A Comprehensive Review of Thromboprophylaxis and Its Implications in Regional Anaesthesia | Chapter 12 | Medical Science: Recent Advances and Applications Vol. 7

 

Venous thromboembolism, comprising both Deep Venous Thrombosis and Pulmonary Embolism, is a chronic illness. VTE is an important cause of postoperative morbidity and mortality, especially when patients with co-morbid conditions (like obesity, coronary artery disease, or cancer) are on the rise. This necessitates the use of various thromboprophylaxis measures to prevent the occurrence of fatal VTE. However, the pharmacological thromboprophylaxis carries an inherent risk of bleeding, especially when the area of invasive work involves a potential space with a risk of non-compressible arterial puncture. During neuraxial anaesthesia, such bleeding into a closed space can result in spinal hematoma, which carries various neurological sequelae and requires urgent diagnosis and management.

 

The aim of the study is to review and analyse the relevant literature on the modalities of thromboprophylaxis, their mechanism of action and optimal management of such patients in the perioperative setting. In the perioperative setting, managing a patient on thromboprophylaxis therapy is still challenging, and with the introduction of various newer anticoagulants, management becomes more perplexing. In view of limited randomised trials pertaining to the thromboprophylaxis management in regional anaesthesia settings, a thorough knowledge of the mechanism and duration of action of these anticoagulant drugs, as well as recommended guidelines, is essential for the effective management of such patients.

 

Author(s) Details

Ragi Jain
Department of Anesthesia, Santosh Medical and Dental College and Hospital, Ghaziabad (Uttar Pradesh), India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v7/5736

Managing Hemostasis in Dental Practice: Challenges and Solutions | Chapter 7 | New Visions in Medicine and Medical Science Vol. 10

Excessive bleeding can complicate various office dental procedures, potentially leading to increased morbidity or reluctance to undergo similar treatments in the future. While many clinical guidelines consider dental interventions to be minor with a low risk of bleeding, patients undergoing anticoagulation therapy face a heightened risk of bleeding both during and after these procedures. This risk is also relevant for patients diagnosed with hereditary bleeding disorders like von Willebrand disease or Hemophilia, as well as those with no prior history of bleeding complications. These situations may necessitate the use of topical hemostatic agents. This article will explore the mechanisms, practical uses, effectiveness, and potential side effects of commonly used topical hemostatic agents in-office dental surgery, including gelatin sponges, collagen, oxidized regenerated cellulose (ORC), oxidized cellulose, fibrin sealants, flowable hemostats, adhesives, sutures, electrocautery, and topical thrombin.

 

Author (s) Details

 

Smriti Choradia
Department of Oral & Maxillofacial Surgery, Nair Hospital Dental College, India.

 

Neelam Andrade
Department of Oral & Maxillofacial Surgery, Nair Hospital Dental College, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/nvmms/v10/1289

Iatrogenic Urethral Injuries: A Comprehensive Guide to Prevention and Best Practices in Catheterization | Chapter 8 | Newer Frontiers IN Urology

Catheterisation is required for 12–16% of inpatients at any given time. The paramedical support crew, junior medical officers, or trainee intern doctors are typically the ones carrying out this treatment. Urethral catheter insertion is a common procedure done in hospital-admitted patients. Iatrogenic urethral injuries are one of the common preventable complications related to urological procedures. Patients with urethral injury present with frank bleeding from the urethra. The bleeding may sometimes be so severe that it may even occasionally present with urosepsis or hemodynamic instability. We describe a case of iatrogenic urethral injury post-catheterisation, following which the patient returned to the ER in shock with an incorrectly positioned catheter. The patient was resuscitated and managed with suprapubic diversion and a perineal compression tamponade. The patient recovered well and voided normally eventually. An orientation program outlining the techniques for catheterisation and the precautions to be taken before inflating the balloon and during catheter insertion is crucial to minimizing this potentially preventable morbidity since most catheterisations are performed by interns, the paramedical support team, or nursing staff. It is advisable to provide education to patients who require self-catheterisation due to detrusor underactivity or stricture urethra self-calibration. Patients who are paraplegic, and need regular bladder emptying have to exert greater caution, especially if the urethra is insensate. A few learning points are to be borne in mind before insertion of the catheter, which if properly followed, can minimize catheterisation-associated morbidity and ensure patient wellness. In order to reduce iatrogenic urethral injuries caused by catheterization, it is the duty of the urologists and senior surgeons to instruct the junior nursing staff and interns on urethral catheterization practices.

 

Author (s) Details

Pradhyumna Koushik
Department of Urology & Renal transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

Nakul Aher
Department of Urology & Renal transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Velmurugan Palaniyandi
Department of Urology & Renal transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Hariharasudhan Sekar
Department of Urology & Renal transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

Sriram Krishnamoorthy
Department of Urology & Renal transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mono/978-93-49238-86-2/CH8

The Aspects of Bleeding Instability of Portland Cement | Chapter 1 | Recent Progress in Science and Technology Vol. 9

 The aim concerning this review consists in compiling the most current data about cement bleeding as a colloidal allure phenomenon. This idea makes it attainable to better understand allure nature and purify reasons for its poor sameness.Cement paste is a condensed polydisperse suspension of cement atoms in water. The particles tinier than 5-10 µm (about 30-50%) and submicron particles (5-10%) imparts to cement adhesive properties of a structured (Bingham) liquid; these characteristics are attributed to the vehicle der Waals forces acting between pieces. Stability of cement paste against extorting is ensured when the makeup formed on account of these forces is strong enough to counteract the importance effect on even the largest atoms, and to prevent their sedimentation. The force of bleeding of cement glue is related to the worth of its yield stress in a way that when growing the latter, the opposition to the bleeding increases. Yield stress of Portland cement adhesive depends on its aggregation, an average size of cement atoms, as well as particles’ diameter distribution, their shape, makeup and surface nature, material properties of the liquid and stable phases, and of many different factors. Therefore, yield stress and bleeding force are the properties that are troublesome to predict and control.

