3D Laparoscopy. A potential cutting edge in minimal invasive digestive surgery

Laparoscopic surgery has changed surgical landscape, providing reduced surgical trauma, shorter hospital stays, less postoperative pain and better outcomes than open surgery. Since its first development in the 90’s, 3D technology applied to laparoscopic surgery has had several technical improvements and now it represents, together with high definition technology, the best option in minimal invasive digestive surgery, providing shorter operative times and lower blood loss, making easier to perform surgical tasks both for trainees than for skilled surgeons. It remains a little bit more expensive than standard 2D laparoscopic devices but even cheaper than robotic equipment

The Effect Of Reading The Quran On Health

This study reveals how the effects of reading the Koran on health, both physical health and mental health. Because when we read the Koran, it can have a positive effect on him, we will feel there is a feeling of satisfaction and peace of mind about the life we ​​live. Likewise, it will have an effect on the health of the body, because it can improve blood circulation and can stabilize blood sugar levels in the body. That is how it is felt by everyone who reads the Koran correctly. Reading the Qur'an filled with a sense of belief in Allah will lead to a process of self-surrender to the Creator which will bring about a passive state for the reader's body. In addition, reading the Koran like this will also cause a healthy placebo effect and reading the Koran itself can be a form of relaxation, which is called the transcendence meditation method. This relaxation does not focus on the process of relaxing muscles or other processes of physical relaxation, but on phrases that are repeated in a regular rhythm accompanied by self-surrender to God.Penelitian ini mengungkap bagaimana pengaruh membaca Al-Quran terhadap kesehatan, baik kesehatan fisik maupun kesehatan mental. Karena ketika kita membaca Al-Quran dapat memberikan dampak positif padanya, kita akan merasakan adanya perasaan puas dan tenteram terhadap kehidupan yang kita jalani. Begitu juga dengan kesehatan tubuh, karena dapat memperlancar peredaran darah dan dapat menstabilkan kadar gula darah dalam tubuh. Hal itulah yang dirasakan setiap orang yang membaca Al-Quran dengan benar. Membaca Al-Qur’an yang dipenuhi rasa keimanan kepada Allah akan menimbulkan proses penyerahan diri kepada Sang Pencipta yang akan menimbulkan keadaan pasif bagi tubuh pembacanya. Selain itu, membaca Alquran seperti ini juga akan menimbulkan efek plasebo yang menyehatkan dan membaca Alquran sendiri dapat menjadi salah satu bentuk relaksasi yang disebut dengan metode meditasi transendensi. Relaksasi ini tidak terfokus pada proses relaksasi otot atau proses relaksasi fisik lainnya, melainkan pada ungkapan-ungkapan yang diulang-ulang dalam ritme yang teratur disertai penyerahan diri kepada Tuhan

A retrospective study of urological injuries during obstetrics and gynecological procedures

Background: Urological injury in obstetrics and gynaecology are not uncommon because there is a close anatomical association between reproductive and urological system. The objective of this study was to find out the incidence and types of urological injuries in obstetric and gynaecological procedures, clinical presentation and various management option in a tertiary care hospital.Methods: The study was a retrospective analysis of all obstetric and gynecological surgeries over a period of 6 years from January 2014 to December 2019. Cases with the documented urological injuries during these procedures were analyzed further.Results: Total 8595 patients had undergone different obstetrics and gynecology procedures, out of which 5429 were obstetrics and 3166 were gynecology surgeries.  Out of 3166 of gynecology procedures, there were 16 cases (0.5%) of bladder injuries and one case (0.03%) of ureteric injury. Out of 5429 cases of obstetric procedures there were 11 (0.2%) cases of bladder injury and one case (0.01%) of ureteric injury.Conclusions: The incidence urological injuries during obstetrics and gynecological procedures are rare but the morbidity associated these are significant. Therefor surgeons should be more cautious and high degree of suspicion can help in early diagnosis and avoid the sequel

