African Journal of Medicine and Surgery

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (11), pp. 001-007, November, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Review

The Effects of Laparoscopic Surgery on Inflammatory Response: A Review of Cytokine Levels Post-Colonic Resection

Dimitrios Tsamis^1, George Theodoropoulos^1, V. Nikolaos Michalopoulos^1, Thalassini Delistathi^1, Nikolaos Nikiteas^2, Christos Tsigris³ and Emmanuel Leandros¹

¹Propedeutic Surgical Department, Hippokration University Hospital, Athens Medical School, Athens, Greece.
²Propedeutic Surgical Department, Laiko University Hospital, Athens Medical School, Athens, Greece.
³Surgical Department, Laiko University Hospital, Athens Medical School, Athens, Greece. 

Accepted 21 July, 2024

Abstract

Surgical trauma may lead to immune dysfunction as a result of the intense inflammatory response which arises in order to restore tissue function. The inflammatory response after surgical trauma is mediated by a number of substances which are produced at the site of wounded and manipulated tissues or at more distant places and they can act locally and systematically. These substances are TNF, Interleukins, Heat shock proteins, etc. Laparoscopic surgery is associated with reduced surgical trauma, much less manipulation of tissues and an environment of CO2 pneumoperitoneum comparatively with open procedures. All of these contribute to the theory that laparoscopic colonic resections are expected to be associated with less inflammatory and acute phase response than open resections. As indices of inflammation in colon surgery cytokines, such as TNF, Interleukins and CRP are the most studied ones. From the studies which are reviewed, comparing these cytokines in serum and peritoneal fluids in patients undergoing open versus laparoscopic colectomy, some showed that inflammatory response after laparoscopic colorectal resections seems to be slightly attenuated, as long as values of IL-6, IL-8 and CRP in peripheral blood are in lower levels in the first postoperative hours than open procedures. This phenomenon was not noticed in all studies and for other inflammatory and anti-inflammatory cytokines in the serum of the patients or in the peritoneal fluids.

Key words: Laparoscopic colectomy, open colectomy, inflammatory response.
 

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (10), pp. 001-005, October, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

The Prevalence and Impact of Motorcycle-Related Neurotrauma in South-East Nigeria: A Retrospective Study

Emejulu C. Jude-Kennedy¹*, Ekweogwu C. Ofodile¹ and Nottidge Timothy²

¹Neurosurgery Unit, Department of Surgery, Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State,
Nigeria.
²Orthopaedic Surgery Unit, University of Uyo Teaching Hospital Uyo, Akwa Ibom State, Nigeria.

Accepted 22 September, 2023

Abstract

Neurotrauma or cranio-spinal trauma is the most common pathology in multiple injuries, causing significant morbidity and mortality. Majority of cases result from road traffic accidents. In one of Nigeria’s centres for neurosurgery, we evaluated our local etiological patterns to ascertain the impact of motorcycles, the most commonly used mode of intra-city transportation, on neurotrauma. This is a retrospective study of all consecutive neurotrauma patients presenting in our unit in the first 30 months after the commencement of neurosurgical services. The data were collected for each patient with a structured proforma, and were analyzed. A total of 1055 neurosurgical cases were attended to in our service in the period under study, out of which 138 had congenital anomalies and 917 had acquired diseases. Among the acquired cases, 785 had trauma but only 748 (95.3%) of them had complete re-cords, with 658 (88%) cases of head injury, 61 (8.1%) cases of spinal injury, and 29 (3.9%) concomitant head and spinal injuries. These are distributed thus: road traffic accidents 537 (71.8%), falls 120 (16.0%), assaults 47 (6.3%), missiles 20 (2.7%), falling objects 11 (1.5%), de-celeration/acceleration injuries 7 (0.9%), sports/recreational activities 3 (0.4%) and birth trauma 3 (0.4%). Majority were males 569 (76.1%), and in the 15-40year age group 376 (50.3%). Of the 537 cases of road accidents, those related to motorcycles were 367 (68.3%), motor vehicles 169 (31.5%) and bicycle 1 (0.2%); and none of the motorcycle cases wore a protective helmet at the time of the accident. Most of the cases were treated conservatively 559 (74.7%), and the mortality rate from all neurotrauma cases was 17.7%. Neurotrauma is the major reason for neurosurgical consultations in our service, affecting mostly the young male age group, and most cases result from motorcycle accidents caused by the poor compliance with traffic regulations. There is an urgent need to stringently control the use of motorcycles to reduce the morbidity and mortality amongst Nigerian youths.

Key words: Head, injury, spinal, road, traffic, accidents.
 

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (10), pp. 001-005, October, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research paper

Initial Outcomes of Laparoscopic Anterior 180° Partial Fundoplication: A Focus on Symptomatic Relief

S. Kumaresan, A. Sudirman and G. Ramesh*

Department of Surgery, Tuanku Jaafar Hospital, Seremban, Negeri Sembilan, Malaysia.

