Ali Gohar Khan, Sadam Zia, Syed Khizar Naim, Abdul aziz laghari, Saba ashraf, Arooj Fatima, Sohail Ashraf, Mehwish Zia, Ahmed Ali Danish
Online date : 2018-10-19 09:06:11
PROSTHETIC MESH REPAIR IN OBSTRUCTED INGUINAL HERNIA: A RESEARCH ANALYSIS
Ali Gohar Khan, Sadam Zia, Syed Khizar Naim, Abdul aziz laghari, Saba ashraf, Arooj Fatima,...
Introduction: Inguinal hernia is a commonly encountered urgent condition in surgical clinics. An abdominal wall hernia is a protrusion of the abdominal tissues or organs through a weakness in the muscular structure of the wall of the abdomen. Inguinal and femoral hernias are usually classified together as groin hernias. Objective of the study: The main objective of the study was to compare the outcomes of different surgical techniques performed for inguinal hernia, and to evaluate the effect of prosthetic mesh repair in obstructed inguinal hernia. Methodology of the study: This retrospective study was performed with 70 patients who had been admitted to our hospital’s emergency department between 2016 and 2017 to undergo surgery for a diagnosis of obstructed inguinal hernia. Results: The patients were divided into two groups based on the applied surgical technique. In Group 1, it was observed that eight of the patients had wound infections, while two had hematomas, four had seromas, and one had relapse. In Group 2, one of the patients had a wound infection, while three had hematomas, one had seroma, and none had relapses. In Group 3, it was observed that one of the patients had wound infections, while one had a hematoma, one patient had seroma, and none had relapses. In Group 4, seven of the patients had wound infections, while one had a hematoma, three had seromas, and one had a relapse. Conclusion: There were no significant differences between the two groups with respect to wound infection, seroma, hematoma, or relapse (p>0.05). In urgent groin hernia repair surgeries, polypropylene mesh can be safely used even in the patients undergoing bowel resection.
THE ETIOLOGY AND TREATMENT OF BRONCHIOLITIS IN CHILDREN (A REVIEW)
Magid Reza Akbarizadeh
Respiratory syncytial virus (RSV) is the main cause of bronchiolitis in infants, and it is commonly the main cause of epidemics. The main cause of bronchiolitis is generally viral, including RSV, human metapneumovirus, influenza virus, human parainfluenza viruses, adenoviruses, and rhinovirus. From among the bacterial causes, pertussis has been introduced as the one making bronchiolitis symptoms. As the age increases, the prevalence rate and severity of diseases arising from RSV decreases. This virus brings about 90,000 hospitalization cases and 4500 deaths in the United States. This virus has been observed in at least 20% of the children hospitalized. The treatment of bronchiolitis is a supportive one, and it includes monitoring, fever control, proper hydration, upper airway suctioning, and oxygen prescription. The main treatment of bronchiolitis is oxygen prescription; patients feeling worse tend to be hypoxic. The oxygen saturation percentage needs to be at the level of 92% or higher. For this purpose, the prescription of lukewarm and wet oxygen (30% to 40%) through mask or nasogastric tube is sufficient. Bronchiolitis complications include apnea, dehydration, electrolyte disorders (usually hyponatremia), added bacterial infection, myocardial dysfunction, Myocarditis, and respiratory failure. Most of the children hospitalized in the hospital will recover significantly only through a supportive treatment within 2-5 days. After the recovery, wheezing or coughing lasted for several weeks or months in less than 20% of the patients. Older children and adults produce an antibody against RSV. However, the immunity is not complete and reinfection can occur at any age.
THE DIAGNOSIS OF BRONCHIOLITIS IN NEONATES (A REVIEW)
Magid Reza Akbarizadeh
Bronchiolitis is the most common disease of the lower respiratory tract in patients under the age of 2 years; the main clinical symptom includes the occurrence of the first visceral attack in infants younger than 12-24 months, with physical findings of a viral infection rather than pneumonia or atopy. Bronchiolitis occurs as a result of inflammation in small airways (bronchioles). Upper respiratory infections with any of the seasonal viruses can cause bronchiolitis. The disease may cause a range of complications, from a mild to severe clinical symptom and a life-threatening respiratory distress. The main factors causing the development of the severe form of bronchiolitis include racial factors, prematurity, bronchopulmonary dysplasia (BPD), congenital heart disease, and current weights of less than 5 kg. Being male, belonging to African-American ethnicity, and a history of asthma in parents are associated with an increased risk of outbreak or prolonged period of this disease. Routine laboratory tests do not have the necessary attributes for the diagnosis of bronchiolitis and are not required for confirmation of diagnosis. Mild leukocytosis of 12,000 to 16,000 per microliter is often present but non-specific.
The count of eosinophils in acute RSV infection is reduced like other infections. However, some patients develop elevated eosinophils, making them more prone to the progression to asthma. The pulse oximeter technique limits the need for an arterial blood sample, except in the case of extreme cases of anxiety. Recent studies do not routinely take photos of chest x-ray in infants with bronchiolitis. Although there are abnormalities in the breast picture of most infants with bronchiolitis, they include non-specific findings. There is insufficient information to prove that chest x-ray is associated with severity of bronchiolitis.