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The effect of rearing structures on behaviour and movement of juvenile steelhead Oncorhynchus mykiss.
K E Self, C B Schreck, K M Cogliati, E J Billman, D L G Noakes
Published: 23 June 2018 by Wiley Blackwell (Blackwell Publishing) in Journal of Fish Biology
Wiley Blackwell (Blackwell Publishing), 10.1111/jfb.13657
The relative movement of juvenile steelhead Oncorhynchus mykiss reared on two treatments was investigated to provide insight on the effect of structure in the rearing environment on the behaviour of the fish before potential release into a natural river system. The progeny of wild broodstock were reared either in the presence or absence of structure in the tank environment for 7 months at the Oregon Hatchery Research Center located in Oregon, U.S.A. Behavioural assessments, including movement response to a simulated predator, showed that fish reared on structure moved a similar amount (based on line crosses) as fish reared in bare hatchery tanks. No significant difference was observed in the proportion of time spent near a small structure within the behavioural test tank between the two treatments, but all fish showed decreased movement over time with each subsequent predation event. Fish from both treatments spent c. 30% percent of their time in the section of the tank containing the structure, which was 1 section out of a total of 8 sections. In both treatments, fish foraged 20% of the time in the 2 min following the introduction of live tubifex prey (2 separate events). Overall, similar movement and foraging responses occurred following mock predation events for juveniles reared either with or without structure. Developing assessment tools such as these, that measures behaviours related to survival based on rearing environment should allow managers to better predict the survival and effect of rearing conditions on the release of hatchery-origin fish into the wild. This article is protected by copyright. All rights reserved.
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The state of dyslipidemia after laparoscopic sleeve gastrectomy
Ahmed Mahmoud Hussein
Published: 23 June 2018 by Medip Academy in International Surgery Journal
Medip Academy, 10.18203/2349-2902.isj20182394
Background: Obesity and dyslipidemia have a strong relation to the development of cardiovascular diseases. Bariatric surgery is directed towards the loss of patients weight and resolution of comorbidities as hyperlipidemia. Laparoscopic sleeve gastrectomy, a feasible restrictive procedure, is one the most popular and successful operations for achieving this purpose. The aim of present study was to evaluate the effect of laparoscopic sleeve gastrectomy on the lipid profile, comparing preoperative with postoperative results 12 months after surgery.Methods: This study included fifty morbidly obese cases that underwent laparoscopic sleeve gastrectomy (LSG). Preoperative and postoperative BMI and lipid parameters were documented and analysed at 12 months postoperatively.Results: The mean age of the studied group ±SD was 32.7±9.2 years, female predominance was found. BMI improved significantly after the LSG procedure with a mean±SD of 32.2±4 kg/m2. A significant improvement of dyslipidemia was found with a p-value (
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Conservative management versus surgical drainage in pancreatic pseudocyst
Abdullah Almaihan, AHMED MATAR, Eman Murshid, Sama Al-Ostaz, Ahmed Shebly, Mohammed Miftah, Eman Alsaif, Doaa Alzaher, Hadi Alyami, Fetoun Al-Ajmi
Published: 23 June 2018 by Medip Academy in International Surgery Journal
Medip Academy, 10.18203/2349-2902.isj20182438
Pancreatic pseudocyst is not an uncommon complication of acute or chronic pancreatitis. It often presents with persistent abdominal pain and tenderness after the resolution of pancreatitis. Two lines of management are available for treatment of pancreatic pseudocyst: conservative management and surgical drainage. Conservative management is preferred in small-sized, asymptomatic, and short-lasting pseudocysts, whilst surgical management is often indicated when the cysts are larger in size, symptomatic, long-lasting, or when complications occur. Overall, 50% of cysts resolve spontaneously and only require conservative management, whilst surgical management is indicated for prevention of potential complications. This article will review and discuss in detail and compare between conservative management and surgical drainage of pseudocyst as regards indications, advantages, disadvantages, outcomes, and complications.
