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1.
Turab Janbakhishov Selda Dogan Erbil Dogan 《Taiwanese journal of obstetrics & gynecology》2013,52(4):568-570
ObjectiveTo report a case of recurrent ectopic pregnancy in the ipsilateral salpinx after and intrauterine insemination treated by laparoscopy.Case reportA 33-year-old woman with unexplained infertility sought evaluation at our hospital due to pelvic pain after ovulation induction and intrauterine insemination. She had a history of a right salpingectomy. Transvaginal ultrasonography did not reveal an intrauterine pregnancy, but showed a suspected extrauterine gestational sac on the operated adnexal area with free fluid in the pouch of Douglas. The patient was diagnosed with a recurrent ruptured ectopic pregnancy and an emergency laparoscopy was performed.ConclusionRecurrent ectopic pregnancy in the ipsilateral fallopian tube is rare, but it is important to be suspicious of the diagnosis to prevent serious morbidity. This case also demonstrates transtubal or transperitoneal migration of the gametes because ovulation and ectopic pregnancy occurred on opposite sides. 相似文献
2.
BACKGROUND: A surveillance system was established at the Aga Khan University Hospital in Karachi, Pakistan, to determine surgical wound infection (SWI) rates, trends, and risk factors; and to compare rates with those reported by the National Nosocomial Infection Surveillance (NNIS) system of the Centers for Disease Control and Prevention. METHODS: Surveillance was performed from January 1997 to December 1999. Risk categorization was on the basis of the NNIS system. P <.05 was set for statistically significant difference between groups. Data were analyzed using the Epi-Info software (version 6.04, CDC, Atlanta, Ga). RESULTS: Overall SWI rates for the NNIS risk categories 0, 1, 2, and 3 were 1.9%, 3.7%, 6.7%, and 5.1%, respectively. SWI rate in 0 risk category decreased from 3% in 1997 to 1.1% in 1999 (P =.06). Multivariate analysis showed that SWI rates were higher after mastectomy (odds ratio [OR] 4.28, 95% confidence interval [CI] 1.8-10), hernia repair (OR 3.28, 95% CI 1.6-6.7), gastrointestinal resection (OR 2.2, 95% CI 0.88-5.9), skin procedures (OR 1.97, 95% CI 0.89-4.3), appendectomy OR 0.57, 95% CI 0.20-1.60, and miscellaneous procedures (OR 3.6, 95% CI 1.6-7.7), as compared with cholecystectomy. Other risk factors were contaminated type of operation (OR 2.6, 95% CI 1.2-5.5), and duration of operation exceeding the NNIS standard of "T" hours (OR 2.6, 95% CI 1.7-4). CONCLUSION: The SWI rates at the Aga Khan University Hospital are higher than the NNIS standards. There was a downward trend in the SWI rates during the surveillance period. A decrease in the duration of surgical procedures could further reduce the risk. 相似文献
3.
Zmora O Khaikin M Pishori T Pikarsky A Dinnewitzer A Weiss EG Nogueras JJ Wexner SD 《International journal of colorectal disease》2007,22(3):289-292
Introduction and objective Much debate has revolved around whether patients with mucosal ulcerative colitis (MUC) receiving immunosuppression should
be weaned off immunosuppressives before undergoing ileal pouch surgery. Therefore, the aim of this study was to assess the
affect of immunosuppressive drugs on postoperative complications after ileoanal pouch surgery.
Materials and methods A retrospective medical record review of patients with MUC who underwent ileal pouch surgery while taking immunosuppressive
drugs such as azathioprine, 6-mercaptopurine (6-MP), methotrexate, and cyclosporin A was performed. Postoperative complications
in the study group were compared to three matched groups: patients with MUC who had ileoanal pouch surgery while taking systemic
steroids, patients with MUC not receiving any immunosuppressive drugs, and patients with familial adenomatous polyposis.
Results Twenty-two patients with MUC who underwent ileoanal pouch surgery while taking immunosuppressive drugs were identified from
a prospectively entered database of patients who had this surgery between 1988 and 2005. All but two patients underwent temporary
fecal diversion. Fifteen patients were taking 6-MP or azathioprine; six were on cyclosporine A, and one both on azathioprine
and cyclosporine A. Fifteen patients were also taking steroids at the time of ileoanal pouch surgery. Early (within 30 days
of surgery) and late complications occurred in 36 and 50% of the study group patients, respectively, but did not significantly
differ from a matched group of patients with MUC who did not take immunosuppressive drugs. Patients with familial adenomatous
polyposis had a significantly lower long-term complication rate.
Conclusion This retrospective case-matched study suggests that the use of immunosuppressive drugs and cyclosporine A may not be associated
with an increased rate of complications after ileoanal pouch surgery.
