Case Report
Appendiceal Obliterans Fibrosis: A Five-Year Case Series Report in a Community Hospital
Issue:
Volume 5, Issue 2, December 2024
Pages:
18-22
Received:
26 September 2024
Accepted:
14 October 2024
Published:
18 November 2024
Abstract: Acute appendicitis is the most common appendiceal disease, however, there are some chronic inflammatory disease pathologies such as appendiceal obliterans (AO) that mimic acute appendicitis. We present a five-year retrospective case series analysis in a community hospital for patients who underwent appendectomy. Fibrous obliteration of the appendix occurs when there is a replacement of the mucosa and submucosa with fibrotic tissues. In a small community hospital, there were 195 patients that underwent appendectomy within a five-year period, in which 6.66% of patients' final pathology confirmed AO. There are some similar clinical symptoms and computed tomography (CT) findings of AO that can mimic acute appendicitis, but there is no consensus for any criteria to definitively diagnose this condition radiologically. The current method to determine the etiology of this appendiceal condition is through appendectomy followed by histological evaluation by a pathologist. We aim to analyze prior patients and their risk factors to find an alternative diagnostic method. We explore several factors including age, to determine if there can be any basis to creating a diagnostic criterion for this condition. The mean age within our case series was 58 years old. While fibrous obliteration of the appendix is a chronic inflammatory process, patients may present with acute abdominal pain, making the diagnosis difficult. Therefore, clinicians should make AO a part of their differential diagnosis which may require surgical intervention.
Abstract: Acute appendicitis is the most common appendiceal disease, however, there are some chronic inflammatory disease pathologies such as appendiceal obliterans (AO) that mimic acute appendicitis. We present a five-year retrospective case series analysis in a community hospital for patients who underwent appendectomy. Fibrous obliteration of the appendix...
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Case Report
Rare Case of Anterior Vaginal Cyst Presenting as Huge Cystocoele
Sweety Kumari*
Issue:
Volume 5, Issue 2, December 2024
Pages:
23-26
Received:
7 November 2024
Accepted:
2 December 2024
Published:
19 December 2024
Abstract: This article aims to report a rare case of a 38 years old Para 2 who was referred to the outpatient clinic of Vikash Multispecialty Hospital as a case of grade 3 uterovaginal prolapse with complaint of something coming out per vagina since 12 years. She also complained of heavy bleeding during menstruation, not responding to medical management since 2 years. Clinical and imaging studies lead to the diagnosis of anterior vaginal cyst, intramural fibroid and cervical polyp. After detailed counseling of the risks and benefits of surgical excision of the cyst with or without removal of uterus, she opted for removal of vaginal cyst and vaginal hysterectomy as she was tired of the medical management and had to undergo blood transfusion twice due to heavy menstrual bleeding. She had an uneventful postoperative period and was discharged in good condition on the third day. This case stresses on the importance of right diagnosis and proper management of the masses coming out of vagina as not everything which comes out of vagina is prolapse. Hesitancy in seeking medical care and lack of proper medical facilities, especially in rural areas in underdeveloped and developing countries, are among the major reasons these cases are unreported in medical literature.
Abstract: This article aims to report a rare case of a 38 years old Para 2 who was referred to the outpatient clinic of Vikash Multispecialty Hospital as a case of grade 3 uterovaginal prolapse with complaint of something coming out per vagina since 12 years. She also complained of heavy bleeding during menstruation, not responding to medical management sinc...
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Research Article
Comparison Between General Anesthesia and Spinal Anesthesia in the Effect on Hemodynamic Stability in Patients Hernia Repair in Hospitals in the Iraqi City of Karbala
Issue:
Volume 5, Issue 2, December 2024
Pages:
27-32
Received:
28 November 2024
Accepted:
9 December 2024
Published:
25 December 2024
DOI:
10.11648/j.wjmcr.20240502.13
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Abstract: Introduction: When it comes to methods, drugs, strategies, and guidelines for selecting the best anesthesia, the primary concern of the anesthesia and critical care department staff remains selecting the anesthetic that poses the least risk to the patient's life. For individuals who repair hernias, spinal anesthesia is the most effective and common type of anesthetic. Subjects and methods: a current and precise analysis of the patients that visit Karbala's Al-Hassan Hospital and Al-Hussein Medical City. We separated the (100) patients who had a herniotomy into two groups based on the forms of spinal and general anesthesia (50) patients were put under spinal anesthesia and (50) patients were put under general anesthesia. Analysis was done on the patient's age, weight, blood pressure change, and pulse rate. In order to conduct meticulous follow-up before to, during, and following procedures, the study examined patients between the ages of (20) and (90) and separated them into two groups: general anesthesia (GA) and spinal anesthesia (SA). Results: We demonstrate that it is also more stable in SA, which is around (56%), compared to (GA), which is roughly (40%). However, blood pressure is higher in (GA), which was (32%), and in (SA), which was (24%), and lower in (GA), which was (28%), and in SA, it was (20%). As demonstrated in this study, the heart rate is more stable in (SA 56%) compared to (GA 32%), and it increases in (SA 34%), while it increases in (GA 60%). The impact of (SA) is more consistent, and the heart rate dropped by 10% in (SA) and around 8% in (GA). Conclusions: We discovered that spinal anesthesia was superior to general anesthesia in terms of maintaining minimum or normal heart rate and blood pressure stability.
Abstract: Introduction: When it comes to methods, drugs, strategies, and guidelines for selecting the best anesthesia, the primary concern of the anesthesia and critical care department staff remains selecting the anesthetic that poses the least risk to the patient's life. For individuals who repair hernias, spinal anesthesia is the most effective and common...
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