Accepted 16 March, 2024

Abstract

Gastroesophageal reflux disease is increasing in frequency in the Asia Pacific region, which can be attributed to increase in awareness among doctors and patients and/or true increase in the prevalence of this disease. Surgical treatment of GERD is well established in the West and in selected clinical situations, provides well recognized benefits over non-surgical treatment. In contrast, there are only a few published studies in Asia especially on the outcome of the laparoscopic anterior fundoplication within the Asian community. Our aim is to evaluate symptomatic outcome of laparoscopic anterior 180° fundoplication in our community. Prospective analyses of 25 consecutive patients were done using a standardized questionnaire post-operatively. Overall satisfaction and the symptoms of heartburn and dysphagia were assessed together with other adverse effects of the surgery. Follow up was carried at a median of 9 months after surgery. Symptoms of heartburn assessed using the VAS showed significant drop from mean 7.4 pre-operatively to mean 1.75 postoperatively. De Meester symptom score indicated that a majority (56%) of patients reported none/minimal GERD symptoms, the other 44% reported mild GERD symptoms. This showed a vast improvement compared to pre-operative scoring where 80% of the patients reported moderate to severe GERD symptoms. This directly correlates with the estimation of patient satisfaction using Visick grading system with 24 (96%) patients reported none or mild symptoms post operatively. Overall, it is reasonable to conclude that laparoscopic anterior partial fundoplication achieved a satisfactory rate of overall success in our centre at short term follow up.

Key words: Laparoscopic anterior fundoplication, GERD, symptomatic outcome.
 

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (10), pp. 001-005, October, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Case Report

Immature Gastric Teratoma: Clinical Insights from a Newborn Case

Ahmed H. Al-Salem

Department of Pediatric Surgery, Maternity and Children Hospital, Dammam, Saudi Arabia. E-mail: [email protected].

Accepted 25 April, 2024

Abstract

Gastric teratomas are rare embryonal neoplasms, comprising less than 1% of teratomas in infants and children, typically occurring in male infants with upper abdominal masses. This report discusses a large immature grade II gastric teratoma found in a male newborn, which was treated through total excision, including a portion of the stomach. Most gastric teratomas are benign, but this case highlights the need for surgical intervention.

Key words: Gastric teratoma, newborn, immature.
 

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (9), pp. 001-006, September, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Evaluating the Therapeutic Benefits and Adverse Effects of Intrathecal Analgesia: A Prospective Randomized Controlled Trial

Abdul Muthalib Hussain* Badrudeen Mahmood Buhary, Shaeeb Mustafa, Areej Al Godair and Zikrullah Tamanna

King Fahad Medical City, Riyadh, Saudi Arabia.

Accepted 24 April, 2024

Abstract

Spinal anesthesia effectively offers sufficient motor block and pain relief during the early postoperative phase. To enhance postoperative analgesia, various adjuncts have been incorporated into local spinal anesthetics. This study aims to evaluate the benefits and side effects of intrathecal midazolam versus ketamine in patients undergoing lower limb surgeries. Conducted as a prospective, open-label, parallel assignment, randomized, single-center trial, the study involved eighty patients aged 20 to 60 years with American Society of Anesthesiologists (ASA) grades I and II, admitted for lower limb surgery over a period of six months. Key data collected included intra-operative and postoperative vital signs, pain levels assessed using the Visual Analogue Scale (VAS), adverse effects during and after surgery, and the timing of postoperative analgesic supplementation. Results indicated that the intrathecal ketamine group (Group I) had significantly higher VAS scores compared to the midazolam group (Group II). The average time until supplemental analgesics were needed postoperatively was notably shorter for Group I (482 ± 68.22 minutes) than for Group II (645 ± 61.28 minutes), with this difference being statistically significant (p < 0.001).In conclusion, the combination of intrathecal midazolam and bupivacaine offers superior and prolonged postoperative analgesia compared to intrathecal ketamine with bupivacaine, with fewer side effects reported in the midazolam group.

Key words: Analgesia, intrathecal analgesia, ketamine, midazolam.
 

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 11 (8), pp. 001-012, August, 2024. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Osteoinductive Properties of 17% Chitosan-Enhanced Bioactive Glass in Bone Regeneration: Insights from a Rat Model Study

Samira Jebahi^1,2*, Hassane Oudadesse¹, Bui XV^1, Hassib Keskes^3, Tarek Rebai^4, Abdelfattah el Feki² and Hafed el Feki⁵

¹Université de Rennes 1, UMR CNRS 6226, Campus de Beaulieu, 263 av. du Général Leclerc, 35042 Rennes, France.
²Animal Ecophysiology Laboratory, Sciences Faculty of Sfax, Department of Life Sciences Sfax, Tunisia.
³Laboratory of Orthopaedic and Traumatology, Medicine Faculty of Sfax, Sfax, Tunisia.
⁴Laboratory of Histology, Medicine Faculty, Sfax, Tunisia.
⁵Laboratory of Science Materials and Environment Faculty, Sfax, Tunisia.

Accepted 11 April, 2024

Abstract

Bone loss due to skeletal trauma or metabolic diseases often necessitates bone grafting. This study evaluates the effectiveness of a bioactive glass-chitosan composite (BG-CH) created through a freeze-drying method. The composite, containing 17% wt% chitosan, was implanted in the femoral condyle of ovariectomized rats. The resected bone samples underwent analysis using various physicochemical techniques, including Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX). After two weeks, the spectrum of the implanted sample showed two significant absorption bands at 932 and 1036 cm-1, linked to (Si-O-Si) groups, which disappeared by 15 days post-surgery. These bands were replaced at 30 days by peaks at 601 and 564 cm-1, indicating the presence of phosphate groups from bone apatite. After four weeks, peaks at 31.6° and 25.8° (2θ) were observed, reflecting the degradation of BG-CH, which coincided with the replacement of the implant by bone cells. Our findings suggest that the addition of 17% wt% chitosan to the bioactive glass matrix significantly enhances bioactivity and osteoinductive properties, positioning BG-CH as a promising biomaterial for biomedical applications.

Key words: Chitosan-glasses, biomineralization, osteoinductivity, biomedical applications, bone defect healing.