212 research outputs found

    Micro-core decompression combined with intralesional zoledronic acid as a treatment of osteonecrosis of femoral head: a novel technique

    Get PDF
    Background: Avascular necrosis (AVN)/osteonecrosis of the femoral head is a debilitating condition affecting the hip joint and is one of the most common causes of total hip replacement. The available treatments include pharmacological and surgical options with total hip arthroplasty (THA) being the mainstay of treatment. This present study is a novel technique of combining micro core decompression with intra-lesional bisphosphonate as a treatment for osteonecrosis of the hip.Methods: A prospective study of 19 hips was done. There were 11 males and 4 females ranging 42-63 years. Four hips were stage I, ten hips were stage IIA, three hips were stage IIb and two hips were stage III.  16 hips (40%) had stage IIb and 24 hips (60%) had stage III ONFH. The minimum period of follow up was 24 months. All patients were assessed according to the Harris hip score. The operative procedure includes decompressing the avascular area with drilling then injecting the zoledronic acid locally.Results: The mean preoperative modified Harris hip score in stage I (n=4), stage IIa (n=10), stage IIb (n=3) and stage III (n=2) were 81.9, 72.7, 68.8 and 59.2 respectively. The mean postoperative modified Harris hip score at two years in stage I, stage IIa, stage IIb and stage III were 97.3, 91.1, 88.4 and 82.5 respectively.Conclusions: We found that the use of micro core-decompression with intra-lesional bisphosphonate will provide higher chances towards hip preservation especially in late cases or cases with larger lesions where core decompression may not be successful.

    Hepatobiliary Manifestations of Inflammatory Bowel Disease

    Get PDF
    Hepatobiliary manifestations occur quite frequently in patients suffering from chronic ulcerative colitis and Crohn's disease and carry with them considerable morbidity and mortality. Although the true incidence is difficult to determine, clinically, significant hepatobiliary disease occurs in 5%–10% of patients. At the present moment, the aetiology and pathogenesis of inflammatory bowel disease and its systemic manifestations remains speculative. For those hepatobiliary manifestations that respond to therapy of the underlying bowel disease, medical and/or surgical therapy must be aggressively pursued. More urgent research is required towards understanding the underlying cause(s) of the primary bowel disease and its systemic manifestations in order to improve the overall management of this condition

    Spontaneous Erosion of a Lost Intra-Abdominal Gallstone Through the Back Eight Months Following Laparoscopic Cholecystectomy

    Get PDF
    A prospectively maintained database of 856 laparoscopic cholecystectomies was analyzed to determine the complications of lost intra-abdominal gallstones which occurred in 165 patients

    Suture cruroplasty versus prosthetic hiatal herniorrhaphy for large hiatal hernia: a meta-analysis and systematic review of randomized controlled trials

    Get PDF
    OBJECTIVE: The aim was to conduct a meta-analysis of randomized controlled trials (RCTs) comparing 2 methods of hiatal closure for large hiatal hernia and to evaluate their strengths and flaws. METHODS: Prospective RCTs comparing suture cruroplasty versus prosthetic hiatal herniorrhaphy for large hiatal hernia were selected by searching PubMed, Medline, Embase, Science Citation Index, Current Contents, and the Cochrane Central Register of Controlled Trials published between January 1991 and October 2014. The outcome variables analyzed included operating time, complications, recurrence of hiatal hernia or wrap migration, and reoperation. These outcomes were unanimously decided to be important because they influence the practical approach toward patient management. Random effects model was used to calculate the effect size of both dichotomous and continuous data. Heterogeneity among the outcome variables of these trials was determined by the Cochran's Q statistic and I index. The meta-analysis was prepared in accordance with Preferred Reporting of Systematic Reviews and Meta-Analyses guidelines. RESULTS: Four RCTs were analyzed totaling 406 patients (Suture = 186, Prosthesis = 220). For only 1 of the 4 outcomes, ie, reoperation rate (OR 3.73, 95% CI 1.18, 11.82, P = 0.03), the pooled effect size favored prosthetic hiatal herniorrhaphy over suture cruroplasty. For other outcomes, comparable effect sizes were noted for both groups which included recurrence of hiatal hernia or wrap migration (OR 2.01, 95% CI 0.92, 4.39, P = 0.07), operating time (SMD -0.46, 95% CI -1.16, -0.24, P = 0.19) and complication rates (OR 1.06, 95% CI 0.45, 2.50, P = 0.90). CONCLUSIONS: On the basis of our meta-analysis and its limitations, we believe that the prosthetic hiatal herniorrhaphy and suture cruroplasty produces comparable results for repair of large hiatal hernias. In the future, a number of issues need to be addressed to determine the clinical outcomes, safety, and effectiveness of these 2 methods for elective surgical treatment of large hiatal hernias. Presently, the use of prosthetic hiatal herniorrhaphy for large hiatal hernia cannot be endorsed routinely and the decision for the placement of mesh needs to be individualized based on the operative findings and the surgeon's recommendation

