Endoscopic laser operations on the trachea and bronchi

The result of 596 laser endoscopic operations in 368 patients with tracheobronchial tumor was analyzed. In 175 (47.5%) patients the complete recanalization of stenosis was noted, in 119 (32.4%)--partial and in 74 (20.1%)--treatment was uneffective. In 9 (3.4%) patients the complications occurred.     

The use of fibrin glue in abdominal surgery

The data on use of fibrin glue (FG) in 215 patients operated on the abdominal organs, employing laser surgical techniques, are presented. In 132 patients, the complicated forms of gastric and duodenal ulcer disease, in 25--gastric cancer, in 24--colonic tumors, in 26--injuries to the liver were revealed. Considerable reduction in incidence of early postoperative complications as compared with that in patients operated on with the use of conventional techniques was noted.     

The use of a laser in the surgical treatment of an epithelial coccygeal cyst

In acute inflammation of pilonidal sinus (PS), use of a laser scalpel permitted to reduce considerably the incidence of postoperative suppuration. Pain syndrome became less pronounced, or was absent, wound swelling disappeared at the early period. No differences in results of surgical treatment of uncomplicated PS at the stage of chronic inflammation in use of CO2-laser and conventional methods of treatment were noted. An original technique of operation for PS complicated by multiple fistulas, purulent leaks, pyodermia has been suggested. For plastic closure of a wound, the effect of laser photohydraulic preparation was used. Operated on was 31 patient, no disease recurrence was noted. Rough cicatricial deformity of the sacro-coccygeal region was absent.     

Distribution and risk factors of postoperative endophthalmitis in people with diabetes

Purpose:To evaluate (i) the distribution of postoperative endophthalmitis (POE) in patients who underwent cataract surgery, (ii) risk factors in diabetic versus nondiabetic patients, and (iii) distribution of POE in those who had undergone rapid reduction of preoperative blood sugar levels versus those with normal blood sugar levels.Methods:Medical records were reviewed from January 1995 to July 2021. In total, 391 eyes of 391 patients who developed POE after cataract surgery were studied. Patients with POE were divided into Group A, patients with diabetes (n = 128), and Group B, patients without diabetes (n = 263), and the associations of various clinical factors in the two groups were studied. Patients with diabetes with raised random blood sugars (RBS) preoperatively were subjected to a rapid reduction of blood sugar (RBS <200 mg%) to be considered eligible for surgery. Microbiological profile of patients was examined.Results:The cumulative incidence of POE over 26 years was 0.09%. Those who underwent a rapid reduction in preoperative blood sugar levels had higher rates of POE (53.1%) compared with (46.9%) those with blood sugar levels under control (P = 0.486). Men with diabetes had 1.634 times higher odds of POE (P = 0.048), and those with diabetes and hypertension had 3.961 times greater odds of having POE (P < 0.001) when adjusted for age, alcohol, smoking, and socioeconomic strata and presence of posterior capsule rupture. Positive culture results were observed in 45/128 (35%) patients with diabetes and 71/263 (27%) patients without diabetes. Staphylococcus epidermidis was the most commonly identified organism and was detected in 10/45 (22%) in those with diabetes and 21/71 (29%) in those without diabetes of all the culture-positive cases.Conclusion:In patients with POE, the odds are greater for men with diabetes, those with a history of hypertension, as well as those who undergo a rapid reduction of preoperative blood sugar.     

Antidiabetic and antioxidant potentials of spent turmeric oleoresin,a by-product from curcumin production industry

ObjectiveTo investigate the antidiabetic and antioxidant activity of spent turmeric oleoresin (STO).MethodsAntidiabetic activity of STO evaluated by α-amylase and α-glucosidase enzyme inhibition assays. The antioxidant capacity studied by DPPH., ABTS., superoxide radical scavenging and metal chelating activity methods.ResultsThe STO showed good antidiabetic activity by inhibiting key enzymes linked to type 2 diabetes, viz α-glucosidase and α-amylase with an IC50values of 0.71 and 0.16μg/mL respectively. The IC₅₀values for DPPH. and ABTS. assay were 58.1 and 33 μg/mL respectively. STO effectively scavenged the superoxide free radical with an IC50 value of 61.5μg/mL and showed a moderate iron chelation property.ConclusionsThe above study reveals that the spent turmeric oleoresin being wasted at present can be used as antioxidant and antidiabetic agent in food and neutraceutical products.     

Reversible “Pulvinar sign” in Wernicke's encephalopathy

Young onset dementia is a challenge. We describe a case, where a patient presented with psychosis, dementia and MRI showing pulvinar sign, all of this typical of variant Cruetzfelt Jacob disease (CJD). Subsequent investigations lead to the diagnosis of a treatable illness and patient was improved and MRI sign reversed, underlining again the importance of search needed for treatable diseases in any “typical” case of fatal illness.     

Metaphyseal growth arrest lines in psychosocial short stature

Metaphyseal growth arrest lines are seen in children who experience significant physical stress such as infection or malnutrition over a sufficient period of time. These lines have not been reported previously in children with psychosocial short stature (PSS). Two boys and a girl with PSS with metaphyseal growth arrest lines on skeletal radiographs at the time of maximal stress in their homes are described. All three had reversible growth hormone insufficiency during admission, which is pathognomic for PSS. Multiple growth arrest lines in the distal end of the radius or vertebrae should alert clinicians to an alternative diagnosis in a child with growth hormone insufficiency. This may provide a clue to the diagnosis of occult PSS.     

Laparoscopic common bile duct exploration versus open surgery: comparative prospective randomized trial

The aim of the study was to analyse safety and benefits of laparoscopic common bile duct (CBD) exploration compared to open. Prospective randomized trial included a total of 256 patients with CBD stones operated from 2005 to 2009 years in a single center. There were two groups of patients: group I-laparoscopic CBD exploration (138 patients), group II-open CBD exploration (118 patients). Patient comorbidity was assessed by means of the American Society of Anesthesiology (ASA) score; i.e. ASA II-109 patients, ASA III-59 patients. Bile duct stones were visualized preoperatively by means of US examination in 129 patients, by means of ERCP in 26 patients, by magnetic resonance cholangiopancreatography in 72 patients. Preoperative evaluation was done through medical history, biochemical tests and ultrasonography. There was no statistical significant difference between 2 groups of patients. No mortality occurred. The mean duration of laparoscopic operations was 82 min (range, 40-160 min). The mean duration of open operations were 90 min (range, 60-150 min). Mean blood loss was much less in laparoscopic group than in open group (20 ± 2 vs. 285 ± 27 ml; p < 0.01). Postoperative complications were observed is nine patients of laparoscopic group and in 15 patients in open group (p < 0.01). There were 102 attempts to perform transcystic exploration of CBD. External drainage was used in 25 (32.8%) patients with transcystic approach. Conversion to laparotomy was performed in two patients. Open operations were performed in 118 patients with choledocholithiasis. External drainage was used in 85% of patients. Morbidity in open group was higher (12.7%) than in laparoscopic group (6.5%). Laparoscopic CBD exploration can be performed with high efficiency, minimal morbidity and mortality. Laparoscopic procedures have advances over open operations in terms of postoperative morbidity and length of hospital stay.