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Search Results: 1 - 7 of 7 matches for " Alfer Nafae "
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An Experience of Short-Term Results of Laparoscopic Inguinal Hernioplasty Using 3D Mesh in a Developing Country  [PDF]
Iqbal Saleem Mir, Alfer Ah Nafae, Aijaz Ahmed Malyar, Muntakhab Nafae, Yawar Watali, Mudasir Farooq, Shahnawaz Bashir Bhat, Sheikh Viqar
International Journal of Clinical Medicine (IJCM) , 2015, DOI: 10.4236/ijcm.2015.61010
Background: The experience of short term results of laparoscopic inguinal hernia repair using 3D mesh in a developing country is reviewed. Methods: From January 2012 to February 2014, 53 patients underwent laparoscopic inguinal hernioplasty. A retrospective case series of 53 consecutive patients undergoing TEP/TAPP by a single surgical team was followed prospectively with a focused physical examination and interview. 4 out of 53 patients had recurrent hernia following open repairs and 49 had primary hernias. Data collected included operative time, intraoperative bleeding, intraoperative difficulties, immediate postoperative pain, chronic groin pain, recurrence, sensory disturbance, activity or occupational limitation and personal satisfaction. Results: All the patients were male aged 32 to 75 years with a mean age of 53.5 years. Mean operative time was 37.4 minutes; intraoperative dissection, blood loss were less; and immediate postoperative pain was negligible as assessed by VAS. There was no mortality or major morbidity. Mean follow-up was 12 months (2 to 18 months). Follow-up was completed by interview and physical examination. Hernia was not found to recur during the follow up period. Chronic pain occurred in 2 patients (3.7%), which was mild in nature. Ninety-seven percent of patients were satisfied with their repair and would or had recommended TEP/TAPP to others using 3D Mesh. Conclusions: Short-term results of TEP/TAPP hernia repair using 3D mesh demonstrated to be an effective and safe procedure with low prevalence of chronic pain that is generally of a mild, infrequent nature. It was also concurred that there is decrease in operative time. Manipulation of mesh was significantly reduced. Intraoperative bleeding and use of post operative analgesia was reduced considerably. There was no recurrence, however the cost of the mesh increased the overall cost of the procedure acting as a limiting factor in a developing country.
Isolated Blunt Traumatic Diaphragmatic Rupture in a Case of Situs Inversus  [PDF]
Raiees Ahmad, Malik Suhail, Alfer Nafae, Qayoom Khan, Pervaze Salam, Shahnawaz Bashir, Yawar Nisar
Surgical Science (SS) , 2015, DOI: 10.4236/ss.2015.63021

Situs inversus, a very rare congenital anomaly of reversal site of thoracic and abdominal organs, can be very problematic to surgeon while dealing with a case of trauma in emergency. Surgical procedures are considered difficult, complex and more challenging in patients with this condition due to the anatomical difference and position of organs. We came across an interesting and very rare case of isolated blunt traumatic diaphragmatic injury in a case of situs inversus. Traumatic injuries of the diaphragm are uncommon and isolated blunt traumatic injuries of diaphragm are very rare. Our case is very unique of its kind of situs inversus with isolated right sided diaphragmatic rupture in a 60-year-old male patient presenting 4 hours after blunt trauma to chest and abdomen.

A Prospective Study of Cholilithiasis in Children  [PDF]
Raiees Ahmad, Alfer Nafae, Shahnawaz Bashir, Pervaze Salam, Qayoom Khan, Malik Suhail, Umer Mushtaq, Javid Ahmad
Surgical Science (SS) , 2015, DOI: 10.4236/ss.2015.63024