Author(s) Details:

Aleksei S. Brykov,
St. Petersburg Technological Institute, Moskovsky Pr. 28, St. Petersburg, Russia.

Please see the link here: https://stm.bookpi.org/RPST-V9/article/view/10262

Potential Port Site Consequences in Laparoscopic Cholecystectomy Using an Open versus Closed Approach of Pneumoperitoneum: A Comparative Study | Chapter 6 | Perspective of Recent Advances in Medical Research Vol. 11

 The standard pattern for cholecystectomy is laparoscopic surgery, and pneumoperitoneum maybe performed in either a closed or open method. However, exposure to the traffic's consequences may improve the patient's morbidity. As a result, this study was completed activity to compare two together approaches in terms of complications at the traffic site of each process and potential risk factors.A potential study was carried out in the department of medical procedure, in hospitals owned by Kirkuk and Diyala governorates in Iraq, from January 2019 to March 2022. The 200 patients who accepted part in the study were divided into two groups, each accompanying 100 patients. The two processes were compared for intraoperative and postoperative questions that could have stood from port insert up to 18 weeks.The findings demonstrated that the highest allotment was for the following: females (84.0%), ages between 50 and 59 age (43.5%), and body bulk index (BMI) range 25-30 kg/m2 (49.0%). No significant distinctness was observed between those variables for two together surgical techniques (p-worth > 0.05). No death was recorded in the study. The following snags were observed at the traffic site in 10.5% of victims, with the majority stated in the open approach (8.5%): draining (3.0%), hematoma (2.0%), wound infection (1.5%), break (1.5%), and vascular injury (0.5%).Thus, we concluded that traffic site problems are lowest in closed laparoscopic abscission which was not proved to be statistically important but values showed less obstacles. Furthermore, samples could be used to gain a good mathematical significance.

Author(s) Details:

Awni Ismail Sultan,
Department of Surgery, College of Medicine, Tikrit University, Iraq.

Sami Hassoon Ali,
Department of Surgery, Jalawla General Hospital, Iraq.

Ozdan Akram Ghareeb,
Department of Community Health, Northern Technical University, Kirkuk, Iraq.

Please see the link here: https://stm.bookpi.org/PRAMR-V11/article/view/9513

Could FXIII Deficiency Influence Intracerebral Hemorrhage after Neurosurgery? | Chapter 9 | Current Practice in Medical Science Vol. 8

The main objective was to determine how perioperative FXIII levels affected ICH following brain surgery. An 18-month prospective observational study was conducted at a Spanish third-level hospital. It comprised all consecutive adults (18 years or older) who underwent elective brain tumour surgery and underwent postoperative care in the Neurointensive Care Unit (N-ICU). Ages under 18, informed refusals, deaths in operating rooms, inadequate blood samples, and non-tumor tissue were prohibited. FXIII levels in three blood samples were measured (A-presurgical, B-postsurgical and C-24 hours after surgery). The study involved 109 patients. Final ICH confirmation was made in 39 of them (35,78 percent). An association between the length of the ICU stay (p0,01) and the male gender (p0,03) and the ICH was found by inferential studies. Particularly in the B sample, ICH patients' average FXIII was lower (A 71,2 percent, B 51,57 percent, C 52,14 percent). After brain tumour surgery, acquired FXIIID (70%) elevated ICH, indicating that it might be employed as a risk marker for haemorrhage. Additionally, male gender, baseline variation, and a longer ICU stay were all associated with ICH. Tests for normal coagulation did not exclude FXIII disease. Future research may focus on FXIIID detection and replacement therapy as a therapeutic goal.

 

Author (s) Details

Estela Val Jordan

Department of Critical Care, Hospital Universitario Miguel Servet, Paseo Isabel La Católica, 1-3. 50009, Zaragoza, Spain.

 

Please see the link here:- https://stm.bookpi.org/CPMS-V8/article/view/7798

Post-Transurethral Resection of Prostate Recurrent Life Threatening Hematuria: A Case Report with Review of Literature | Chapter 10 | Research Trends and Challenges in Medical Science Vol. 1

Review of Literature  | Chapter 10 | Research Trends and Challenges in Medical Science Vol. 1

Herein, we present a case report of post-TURP (transurethral resection of prostate) recurrent severe hematuria due to right internal iliac artery pseudoaneurysm protruding into bladder lumen. A 60-yearold male presented with recurrent massive hematuria following TURP done elsewhere 15 days before. His hemoglobin was 4gm/dL after 13 units of blood transfusion and repeated clot evacuations. His blood urea, serum creatinine, and coagulation profile studies were normal. Ultrasonography of abdomen showed multiple clots in the bladder. Cystoscopy revealed clots with a right posterolateral wall unhealthy area. After stabilizing the patient, contrast enhanced CT urography revealed intravesical pseudo aneurysm. CT angiography showed pseudo aneurysm of a branch of internal iliac artery protruding into urinary bladder lumen. We referred patient to selective embolization of the lesion but the procedure was unsuccessful. At last, ipsilateral internal iliac artery ligation relieved hematuria. But on postoperative day 2, patient suddenly collapsed and deceased, presumably due to cardiomorbidities.

Author (s) Details

Dr. Vivek Vasudeo
Department of Urology, Sardar Patel Medical College, Bikaner 334001, Rajasthan, India.

Dr. Samir Dhingra
Department of Cardio Thoracic and Vascular Surgery, PSRI Heart Institute, New Delhi, India.

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