Robot-assisted pancreaticoduodenectomy. Safety and feasibility

Background: The availability of robotic assistance could make laparoscopic pancreaticoduo- denectomy safely feasible. We herein provide a systematic review on laparoscopic robot-assisted pancreaticoduodenectomy (RAPD). Methods: Literature search was conducted on multiple databases considering articles published in English up to October 31, 2014, reporting on ten or more patients. Results: A total of 262 articles were identified. Excluding duplicates (n=172), studies not matching inclusion criteria (n=77), and studies not suitable for other reasons (n=6), a total of seven studies reporting on 312 RAPDs were eventually reviewed. These studies were either retrospective cohort studies (n=4) or case-matched studies (n=3). No randomized controlled trial was identified. Most patients undergoing RAPD were diagnosed with malignant tumors (224/312; 71.8%). RAPD was feasible in most patients. Conversion to open surgery was reported in 9.2% of the patients. A hybrid RAPD technique, employing standard laparoscopy or open surgery through a mini-incision, was adopted in most patients (178/312; 57.0%). Overall, there were six postoperative deaths at 30 days (6/312; 1.9%), including one intraoperative death caused by portal vein injury, while 137 out of 260 patients with complete information developed postoperative complications (52.7%). The mean length of hospital stay ranged from 10–29 days. Postoperative pancreatic fistula (POPF) occurred in 66 patients (66/312; 21.1%). Grade C POPF was reported in eight patients (8/312; 2.5%). The costs of RAPD were assessed in two studies, demonstrating additional costs ranging from 4,000–5,000 US dollars to 6,193 Euro. The mean number of examined lymph nodes and the rate of positive surgical margins indicate that RAPD could be an appropriate oncologic operation. Conclusion: RAPD is safely feasible. These results were obtained in selected patients and in specialized centers. RAPD should not be implemented in the occasional patient by surgeons without advanced laparoscopic skills and formal training in robotic surgery

EVIDENCE BASED NURSING (EBN): BLADDER TRAINING IN URINE ELIMINATION DISORDERS PATIENTS IN LABUANG BAJI MAKASSAR HOSPITAL

Bladder Training is one of the applications of Evidence Based Nursing (EBN) to reduce urinary elimination disorders in Chronic Kidney Disease (CKD) patients with urinary catheters. Bladder training is bladder training that aims to develop muscle tone and bladder sphincter muscles for maximum purpose. The purpose of this EBN is to identify the effectiveness of Bladder Training (delay urination) in reducing urinary elimination disorders in Chronic Kidney Disease (CKD) patients . The results of this EBN application were found that at the time of administering bladder training,on the first day the patient has not felt the sensation of wanting to urinate and at the time of giving bladder training on the second day the client has felt the sensation of wanting to urinate. Bladder training (delay urination) can be recommended as a non-pharmacological therapy to reduce urinary elimination disorders, is easy to do, safe and technically practical to reduce elimination disorders in Chronic Kidney Disease (CKD) patient

Clinicopathological study of testicular tumors: an experience in a tertiary care hospital in Kashmir valley, Jammu and Kashmir, India

Background: Testicular and paratesticular neoplasia are rare type of tumors affecting adolescents and young adults in India, as observed by paucity of published data. This study was undertaken to analyze the patterns of testicular tumors at a tertiary level hospital in Kashmir valley, Jammu and Kashmir, India highlighting the patient’s demography, clinical presentation, diagnostic evaluation and pathological finding.Methods: This 5-year (retrospective and prospective) study was performed in the Department of Pathology, Government Medical College Srinagar, Jammu and Kashmir, India from January 2012 to December 2016. For the retrospective study, all cases of testicular tumors, their histopathological reports and required clinical details were searched from records maintained in the Department of Pathology, GMC Srinagar, Jammu and Kashmir, India. For the prospective study, the orchiedectomy specimens received in our department were subjected to routine histopathological processing followed by a detailed gross and microscopic examination. Tumour typing and subtyping was done according to WHO classification (2004).Results: A total of 37 cases of testicular and paratesticular neoplasia were included in present study with a mean age of 35.1 years. Out of these 37 cases, 31 (83.78%) were malignant and 6 cases (16.22%) were benign. Right testis was affected in 70.3% of cases. The most common clinical presentation was scrotal swelling. Germ cell tumor was the most common type accounting for 89.2% of tumors followed by lymphomas (8.1%).Conclusions:It is concluded that despite new techniques in imaging and tumor marker assay, the diagnosis of testicular tumors is dependent upon histopathological examination. The present study fairly provides an insight into the clinical presentations, prevalence and patterns of testicular tumors.