Background: Gallstones are generally uncommon in infants and children. Formation of gallstone is a very poorly understood phenomenon. In general, the risk factors for cholithiasis in infants include patients who are ill, are receiving hyperalimentation, are premature, have congenital anomalies and have necrotizing enterocolitis. Children aged 1 - 5 years most frequently have hemolysis as the underlying condition [1]. Materials and Methods: From Jan 2012 to Feb 2014, a study entitled “A Prospective Study of Cholelithiasis in Children” was conducted in Postgraduate Department of General Surgery Govt. Medical College Srinagar. The patients selected for the study were in the age group of 1 to 14 years of either sex. There were a total of 141 cases, out of which only 38 had ultrasound documented gallstones. All the patients included in the study were evaluated for prevalence, clinical presentation, and pathological features of gallstones, and were analysed for metabolic causes of gallstones. Results: The prevalence of chliothiasis in symptomatic patients was found to be 26.95% higher than the prevalence of gallstones in children in other parts of world, also the mean age of presentation was 9.3 years ranging from 6 - 14 years. Male to female ratio was 3:2 and male predominance was found in all age groups contrary to female predominance in adults. Most common presenting symptom was right upper quadrant pain followed by vomiting and nausea similar to presentation of symptomatic gallstones in adults. 4 patients had a positive family history of cholithiasis in the first degree relatives; 25 (65.7%) patients had no underlying risk factor for gallstones contrary to presumption that gallstones in children are mostly secondary to some hematological disorder or other predisposing factors. Chronic cholecystities was found in 81% of patients with gallstones and composition of gallstones retrieved was different from those of adult gallstones with calcium carbonate gallstones relatively common in children but composition of black and brown stones was almost similar to adult stones. Conclusion: Gallstone disease was increasingly gaining recognition in peadiatic practice due to significant documented increase in non-heamolytic cases

Sleep problems, strengths and difficulties in elementary school children  [PDF]
Jamal Driouch, Dirk Alfer, Leonie Fricke-Oerkermann, Gerd Lehmkuhl
Health (Health) , 2013, DOI: 10.4236/health.2013.58A2013

Aim: To assess behavioral and sleep disturbances in childhood, it is necessary to implement standardized brief questionnaires for children and their parents. Especially complaints of insomnia often are underdiagnosed in pediatric medicine. Methods: We developed a sleep questionnaire (K?SI-KJ) and used it together with German versions of the SDQ (parent and child reports) for epidemiologic studies in Cologne. The sleep questionnaire obtains 33 items for parents and 28 items for children. Ratings were dichotomized for this analysis in “sometimes/ often present” versus “not present”. The German versions of SDQ contain 5 subscales each with 5 items. Data from a sample of 1490 children of fourth grade in elementary schools inCologne(age ranged from 8 to 11 years) are shown. Results: Children indicate signs of sleep disturbances in higher frequency than their parents do. Concerning gender and ethnical group, there no significant differences can be shown. Children with signs of insomnia, dyssomnia, daytime sleepiness or restless sleep showed significantly higher scores for all relevant SDQ subscales in parental and children's reports. Children with signs of parasomnia showed higher scores concerning emotional problems and the SDQ total score. Children with enuresis showed higher scores for all SDQ subscales and the total score.

A Point-Specific Site for Placement of Epigastric Port in Iaparoscopic Management of Gallbladder Disease: An Observational Study  [PDF]
Mushtaq Chalkoo, Shahnawaz Ahangar, Faud Sadiq Baqal, Alfar Ah Nafae, Muntakhab Nafae, Raiees Ahmad Malla, Ajaz Ahmad Mallar
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.47060

Backgound: Laparoscopic cholecystectomy has revolutionized the world in the surgical management of benign gallbladder disease. However, for any procedure to learn properly, anatomy becomes a major concern. Aims and Objectives: We present a point, a convenient site, speedily accessible by our maneuver of placing epigastric port on the patient. Materials and Methods: This is an outcome of an observation with the prospective study of 100 patients irrespective of age, sex, body habitus and severity of gallstone disease. Our point for epigastric port satisfies all the criteria for an ideal port. Results: Our general observation with majority of patients with this point specific epigastric port placement was that it is easy to locate, needs less thrust on trocar for creation, stays on the linea alba, is easily maneuverable facilitates safe, easy and speedy dissection, causes less portal bleeds and is easy to angulate towards the right of falciform ligament. Conclusion: The point specific epigastric port conveys many benefits to the operating surgeon in terms of easy location, adds safety and speed to the procedure, causes less portal bleeds, needs less thrust and is easy to angulate to the right of the falciform ligament adding technical ease to the surgeon. It is easy to be learnt, taught and practiced by the young surgeons.

