Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Dec 2019
Comparative StudyHand-made Extracorporeal Knotting versus Hem-o-Lok Clip for Stump Closure in Laparoscopic Appendectomy.
To compare hand-made extracorporeal knotting and hem-o-lok clip for the closure of appendix stump regarding safety, complications and cost-effectiveness. ⋯ Of 287 patients, 149 (51.9%) were female and 138 (48.1%) were male. The mean age was found 34.9 years. No statistical difference was observed between groups according to age, gender, duration of symptoms, serum leukocyte count, ASA score, operation time and hospital stay. Intraoperative findings were different between groups (p<0.05). Overall postoperative complication rate was 6.6%. No statistical difference was observed regarding complications Conclusion: Both hand-made extracorporeal knotting and hem-o-lok clips can be used for stump closure in laparoscopic appendectomy. Hand-made extracorporeal knotting is an effective, safe and costeffective method alternative to hem-o-lok clips.
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J Coll Physicians Surg Pak · Dec 2019
Mortality Related Factors in Patients with Variceal Bleeding with MELD Score ≥ 18.
To find and analyse the associated determinants of mortality in admitted patients in cirrhotic patients with MELD score >18 presenting in emergency department with variceal bleeding. ⋯ Liver cirrhosis with MELD score >18 and variceal bleeding is highly prevalent in young adult patients, more likely in male patients having duration of disease since >1 year to 3 years such that every 1 of 5 patients expired during the hospital stay. Probability of survival was 80%.
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To evaluate the results of pars plana vitrectomy for cystoid macular edema (CME) resistant to medical treatment. ⋯ Pars plana vitrectomy with ERM / ILM peel and gas injection for CME refractory to medical treatment is an effective treatment. There was significantly improved best corrected visual acuity (BCVA) postoperatively along with decreased CMT on optical coherance tomography (OCT).
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsUnilateral Synchronous Multiple Kidney Tumors Managed by Laparoscopic Partial Nephrectomy: Five-year Follow-up.
Unilateral synchronous multifocal renal tumors are rare. Due to the limited data in the literature and challenges in the technique, there is still doubt on the application of laparoscopic partial nephrectomy (LPN) for the management of such tumors. Herein, we report a 36-year male patient presenting with right-sided flank pain and microscopic hematuria. ⋯ Final pathology revealed renal cell carcinoma in all masses. Postoperative period was uneventful. No recurrence was detected during a 5-year follow-up.
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J Coll Physicians Surg Pak · Dec 2019
Percutaneous Venoplasty for Central Venous Stenosis: Effect on Patient's Symptoms and Patency of Arteriovenous Accesses.
To determine symptomatic relief and patency rate of arteriovenous (AV) fistulae and grafts after venoplasty in patients with central venous stenosis (CVS) on hemodialysis. ⋯ Percutaneous venoplasty provided symptomatic relief to the patients and improved the short-term patency of AV accesses.