    Gallbladder carcinoma: a retrospective analysis of twenty-two years experience of a single teaching hospital

    Get PDF
    BACKGROUND: The purpose of this study was to retrospectively evaluate our experience with gallbladder cancer since the establishment of a tumour registry in our institute. METHODS: Between 1975 and 1998, 23 consecutive patients with gallbladder cancer were identified using the tumour registry database. There were 18 females (78%) and 5 (22%) males. The mean age at diagnosis was 70.6 (range 42–85) years. The diagnosis was achieved either intra-operatively or following the histological analysis of the gallbladder (n = 17), following gallbladder or liver biopsy (n = 4) or at autopsy (n = 2). Presenting symptoms included upper abdominal pain, weight loss, nausea, vomiting, fever, painless jaundice, hepatomegaly, upper abdominal mass, upper abdominal tenderness, and gastrointestinal haemorrhage. RESULTS: Histological examination revealed 20 adenocarcinomas (87%), 2 squamous cell carcinomas (9%) and one spindle cell sarcoma (4%). At presentation, 14 (61%) gallbladder cancers were stage IV, 5 (22%) were stage III and 4 (17%) were stage II. Kaplan Meier analysis revealed a mean survival of 3.2, 7.8 and 8.2 months for stage IV, III, and II disease respectively. Out of 14 patients with stage IV disease, 8 patients received adjuvant chemotherapy and survived for 4.6 months whereas six patients who did not receive adjuvant chemotherapy survived for 1.3 months. This difference was statistically significant (p = 0.04). CONCLUSION: The majority of patients with gallbladder cancer presented with advanced stage disease (stage IV) which carries a dismal prognosis. Patients who received chemotherapy with stage IV disease, however, did better than those who did not, but this is probably a reflection of patient selection

    Guest editorial Accounting, Accountability and Global Development: Key perspectives

    Get PDF
    Purpose:This paper provides a review and reflection on the contributions of the special issue papers on accounting, accountability and global development. Design/methodology/approach:The journal review approach is adopted to identify the emergent themes, contributions and potential for future studies from the prior literature and accepted papers. Findings:The findings from the selected papers represent three emergent inter-related themes on accounting, accountability and development: i.) financialization and ‘intellectual’ colonization of the developed world; ii.) the nexus between the Western world/epistemic community and the local elites; and iii.) the ‘resistance’ against the above through exploring the role of state and local actors in securing better life-chances for the people and the environment in emerging economies.Research limitations/implications:This paper implicates observations and directions for future research in accounting, accountability and development in emerging economies: (i) success vs failure of development initiatives, (ii) successful ‘resistance’ and emancipation, (iii) role of State in the development discourse, and (iv) COVID-19 and ‘new normality’. Originality/valueThis special issue papers problematise and extend the knowledge on accounting, accountability and development, particularly in relation to emerging economies and provides a way forward

    Investigation on a vision-based approch for smart pothole detection using deep learning based on fast CNN

    Get PDF
    The quality of road these days are important and roads always dangerous since its filled with potholes and damages which cause a lot of incident and numbers gets more increased in crowded area , this article investigates and compare the performance metrics of different object detection models that utilized the Fast CNN structure in it's backbones , Four processes make up the standard method of pothole detection: data acquisition, data pre-processing, feature extraction, and pothole classification. for the task of pothole detection. The study focuses on the evaluation of YOLOv6n, YOLOv8n, YOLOv5n, and YOLOv7 models using a dataset of road images containing pothole instances. The performance metrics analyzed include precision (P), recall (R), mean average precision at 50% IoU ([email protected]), and mean average precision from 50% to 95% IoU ([email protected]:.95) . The findings indicate that YOLOv8n demonstrates the highest overall performance, achieving significant precision and recall rates. These results provide valuable insights into the effectiveness of object detection models for pothole detection, contributing to the field of road maintenance and safety. The outcomes of this study can assist in the development of intelligent systems for automated pothole detection and maintenance plannin
    corecore