PERAN STEM CELL PADA GLAUKOMA

Stem cell telah menarik minat yang cukup besar dalam beberapa dekade terakhir mengingat merupakan suatu metode terapeutik baru. Glaukoma adalah salah satu penyebab utama kehilangan penglihatan dan kebutaan total di dunia saat ini terutama di negara-negara Afrika dan Barat yang mempengaruhi lebih dari 60 juta orang. Peningkatan Tekanan intraokular (TIO) merupakan faktor risiko utama untuk kematian retinal ganglion cell (RGC), yang fungsinya menyampaikan informasi visual ke otak dari mata melalui saraf optik. Pengurangan TIO saat ini dicapai melalui berbagai cara, termasuk terapi obat dan intervensi bedah. Namun, tidak ada terapi yang bisa mengembalikan penglihatan pasien menjadi lebih baik oleh karena sudah terjadi kematian RGC yang luas dan tidak dapat ber-regenerasi. Oleh karena itu, stem cell dapat menjadi pilihan satu-satunya untuk mengembalikan penglihatan. Studi sebelumnya telah menunjukkan bahwa pluripotent stem cell (PSC), retinal progenitor cells (RPC) dan sel Muller dapat digunakan untuk meregenerasi RGC. Akan tetapi, ampai saat ini hanya beberapa terapi stem cell yang telah disetujui untuk digunakan dalam praktik klinis penyakit mata, diantaranya inherited retinal dystrophies dan age-related macular degeneration (AMD). Penelitian lain yang dilakukan oleh vilela et al. pada tahun 2015 pada 2 pasien dengan POAG stadium lanjut menggunakan pemberian stem cell yang berasal dari bone marrow pasien tersebut (autolog) secara intravitreal, setelah dilakukan pemeriksaan dengan menggunakan elektroretinografi tidak ada respon setelah terapi dan salah satu pasien mengalami ablasio retina disertai proliferative vitreoretinopati setelah 15 hari post injeksi. Stem Cell merupakan terapi yang sangat menjanjikan bagi pasien dengan glaukoma terutama dengan stadium lanjut oleh karena kerusakan saraf optik yang dialami pasien glaukoma yang tidak dapat diperbaiki dengan terapi yang telah dilakukan sampai sekarang yaitu obat penurun tekanan intraokular maupun dengan operasi. Namun, harus diperhatikan bagaimana Teknik dan pemilihan jenis yang paling baik untuk mencapai outcome terbaik dan dengan efek samping yang paling sedikit

Resuming elective hip and knee arthroplasty after the first phase of the SARS-CoV-2 pandemic: the European Hip Society and European Knee Associates recommendations

The Covid-19 pandemic has disrupted health care systems all over the world. Elective surgical procedures have been postponed and/or cancelled. Consensus is, therefore, required related to the factors that need to be in place before elective surgery, including hip and knee replacement surgery, which is restarted. Entirely new pathways and protocols need to be worked out. Methods A panel of experts from the European Hip Society and European Knee Association have agreed to a consensus statement on how to reintroduce elective arthroplasty surgery safely. The recommendations are based on the best available evidence and have been validated in a separate survey. Results The guidelines are based on five themes: modification and/or reorganisation of hospital wards. Restrictions on orthopaedic wards and in operation suite(s). Additional disinfection of the environment. The role of ultra-clean operation theatres. Personal protective equipment enhancement. Conclusion Apart from the following national and local guidance, protocols need to be put in place in the patient pathway for primary arthroplasty to allow for a safe retur

The 'incidentaloma' of the pituitary gland. Is neurosurgery required?

We describe a series of 18 patients with an intrasellar mass incidentally discovered by computed tomography or magnetic resonance imaging. The average size of the mass was 13 mm, with a range from 5 to 25 mm. Initial ophthalmologic examination revealed bitemporal hemianopia in 2 patients. Results of routine endocrine testing showed partial hypopituitarism in 5 patients and growth hormone hypersecretion without signs and symptoms of acromegaly in 1 patient. Four patients underwent neurosurgery. Histologically, one chondroid chordoma and three pituitary adenomas were found. In the remaining 14 patients treated conservatively, repeated computed tomography and magnetic resonance imaging revealed no significant change in tumor size at the time of follow-up (median, 22 months). Our results suggest that the "incidentaloma" of the pituitary gland is a benign condition that does not necessarily require neurosurgical intervention