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Surgical Results of Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) Compared to Open Thyroidectomy in Patient with Benign Thyroid Nodule
Kornwalee Koichusakul,
Khwannara Ketwong
Issue:
Volume 9, Issue 2, December 2021
Pages:
15-19
Received:
4 August 2021
Accepted:
16 August 2021
Published:
4 September 2021
Abstract: Background: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is an innovative technique to perform thyroidectomy which provides excellent cosmetic and surgical outcomes. Methods: Between June 2018 to January 2020 all patients pathological diagnosis with benign thyroid nodule in Chiangrai Prachanukroh Hospital were reviewed retrospectively. TOETVA and Open thyroidectomy were performed in 55 cases per each group, respectively. Patient baseline characteristics and surgical results, including postoperative pain, estimate blood loss, operative time, length of hospital stay and postoperative complications, were investigated and compared. Results: TOETVA and open thyroidectomy was performed on 110 consecutive patients. The baseline characteristics were similar in both groups. The mean postoperative visual analog scale for pain score in the first three days was comparable for both groups (4.43 [2.01] vs 3.73 [2.5], P=0.126). Mean estimate blood loss was not statistically different for both groups (20 [76.19] vs 30 [44.28] ml, P=0.302). But the median operative time was longer for the TOETVA group compared to the open thyroidectomy group (120 [61.55] vs 60 [33.70] mins, P=0.00003). Mean length of stay was comparable for both groups (3.7 [0.98] vs 3.43 [1.05] days, P=0.072). For the postoperative complication, 3 patients (5.45%) in TOETVA and 6 patients (10.91%) in open thyroidectomy group has recurrent laryngeal nerve injury. One patient (1.82%) had hypocalcemia in both groups. In TOETVA group, one patient (1.82%) had wound infection and one patient (1.82%) had transient mental nerve injury. Conclusion: TOETVA is an effective and safe surgical approach for benign thyroid nodule with excellent cosmetic outcome. This technique is a reasonable optional treatment for patients who demanded a scarless wound. The surgical outcomes and complication rates were similar but TOETVA is associated with longer operative time.
Abstract: Background: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is an innovative technique to perform thyroidectomy which provides excellent cosmetic and surgical outcomes. Methods: Between June 2018 to January 2020 all patients pathological diagnosis with benign thyroid nodule in Chiangrai Prachanukroh Hospital were reviewed retrospect...
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Association Between Asthma Control Status and Lung Function with Vitamin D Level in Children with Bronchial Asthma
Lali Bugadze,
Nino Manjavidze,
Lia Jor Joliani
Issue:
Volume 9, Issue 2, December 2021
Pages:
20-24
Received:
27 May 2021
Accepted:
30 July 2021
Published:
12 October 2021
Abstract: Bronchial asthma is one of the most common chronic diseases in childhood. Pooled vitD levels were positively correlated with pooled ACT scores, Treg counts, FEV1% values and VDBP levels. Vitamin D supplementation reduced the rate of asthma exacerbation, especially in patients with vitamin D insufficiency. The 25-OH vitamin D levels were lower in pediatric asthma patients with worse spirometry results. Lower vitamin D levels in children with STRA were associated with increased ASM mass and worse asthma control and lung function. Materials and methods: The study was performed in children aged 6 -15 years old, including patients with asthma (n=50), who referred to Sachkhere medical center for a visit. The status of asthma control in the basic group was classified as controlled (n=31) and uncontrolled (n=19). The children underwent serum vitamin D and IgE level, spirometry and skin prick tests for the study. Results: Using the multivariate logistic regression analysis, the presence of asthma was associated with the reduced level of vitamin D (OR=1.35, 95% CI (1,14-1.58) P=0.011; X²=6.78; F-0.022) in children with uncontrolled bronchial asthma. 48% of the patients in the group- controlled asthma (n=15) had vitamin D deficit, and in 52% of the cases (n=16) was confirmed with vitamin D insufficient. In the group –uncontrolled asthma - 5% of the patients (n=1) had Vitamin D insufficiency in blood serum. In 95% (n=18) of the patients vitamin D level was significantly low < 20 ng/ml. According the results, decreased pulmonary function (p-0.039; x2-3.12) is strongly associated with low level of vitamin D; but neither serum IgE level (p-0.54; x2-10.9), nor skin prick test result on dust mite (p-0.50, x2-5.12) was correlations with serum vitamin D low level. Conclusion: The presence of vitamin D deficiency effectively predict increased risk of uncontrolled bronchial asthma in children. Serum vitamin D level is related to lung function too. Therefore, by normalize vitamin D level in blood serum maybe improve lung function and control status in children with bronchial asthma.
