Effects of time on differential leucocyte counts and biochemical parameters of ovariohysterectomy, gastrotomy and intestinal resection and anastomosis in Nigerian indigenous dogs.

Differential leucocytes counts and some biochemical parameters could be affected over time by surgical procedures leading to kidney failure. Hence this study evaluates the effects of ovariohysterectomy (OVH), gastrotomy (GAT) and intestinal resection and anastomosis (ITR) on differential leucocyte counts and some biochemical parameters in Nigerian dogs. Twelve dogs of both sexes weighing 10.8±0.7 kg were randomly divided into three experimental groups of four each. The dogs were pre-treated with atropine sulphate (0.04 mg/kg), Xylazine (2 mg/kg) and propofol (6 mg/kg) parenterally, for induction and maintenance of anaesthesia. Pentazocine (3 mg/kg) was injected after surgery. Pre and post-surgery blood samples were obtained at 0, 2, 24, 48, 72, 96, 120 and 144 h respectively to determine differentials in leucocyte counts, electrolytes, lactate, blood urea nitrogen (BUN) and serum creatinine. Mathematical formulas were used to calculate plasma creatinine, creatinine clearance, plasma creatinine clearance, creatinine half- life, urine creatinine and urine volume. There were significant increases (p ≤ 0.05) in mean sodium, chloride and bicarbonate concentrations at 2, 24, 48, 72, 96 and 120 h post-surgery in group 1 and 2, while group 3 had significant decreases (p ≤ 0.05) in sodium, chloride and bicarbonate ions. Lactate value decreased significantly (p<0.05) in group 1, and increased in group 2 and 3 respectively.BUN increased significantly (p<0.05) in group 1,2 and 3.However, there were significant increases (p<0.05) in lymphocyte concentrations in group 1 and 3, respectively. Monocytes decreased significantly (p<0.05) after surgery. Conclusion: Xylazine and propofol anaesthetics cause hyperlactatemia which can be detrimental in surgical patients with co-morbidities.

Ultramicrosurgery: A new approach to treat primary male genital lymphedema.

BACKGROUND: Lymphedema is a chronic pathology characterized by progressive swelling due to lymphatic dysfunction (1). Literature contains few studies that focus on male genital lymphedema. A variety of surgical techniques as part of the male genital lymphedema therapeutic strategy has been described. Supramicrosurgical lymphatico-venular anastomosis s-LVA, based on connecting lymphatic collectors to venules, has evidenced efficient outcomes thus far. However, the peculiarity of the genital area may lead to an innovative and even more accurate surgical technique as a treatment of male genital lymphedema: lymphatic pre-collectors located superficially over the fascial layer can be used to perform the ultramicrosurgical anastomosis. PURPOSE OF THE STUDY: In this paper, the authors report their experience of this new surgical concept based on anastomosing lymphatic precollectors to venules. METHODS: We performed a retrospective study from 2014 to 2016. Six male patients with primary genital lymphedema underwent ultramicrosurgical lymphatico-venular anastomosis in Siena University Hospital, Italy. RESULTS: Ultramicrosurgical lymphatico-venular anastomosis has evidenced positive outcomes in terms of prognosis, infectious complications, volume reduction, and quality of life. The average cellulitis rate dropped from 2.5 episodes a year to 0.5 episodes after surgical intervention. The mean satisfaction index passed from 1.33 before the intervention to 2.83. CONCLUSION: Ultramicrosurgical lymphatico-venular anastomosis represents a challenging physiological approach for male genital lymphedema with promising outcomes.

Supramicrosurgical lymphatico-venular anastomosis (LVA) in treating lymphoedema: 36-months preliminary report.

OBJECTIVE: Lymphoedema of the extremities is a widespread pathological condition that mostly occurs as a complication of cancer resections, especially in women. Conventional therapy refers to conservative and physiotherapeutic approaches. Surgical strategies have been widely reported in the literature and are still challenging. Part of this literature focuses on the supra microsurgical lymphaticovenular anastomosis (LVA) technique. LVA is characterized by a high success rate, minimal invasivity and broad indications. Furthermore, this procedure can be performed under local anesthesia. PATIENTS AND METHODS: From October 2011 through October 2014, 69 patients affected by lymphedema underwent LVA surgery in Siena University Hospital, Italy. Preoperative and postoperative evaluations were taken. RESULTS: Totally, 366 anastomosis have been performed. The average rate was 5.3 anastomosis per patient. All patients registered a decrease in the size of the affected side. The average volume reduction was 50%. Patients also showed a reduction of lymphangitis episodes and reduction of compression garments class. Moreover, a satisfaction index was evaluated. The majority of patients (72.5%) was extremely satisfied of the surgery. CONCLUSIONS: LVA has demonstrated to be an effective surgical strategy to treat lymphoedema, especially in secondary cases in early stages. Although LVA is widely discussed in the literature, the majority of works relates to Japanese authors and few reports exist outside Japan. This paper represents the very first retrospective analysis of the adoption of LVA technique in Italy and one of the few outside Japan.

