diagnose. It is known that seatbelt trauma from motor vehicle accidents is the most common mechanism of mesenteric injury and that the mesentery of the small bowel is injured more frequently than that of the colon. We present an unusual case, a seven-year-old boy who was injured while skiing. The patient was in a state of hemorrhagic shock and underwent emergency surgery after an urgent diagnosis. During the operation, the leading trauma and the reason for the hemorrhagic shock were found to be a mesenteric injury, and bleeding from the branches of the superior mesenteric artery. Early transport, monitoring and diagnostics significantly contribute to reducing morbidity and mortality. The standard in surgery is non-operative treatment of injured parenchymal organs. A multidisciplinary approach that includes doctors of various specialties (pediatric surgeons, pediatricians, neurosurgeons, anesthesiologists and radiologists) who contribute to the diagnosis and treatment of injured children through diagnostic and therapeutic procedures has a key role. At the end, the decision regarding surgical treatment is responsibility of pediatric surgeon.","PeriodicalId":433748,"journal":{"name":"Journal of Clinical Surgery and Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128774257","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 Twenty-five to Fifty Year Follow-up of Twenty-seven Pediatric Surgical Residents","authors":"J. Raffensperger","doi":"10.31579/2768-2757/041","DOIUrl":"https://doi.org/10.31579/2768-2757/041","url":null,"abstract":"This survey of 27 pediatric surgeons who were residents at the Children’s Memorial Hospital in Chicago from 1970 to 1996 correlates their education, general surgery residency, extra training and research with their practice, publications and leadership positions. This study also reviews health issues, family life, continuing education, proficiency in index cases, intrusion of subspecialties and opinions on surgical education.","PeriodicalId":433748,"journal":{"name":"Journal of Clinical Surgery and Research","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120936641","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":"Are we Over Treating Ductal Carcinoma in Situ? – Single Center Experience","authors":"Sami Al Kalbani, Rudainy Kaddoura, Ali Al Sharqi, Ola AL Hamdani, Ibrahim Al Waili","doi":"10.31579/2768-2757/044","DOIUrl":"https://doi.org/10.31579/2768-2757/044","url":null,"abstract":"Background and Aim: Breast cancer is the most common cancer among females worldwide. Ductal carcinoma in situ (DCIS) is a heterogeneous group of neoplastic lesions confined to the breast ducts with the absence of the basement membrane infiltrations. It is usually diagnosed accidently as micro calcifications on mammograms. Materials and Methods: This is a retrospective cohort study which includes all patients who were managed surgically as cases of DCIS at Royal hospital between 2006 and 2019. Clinicopathological data were collected for all patient. The samples were divided into three groups according to their pathological analysis: Positive margin, close margin (0.1 mm to 1.9 mm), and negative margin group (> 2 mm). The recurrence rate for each group was assessed. A p-value <0.05 was considered statistical significant. Results: 72 patients with pure DCIS were included in the present analysis, the mean age was 47.9 years. Ten (13.0%) patients had a positive margin, 29 (37.7%) patients had a close margin, and 33 (42.9%) patients had a negative margin. There was recurrence in 3 patients) 30%) in positive margin group and 7 patients (70%) had no recurrence. On the other hand, 5 patients (17.2%) in close margin group and 1 patient (3%) in clear margin group had recurrence. The recurrence rate was higher in the non-re-excision group compare to the re-excision group. In univariate analysis, there was a significant difference in IBTR by comparing positive versus close and negative margins of excision (p = 0.040). Conclusion: The optimal margin for DCIS tumors remain controversial, nonetheless, our study highlighted the importance and the effect of following the current recommendations of a minimal 2 mm margin width in the breast conserving surgery of DCIS. Also, we have concluded that radiotherapy and hormonal therapy cannot replace obtaining a clear margin of > 2 mm after breast conserving surgery in DCIS.","PeriodicalId":433748,"journal":{"name":"Journal of Clinical Surgery and Research","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124819696","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":"Penetrating Abdominal Trauma Complicated Byascariasis- our Experiencec","authors":"Obonna Gc, Obonna Mc","doi":"10.31579/2768-2757/043","DOIUrl":"https://doi.org/10.31579/2768-2757/043","url":null,"abstract":"Penetrating abdominal trauma typically involves the violation of the abdominal cavity by gunshot wound (GSW) or stab wound (SW). The surgical complications of ascaris lumbricoides have been well documented, however very few studies have tried to elucidate the impact of ascariasis in patients with penetrating abdominal injury.In the tropical Environment such as ours it is most relevant to consider ascariasis as a factor which could mordify the short and long time outcome in the management of patients with penetrating abdominal trauma. The aim was to look at the demographics and outcomes in the management of penetrating abdominal trauma in patients with intra operative finding of ascariasis. This study was retrospective, in which patients with penetrating abdominal injury and coexisting ascariasis were analysed. The study population included all such patients for a period of 10 years between January 2012 to January 2021.The patients were evaluated with their case notes retrieved from the medical record department and their operative note and laboratory investigations recorded. Excluded from the study were those with associated injuries in other regions of the body. A total of 300 patients who had penetrating abdominal injury were seen within the study period. 220 cases (66.7%) were due to gunshot wound to the abdomen while 80 cases (33.3%) were due to stab injury to the abdomen. All of them had the intra operative finding of ascarids within the abdomen. The male to female ratio was 2:1. The incidental finding of ascarid during surgery for penetrating abdominal trauma is common and accounts for high mobidity and mortality in patients who have penetrating abdominal trauma. It is therefore of public health importance to engage in mass deworming exercise especially in the tropics were ascariasis is endemic. Elimination of this round worm would ensure a better postoperative outcome in patients who have penetrating abdominal trauma.","PeriodicalId":433748,"journal":{"name":"Journal of Clinical Surgery and Research","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132558464","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}