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Unroofing of Left Coronary Artery in a Patient with Aortic Valve Replacement
Syed Shahabuddin,
Osama Ahmed Sami,
Jamal Kabeer Khanv,
Shahid Ahmed Sami
Issue:
Volume 6, Issue 3, June 2018
Pages:
58-60
Received:
11 January 2018
Accepted:
7 February 2018
Published:
7 May 2018
Abstract: During aortic valve replacement, coronary artery obstruction is a rare but fatal complication. It may require revision of the surgical procedure including re-implantation of the valve or additional coronary revascularization. It is more common in the presence of abnormality of coronary artery like malposition or abnormal course. We report a case of 32 years old gentleman undergoing aortic valve replacement for severe aortic stenosis, having an abnormally placed left main coronary artery ostium. The risk of coronary ostial compression on seating the prosthetic valve was evident. A left main coronary artery unroofing was performed to translocate the ostium to avoid the obstruction. The patient recovered well intra and postoperatively and is doing well at nine months follow up.
Abstract: During aortic valve replacement, coronary artery obstruction is a rare but fatal complication. It may require revision of the surgical procedure including re-implantation of the valve or additional coronary revascularization. It is more common in the presence of abnormality of coronary artery like malposition or abnormal course. We report a case of...
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Long-Term Effects of Bariatric Surgery on Health-Related Quality of Life: A Systematic Review
Roberta Sônia Rodrigues Álvares,
Maria de Fátima Haueisen Sander Diniz,
Ana Luisa Bagno de Almeida,
Matheus Nagib Lemos Paulo,
Alline Maria Rezende Beleigoli
Issue:
Volume 6, Issue 3, June 2018
Pages:
61-67
Received:
12 March 2018
Accepted:
8 April 2018
Published:
9 May 2018
Abstract: Introduction: Obese patients who seek bariatric surgery (BS) have great impairment in health-related quality of life (HRQoL). Along with weight loss, BS leads to improvement in HRQoL in the short-term. However, physical, psychological and social issues that ensue after BS might impact on HRQoL in the long-term. The aim was to systematically review the literature in order to explore the impact of bariatric surgery on HRQoL of severely obese patients in the long-term. Methods: Electronic databases were searched (Pubmed/Medline, Lilacs, IBECS, Cochrane Library, SciELO) to retrieve studies of adults with BMI≥35kg/m² which assessed HRQoL five or more years after BS. Hand search of references of previous reviews was also performed. GRADE was used to assess the quality of the evidence. Results: Of the 1226 articles retrieved, nine longitudinal studies were selected. A total of 4031 patients were followed-up. Female sex was predominant in all studies. Only one study did not find improvement in HRQoL after BS. Improvement of physical aspects of HRQoL was more commonly reported than mental aspects. The quality of the evidence retrieved was rated as low mainly due to the lack of adjustment for prognostic factors that might have led to counfounding in the assessment of HRQoL and under-report of follow-up rates. Differences in the instruments to assess HRQoL and in the composition of control groups among the studies did not allow to perform meta-analysis. Conclusion: BS was associated with improvement in HRQoL in the long-term, particularly in physical aspects. The low quality of the studies selected points out to the need of controlled trials to better assess the long-term effects of BS on HRQoL.
Abstract: Introduction: Obese patients who seek bariatric surgery (BS) have great impairment in health-related quality of life (HRQoL). Along with weight loss, BS leads to improvement in HRQoL in the short-term. However, physical, psychological and social issues that ensue after BS might impact on HRQoL in the long-term. The aim was to systematically review ...
