Introduction Arteriovenous fistula (AVF) is the commonest vascular access for patients with end stage renal disease (ESRD) undergoing hemodialysis, however there is no consensus regarding mode of ...anaesthesia for creation of AVF. Mode of anaesthesia may have effect on outcome and complication of AVF.
MethodsThis is a retrospective descriptive study conducted on the basis of data collected from patients undergoing AVF under brachial plexus block (BPB) from January 2018 to December 2018 at Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC). Data regarding demographics, results and complications have been analyzed.
ResultsA total of 79 patients (male: female=45:34) underwent AVF under BPB during one year period at University teaching hospital with a mean age group of 56.76±11.65 years (24-86 years). In three patients, the brachial plexus block failed and was substituted with general anaesthesia while 21 patients needed some adjuncts with block to create fistula. In 38 patients (48.10%) brachiocephalic fistula was created and in 48 patients (60.76%), plan to make fistula at proximal site was changed after application of block to more distal level. All fistulas were patent at 24 hours (100%, 79 patients) and the rate was 93.67% (74 patients) at 6weeks. The complications seen post procedure were limb oedema in five patients (6.33%), thrombosis and infection in one patient each, hematoma in two patients and bleeding in three patients.
ConclusionBrachial plexus block is effective modality of anaesthesia to create AVF for hemodialysis as it increases chances of creating distal fistula and also increases the effectiveness of it.
An unusual case of pulmonary embolism Khakural, Prabhat; Shrestha, Kajan R; Sapkota, Ranjan ...
Journal of surgical case reports,
2015-Feb-15, Letnik:
2015, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Pulmonary embolism carries a significant morbidity and mortality. Metastatic choriocarcinoma presenting as pulmonary embolism is a rare event. Here, we report a case of a 25-year-lady with a history ...of worsening shortness of breath for 4 months who was treated as a case of pneumonia and tuberculosis. Owing to the worsening condition, she had a contrast enhanced computed tomography (CECT) chest done and was diagnosed to have pulmonary embolism. She underwent pulmonary embolectomy. The histopathological examination of the embolus revealed it to be metastatic choriocarcinoma. She showed a good response to chemotherapy. Metastatic choriocarcinoma should be considered as a differential diagnosis in females presenting with pulmonary embolism.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Introduction Extracranial carotid pseudoaneurysm (ECPA) is commonly associated with blunt or penetrating trauma and can result in thromboembolic event, cranial nerves palsies, rupture and hemorrhage. ...Due to the limited number of large studies, safety and efficacy of surgical and interventional management of ECPA is not well characterized. Open surgery with resection of pseudoaneurysm with end-to-end anastomosis or interposition graft is currently the preferred method of management. The aim of this study is to study the demographics, etiopathogenesis, presentation and outcome after surgical intervention of ECPA at our center.
MethodsAll patients who underwent surgery for carotid pseudoaneurysm form June 2012 to December 2019, at Department of Cardiothoracic and Vascular Surgery were included in this retrospective chart review study after evaluation of the hospital record book and electronic medical record. Patients who had stroke or cranial nerve injury before surgery, were excluded from this study.
ResultsFifteen patients met the inclusion criteria. Male to female ratio was 11:4. Mean age of presentation was 38.17±18.98 years. All patients presented with tender and pulsatile neck swelling. Common carotid artery involvement was more common. Three patients suffered from stroke postoperatively, and all of these patients died, however, one patient with stroke died due to reasons not related to pseudoaneurysm. Two patients suffered cranial nerve injury and ten patients had no other disabling complications.
ConclusionECPA is an uncommon but a serious disease and ischemic stroke after surgery is associated with high mortality.
Introduction Carotid endarterectomy for carotid artery disease is one of the surgeries performed by vascular surgeons for carotid artery disease. The objective of this study is to describe the early ...and late outcome of the patient undergoing carotid endarterectomy and the association between the complication and comorbidities present previously in the patient.
MethodsAll patients undergoing carotid endarterectomy at Manmohan Cardiothoracic Vascular and Transplant Centre between April 2010 to April 2020 were included. The follow-up data for upto a year from medical and clinical records, telephone interview regarding the immediate and late postoperative complications in patients with and without comorbidities were investigated and compared.
ResultsThe total study population was 42 patients. Two patients (4.7%) developed stroke, one immediately in postoperative period and the other during follow up. There were two deaths (4.7%) postoperatively due to cardiac events and three (7.14%) recurrences of carotid stenosis among whom one (2.5%) developed late stroke. Twenty six patients (61.90%) were symptomatic prior to the procedure of which 20 patients (47.61%) had brain infarct. Overall one year survival was 95.2% post procedure and overall complication rate was 7.14%. The consequence in the form of death and stroke occurred more in the patients with comorbidities (3vs1) p=0.42.
ConclusionThe immediate and late postoperative complications following carotid endarterectomy were death (4.7%), stroke (4.7%), cranial nerve injury (9.5%). The most frequent cause of death was postoperative cardiac event. Though major complications occurred more frequently in patients having comorbidities, it was statistically insignificant.
Introduction: Brachiobasilic fistula (BBF) with transposition is one of methods for creating native arteriovenous fistula (AVF) for hemodialysis. This study aims to highlight the result of a BBF in a ...tertiary referral center and aims to improve its result.
Methods: This is a retrospective descriptive study conducted on the basis of data collected of patients undergoing BBF with transposition from January 2014 to December 2018 (5 years) at Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC). Data regarding demographics, results and complications has been analyzed.
