ABSTRACT
Objective To summarize the experience of partial tubeless mPCNL. Methods A retrospective analysis of partial tubeless mPCNL surgery experience from January 2010 to December 2016. Atotal of 1320 patients underwent mPCNL surgery in these 7 years.Out fo those 1320 patients,554 patients underwent partial tubeless mPCNL,766 patients underwent standard mPCNL,and 85 exception cases of standard mPCNL were forced to abort surgery due to maximum surgery time of 2 hours and different complications such as bleeding, infections and etc, so total of 681 patients with standard mPCNL were compared with partial tubeless mPCNL.Results The rate of partialtubeless mPCNL has increased by 84% in 2016, with an indication of tubeless mPCNL being extended, while the complication rate showed no increase. Compared with the standard mPCNL, there was no significant dif-ference between the two groups in the rate of stone removal, drop in mean hemoglobin, blood transfusion and postoperative fever. There were significant differences in postoperative analgesic use rate (5%:21%,P=0.001) and hospitalization stay (2.5:4.5d,P=0.001) . The rate of postoperative bleeding complications in partial tubeless group and standard group is 1.1%and 2.5%respectively, but difference is not statistically significant. There were 1cases of urinary extravasations in the partial tubeless group which was treated by perirenal drainage, antibiotic treatment, and 1 cases of pleural injury, which were treated by open exploration, and chest tube placement. Conclusion In compared to standard mPCNL partial tubeless mPCNL significantly increased patients postoperative comfort, shorten hospital stay,and no complications increased.Partial tubless mPCNL is a safe and practicable procedure.
ABSTRACT
Ileal ureter is a suitable treatment option for patients with long ureteric strictures. Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of lesser trauma, less bleeding and less postoperative recovery time. In order to evaluate the feasibility and clinical efficacy of laparoscopic ileal ureter replacement, review of related literatures, indications, contraindications, surgical method, postoperative results combined with experience of our center has been done. Total 20 cases of laparoscopic ileal ureteral operation have been reviewed, the mean operation time was 195480 and blood loss was 50 ～ 375 ml and 7 Robotic ileal ureter replacement were reviewed median surgery time was 320720 min and bleeding is less then 10 ml100 ml. The operation complications include urinary leakage, intestinal obstruction, anastomotic site leakage, transient azotemia, urinary tract infection and so on. Postoperative renal function of all patients was improved in different degrees. Laparoscopic and Robotic ileal ureter replacement is feasible and can be used as an effective treatment for long ureteral injuries, although the curative effect is same as that of traditional open surgery, but Comparatively laparoscopic and robotic postoperative morbidity is less and have advantages such as it reduces surgical trauma, intraoperative bleeding, postoperative complications, less surgical scar and recovery time.The cases in the reports are limited, more cases need to be studied, and long-term results need to be assessed to establish and standardize these technique.
ABSTRACT
Introduction: Linguistically adapted oral health literacy tools are helpful to assess oral health literacy among local population with clarity and understandability. The original oral health literacy adult questionnaire, Oral Health Literacy Adult Questionnaire, was given in English [2013], consisting of 17 items under 4 domains. The present study rationalizes to culturally adapt and validate Oral Health Literacy Adult Questionnaire into Hindi language. Thus, we objectified to translate Oral Health Literacy Adult Questionnaire into Hindi and test its psychometric properties like reliability and validity among primary school teachers
Methods: The Oral Health Literacy Adult Questionnaire was translated into Oral Health Literacy Adult Questionnaire - Hindi Version using the World Health Organization recommended translation backtranslation protocol. During pre-testing, an expert panel assessed content validity of the questionnaire. Face validity was assessed on a small sample of 10 individuals. A cross-sectional study was conducted [June-July 2015] and OHL-AQ-H was administered on a convenient sample of 170 primary school teachers. Internal consistency and testretest reliability were assessed using Cronbach's alpha and Intra-class correlation coefficient [ICC], respectively, with 2 weeks interval to ascertain adherence to the questionnaire response. Predictive validity was tested by comparing OHL-AQ-H scores with clinical indicators like oral hygiene scores and dental caries scores. The concurrent and discriminant validity was assessed through self-reported oral health and through negative association with sociodemographic variables. The data was analyzed by descriptive tests using chi-square and bivariate logistic regression in SPSS software, version 20 and p<0.05 was considered as the significance level
Results: The mean OHL-AQ-H score was 13.58 +/- 2.82. ICC and Cronbach's alpha for Oral Health Literacy Adult Questionnaire - Hindi Version were 0.94 and 0.70, respectively. Comparisons of varying levels of oral health literacy with self-reported oral health established significant concurrent validity [p=0.01]. Significant predictive validity was observed between OHL-AQ-H scores and clinical parameters like oral hygiene status [p=0.005] and dentition status [p=0.001]
Conclusion: The translated and culturally adapted Oral Health Literacy Adult Questionnaire - Hindi Version indicated good reliability and validity among primary school teachers to assess oral health literacy among Hindi speaking population. Hence, improving OHL levels and implementing education oriented policies can improve the quality of life