ABSTRACT
[This corrects the article DOI: 10.1016/j.aju.2014.10.001.].
ABSTRACT
OBJECTIVE: To assess the benefit of a new technique of a Plastibell circumcision supported by a ventral calcium-alginate fibre dressing, to reduce bleeding from the frenular vessels, the commonest complication of Plastibell circumcision. PATIENTS AND METHODS: This was a retrospective study of 200 neonates circumcised in the Royal Bahrain Hospital over a 2-year period from 2012 to 2014. They had a standard Plastibell circumcision, but a calcium-alginate fibre dressing (Hypo-sorb, Plastod, Italy) was placed over the glans and under the foreskin, to help control bleeding from the frenular vessels. RESULTS: Circumcision using the calcium-alginate fibre dressing reduced the bleeding complication rate to zero. The delayed separation of the bell was 2.9% when using the new technique and 2.5% from our previous data. There were no cases of urinary retention reported, compared to two in the previous results. CONCLUSION: A Plastibell circumcision supported by the calcium-alginate fibre dressing was a safe technique to reduce bleeding.
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OBJECTIVE: To compare the perioperative morbidity and early follow-up after diode laser vaporisation of the prostate (LVP) and its modification, diode laser under cold irrigation (LUCI) in patients with symptomatic benign prostatic hyperplasia, as the main disadvantages of LVP are the postoperative pain, dysuria and storage urinary symptoms. PATIENTS AND METHODS: This was a single-centre prospective randomised control trial in which 100 patients were randomised to receive LVP (50) or LUCI (50) from June 2011 until July 2012. LUCI is similar to LVP except that it is done under normal irrigation with saline at 4 °C instead of saline at room temperature. The primary outcome measures were the International Prostate Symptom Score (IPSS), IPSS-Dysuria, a pain scale (PS), maximum flow rate (Q max), a quality-of-life (QoL) score and the postvoid residual urine volume (PVR) after 1 month, then the IPSS, Q max, QoL, and PVR at 3 and 12 months. Secondary outcomes included intraoperative surgical variables, e.g., the decline in core temperature, bleeding, peri- and postoperative morbidity. RESULTS: The baseline characteristics of both groups were similar. For the primary outcome measures, there was a statistically significant difference between the groups in all variables except Q max after 1 month, in favour of LUCI. The mean (SD) IPSS at 1 month in the LVP group was 8.97 (1.68), statistically significantly different from that after LUCI, of 6.89 (1.5) (P < 0.05). The mean IPSS-Dysuria at 1 month was also significantly, at -2.32 (0.91) for LVP and 3.54 (1.07) for LUCI (P < 0.05). The respective mean PS at 1 month was 7.84 (2.92) and 5.7 (2.1) (P < 0.05). The QoL and PVR at 1 month were also significantly different. Within the first month 17% of patients in the LVP group and 4% in the LUCI group complained of transient urgency or stress incontinence, and this difference was statistically significant (P < 0.05). There was no significant bleeding in either group. The mean operative time or applied energy of LVP was not statistically significant from that of LUCI, and there was no significant difference in the decline in core temperature between the groups (P > 0.05). CONCLUSION: LUCI is a good modification for reducing the pain, dysuria and storage symptoms associated with LVP. The procedure appears to be safe, with no significant decrease in core temperature in either group.
ABSTRACT
The design and development of a novel supercritical extraction experimental facility adapted for safe operation in a glove box for the recovery of radioactive elements from waste is described. The apparatus incorporates a high pressure extraction vessel, reciprocating pumps for delivering supercritical fluid and reagent, a back pressure regulator, and a collection chamber. All these components of the system have been specially designed for glove box adaptation and made modular to facilitate their replacement. Confinement of these materials must be ensured in a glove box to protect the operator and prevent contamination to the work area. Since handling of radioactive materials under high pressure (30 MPa) and temperature (up to 333 K) is involved in this process, the apparatus needs elaborate safety features in the design of the equipment, as well as modification of a standard glove box to accommodate the system. As a special safety feature to contain accidental leakage of carbon dioxide from the extraction vessel, a safety vessel has been specially designed and placed inside the glove box. The extraction vessel was enclosed in the safety vessel. The safety vessel was also incorporated with pressure sensing and controlling device.
