Role of Sentinel Lymph Node in Early Stage of Uterine Cervical Cancer

Cervical cancer is currently the second most common form of neoplasia worldwide and third in the female population.

Dissemination can occur directly (isthmus, parametrium, vagina, urinary bladder and/or rectum), through the lymphatic system (parametrium, internal iliac, external iliac, common iliac, obturator lymph nodes and rarely in the inferior gluteus, superior gluteus, superior rectum, sacrum, aortic lymph nodes) and through the circulatory system (lung, mediastinum, bones, liver).

 The risk of pelvic lymph nodes invasion in stage IB (FIGO) is 9-17%. The standard surgical treatment, for stages IA2-IIA, is radical hysterectomy with pelvic lymphadenectomy.

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Right Versus Left Laparoscopic Donor Nephrectomy: Initial 3 year Experience from a Single Centre Transplant Program

Laparoscopic living donor nephrectomy is the standard of care at high volume transplant centers.

Despite this there is still reticence to harvest the right kidney laparoscopically because of concerns regarding the shorter renal vein, higher complexity of dissection and potentially higher complication rates and worse renal allograft outcomes.

The aim of this single-center study of 72 consecutive laparoscopic donor nephrectomies was to compare left versus right-sided laparoscopic donors in terms of surgical difficulty, complication rates and outcomes.There were 56 left-sided and 16 right-sided donors.

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A Pediatric Case of Very Late Onset Non-infectious Pulmonary Complication (LONIPC) after Allogeneic Hematopoietic Stem Cell Transplantation

17-months old infant with Wiskott-Aldrich syndrome was transplanted with genetically two-locus mismatched unrelated cord blood cells under the conditioning regimen of busulfan, cyclophosphamide and anti-thymocyte globulin.

GVHD prophylaxis was cyclosporine (CSP) plus short-term methotrexate with prednisolone (1 mg/kg). Acute and chronic GVHD were not observed during the course.

About six years later, he suffered from severe cough and dyspnea with no fever, and diagnosed as late onset non-infectious pulmonary complications (LONIPC).

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Hidden Penis in Children: Evaluation of Outcomes and Review of the Literature

There are many categories in hidden penises usually differentiation among the terms includes: concealed (before circumcision), trapped (cicatricial or scarred) after circumcision), and buried (associated with adolescence and obesity).

Methods: From December 2014 to August 2015, we evaluated 10 patients (6 months–10 years old) with buried penises, concealed penises, trapped penises and webbed penises that were surgically. All the patients were scheduled for regular follow-up at 1, 4, and 12 weeks postoperatively.

Results: l0 patients underwent surgical repair, all buried and concealed patients had penile degloving and penile fixation. All patients reported much improved urinary function, and all patients stated that they were pleased or very happy with their outcome.

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Off-Road Motorbike and All-Terrain Vehicle/Quadbike Accidents in Rural New South Wales

Motorized off-road vehicles are a common form of transportation used by the rural community. These vehicles are rugged and relatively inexpensive, making them practical and versatile in mining, logging and farming communities.

They are ideal modes of transport especially on farms where there is little or no paved roads as the bikes can easily navigate over uneven surfaces. There are two main forms of off-road vehicles used in rural communities.

The first main form of off-road vehicle is the off-road motorbikes. These bikes are specifically designed for off-road riding and are also known commonly as ‘dirtbikes’.

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Large Cavernous Hemangioma of the Kidney Mimicking a Renal Cancer: A Diagnostic Challenge

A 69-year-old man presented with a 9-months intermittent macroscopic painless hematuria. He had a previous left kidney surgery for renal lithiasis 24 years ago. There were no particular physical findings, such as flank pain.

Routine laboratory tests including hematology, biochemistry, urine analysis and coagulation tests showed no abnormalities. Urine cytology studies and cultures were negative.

Renal ultrasound depicted an enlarged left kidney with heterogeneous solid mass. An enhanced computed tomography (CT) revealed a 10 × 9 × 8, 5 cm, low-density, large heterogeneous renal mass.

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Proximal Tibial Epiphyseal Fracture, Complete Separation: A Rare Occurrence

Dislocation of the knee joint and fractures about the proximal tibia are extremely rare occurrences in the paediatric age groups.

Based on the Salter and Harris classification system, we present a case of Type 1 fracture of the proximal tibia with complete separation of the epiphysis.

The case also highlights the presence of other concomitant injuries that accompany the trauma around the knee.

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Effects of Bariatric Surgery on Weight Loss and Quality of Life

Bariatric surgery is the most effective treatment for severe obesity. The mean weight loss is approximately 30-40 kg/11-15 BMI units or approximately 60 % of excess body weight.

Many patients pursue bariatric surgery for improvement in their physical image and self-esteem rather than somatic health improvement.

Health-related quality of life improves after bariatric surgery and the long-term improvements are positively associated with the long-term amount of weight reduction.

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Problems and Possibilities in Tissue Engineering

Organ and tissue transplantation in developed countries is in steady increase. We are living in fast changing world with path-breaking technological advancements as a norm of the day.

Development of the field of organ and tissue transplantation has accelerated remarkably since the human major histocompatibility complex (MHC) was discovered.

The major histocompatibility complex (MHC) contains a set of cell surface molecules responsible for binding peptide fragments derived from pathogens and display them on the cell surface for recognition by the appropriate T cells.