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Patient related outcomes and ergonomic evaluation of triangular 3-port or ‘two-hand’ TEP hernioplasty: a preliminary analysis in a university hospital
Awanish Kumar, Avatar Pauchari, Akshay Anand, Abhinav Arun Sonkar
Published: 23 June 2018 by Medip Academy in International Surgery Journal
Medip Academy, 10.18203/2349-2902.isj20182436
Background: Standard TEP technique requires three skin incisions for placement of three trocars in the midline. This can be done by 3 port triangular technique or two-hand technique. This study reports a preliminary analysis of peri-operative outcomes and ergonomics characteristics of this procedure in our setup.Methods: N=10 patients underwent triangular 3 port technique or two-hand TEP hernioplasty after informed written consent in Department of Surgery, King George’s Medical University UP between January to June 2016 after institutional ethical approval. Patient related outcomes in terms of quality of life (QOL) and ergonomic evaluation of the technique have been reported in this study.Results: The mean duration of surgery was 79.4±4.5 minutes with duration of hospital stay 2.4±0.5 days. The time to return to routine work was 1.0±0.2 days and office work was 4.0±1.8 days. Hernioplasty related QOL calculated using Carolina comfort scale showed improved with increased follow up period. Ergonomically the procedure can be safely performed without added stress on the surgeon.Conclusions: ‘Two-hand approach’ or triangular 3-port TEP hernioplasty is ergonomically feasible and enables a surgeon to perform surgery safely using basic principles of laparoscopy.
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Determinants of conversion during laparoscopic cholecystectomy among a sample of Iraqi patients
Abutalib B. Alluaibi, Bahaa K. Hassan, Alaa H. Ali, Ahmed A. Muhsen
Published: 23 June 2018 by Medip Academy in International Surgery Journal
Medip Academy, 10.18203/2349-2902.isj20182462
Background: Laparoscopic cholecystectomy has become a standard technique for gall bladder surgery of symptomatic cholelithiasis. However, conversion to open cholecystectomy is sometimes necessary. The aim of the present study was to assess the predictive factors that increase the possibility of conversion of laparoscopic cholecystectomy to open cholecystectomy.Methods: A total of 621 laparoscopic cholecystectomies were attempted at AL-Mawanee General Hospital and AL-Sader Teaching Hospital in Basrah, IRAQ from June 2012 till June 2016.Of these,43 had to be converted to open cholecystectomies. Patients assessed according to different factors, including age, sex, acute cholecystitis, adhesions of gallbladder and calot's triangle, obesity, previous abdominal surgery, anatomical variation of gallbladder and Calot's triangle and intraoperative complications (bleeding, bile duct injury, visceral injury).Results: Conversion to open cholecystectomy was performed in 43 patients (6.92%). The significant factors for conversions were adhesions of gallbladder and Calot's triangle(39.53%) followed by acute cholecystitis(34.88%). Rate of conversion in other factors are as the following i.e., isolated male gender (0%), age (0%), previous abdominal surgery (9.3%), obesity (2.33%), anatomical variations of gall bladder and calot's triangle (2.33%), intra operative complications including bleeding (4.65%), bile duct injury (4.65%), visceral injury (2.33%) were insignificant factors for conversion.Conclusions: Adhesions of gallbladder and calot's triangle is the most common predictive factor and cause for conversion from laparoscopic cholecystectomy to open cholecystectomy. Acute cholecystitis found to be the strongest factor for conversion despite its incidence is lower than adhesions of gall bladder and calots triangle. Male gender and age more than fifty years are not direct predictive factors for conversions.