Hyaluronic acid's biomechanical stabilization function in the temporomandibular joint.

Hyaluronic acid is one of the components of synovial fluid. According to what is already well known in national and international biomedical literature, hyaluronic acid in the context of the TMJ serves two important biomechanical tasks. The first is feeding the articular cartilage; the second is lubricating the components of the joint. These two functions served by the same element change each other according to the continuous alternation of values of pressure in the articular cavity. The authors propose to overcome this statement by demonstrating that hyaluronic acid plays a third function in the TMJ, which is the biomechanical function of stabilizing the articular components.

Pattern of gastrointestinal diseases in adult patients admitted to Samtah General Hospital, Gizan region, Saudi Arabia.

To determine the relative frequencies of gastrointestinal diseases (GI) in patients admitted to Samtah General Hospital, Gizan, the records of 2,442 adults admitted to the medical and surgical services for gastrointestinal diseases during the period 1413 to 1416 were analyzed retrospectively. 1,028 patients had acute appendicitis. The remaining 1,414 patients were admitted for various other GI diseases. In these 1,414 patients the commonest diseases were gastrointestinal infections (36.4%), peptic ulcer disease (19%), gall bladder disease (18.5%), viral hepatitis and its sequelae (20.7%). Despite the high prevalence of cholelithiasis, acute pancreatitis was uncommon (0.1 %). Inflammatory bowel disease was rare. There was no gender - related difference in the prevalence of gastrointestinal infections, peptic ulcer disease and carcinoma of the stomach. Males were significantly more afflicted than females with viral hepatitis (p< 0.0001), cirrhosis of the liver (p< 0.0001), hepatocellular carcinoma (p< 0.0005), variceal bleeding (p< 0.0005), and peptic ulcer bleeding (p< 0.005). As a large proportion of our patients had preventable diseases, it is expected that immunization and other public health measures will reduce the frequency of these diseases in the future.

Environmental impact of the gold mining industry in Ghana.

X-ray Fluorescence (XRF) Analysis and Atomic Absorption Spectrophotometry (AAS) have been used in assessing heavy metal pollution from some gold mines in Ghana. The presence and levels of heavy metals in gold ore, gold tailings, inland waters, and river sediments have been determined. Using these techniques, the heavy metals: Cr, Mn, Fe, Cu, Zn, As, Pb, Rb, Sr, Y, Zr, and Nb were identified in some of the solid samples within a concentration range of 0.08 ppm--4.9%. However, the inland waters showed the presence of only Fe and Zn at levels of 0.08-2.4 micrograms/mL.

Breast cancer in pregnancy and lactation.

Thirty-six Nigerian women admitted with breast cancer during pregnancy and/or lactation (SGP) are the basis of this study of breast cancer in pregnancy and lactation. Thirty-six non pregnant but age and c TNM stage matched breast cancer patients and another thirty-six non pregnant, age matched women with benign breast neoplasms served as control group A (CGA) and control group B (CGB) respectively. Even though of similar c TNM state, the mean duration of tumor presence in the SGP (6 months) was shorter than in CGA (12 months). Also the SGP presented with tumor of higher histological grade (grade III, 55.6%) than those of CGA (grade III, 19.4%). These lead to the conclusion that breast cancer in the study group patients was more rapidly progressing and was therefore of worse prognosis. This conclusion is confirmed by a finding of survival in CGA patients that was 1.4 times that of the study group patients. We therefore conclude that breast cancer associated with pregnancy or lactation in Nigerian women progresses more rapidly and has a worse prognosis than cancer in their non pregnant counterparts.

Intestinal injuries following induced abortion.

Sixteen cases of intestinal injuries following illegally induced abortion are reviewed. They constituted 2% of all such cases in the study period. Ten were terminal ileal injuries while six were colonic. Colonic injuries were predominantly encountered in the first trimester. The relative fixity of the terminal ileum and pelvic colon may be a factor in the determination of the site of injury. Morbidity and mortality are related to both gestational age and site of injury.

PIP: 16 cases of intestinal injuries following illegally induced abortion are reviewed. The constituted 2% of all such cases in the study period. 10 were terminal ileal injuries while 6 were colonic. Colonic injuries were predominantly encountered during the 1st trimester. The relative fixity of the terminal ileum and pelvic colon may be a factor in the determination of the site of injury. Morbidity and mortality are related to both gestational age and site of injury.

Mechanical bowel obstruction. Review of 316 cases in Benin City.

A retrospective study of 316 patients with a diagnosis of intestinal obstruction admitted to the University of Benin Teaching Hospital over a 5 year period is presented. The overall mortality was 10.6 percent. Attention is called to the unacceptably high morbidity and mortality associated with volvulus in this and other series. Because the most common cause of intestinal obstruction in Africa is strangulation, a preventable complication of inguinal hernia, the clinician has a unique opportunity to significantly decrease the incidence of intestinal obstruction in Africa. Finally, our study confirms that the single most important antecedent of a grave prognosis in intestinal obstruction is late presentation of the patient.