20 research outputs found
Hyperprolectinemia in newlyHyperprolectinemia in newly diagnosed Breast cancer in younger (<50) women diagnosed Breast cancer in younger (<50) women
No full textBreast cancer is a common malignancy among women. There are a number of established risk factors for breast cancer in younger population. Hyperprolactinemia is observed to be higher in breast cancer patients. However its presentation in younger (<50 years) women is not well understood. This study was conducted to describe serum prolactin level in newly diagnosed breast cancer patients presented with nipple discharge without any apparent other cause of hyperprolactinemia. The results showed high serum prolactin levels in all these patients. There was no significant correlation observed between serum prolactin and the age of the patients.
It was concluded that breast cancer patients presenting with nipple discharge show varying degree of hyperprolactinemia. It requires further studies to explore if it has a causal relationship or it is a feature of breast cancer
Hydraulic simulations to evaluate and predict design and operation of the Chashma Right Bank Canal
No full textIrrigation systems / Irrigation canals / Flow control / Velocity / Canal regulation techniques / Hydraulics / Simulation models / Design / Operations / Crop-based irrigation / Distributary canals / Water delivery / Policy / Protective irrigation / Water allocation / Water requirements / Sedimentation / Water distribution / Equity / Water conveyance / Pakistan / Chashma Right Bank Canal
Randomized, Clinical Trial on Diathermy and Scalpel Incisions in Elective General Surgery
No full textIatrogenic biliary injuries during laparoscopic cholecystectomy. A continuing threat
No full textAbstractBackgroundDespite improvement in the technique and increasing experience, complications of different nature and severity continue to occur during laparoscopic cholecystectomy all around the world. We present bile duct injuries in this series with regards to the incidence, severity and management of this problem.Study designDescriptive.Place and durationDepartment of surgery, Liaquat University of medical and Health Sciences, Jamshoro and other private hospitals at Hyderabad city during April 2003 to December 2007.Materials and methodsA total of 1132 patients with symptomatic gallstone disease were included in the study regardless of their age and gender. Laparoscopic cholecystectomy by classical four-port technique performed in all cases with few amendments as per situation. Patients with growth in gallbladder and with severe associated medical or cardiac problems were excluded from the study. Details of every patient collected on a proforma and data finally analyzed on SPSS version 10.ResultsOf total 1132 patients, 1088 (96%) were females and 44 (4%) were males with a mean age of 47.64 years. Elective laparoscopic cholecystectomy was performed in 1118 (98.7%) patients whereas emergency laparoscopic cholecystectomy was done in 14 (1.23%) patients. Various types of common bile duct injuries as well as post -operative bile leaks and their management is discussed with a view to improve upon the technique and out come.ConclusionIatrogenic biliary injuries continue to occur despite tremendous overall improvement in technique and expertise
Extra-biliary complications during laparoscopic cholecystectomy: How serious is the problem?
No full textObjective: To deteremine the incidence, nature and management of
extra-biliary complications of laparoscopic cholecystectomy. Materials
and Methods: This study presents a retrospective analysis of
extra-biliary complications occuring during 1046 laparoscopic
cholecystectomies performed from August 2003 to December 2006. The
study population included all the patients with symptomatic gallstone
disease in whom laparoscopic cholecystectomy was performed. The
extra-biliary complications were divided into two distinct categories:
(i) Procedure related and (ii) Access related. Results: The incidence
of access-related complications was 3.77% and that of procedure-related
complications was 6.02%. Port-site bleeding was troublesome at times
and demanded a re-do laparoscopy or conversion. Small bowel laceration
occurred in two patients where access was achieved by closed technique.
Five cases of duodenal and two of colonic perforations were the major
complications encountered during dissection in the area of
Calot′s triangle. In 21 (2%) patients the procedure was converted
to open surgery due to different complications. Biliary complications
occurred in 2.6% patients in the current series. Conclusion: Major
extra-biliary complications are as frequent as the biliary
complications and can be life-threatening. An early diagnosis is
critical to their management
Laparoscopic cholecystectomy in empyema of gall bladder: An experience at Liaquat University Hospital, Jamshoro, Pakistan
No full textObjective: To find out the safety profile of laparoscopic
cholecystectomy in empyema of gallbladder. Background: Empyema of gall
bladder is a severe form of acute cholecystitis with superadded
suppuration. It has been considered a contraindication for the
laparoscopic cholecystectomy (LC) because of fear of life-threatening
complications. This study aimed to determine the safety and feasibility
of LC in empyema of gallbladder. Materials and Methods: LC was
attempted in 67 patients of empyema of gallbladder within 24h. However
in few cases there was a delay because of reluctance for surgery or
delay in giving consent etc. The procedure was performed by standard
four-port technique with few changes made to facilitate dissection
according to situation. Results: Between April 2003 to June 2006,
970 LC performed for gallstone disease at surgical unit-1 of LUMHS by
the same surgical team. Among these, 67 (6.90%) patients were diagnosed
to have empyema gall bladder. LC successfully completed in 54 (80.59%)
patients. In 13 (19.40%) patients the procedure was converted to open
cholecystectomy (OC) due to various operative difficulties of which the
most serious injuries included bleeding from cystic artery (four
cases), common bile duct injury (two cases) and duodenal injury in one
case. Maximum operating time was up to 160 minutes (one case).