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Evaluation of laparoscopic retroperitoneal approach for management of various renal calculi
Vikas Singh, Shesh Kumar, Anil Kumar, SHAILENDRA KUMAR, Manish Kr. Singh
Published: 23 June 2018 by Medip Academy in International Surgery Journal
Medip Academy, 10.18203/2349-2902.isj20182486
Background: Despite the availability of Multimodality treatment for management of renal calculi as ESWL (Extra Corporeal Shock Wave Lithotripsy), PCNL (Percutaneous nephrolithotomy), URS (Ureterorenoscopy), RIRS (Retrograde intrarenal surgery) and open surgery and Percutaneous nephrolithotomy (PCNL), the gold standard, laparoscopic pyelolithotomy is an alternative treatment modality as long as the operator has adequate laparoscopic experience. Evaluation of Laparoscopic retroperitoneal approach for management of various renal calculi must be done to get the efficacy of the procedure according to the calculus and renal morphology.Methods: Laparoscopic retroperitoneal pyelolithotomy/nephrolithotomy was performed on 58 patients with various renal calculi patterns viz. solitary pelvic calculus, staghorn calculus, staghorn calculus with calyceal and isolated calyceal calculi. Extended pyelolithotomy, Gilvernet’s technique were used as per the need.Results: Out of the 58 cases with renal calculi, solitary renal pelvic stones (n=23; 39.7%) were most common followed by staghorn (n=11; 19% Mean size 4.40±1.17 cm) and isolated caliceal stones (n=9; 15.5% with Mean size2.21±0.25 cm) respectively. There were 15 (25.9%) cases with mixed stones (11 cases solitary renal pelvic and isolated caliceal stones and 4 cases had staghorn and isolated caliceal stones). Stone clearance was 93.3 to 100%.Conclusions: laparoscopic retroperitoneal approach is a useful modality for clearance of renal calculi of different types with minimum complications and a high success rate. However, the technique seems to have a limited role for isolated caliceal stones where direct or C-arm guided nephrolithotomy can be performed for better clearance of stones.
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Acute viral Hepatitis E in antenatal women: a multicenter prospective study
Kaveri Shaw Patel, Manish Tiwari, Sudha Choubey, Anivesh Jain, Lovely Jain, Manish Gupta
Published: 23 June 2018 by Medip Academy in International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Medip Academy, 10.18203/2320-1770.ijrcog20182484
Background: Hepatitis E has poor prognosis in pregnancy and leads to 20-30% mortality in term cases. The Aim of the study was to observe the trend of maternal and perinatal outcome in acute viral hepatitis E.Methods: A prospective study conducted in two high risk obstetric center of Jabalpur district in January 2015 to December 2017. The inclusion criteria were all antenatal women diagnosed with acute viral Hepatitis E entering to the Intensive care unit of any gestational age who later delivered in the same center. Other than acute hepatitis E all acute hepatitis cases and women missed in follow up in delivery were excluded from the study. The data collected on demographic, clinical and biochemical variables in excel sheet and descriptive analysis done by SPSS system.Results: There were 72 antenatal women enrolled with mentioned criteria in study duration. Out of these only 67 were in follow up and alive till their delivery in the same set ups. Out of these 70.14% were Primigravida of median age 27 year. The mean gestational age at detection of hepatitis E was 30.3week. The maternal mortality observed was 17.9% (12/67) in the total study population. The high grade of mortality was significantly associated with high grade of disease. There were 19.4% (13/67) perinatal (mortality seen which included intrauterine (14.9%) and neonatal (4.4%).Conclusions: The severity of Hepatitis and high grade of hepatic encephalopathy following poor primary care in the beginning of disease results in poor perinatal and maternal outcome.
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Risk factors of acute and perforated appendicitis in a semi-rural population: a retrospective study
Kiran Kumar Paidipelly
Published: 23 June 2018 by Medip Academy in International Surgery Journal
Medip Academy, 10.18203/2349-2902.isj20182488
Background: Acute appendicitis is one of the common conditions observed in the surgery department, which requires an emergency appendectomy with complicated appendicitis including perforated appendicitis is a cause of great concern involving severe morbidity and mortality. To improve our understanding of the sign and symptoms as well as the clinical findings of appendectomy, both in perforated and non-perforated appendicitis, this study was conducted retrospectively on the –patients who attended our hospital.Methods: T The demographic details of 184 the patients in this retrospective study were noted such as age, sex, weight and height, socioeconomic status, the sign and symptoms of the illness at the time of admission, time taken for the surgery to be performed after the admission was noted. All the investigations details such as random blood sugar, complete blood picture, hemoglobin, radiological findings abdominopelvic CT scan where necessary were also noted.Results: Out of the 184 patients admitted to our hospital for appendectomy 22% had perforated appendicitis and 78% had uncomplicated nonperforated appendicitis. The mean age of all the patients in the no perforated group was 30 ± 8.3 and 33±10.2 among the perforated group, with males being more affected than females. The most common symptom among all the patients was migrating pain in the abdomen, followed by anorexia, fever and vomiting. There was a greater time lapse between the onset of symptoms to the admission time in the patients with perforated appendicitis (4.9±1.6 days), compared to the non-perforated cases (2.4±1.8 days), with longer hospital stay and raised WBC counts.Conclusions: Proper education regarding the health and well-being of a patient of any age group should properly be given to the patient and their approach to the hospital at the earliest must be reiterated.
