Incidence of Post-septoplasty Bleeding in patients without Nasal Packing

Objective: To evaluate the incidence of post-septoplasty hemorrhage and hematoma formation in patients without anterior nasal packs

Design: A Retrospective Study

Setting: ENT Department, Salmaniya Medical Complex, Kingdom of Bahrain

Method: Fifty-one patients with a symptomatic deviation of nasal septum who had septoplasty with/without inferior turbinoplasty were included in the study from August 2008 to April 2015. Patients who underwent septoplasty combined with endoscopic sinus surgery were excluded. Septoplasty was performed without postoperative anterior nasal packing, and the patients were assessed for postoperative bleeding and hematoma formation. All patients were followed-up for 4 weeks

Result: Two [3.9%] patients had postoperative bleeding on the day of operation. Forty-nine [96.1%] patients had no nasal bleeding during the hospital stay and no patient had hemorrhage after discharge. No patients had septal hematoma during the follow-up period

Conclusion: Incidence of bleeding following septoplasty without anterior nasal packing is very low and nasal packing should not be routinely used for this procedure

Clinical Response of 277 Patients with Spinal Cord Injury to Stem Cell Therapy in Iraq

BACKGROUND AND OBJECTIVES: Spinal cord injury is a common neurological problem secondary to car accidents, war injuries and other causes, it may lead to varying degrees of neurological disablement, and apart from physiotherapy there is no available treatment to regain neurological function loss. Our aim is to find a new method using autologous hematopoietic stem cells to gain some of the neurologic functions lost after spinal cord injury. METHODS AND RESULTS: 277 patients suffering from spinal cord injury were submitted to an intrathecally treatment with peripheral stem cells. The cells were harvested from the peripheral blood after a treatment with G-CSF and then concentrated to 4~6 ml. 43% of the patients improved; ASIA score shifted from A to B in 88 and from A to C in 32. The best results were achieved in patients treated within one year from the injury. CONCLUSIONS: Since mesenchymal cells increase in the peripheral blood after G-CSF stimulation, a peripheral blood harvest seems easier and cheaper than mesenchymal cell cultivation prior to injection. It seems reasonable treatment for spinal cord injury.

Evaluation of holmium: YAG laser versus pneumatic lithotripsy for the intra corporeal lithotripsy of the ureteric stones

Background: Ureteroscopy [URS] is a precise, minimally invasive surgical intervention that can assess the entire collecting system to treat a stone using intracorporeal lithotripsy.The implication of laser technology in the development of lithotripter fibres has revolutionised intracorporeal lithotripsy

Objective: To compare the efficacy and safety of Holmium: YAG laser and pneumatic lithoclast in treating ureteric calculi

Subjects and Methods: The study included total of 65 patients divided into two groups of laser lithotripsy [LL] [25 patients] and pneumatic lithoclast [PL][40 patients]. Inclusion criteria were patients with a single ureteric stone of size 0.7cm-2.0 cm. Stone size was determined with pre op CT scan. A 8 French rigid ureteroscope was used for all cases. Holmium: YAG laser with 600 µm wide fiber size was employed in laser group and frequency was set at 8 Hz at a power of 1.2 joule.Pneumotic lithoclast with used in PL group. Postoperatively patients underwent radiography and helical CT as required to asses stone clearance

Results: The mean patient age, the male to female ratio, stone size and site were similar between the two groups. Mean operative time in LL group was 35.5 minutes as compared to 25.7 minutes in PL group, the Stone migration up in pelvicalyceal system occurred in one patients[4%] of LL group while in nine patients[22.5%] of PL group. Double J [DJ] Stent was placed in 9 [36%] patients in LL group where as 17[42%] patients required it in PL group. Stone free rate at 4 weeks was 84% in LL group as compared to 72.5% in PL group

Conclusion: Holmium: YAG laser lithotripsy is a superior technology compared to pneumatic lithoclast in terms of rate of stone clearance and complications especially in upper ureteric stones