5478 N Palm Ave
Fresno CA 93704
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 13090T
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Impact of fetal presentation on pregnancy outcome in preterm premature rupture of membranes. - Journal of clinical and diagnostic research : JCDR
To determine the impact of fetal presentation on pregnancy outcome in preterm premature rupture of membranes (PPROM).Retrospective.Fifty eight PPROM patients (gestational age of 24-34 wk, complicated by PPROM and latency more than 24 h) between January 2008 to December 2012 were categorized into cephalic and non cephalic and pregnancy outcome were analyzed with standard statistical methods including the Chi-square test, t- test and Mann Whitney test.The non cephalic (20.7%, 12/58) and cephalic group (79.3%, 46/58) among the 58 patients with PPROM were demographically homogenous. PPROM was significantly earlier in non cephalic group although latency was not much different in both groups. Maternal complications (abruption, chorioamnionitis and post operative wound infection) as a composite were more in non cephalic group. Neonatal death was also significantly more in non cephalic than cephalic.Non cephalic presentation at diagnosis of PPROM is likely to have an unfavorable effect on the maternal and fetal outcome.
Ultrasonic shears versus electrocautery in axillary dissection for breast cancer-a randomized controlled trial. - Indian journal of surgical oncology
Theoretical advantages of use of Ultrasonic shears include less tissue damage and better sealing of lymphatic vessels. This may play a role in reducing prolonged drainage following axillary dissection for breast cancer. We conducted a prospective randomized controlled study to evaluate efficacy of ultrasonic shears over cautery for axillary dissection. Between April 2011 and April 2013, 92 patients were randomized to undergo axillary dissection with either ultrasonic shears (nâ€‰=â€‰46) or electrocautery (nâ€‰=â€‰46). Primary endpoints were time till drain removal and cumulative axillary drainage. Categorical data were compared by Pearson's chi-squared test. Continuous variables were compared by Independent t test or Mann Whitney U test. Data was analyzed using SPSS version 18.0. Both groups were comparable with respect to clinical and pathologic characteristics. Clinical characteristics of mean age, body mass index, side of tumor, neoadjuvant chemotherapy, and type of surgery (breast conservation or mastectomy) were similar. Pathologic variables (weight of specimen, number of lymph nodes harvested, pathologic T and N status, as well as grade of tumor) were also comparable among the two groups. There was no statistically significant difference in either primary endpoint of time till drain removal (15 vs. 14.5Â days, pâ€‰=â€‰0.73) or cumulative axillary drainage (1,260 vs. 1,086.5Â ml, pâ€‰=â€‰0.79). Patient and disease characteristics among the two groups were similar. But, there was no difference in either primary endpoint of cumulative axillary drainage or time to drain removal. We conclude that there is no advantage to use of ultrasonic shears over cautery in reducing drainage following axillary dissection for breast cancer.
Comparison of the vertical and the highest point of shoulder methods in brachial plexus block. - International journal of biomedical science : IJBS
Brachial plexus block by the highest point of the shoulder method may decrease the rate of complication in comparing with the vertical method because the needle is more lateral in the former. We aimed to investigate the highest point of the shoulder block technique against the vertical infraclavicular plexus method regarding the success rates and complications.Thirty patients with ASA I-III undergoing elective surgery were included in this study. Patients were divided into two groups, randomly. Group 1 was the highest point of the shoulder method (n of 15), and goup 2 was the vertical approach technique (n of 15). The extensor motor response of hand, wrist and elbow (The target nerves in the operation area: n. medianus, n. ulnaris, n. radialis and n. musculocutanaeus) was obtained by neurostimulation technique. Then, 30 ml bupivacaine (0.5%) was used for the initial block. Spread of analgesia and sensory and motor blocks were evaluated every 5 minutes by an anesthesiologist who was blind to the block techniques.T-test and Mann-Whitney U test were used.Successful block was achieved in all patients in both groups. There was no difference among the groups for the onset of block and the duration of block (both sensory and motor), the number of attempt, and the depth of the neddle. One patient developed pneumothorax in group 2. Procedure time of the block was longer in group 2 than in group 1 (p<0.05).The highest point of shoulder method with a less complication rate and shorter procedure time has a comparable success rate to vertical approach technique.
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5478 N Palm Ave Fresno, CA 93704
5151 N Palm Ave Suite 605