Results: Total 59 patients underwent brachiobasilic fistula performed by 3 surgeons with male to female ratio of approximately 3:2 with mean age of patient 68.78±13.77 years. Hypertension was the most common comorbidity present in 91.53% (54) of patients. Fifty six (94.92%) patient had previous undergone some sort of arteriovenous fistula creation and in 10 (16.95%) patients it was done in two stages. There were 2 immediate failures (within 1 week) and 9 early failures (before 1st dialysis) however 2 patients presented later with blocked BBF after starting dialysis. Only 31 patients could be followed up with patent BBF after 1 year of creation. About 71.19% of fistulas were able to mature and undergo dialysis by 6 week period and most common complication was bleeding from incision site in 20 patients (33.90%).
Conclusion: Brachiobasilic fistula is the good option for native arteriovenous fistula access for hemodialysis but it need proper selection of cases to decrease complication rates.
In various applications, a wider area needs to be covered by fiduciary markers but a large marker cannot be used because only a fraction of the area is to be viewed by the camera. Such an area can be ...covered by a number of small markers with unique identifiers. However, with the camera freely moving in the scene and with occluders present, it is difficult to ensure that at least one of the individual markers is completely visible, unless the markers are small and numerous. In that case, the markers are not recognizable from larger distances. In this paper we introduce the concept of Marker Fields which overcome this limitation. The Marker Field covers a large-scale planar (or non-planar) area and it is composed of mutually overlapping partial markers. We propose a particular arrangement of the Marker Field: a Uniform Checker-Board Marker Field, which is a black- and-white checkerboard whose square modules are defined by aperiodic 4-orientable binary n 2 -window arrays (De Bruijn tori). We propose a genetic algorithm for construction of 4-orientable n 2 window arrays. We used a supercomputer to synthesize large 4-orientable 4 2 window arrays and offer them publicly for downloading. We prototyped an algorithm for detection of the checkerboard marker fields and measured its performance. When processing input video from a cellphone camera, the algorithm visits only about 5 % of image pixels for reliable detection and the processing time is about 1 ms on a mid-range PC processor. The Uniform Marker Field increases freedom of camera movement, especially with occluders present in the scene. The detection algorithm is efficient and real-time marker field detection will be feasible on ultramobile devices.
Tube-dwelling invertebrates affect microbial processes by feeding on sediment bacteria, by creating structures with properties different from that of the bulk sediment, by disturbing the benthic ...boundary layer, and by pumping water through their tubes. We studied the effects of Chironomidae in a flooded soil. Tubes were at least 1.5 cm long and ca. 2 mm in diameter, and extended through the anoxic subsurface soil over most of their length. Larvae had no effect on CH
4 flux across the sediment surface either by diffusion or by ebullition. In vitro, CH
4 oxidation rates in tubes were significantly (
P<0.05) higher than those in surface and subsurface soil. At a mixing ratio of 20 000 ppm
v, average CH
4 oxidation rates of tubes, surface soil, and bulk soil were 2, 0.4, and 1 μmol g dry wt.
−1 h
−1, respectively. The number of CH
4 oxidizing bacteria determined by the most probable number (MPN) technique was higher in chironomid tubes than in the other soil compartments. CH
4 production in tubes was significantly (
P<0.05) higher than in the anoxic bulk soil, while no CH
4 was produced in the surface soil during 240 h of incubation. We conclude that chironomid tubes are microsites with an intensified microbial activity, where CH
4 production and oxidation may be tightly coupled.
Tube-dwelling invertebrates affect microbial processes by feeding on sediment bacteria, by creating structures with properties different from that of the bulk sediment, by disturbing the benthic ...boundary layer, and by pumping water through their tubes. We studied the effects of Chironomidae in a flooded soil. Tubes were at least 1.5 cm long and ca. 2 mm in diameter, and extended through the anoxic subsurface soil over most of their length. Larvae had no effect on CH4 flux across the sediment surface either by diffusion or by ebullition. In vitro, CH4 oxidation rates in tubes were significantly (P <0.05) higher than those in surface and subsurface soil. At a mixing ratio of 20 000 ppm(v), average CH4 oxidation rates of tubes, surface soil, and bulk soil were 2, 0.4, and 1 micromole g dry wt.-1 h-1, respectively. The number of CH4 oxidizing bacteria determined by the most probable number (MPN) technique was higher in chironomid tubes than in the other soil compartments. CH4 production in tubes was significantly (P < 0.05) higher than in the anoxic bulk soil, while no CH4 was produced in the surface soil during 240 h of incubation. We conclude that chironomid tubes are microsites with an intensified microbial activity, where CH4 production and oxidation may be tightly coupled.
Augmented reality does not make any sense for fixed cameras. Or does it? In this work, we are dealing with static cameras and their usability for interactive augmented reality applications. Knowing ...that the camera does not move makes camera pose estimation both less and more difficult - one does not have to deal with pose change in time, but on the other hand, obtaining some level of understanding of the scene from a single viewpoint is challenging. We propose several ways how to gain advantage from the camera being static and a pipeline of a system for broadcasting a video stream enriched by information needed for its interactive visual augmenting - Interactive Camera Streams, INCAST. We present a proof-of-concept system showing the usability of INCAST on several use-cases - non-interactive demos and simple AR games.
An unusual case of pulmonary embolism Khakural, Prabhat; Shrestha, Kajan R; Sapkota, Ranjan ...
Journal of surgical case reports,
02/2015, Letnik:
2015, Številka:
2
Report
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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