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Compression Therapy in the Management of Cellulitis: A Comparative Study
Kipsang Joseph,
Nangole Wanjala,
Khainga Stanley
Issue:
Volume 6, Issue 3, June 2018
Pages:
68-72
Received:
31 March 2018
Accepted:
17 April 2018
Published:
10 May 2018
Abstract: Cellulitis is a common condition causing significant morbidity. Conventional treatment has been mainly by the use of antibiotics, limb elevation and analgesics. There is no consensus on the role of compression therapy in the management of cellulitis. This study was a comparative study of patients who presented with cellulitis at Kenyatta National Hospital. The study was set to determine the effect of compression therapy as an adjunct in the treatment of limb lower limb cellulitis The study period was between May 2014 and May2015 Patients were randomly assigned into two groups through a computer generated program. Group A patients were managed with antibiotics, limbelevation, analgesia and elasticcompression therapy.. Group Bpatients were managed with elevation, antibiotics and analgesia. The antibiotic used was amoxyclavulinic acid while the analgesic was paracetamol and diclofenac. The parameters assessed wereoedema resolution, pain, tenderness and length of hospital stay. A total of eighty patients withcellulitis were recruited inbothgroupswith each arm having 40 patients. Group A patients who were managed with compression therapy had greater reduction in pain, tenderness and oedema as compared togroup B patients. The length of hospital stay was 10.2 days in group Aand 13.4 days in groupB. Elasticcompression therapy as demonstrated in this study is beneficial inthe management of cellulitis. It results in faster resolution of cellulitis with reduction in the length of hospital stay and with no increase in complications.
Abstract: Cellulitis is a common condition causing significant morbidity. Conventional treatment has been mainly by the use of antibiotics, limb elevation and analgesics. There is no consensus on the role of compression therapy in the management of cellulitis. This study was a comparative study of patients who presented with cellulitis at Kenyatta National H...
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Helmet Wearing and Traumatic Brain Injuries Among Motorcyclists in Cotonou
Iréti Fiacre Tidjani,
Sègla Pascal Chigblo,
Valentin Houannou,
Thierry Alihonou,
Eric Lawson,
Penance Agbélélé,
Soumaïla Madougou,
Aristote Hans-Moevi Akué
Issue:
Volume 6, Issue 3, June 2018
Pages:
73-77
Received:
28 April 2018
Accepted:
16 May 2018
Published:
8 June 2018
Abstract: Background: traumatic brain injury is a real health problem, especially in low-income countries. The aim of this study was to assess the impact of helmet wearing on primary injuries in motorcycle trauma. Methods: this was a cross-sectional study from 1st January to 31st December 2013. It covered all motorcycle users, admitted in emergency at Cotonou National Teaching Hospital, with a traumatic brain injury. Epidemiological variables and primary lesions were identified. Statistical analysis was performed with Chi2 and Fischer’s tests; a p-value ≤ 0.05 was considered statistically significant. Results: we collected 310 patients (57.9% of traumatic brain injury), 11 of whom wore a helmet. They were predominantly male (male to female ratio =7.6), with a mean age of 33.2 ± 10.9 years. Craftsmen (24.4%) were the most affected. The head trauma was often opened (172 cases / 299) in patients without helmet compared with 4 cases / 11 in patients with helmet (p = 0.001). Similarly, primary lesions were often more severe in patients without helmet, with a large number of primary lesions requiring surgery. Conclusion: helmet wearing significantly reduces the risk of serious primary injuries in motorcyclists in our context. Strict enforcement of mandatory helmet use should reduce the incidence of disabling injuries in our country.
Abstract: Background: traumatic brain injury is a real health problem, especially in low-income countries. The aim of this study was to assess the impact of helmet wearing on primary injuries in motorcycle trauma. Methods: this was a cross-sectional study from 1st January to 31st December 2013. It covered all motorcycle users, admitted in emergency at Cotono...
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Carbon Dioxide Assisted Subcision in the Treatment of Adherent Localized Scars
Issue:
Volume 6, Issue 3, June 2018
Pages:
78-81
Received:
19 April 2018
Accepted:
21 May 2018
Published:
12 June 2018
Abstract: Modified subcision assisted with Carbon Dioxide insufflation is described in 2 patients; one with post acne scar and another with adhesion following liposuction. Both subjects have satisfactory results after 3 fortnightly sessions. The Carbon Dioxide flow controlled by the flow rate and procedurist’s maneuvering adjusted to the size and positon of the scars help to separate the underlying fibrotic bands allowing the reach beyond the length of the subcising device; in this case being a 30G ½ needle. The results and recovery is being compared with traditional subcision and possible benefits of Carbon Dioxide assisted subcision are discussed.
Abstract: Modified subcision assisted with Carbon Dioxide insufflation is described in 2 patients; one with post acne scar and another with adhesion following liposuction. Both subjects have satisfactory results after 3 fortnightly sessions. The Carbon Dioxide flow controlled by the flow rate and procedurist’s maneuvering adjusted to the size and positon of ...
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