https://myresearchjournals.com/index.php/iarjs/issue/feed 2022-07-24T13:35:37+02:00 Mohammad Nasim [email protected] Open Journal Systems https://myresearchjournals.com/index.php/iarjs/article/view/10390 2022-07-24T13:35:37+02:00 Ouahmane Khalid . Hicham Ziani . Ayoub Ettaje . Anas Saoud Tazi .

The use of spinal anesthesia in obstetrics is justified by the advantages it has over general anesthesia. It is a simple and easy technique. However, the possibility of serious complications or even death with this technique during cesareans leads to questions about its place. We report a case of totalization of spinal anesthesia during a cesarean section, that had a favorable evolution for both mother and child.

2022-02-28T00:00:00+01:00 ##submission.copyrightStatement## https://myresearchjournals.com/index.php/iarjs/article/view/10391 2022-07-24T13:35:37+02:00 Widyanti Soewoto . Ida Bagus Budhi Surya Adnyana . Muhammad Fahmi Salafuddin . Muhammad David Perdana Putra . Galih Santoso Putra . Rizka Vinkan Septiani . Muhamad Muamar . Ikhdin Radiamin Saadhi . Meirisa Ardianti . Dea Alberta Setiawati . Rico Alfredo Hutabarat . Dinar Kukuh Prasetyo .

Background: The novel coronavirus known as SARS-CoV-2 has spread worldwide and caused the COVID-19 pandemic. In September 2020, more than 32 million confirmed cases of COVID-19, with a death toll of more than 990,000. Among COVID-19 patients, those with cancer had worse outcomes than those without malignancy, but in some studies, the mortality rates differed significantly, ranging from 3.7% to 61.5%. Method: In this descriptive study, survival analysis with the Kaplan Meier curve was used to determine the healing rate of patients with cancer exposed to COVID-19 and undergoing treatment at dr. Moewardi General Hospital Surakarta-Indonesia from February to December 2020, and the Log Rank test was used to analyze data on two related groups. Results: The analysis using the Kaplan Meier method, female patients were found to have a higher survival rate than females, paged less than 50 years had a higher survival rate than those aged > 51 years, breast cancer had the lowest survival rate, and comorbidity of anemia had a higher survival rate than those with other comorbidities. The Log Rank test found a significant difference in the cumulative survival rates of cancer patients with COVID-19 with a p-value of 0.010 for comorbidity types. Meanwhile, from gender (p = 0.632), age (p = 0.672), type of cancer (p = 0.472), there was no significant difference. Conclusion: COVID-19 female patients aged less than 50 years with types of malignancy other than breast cancer and comorbidity of anemia have a higher survival rate..

2022-02-28T00:00:00+01:00 ##submission.copyrightStatement## https://myresearchjournals.com/index.php/iarjs/article/view/10392 2022-07-24T13:35:37+02:00 Meily Anggreini . Wibisono . . .

Objective: Coronavirus disease firstly discovered in December 2019, has caused many changes in patient management in the hospital, including in urology department. Several studies have demonstrated an increased rate of delayed care, with urology surgery having a delay of more than 8 weeks (Amota, O. et al., 2020). The medical workers are trying to reduce the spread rate by reducing of transmission (Amota, O. et al., 2020;and Sanyaolu, A. et al., 2020). The spread of this infectious disease is continuously increasing, hence the declaration of a pandemic (Cucinotta D). The COVID-19 status in the Solo city was updated to the red zone since the first year of the pandemic which makes the author interested in sharing information about COVID-19 in urology inpatients in the isolation ward (Tanggap Covid 19 Jawa Tengah, 2020). Materials and Methods: This study is a retrospective descriptive study that used secondary medical records data to determine the profile of urology patients in the COVID-19 isolation ward in dr. Moewardi General Hospital Surakarta for 1 year from May 2020 – June 2021. Results: This study found the urology patients in the COVID-19 ward were 26 patients, which was 4% of the total urology inpatients in the dr. Moewardi General Hospital in the first year of pandemic. Male patients consisted 85% of the total patients, with a mean age of over 50 years. The most frequent diagnosis was urinary retention. The mean duration of hospitalization was 2 weeks. The management in ward were urinary catheter insertion, closed cystostomy, prostate biopsy with local anesthesia, and emergency debridement surgery in isolated operating room. Delayed diagnostic procedures consisted of USG and BNO, while the delayed elective surgery consisted of cystoscopy, nephrectomy, direct visual urethrotomy (DVIU), and DJ stent insertion. Conclusions: The urology inpatients in the COVID-19 ward treated by multiple departments, in which the treatment of COVID-19 was prioritized before the definitive management from the urology department.