Postoperative complications occurred in 10 (18.51%) successfully
operated patients. Maximum patients (n=45, 83.33%) were discharged in
48-96 hours while three patients were discharged after two weeks.
Conclusion : Laparoscopic cholecystectomy can be performed in empyema
of gallbladder keeping in mind a slightly increased risk of
complications even in the best hands. However, the experience of the
surgeon plays a key role in the overall outcome
Laparoscopic cholecystectomy in empyema of gall bladder: An experience at Liaquat University Hospital, Jamshoro, Pakistan
No full textObjective: To find out the safety profile of laparoscopic
cholecystectomy in empyema of gallbladder. Background: Empyema of gall
bladder is a severe form of acute cholecystitis with superadded
suppuration. It has been considered a contraindication for the
laparoscopic cholecystectomy (LC) because of fear of life-threatening
complications. This study aimed to determine the safety and feasibility
of LC in empyema of gallbladder. Materials and Methods: LC was
attempted in 67 patients of empyema of gallbladder within 24h. However
in few cases there was a delay because of reluctance for surgery or
delay in giving consent etc. The procedure was performed by standard
four-port technique with few changes made to facilitate dissection
according to situation. Results: Between April 2003 to June 2006,
970 LC performed for gallstone disease at surgical unit-1 of LUMHS by
the same surgical team. Among these, 67 (6.90%) patients were diagnosed
to have empyema gall bladder. LC successfully completed in 54 (80.59%)
patients. In 13 (19.40%) patients the procedure was converted to open
cholecystectomy (OC) due to various operative difficulties of which the
most serious injuries included bleeding from cystic artery (four
cases), common bile duct injury (two cases) and duodenal injury in one
case. Maximum operating time was up to 160 minutes (one case).
Postoperative complications occurred in 10 (18.51%) successfully
operated patients. Maximum patients (n=45, 83.33%) were discharged in
48-96 hours while three patients were discharged after two weeks.
Conclusion : Laparoscopic cholecystectomy can be performed in empyema
of gallbladder keeping in mind a slightly increased risk of
complications even in the best hands. However, the experience of the
surgeon plays a key role in the overall outcome
Overcoming mirror anatomy: surgical strategies for laparoscopic cholecystectomy in situs inversus totalis: a case report
No full textAbstract Background Situs inversus totalis is an uncommon congenital condition characterized by the complete reversal of internal organ placements from their usual orientation. This syndrome presents challenges in both diagnostic and surgical care owing to the anatomical reversal, with an incidence rate of around 1 in 5000 to 20,000 infants. Case presentation A 50-year-old Asian Sindhi Ayan female patient with well-managed hypertension presented with intermittent cramp-like discomfort in the upper left region of her abdomen, which exacerbated after consuming fatty foods, accompanied by feelings of nausea and vomiting. Diagnostic imaging verified the presence of gallstones as the cause of symptoms, as well as a condition called situs inversus totalis. The individual had a planned surgical procedure called laparoscopic cholecystectomy. The surgical arrangement was changed to accommodate the mirrored anatomy, which included using a four-port approach and adjusting the location of the surgical team. The gallbladder was effectively extracted, and a subhepatic drain was inserted. The procedure had a duration of 65 minutes, and there were no anatomical deviations seen in the bile duct system. Discussion The presence of situs inversus totalis makes it more difficult to address abdominal disorders since the organs are not in their usual positions. This example highlights the need of using specialized surgical procedures and comprehensive preoperative preparation to accommodate the inverted anatomy. Conclusion Achieving successful laparoscopic surgery in patients with situs inversus totalis requires meticulous preparation and flexible approaches to overcome the specific difficulties posed by the reversed arrangement of organs
