ABSTRACT
INTRODUCTION: Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal, involving a small incision in the back and insertion of a nephroscope to extract the stones. Recent advancements include super-mini PCNL, employing smaller instruments for less invasive access to the kidney. However, conventional PCNL often requires tract dilation, which can lead to potential complications. CASE PRESENTATION: This case report presents the successful application of our surgical technique using the basic principles of PCNL with the aid of a pediatric trocar cystostomy and ultrasound guidance as a new alternative for super-mini PCNL, offering safer access with reduced bleeding risk and shorter recovery. The surgery was performed on a 55-year-old female with bilateral kidney stones, with the stone in the left kidney being larger than the one in the right kidney. The procedure was completed within 60 min without significant postoperative complications. DISCUSSION: Our new alternative for PCNL offers benefits such as reduced invasiveness, shorter recovery time, decreased risk of complications, and minimal changes in postoperative hemoglobin levels. This new alternative can be performed in developing country hospitals that do not have the expensive PCNL equipment. CONCLUSION: This new alternative of PCNL with pediatric trocar cystostomy proves to be effective and safe.
ABSTRACT
BACKGROUNDS: Surgery clerkship for medical students has been changed in response to clinical exposure limitation due to this pandemic. This study aim to evaluate knowledge and skill of students in surgery clerkship in covid 19 pandemics. METHODS: Cross-Sectional design comparing surgery clerkship before and during COVID-19.A total of 270 fourth and fifth-year medical students have enrolled in surgery clerkship from June 2019-October 2020 were selected for this study. Each student had completed education and training in the hospital for nine weeks in the rotation. RESULTS: There is no significant difference in MCQs scores before and during the pandemic. However, a significant difference was found in OSCE scores. CONCLUSIONS: Combining virtual platforms and in-person clinical rotation is an effective surgery clerkship curriculum, particularly in pandemic covid 19. There are no different skill and knowledge results before and during the pandemic analyzed from MCQs and OSCE exam.
ABSTRACT
BACKGROUND: Mesenchymal stem cells (MSCs) migrate and transmigrate to acute liver failure (ALF) area due to vascular endothelial growth factor (VEGF) stimulation as an attractant molecule then actively giving the paracrine signaling and or differentiating into primary hepatocytes, however the best route of MSCs transplanted to liver injury area remains unclear. AIM: In this study we compare intravenous (IV) and intraperitoneal (IP) route of MSCs administration by analyzing serum glutamic pyruvic transaminase (SGPT), serum glutamic-oxaloacetic transaminase (SGOT) and bilirubin level as improvement markers of liver function and VEGF as attractant-proliferation molecule on days 2 and 5. MATERIALS AND METHODS: Eighteen male Sprague-Dawley rats weighting 200 g were used in this study. They were divided in three study groups: vehicle control, IP and IV groups. The IV group was treated by MSCs at dose 1×106 by lateral tail vein injection and IP group received 1×106 MSCs via IP injection. The level of SGPT, SGOT and bilirubin were measured by an automatic analyzer, the VEGF level using enzyme-linked immunosorbent assay (ELISA), while the CD73 expression was evaluated using immunohistochemistry. RESULTS: This study showed that IV injection of MSCs was more efficient for increasing liver function than IP treatment group that confirmed by the observed significant decrease in SGPT, SGOT and bilirubin level on days 2 and 5 (p<0.001). This effect was most likely mediated by the significant increase of VEGF level (p<0.05) on days 2 and 5. CONCLUSION: Our result conclude that an IV administration of MSCs was more efficacious than the IP administration for liver injury regeneration.