2022-02-28T00:00:00+01:00 ##submission.copyrightStatement## https://myresearchjournals.com/index.php/iarjs/article/view/10393 2022-07-24T13:35:37+02:00 Citra Aryanti . I Wayan Sudarsa . Putu Anda Tusta Adiputra . I Gede Budhi Setiawan .

Background: There were many cases of thyroid cancer proven from histopathology test after lobectomy from single thyroid nodules, which were not being predicted in advanced. The challenge for the clinician is thus to predict the malignancy preoperative to prevent unnecessary second completion thyroidectomy. Objective: This study aimed to determine the cancer probability risk of a single thyroid nodule by using preoperative parameters. Methods: This cohort study was conducted in Sanglah General Hospital, from 2016 to 2021. All data was obtained by Cancer Registry and electronic medical records. There were nine variables that being analyzed in this study, such as age, gender, side, size, consistency, vascularization, node, and cytology. The data was pooled and analyzed in SPSS and R studio. Smart phone application was developed using Android studio. Data were analyzed by logistic regression multivariate analysis. Results: From 2016-2021, there were 198 subjects with single thyroid nodules underwent surgeries in Sanglah General Hospital, Denpasar, Bali, Indonesia. As many as 98 subjects were histopathology proven cancer (follicular, papillary) after surgery. From multivariate analysis, the only left significant variables were vascularization, calcification, age, consistency, and cytology. Further, nomogram was developed to plot the probability of cancer from significant variables. By using only cytology parameter, the cancer predictive value was only less than 10%. Even age and consistency parameter by physical examination gave a higher value of 30% predictive value. The ultrasound parameters, combining the presence of calcification and vascularization, had a good predictive value of 60%. Conclusion: The combination of the ultrasound characteristics, age and physical examination able to accurately predict thyroid cancer.

2022-02-28T00:00:00+01:00 ##submission.copyrightStatement## https://myresearchjournals.com/index.php/iarjs/article/view/10394 2022-07-24T13:35:37+02:00 Amit Kumar C Jain .

The use of spinal anesthesia in obstetrics is justified by the advantages it has over general anesthesia. It is a simple and easy technique. However, the possibility of serious complications or even death with this technique during cesareans leads to questions about its place. We report a case of totalization of spinal anesthesia during a cesarean section, that had a favorable evolution for both mother and child.

2022-02-28T00:00:00+01:00 ##submission.copyrightStatement## https://myresearchjournals.com/index.php/iarjs/article/view/10395 2022-07-24T13:35:37+02:00 Uma Sharma . Manish Sharma .

Background: Present study was done to evaluate the incidence of perforation of gall bladder during laparoscopic cholecystectomy and its associated factors. Material and Methods: This prospective study was conducted in the Department of General Surgery, IGMC, Shimla. 100 consecutive patients of symptomatic gallstones with the documented gallstones undergoing laparoscopic cholecystectomy between July 2011 to March 2012 were included in the study and a study of gall bladder perforation was done. Results: Majority of patients in this study were females and were in age group of 31- 40 years. . Gall bladder perforation was present in 27.83% of patients. Gall bladder perforation was more common in males and in age group of 61- 70 years. Gall bladder perforation occurred during grasping in 44.4 % patients and during dissection from liver bed in 37.04% patients. Gall bladder perforation was more common in case of distended gallbladder with omental adhesions (9 out of 22 patients) and in patients with partly intrahepatic gallbladder (4 out of 8 patients). Conclusion: Gallbladder perforation is common intra-operative phenomenon, more common in males and in older age group. Perforation is more common in gallbladder having adhesion with omentum and if gallbladder is partly intra-hepatic.

2022-02-28T00:00:00+01:00 ##submission.copyrightStatement## https://myresearchjournals.com/index.php/iarjs/article/view/10396 2022-07-24T13:35:37+02:00 Uma Sharma . Manish Sharma .