This paper was presented at the annual meeting of the American Society of Colon and Rectal Surgeons, June 2–7, 2001, San Diego,
CA and at the biennial meeting of the International Society of University Colon and Rectal Surgeons, April 10–14, 2002, Osaka,
Japan. 相似文献
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5.
Although under-recognized, cancer survivors continue to be at an increased risk of death from cardiovascular complications post-remission or cure. This increased burden of cardiovascular disease results from the interplay of various factors. Adequate cardiovascular risk assessment and timely intervention through a multi-disciplinary approach in these patients plays a pivotal role in the prevention of cardiovascular morbidity and mortality. We discuss the shortcomings of using current risk prediction scores in cancer survivors and provide some insights into cardiovascular risk management relevant for primary care physicians, oncologists, and cardiologists alike. 相似文献
6.
Turab Pishori N Khurshaidi S M Khan A S Hussainy 《Indian journal of gastroenterology》2003,22(2):66-67
A 25-year-old man with massive lower gastrointestinal bleeding underwent emergency mesenteric angiography. An actively bleeding lesion was found in the cecum. Right hemicolectomy was performed. Histology revealed a Dieulafoy lesion of the cecum. This is an extremely rare lesion responsible for massive lower GI bleeding. 相似文献
7.
Yousaf Rashid Shah Santosh Nagammanavar Turab A. Syed Fauzia Zafar Martin H. Wetherill 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2008,18(8):591-593
Profunda femoris artery pseudo aneurysm is a rare occurrence following fractures of the proximal femur or their surgical fixation.
They usually present late because of the deep position of the artery. Patients present with a painful expansile mass in the
thigh with or without progressive anaemia. Modalities such as ultrasound scanning may aid in diagnosis but CT arteriography
is used mostly for accurate diagnosis and intervention. We report a case of delayed presentation of profunda femoris pseudo
aneurysm following dynamic hip screw fixation for intertrochanteric femur fracture. 相似文献
8.
Background/Aim:
Stapled hemorrhoidopexy for prolapsing hemorrhoids is conceptually different from excision hemorrhoidectomy. It does not accompany the pain that usually occurs after resection of the sensitive anoderm. This study was carried out to evaluate the clinical outcome of stapled hemorrhoidopexy at The Aga Khan University Hospital.Materials and Methods:
A sample of 140 patients with symptomatic second-, third-, and fourth-degree hemorrhoids and circumferential mucosal prolapse underwent stapled hemorrhoidopexy from July 2002 to July 2007. They were evaluated for postoperative morbidity, analgesic requirement, and recurrence.Results:
Seventy-eight percent were males and the mean age was 45 (range 16-90) years. The mean operative time was 35 (15-78) min. The mean parenteral analgesic doses during the first 24 h were 2.1. All patients received oral analgesics alone after 24 h. No significant postoperative morbidity was observed. The mean in-patient hospital stay was 1.3 (0-5) days. Patients were followed-up for 24 (range, 2-48) months. Minor local recurrence of hemorrhoids was seen in four patients and was managed by band ligation.Conclusion:
Stapled hemorrhoidopexy procedure was found safe, well tolerated by patients with minimal parenteral analgesic use and early discharge from the hospital. 相似文献9.
Introduction
Bone bruising of the scaphoid is a term reported when magnetic resonance imaging (MRI) is carried out for scaphoid injury. The aim of our study was twofold: to see if bone bruising alone without fracture of the scaphoid bone seen on initial MRI, in a clinically symptomatic (tender) patient at 10-14 days, progressed to fracture, and to define how this entity of bone bruising should be managed.Methods
This was a prospective study looking at 170 patients with scaphoid injuries, of which 50 had bone bruising without fracture. These were followed up for at least 8 weeks to ascertain whether or not they had developed a fracture. They were assessed for continuity or resolution of their symptoms by way of clinical examination and/or a further MRI and X-ray (scaphoid views).Results
Of the 170 scaphoid injuries identified, there were 120 scaphoid fractures seen on scaphoid view radiographs. The remaining 50 were clinically symptomatic and had MRI scaphoid imaging, which demonstrated various grades of bone bruising. All were treated in a scaphoid plaster, and re-examined at 8 weeks. There were four patients who remained symptomatic, for whom MRI scans were performed, which revealed all four with resolving scaphoid bone bruising, and one with a scaphoid fracture (p value = 0.0386). Incidentally, 2 further weeks of immobilisation resolved the symptoms of those four patients. The one patient with a fracture was offered further treatment for the risk of progressing to a nonunion.Conclusion
Bone bruising detected on MRI without fracture is an important entity, and can lead to occult fracture (2%). It can take anywhere up to 8 weeks to declare. Treatment for bone bruising should be with a scaphoid cast and follow-up X-ray. 相似文献10.