Abstract: Bronchial asthma is one of the most common chronic diseases in childhood. Pooled vitD levels were positively correlated with pooled ACT scores, Treg counts, FEV1% values and VDBP levels. Vitamin D supplementation reduced the rate of asthma exacerbation, especially in patients with vitamin D insufficiency. The 25-OH vitamin D levels were lower in pe...
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Pulmonary Cavitation Post COVID-19 Pneumonia: A Case Report
Arjun Kumar,
Ayushi Sahu,
Rahul Kumar Gupta,
Manju Bala,
Akhlesh,
Avishek Layek
Issue:
Volume 9, Issue 2, December 2021
Pages:
25-27
Received:
17 July 2021
Accepted:
10 August 2021
Published:
12 October 2021
Abstract: The coronavirus disease 2019 (COVID-19) is now rapidly spreading at a much faster rate than the first wave reported in December 2019. Computed tomography (CT) scans play crucial roles in the diagnosis of COVID-19 pneumonia where rRT-PCR test reported negative in strong clinical suspicion. Common chest radiological findings in COVID-19 are bilateral peripheral ground-glass opacities, consolidation, linear opacities and interstitial thickening. However, bilateral cavitary lung disease is a rare entity in COVID-19. Hare, we present the case of a 62-year-old patient with severe COVID-19 pneumonia with initial rRT-PCR was negative for COVID-19 and who had atypical manifestations of the COVID-19 disease on a CT scan showing multiple cavitation with consolidation in the lungs. Special blood investigations showed raised blood procalcitonin, galactomannan, fibrinogen, D- dimer and BAL fluid pseudomonas aeruginosa growth and raised galactomannan. However, deteriorated on antibiotics along with antifungal drugs and supportive treatment. On high suspicion of viral pneumonia repeated rRT-PCR for COVID-19 came positive leading to fatal outcome.
Abstract: The coronavirus disease 2019 (COVID-19) is now rapidly spreading at a much faster rate than the first wave reported in December 2019. Computed tomography (CT) scans play crucial roles in the diagnosis of COVID-19 pneumonia where rRT-PCR test reported negative in strong clinical suspicion. Common chest radiological findings in COVID-19 are bilateral...
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Contextualization of the Study of Residual Lesions in Conized Patients
Heenry Luis Davila Gomez,
Lidia Esther Lorie Sierra,
Zaskia Matos Rodriguez
Issue:
Volume 9, Issue 2, December 2021
Pages:
28-32
Received:
13 May 2021
Accepted:
31 May 2021
Published:
12 October 2021
Abstract: In the last years, it is evidenced of more remarkable way, an increment of the incidence of the cervical cancer and their lesions precursors in young patients. Conization, as an excisional method, is recommended in the treatment of high-grade epithelial lesions, as well as in the microinvasive stage of cervical cancer when satisfied parity has not yet been achieved. In Clinical Medicine, finding a balance between therapeutic effectiveness and iatrogenic intervention by exaggerated treatments is a challenge, a current scenario in which the probability of the appearance of residual lesions after conization is framed. Although factors related with the biggest probability of appearance of residual lesions are described in patient conizadas, models that demonstrate the interrelation between these variables don't exist; most of the studies are limited to the individual analysis of these factors. The current scientific evidences allow to state that the appearance of post-cone residual lesions is a multifactorial phenomenon dependent on elements related to the nature of the lesion, the surgical technique and the competence of the surgeon; even several of these predictive elements are interrelated in the same patient. The knowledge of these predictors factors of residual lesion, starting from the pattern of the three dimensions, allows to trace clinical and formative strategies of intervention.
Abstract: In the last years, it is evidenced of more remarkable way, an increment of the incidence of the cervical cancer and their lesions precursors in young patients. Conization, as an excisional method, is recommended in the treatment of high-grade epithelial lesions, as well as in the microinvasive stage of cervical cancer when satisfied parity has not ...
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