D1 versus Modified D2 Gastrectomy for Ca Stomach—A Prospective and Comparative Study  [PDF]
Alfar Nafae, Raiees Ahmad, Amber Aliya, Yawar Nisar, Pervaze Salam, Imtiyaz Ahmad
Surgical Science (SS) , 2016, DOI: 10.4236/ss.2016.71002
Abstract: Background: Carcinoma stomach remains a major malignancy and accounts for 10.4% of cancer related deaths globally. Despite improvement in chemo-radiotherapy, surgery remains the primary curative modality with special emphasis on lymphadenectomy. However the extent of lymphadenectomy performed by surgeons all over the world differs. Generally speaking, in Japan and Korea, the standard curative protocol would entail a “D2” lymphadenectomy whereas in the western world it would be considered unnecessary and the standard protocol would entail a standard “D1” lymphadenectomy. Thus prompting a newer surgical therapy of modified D2 in dissection in which pancreas and spleen are preserved. Lymph nodes surrounding stomach are divided into 20 stations and these are classified into three groups depending upon the location of the primary tumour. Aims & Objectives: The aims and objectives are to compare: 1) operative time of modified D2 gastrectomy with that of D1 gastrectomy; 2) operative morbidity and mortality of modified D2 gastrectomy with that of D1 gastrectomy; 3) the disease recurrence between modified D2 & D1 gastrectomy. Materials & Method: The study entitled D1 versus modified D2 gastrectomy for Ca stomach—a prospective, comparative study was conducted in the Postgraduate Department of General Surgery, Government Medical College, Srinagar as a prospective, comparative study over a period of three years 2012-2014. Patients with resectable gastric cancer were taken as subjects for the study and were divided in 2 groups that were closely matched to avoid any bias. Assessment of both the groups was done in identical fashion as per standard protocol. One group underwent gastrectomy with D1 lymph node dissection whereas the other group underwent gastrectomy with a modified D2 lymph node dissection (spleen and pancreas preservation). The type of lymphadenectomy was decided on randomization (simple random sampling). Results: After comparing the two procedures, it was noted that: 1) modified D2 lymphadenectomy took on an average 2 hours more than D1 gastrectomy; 2) operative mortality was same in both the procedures. Operative morbidity was seen more in modified D2 group than D1 group however this difference was statistically insignificant; 3) number of recurrence was quite significant in D1 group but no recurrence was seen in modified D2 group. Conclusion: On the basis of the study, we recommend that modified D2 gastrectomy is a better procedure than D1
Percutaneous prostate cryoablation as treatment for high-risk prostate cancer
El Hayek, Omar Reda;Alfer Jr., Wladimir;Reggio, Ernesto;Pompeo, Antonio Carlos L.;Arap, Sami;Srougi, Miguel;
Clinics , 2007, DOI: 10.1590/S1807-59322007000200003
Abstract: purpose: to evaluate percutaneous cryotherapy as a primary treatment option for high-risk prostate cancer patients. patients and methods: from october 2000 to february 2005, 21 high-risk (gleason e?8 and/or psa > 10 and/or stage > t2a) prostate cancer patients underwent 24 percutaneous prostate cryoablation procedures. patients' median age was 70.9, and the average pretreatment psa was 19.5 ng/dl. the follow-up period ranged from 6 to 60 months (median, 41 months). results: the psa failure rate was 39%, 52.9%, and 42.8% at 12, 24, and 60 months of follow-up, respectively. overall complication rates were low, with 8% of urinary incontinence and no cases of rectal injury; however, 96% of erectile dysfunction occurred. the cryoablation procedure failed in 12 patients (57.2%); 7 (58.3%) of these were local failures (positive prostate biopsies). conclusion: percutaneous cryoablation of the prostate is a safe minimally invasive treatment, but it has poor psa-free survival outcomes in high-risk prostate cancer patients.
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