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Maternal health expenditures and health seeking behavior among lowest wealth quintile of the rural population in an under developed district of the Punjab, Pakistan
Mariam Sughra, Farwa Fatima, Mouzma Marrium, Khizer Abbas
Published: 23 June 2018 by Medip Academy in International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Medip Academy, 10.18203/2320-1770.ijrcog20182505
Background: Expenditures on maternal health is important factor to determine the health seeking behavior in pregnant women among the lowest economical section of Pakistan. This study was carried out determine the maternal health expenditures and health seeking behavior among lowest wealth quintile of rural Rahim Yar Khan.Methods: Sample Size: For this cross- sectional study, a total of 230 subjects were involved in the study from rural areas of Rahim Yar Khan including Basti Bahishti, Bah-o-Bahar and Chak 83/P. This study was comprised of duration of 06 months from 02/03/2016 to 04/09/2016. The head of Family (Husband) with monthly income less than 15000 Pakistani rupees (PKR) were included and marriage with in last 5 years with at alive delivery. While subjects having income more than 15000 PKR and not willing to participate in study were excluded from the study.Results: People with mean monthly income of PKR. 1176±4109 spent mean amount of PKR. 146442 ± 7747 on their marriages. While the mean expenses on treatment of complication in the last pregnancy were PKR. 35808±6771 and the amount saved for the treatment of complication was PKR. 2750±1157 only. Mean antenatal expenses were PKR. 1807±3335, Mean expenses on delivery were PKR. 7351±855 as compared to the money saved for delivery was PKR. 6115±1460. Mean expenses on complications during delivery were PKR. 1692±523. Mean expenses on postnatal care were PKR.8596±3597 while the mean amount used for treatment of postnatal complications were of PKR. 2451±560. Mean expenses on birth celebrations were of PKR. 7697±832.Conclusions: Present study reveals that there is a high financial cost of maternal health expenditures paid by the lowest wealth quintile in rural areas of Rahim Yar Khan when compared with the income of this quintile. Access of the people to the health sector is still limited due to low income of people, low health education and unavailability of health services in rural areas and even in 2017.
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Clinical Manifestation of Acute, Subacute, and Chronic Low Back Pain in Different Age Groups: Low Back Pain in 35,446 Patients
Philipp Hüllemann, Thomas Keller, Maria Kabelitz, Janne Gierthmühlen, Rainer Freynhagen, Thomas Tölle, Julia Forstenpointner, Ralf Baron
Published: 23 June 2018 by Wiley Blackwell (Blackwell Publishing) in Pain Practice
Wiley Blackwell (Blackwell Publishing), 10.1111/papr.12704
Background Low back pain is major health care problem causing tremendous economic cots. Methods Clinical manifestation of low back pain (LBP) was characterized in 35,446 patients. We focused on the comparison of the acute, subacute, and chronic LBP stage with regard to patients’ age, based on epidemiological and clinical questionnaires (e.g. painDETECT, pain disability index), pain intensity, pain descriptors, and functional impairment. Results We found that neuropathic components were most frequent in chronic LBP patients at the age of 51‐60 years. Elderly LBP patients showed a decrease in neuropathic and an increase of nociceptive pain. The most frequently reported pain descriptors were “pressure pain” and “pain attacks” through all stages of LBP, whereas “burning” and “prickling” were most frequent in the chronic stage. Patients after back surgery presented neuropathic pain symptoms most frequently and had the highest amount of pain medication intake. Conclusions Burning and prickling were revealed as possible indicators for LBP chronicity. Combined with pain attacks and pressure pain, these four pain descriptors might be a promising adjunct to pain intensity in terms of outcome parameters for future LBP studies. The decrease of neuropathic pain syndromes in the elderly might be explained by degenerative processes in main parts. The presented work provides important insights on LBP management in the acute, subacute, and chronic stage. This article is protected by copyright. All rights reserved.
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