Background: Present study was done to evaluate the postoperative pain and other complications due to spillage during laparoscopic cholecystectomy. Material and Methods: This prospective study was conducted in the Department of General Surgery, IGMC, Shimla. 100 consecutive patients of symptomatic gallstones with the documented gallstones undergoing laparoscopic cholecystectomy between July 2011 to March 2012 were included in the study and a study of gall bladder perforation was done. Results: Majority of patients in this study were females and were in age group of 31- 40 years. The difference in post-operative pain in patients without spillage and with spillage was significant on the day of surgery (p value=0.015). The difference in the pain was insignificant on 1st post-operative day (p value= 0.101) and on 2nd post operative day (p value= 0.567). Post-operatively fever was present in 3.09% of patients and ileus in 2.06% of patients. The difference in fever and ileus for patients without spillage and with spillage was insignificant (p value= 0.567 and 1 respectively). Port site infection at one week follow up was present in 1.03 % of patients and serous discharge from port site was present in 2.06 % of patients. The difference in port site infection and serous discharge from port site in patients without spillage and with spillage was insignificant (p value= 0.412 and 1 respectively). On post-operative USG collection in Morrison’s pouch was present in 2.06% of patients which settled without any intervention. The difference in patients without spillage and with spillage was insignificant (p value= 1). Conclusion: It was concluded the difference in post-operative pain was significant on the day of surgery while it was insignificant on 1st and 2nd post operative day. Post-operatively fever, ileus, Port site infection and serous discharge from port site was present as post operative complication.

2022-02-28T00:00:00+01:00 ##submission.copyrightStatement## https://myresearchjournals.com/index.php/iarjs/article/view/10397 2022-07-24T13:35:37+02:00 Uma Sharma . Manish Sharma .

Bear attacks are rare but widely publicized incidents. Degradation in form of overgrazing, deforestation, fire, reclamation of forest land for other uses and over extraction of forest resources essential for bear survival is occurring throughout the bear range. For those living nearby forest areas, bear presents a considerable danger worse than the tigers and leopards.

2022-02-28T00:00:00+01:00 ##submission.copyrightStatement## https://myresearchjournals.com/index.php/iarjs/article/view/10398 2022-07-24T13:35:37+02:00 Chaudhary A . Singh R .

Gallstone disease is one of the most common problems affecting digestive tract. The prevalence of gallstones is related to factors like age, gender and ethnic background. The prevalence of gallstone varies widely from place to place. It is estimated that approximately 20-25 million people in the United States have gallstones and that approximately 1 million new cases of cholelithiasis develop each year. Cholelithiasis is 10-15% prevalent in India and approximately 1-2% of asymptomatic patients will develop symptoms and require cholecystectomy each year. Its occurrence has been found to be at least 7.4% in adult population of North India. There has also been a remarkable shift in the trend of gall stone disease from middle aged, fertile, fat, females to young asthenic females in their twenties. Changing incidence in India is mainly attributed to westernization of diet, change in socioeconomic structure and availability of ultrasound as investigation in both rural and urbanareas. The current review was done to determine the efficacy of conventional laparoscopic cholecystectomy in comparison to single incision laparoscopic cholecystectomy.

2022-02-28T00:00:00+01:00 ##submission.copyrightStatement## https://myresearchjournals.com/index.php/iarjs/article/view/10399 2022-07-24T13:35:37+02:00 Amita Chaudhary . Rohit Chauhan . R. S. Jhobta .

Background: Single-incision laparoscopic cholecystectomy (SILC) has been developed to further minimize the invasiveness of laparoscopic cholecystectomy by reducing the number of incisions. Knowledge of preoperative clinical factors to predict difficult SILC may be used for the preoperative counselling of the patients regarding the successful outcome of the surgery as well as to predict the risk of conversion preoperatively for selected patients, prepare the patient psychologically and minimise the procedure related cost. Objective: The present study was conducted to know about radiological predictors for difficult SILC. Methods: The study was a hospital based prospective observational study where 50 patients undergoing elective laparoscopic cholecystectomy due to gall stone diseases were included in the study. Multiple logistic regression analysis was done to predict difficult single incision laparoscopic cholecystectomy. Results: Out of 50 patients 15 patients underwent difficult SILC, while 35 patients had undergone easy single incision laparoscopic cholecystectomy independent risk factors in multivariate logistic regression analysis for difficult SILC were: contracted or distended gall bladder on ultrasound, longer umbilicus to Calot’s triangle distance (UCD) on MRI. Conclusion: Radiological Factors associated with difficult SILC contracted or distended gall bladder on ultrasound and longer umbilicus to Calot’s triangle distance on MRI.

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