14^th international conference on Transplantation and Medical surgery March 22-23, 2021 Prague, Czech Republic

Biography:

Nisha Mallya studied her M.B.B.S in Kasturba Medical College, India.  She is currently training to be a surgeon.  She has worked in Orthopaedics, the Accident and Emergency Department, General Surgery and Intensive Care Unit. 

Abstract:

Aims: To compare outcomes of diathermy and scalpel for skin incision in patients undergoing open inguinal hernia repair.

Methods: We performed a systematic review in accordance with PRISMA statement standards. We conducted a search of electronic information sources to identify all studies comparing use of diathermy and scalpel for skin incision in patients undergoing inguinal hernia repair. Fixed-effect model was applied to calculate pooled outcome data.

Results: We identified 9 studies, 4 randomised controlled trials and 5 prospective cohort studies, enrolling a total of 830 patients. Meta-analysis of RCTs showed no difference between the diathermy and scalpel groups in terms of surgical site infection (OR:0.77,P=0.53), seroma (OR:0.86,P=0.78), VAS pain score at 6 hours (MD:-0.10,P=0.34), 12 hours (MD:-0.10,P=0.40), and 24 hours (MD:0.03,P=0.79). Use of diathermy for skin incision was associated with shorter incision time (MD:-36.00,P<0.00001) and lower risk of haematoma (OR:0.14,P=0.01). Meta-analysis of observational studies showed no difference between the diathermy and scalpel groups in terms of surgical site infection (OR: 0.87, P=0.55), haematoma (OR 0.14,P=0.08), seroma (OR:0.86,P=0.78), VAS pain score at 6 hours (MD:-0.10,P=0.56), 12 hours (MD:-0.10,P=0.58), and 24 hours (MD:0.10,P=0.59).  Use of diathermy for skin incision was associated with shorter incision time (MD:-39.40,P<0.00001).

Conclusions: There is no difference between use of diathermy and scalpel for skin incision in patients undergoing open inguinal hernia repair in terms of surgical site infection, seroma and postoperative pain. Use of diathermy for skin incision may be associated with shorter incision time and may reduce the risk of haematoma formation.

Biography:

Ketevan Papidze Has graduated from Paediatric faculty of Tbilisi State Medical University (MD) and started her postgraduate education in Paediatric Surgery. During 3 years as junior paediatric surgeon she worked in Orthopaedic surgery, Suppurative Surgery, Neonatal surgery and General Surgery departments of TSMU paediatric clinic. She is currently working in YGC in UK as SHO in General Surgery and has previously worked in Urology, Breast Surgery and Vascular surgery. 

Abstract:

Objectives: To investigate whether Neutrophil-to-lymphocyte ratio (NLR) can predict acute appendicitis and whether it can distinguish between uncomplicated and complicated appendicitis.

Methods: A search of electronic information sources was conducted to identify all observational studies reporting NLR in patients with clinical suspicion or confirmed diagnosis of acute appendicitis. We considered two comparisons: 1) appendicitis versus no appendicitis; 2) uncomplicated appendicitis versus complicated appendicitis. NLR was considered as the outcome and the random effects model was used to calculate the pooled effect size. ROC curve analysis was performed to determine cut-off values of NLR for appendicitis and complicated appendicitis. Binary logistic regression models were constructed to investigate whether NLR greater than the calculated cut-off values can predict the presence of appendicitis and complicated appendicitis.

Results: Seventeen studies, enrolling 8,914 patients were included. The NLR was significantly higher in acute appendicitis compared to no appendicitis (MD: 4.94, 95% CI 3.81- 6.06, P<0.00001). The NLR was significantly higher in complicated appendicitis compared to uncomplicated appendicitis (MD: -3.81, 95% CI -4.51 - -3.10, P<0.00001). NLR of 4.7 was cut-off value for diagnosing appendicitis with sensitivity of 88.89 % (95% CI 70.8% - 97.6%) and specificity of 90.91% (95% CI, 58.7% - 99.8%). AUC was 0.96 (95% CI 0.84- 1.0, P<0.0001). NLR of 8.8 was cut-off value for complicated appendicitis with sensitivity of 76.92% (95% CI, 46.2%-95.0%) and specificity 100% (95% CI, 75.3%-100%). AUC was 0.91 (95% CI 0.73-0.99, P<0.0001). NLR > 4.7 was predictor of acute appendicitis (OR: 128, 95% CI 10.16- 1538.15, P<0.0001) and, NLR >8.8 was predictor of complicated appendicitis (OR: 43.33, 95% CI 3.90, 481.82, P<0.0001).

Conclusions: NLR is a promising marker that can predict both diagnosis and severity of appendicitis with acceptable sensitivity and specificity.  NLR may have implications for patients who do not routinely undergo CT scan (pregnant or paediatric patients) and in settings where "twenty-four seven" access to immediate CT is limited.

Biography:

Huang Wei Ling, born in Taiwan, raised and graduated in medicine in Brazil, specialist in infectious and parasitic diseases, a General Practitioner and Parenteral and Enteral Medical Nutrition Therapist. Once in charge of the Hospital Infection Control Service of the City of Franca’s General Hospital, she was responsible for the control of all prescribed antimicrobial medication and received an award for the best paper presented at the Brazilian Hospital Infection Control Congress in 1998. Since 1997, she works with the approach and treatment of all chronic diseases in a holistic way, with treatment guided through the teachings of Traditional Chinese Medicine and Hippocrates. Researcher in the University of São Paulo, in the Ophthalmology department from 2012 to 2013.Author of the theory Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine.

Abstract:

Introduction: Hemorrhoids are swollen veins in the anus and lower rectum. In traditional Chinese medicine (TCM), hemorrhoids can result from Yin, Yang, Qi and Blood disharmonies and Heat Retention. Purpose: To demonstrate that hemorrhoids has energies alterations as the root and correcting it without any surgical procedure is possible. Methods: Two case reports: the first, 42-year-old man had hemorrhoid after an anal fissure surgery. The patient did not intend to undergo another surgical procedure. The patient sought acupuncture treatment for leg pain. He received Chinese dietary counselling, auricular acupuncture/apex-ear bloodletting and the ear’s rectum point and systemic acupuncture. The second patient was a 38-year-old man treating vitiligo with acupuncture when suddenly started to present hemorrhoids as well, for his work included driving cars a lot. Besides the same treatment of the case report one, still the patient complained of no improvement. Then a radiesthesia procedure was made to measure the patient’s chakras energy. All chakras rated 1 out of 8, except for the seventh chakra (normal). The patients were medicated with crystal-based medication and homeopathy according to the Constitutional Homeopathy of the Five Elements based on Traditional Chinese Medicine, created by the author. Results: Case one reported a complete recovery of his hemorrhoids symptoms after the first acupuncture session. The second patient, only had improvement after beginning the replenishment of the energy’s chakras.  Conclusion: Hemorrhoids has an energy alteration as root and treating these energy imbalances and chakra’s energy deficiencies is essential for recovery without any surgical procedure.