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Prevalence of Surgical Site Infections in Non-Diabetic Patients Undergoing Major Surgery at St. Francis Hospital Nsambya

Surgical site infection (SSI) is an infection occurring in an incision wound within 30 days of surgery and significantly effects patient recovery and hospital resources.

 To determine the prevalence of SSI among non-diabetic patients undergoing major surgery at St.Francis hospital Nsambya. This was a Cross-section prospective study, the study was carried out at St. Francis Hospital Nsambya in Kampala.

This is one of the tertiary level referral and teaching hospital for MKPG Nkozi University. It has a bed capacity 342 beds. Approval to conduct the study was obtained from the institutional review board prior to commencement of data collection.

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PRF in Oral Surgery: A Literature Review

The research of adjuvant surgical to promote the healing is a challenge. A lot of processes were done especially the PRF (platelet rich fibrin) that owes its action to its slow polymerization which permits to pick up the growth factors inside the fibrin mesh.

These factors and due to a slow release permit a local stimulation of the healing time as well. Nowadays, with the use of the PRF, the oral surgery undergoes a lot of controversies.

The clinical observations are in advance in regard to the scientific evidence. In spite of the encouraging results, research is to be depending to get a complete scientific validity.

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Pilon Fractures of Middle Phalanx Managed with Lag Screw and Early Mobilisation

Proximal interphalangeal (PIP) joint injuries are commonly seen in athletes and especially the pilon fractures are quite common due to axial loading injuries.

It is associated with volar lip fragment with dorsal subluxation of middle phalanx with varying degree of comminution of the base of middle phalanx.

Varied treatment options have been described ranging from extension block splint, external frame finger distraction and open reduction internal fixation. The key is in restoring the joint congruity with early controlled mobilisation thereby preventing joint stiffness or deformity.

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A Successful Case of Renal Transplantation from Deceased Donor Performed 7 Years after Radioactive Seed Implantation Therapy for Localized Prostate Cancer.

There has been a significant increase in the number of patients with Prostate Adenocarcinoma (PCa) over the last decade, leading to a substantial rise of pre-transplant patients with a history of cured PCa.

Currently, Radical Prostatectomy (RP) and brachytherapy using isotope seeds are good alternatives for treatment of localized low risk PCa. 

In this case, we performed a cadaveric renal transplantation for a patient who 7 years previously underwent radioactive seed implantation therapy for low risk PCa, as defined by the D’Amico classification system.

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Pulmonary Function Assessment Method with Type II Non-heart Beating Donors in Spain is Valid

Lung transplantation unit from Hospital 12 de Octubre began its work in October 2008. In the last five years, 80 lung transplants have been performed with a hospital mortality rate of 6.5% and a five years survival of 79.7%.

As a result of the need of obtaining a greater number of donors, and encouraged by the outpatient non heart beating donors program within our hospital, we considered the possibility of assessing these donors lung grafts.

We have followed the methodology designed and set off with good results by other hospitals in the area of Madrid.

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Extra-corporeal Circulatory Support: A Resurgence of a Life Saving Therapy in the Digital Information Age

Extra-corporeal membrane oxygenation represents an evolving therapeutic tool for the treatment of acute severe cardiac and respiratory failure in patients failing maximal medical therapy.

Advances in technology along, increasing worldwide clinical successes, and broadening applications have encouraged renewed interest in what was previously considered a salvage intervention associated with poor outcomes.

Hopefully, the use of digital media and timely on-line access to scientific advances will allow clinicians and patients who depend on ECMO for survival to benefit in a field in which there is clearly room for improvement in outcomes and understanding.

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Epididymal Sparing Bilateral Orchidectomy with Epididymoplasty for Advanced Cancer Prostate

Rise in incidence and variable natural history of prostatic carcinoma, presents a challenge to professionals involved in its management.

Cases that come for evaluation and treatment in developing countries like ours are elderly and usually present in the late stages of the disease. Perhaps the best option remain at this stage is palliative in the form of channel TURP to improve the urine flow and suppress the cancer growth by androgen deprivation treatment (ADT).

Further improvement of quality of life is achieved by supportive measures like good nutrition, vitamins and calcium supplementation to prevent demineralisation of bones and analgesic for pain relief.

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Osteoporotic Fractures Following Spinal Cord Injury: A Serious Health Problem

Osteoporosis is characterized by low bone mass, deterioration of the bone microarchitecture and increased bone fragility, which inevitably result in an amplified risk for fractures.

Spinal Cord Injury (SCI) is strongly associated with declined bone mineral density and increased incidence of osteoporosis. This is a serious complication of the spinal injury as the osteoporotic paralyzed limbs of the SCI patients are vulnerable to pathological fractures even after subtle and no obvious trauma.

Bone loss in these patients is higher in the first six months after the SCI and stabilizes between 12 and 16 months, with about 30% loss of bone mass.

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Elimination of Environmental Effects on Temperature Assessment in Clinical Postoperative Free Flap Monitoring? A Prospective Cohort Study

The time interval between the onset of ischemia and its clinical recognition is of utmost importance in terms of free flap salvage in free flap surgery.

Although microsurgical free-tissue transfer has become a reliable technique, between 5 to 25 percent of transferred flaps require surgical revision because of circulatory compromise either on the arterial or venous side.

Regardless of the surgeon’s experience or the reliability of the chosen free flap, immediate detection of perfusion failure and prompt revision is paramount for flap salvage as ischemic tolerance of the flap tissue is limited to a few hours and irreversible disseminated microvascular thrombi may form during malperfusion.

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