Post-Operative Complications in Radical Cystectomy: Can the Kind of Urinary Diversion, The Performance Status, Presence of Preoperative Hydronephrosis or Tumor Extension Predict the Likelihood of Post-Operative Complications_ Crimson Publishers

Post-Operative Complications in Radical Cystectomy: Can the Kind of Urinary Diversion, The Performance Status, Presence of Preoperative Hydronephrosis or Tumor Extension Predict the Likelihood of Post-Operative Complications? By Fiorello N* in Gerontology & Geriatrics Studies_ International Journal of Gerontology

  

Introduction
Radical cystectomy (RC) is recommended for T2-4 N0 M0 bladder cancer and high-risk non-muscle invasive bladder cancer [1]. Before planning the surgery it’s extremely important to select the patients to choose the urinary diversion, to evaluate the performance status with a standardized score and any specialist assessments if there are serious comorbidities [2]. Despite improvements in the surgical technique and in the approach, the procedure remains associated with significant postoperative morbidity with high rates of complications [3] Standard RC consists of the removal of the bladder, prostate, seminal vesicles, distal ureters, and regional lymph nodes in men, and the bladder, urethra, adjacent vagina, uterus, distal ureters, and regional lymph nodes in women [4]. In our study we examined post-operative complications, classified with Clavien-Dindo score, and we looked for possible correlations between type of urinary derivation, preoperative hydronephrosis (related to the disease or to a previous Transurethral Resection of Bladder [TURB]), performance status and tumor extension.

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Octopus Clubfoot Rediscovered - World’s First Exotic Case - A Neglected, Triple Axes Rotational, Grade 3 Extreme Deformity: Corrected by, Unparalleled, 4-In-1 Mega Surgical Skin Expansion from Crooked to ROZY Foot_ Crimson Publishers

 Octopus Clubfoot Rediscovered - World’s First Exotic Case - A Neglected, Triple Axes Rotational, Grade 3 Extreme Deformity: Corrected by, Unparalleled, 4-In-1 Mega Surgical Skin Expansion from Crooked to ROZY Foot by Mittal RL* in Orthopedic Research journal_ orthopedic research online journal

 

 

Abstract

Octopus clubfoot is the world’s first, the most spectacular severe/ rigid BIZARRE deformity with this new catchy name given by the author. This 18-year-old girl was operated by 4-in-1 unifying incision (first ever four well known plastic surgery procedures in one incision) with excellent, extremely gratifying, normal looking foot, without any arthrodesis. During The Intervening Period, Numerous, Highly Significant, Firsts Were Discovered relating to this case, having potential for changing global thinking of treating highly prevalent varied neglected deformities, prevalent globally, more in LMICs (as reported in author’s SICOT article at (Table 1) and Clubfoot Book by Taylor & Francis 2018, available, the world over, on Google search). It displayed an AWESOME SHOW IN PRINT MEDIA AND GOOGLE IN ITS FIRST DISCOVERY. It is expected that. RETRIEVAL OF THIS NATURE’S FREAK NEEDS A LOUD REAWAKENING CALL, because of potential to be a game changer in the history of Clubfoot management.

This graded unification of rotation flap, Z-plasty, VY-plasty and fillet flap, is not only a treatment of this case, but also a surgical concept. This can achieve requisite enlargement of contracted skin chamber in any Crooked Clubfoot. In other words, it may be only Rotation flap or in combination with other three as 2, 3, or 4-in-1 incision. This is reproducible too in any, severest of severe deformity, at any age from one year to late adulthood. Author has been actually doing this and documented too. Each one of the four, enlarges skin container, complementing each other for maximum enlargement of fascio-cutaneous room. However, deeper corrections are no less important, which become easier; achieving a longer, flexible and good shape foot, without arthrodesis. Therefore, OCTOPUS CLUBFOOT, incarcerated, like in a cell, in the pages of Sicot journal and Clubfoot book, need to come out into the open sky to become visible worldwide highlighting this surgical concept for clubfoot community and care givers. An ugly Crooked Foot can be converted in to a pleasing ROZY Foot. ROZY is an ACRONYM FROM Rotation, Z-plasty and vY-plasty of SKIN CHAMBER and Crooked depicts the annoying feeling of this deformity.

Introduction
Author has been researching in this grey area of Trimorphic Extreme Clubfoot Deformities since more than 50 years. This nomenclature was given by the author Mittal [1] for 3 grades of this deformity, which are prevalent, worldwide, in all LMICs and 80% of global population. They form a big chunk of the whole, remaining uncorrected, under-corrected or relapsing with age to the tune of 95% Tarraf [2] as reported in literature under various names, for want of a good/ acceptable surgical treatment They are commonly seen in LMICs with millions of DALYs wasted & GBD Ponseti [3]. The most important reason discovered for failures has been the neglect of contracted fascio-cutaneous foot & ankle chamber of varying severity/ rigidity. New surgical techniques were invented, with groundbreaking achievements of innumerable global presentations/ publications Mittal [4-6] with many awards/ rewards. This research has been accomplished in THREE PHASES: first phase for about 25 years in grade 1, 2nd phase about 15 years in grade 2 and the third phase in grade 3 extreme deformities, with landmark unique achievements (still continuing). The third phase has been the most significant.

Rotation flaps, Z-plasty, VY-plasty and Fillet flaps, well known four plastic surgery procedures, are frequently used as single procedures in cases of skin loss in the limbs, due to trauma, but have never been unified as two, three or all fours by any surgeon. This is the one and the only case, where all four procedures have been used by any orthopedic surgeon.

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Growth Performance and Economic Value of garri used as a Replacement for Maize in the Diets of Local Turkeys_ Crimson Publishers

Growth Performance and Economic Value of garri used as a Replacement for Maize in the Diets of Local Turkeys by Eugenes K Ndelekwute* in Approaches in Poultry, Dairy & Veterinary Sciences_ Dairy and Veterinary Sciences journal

 

Abstract
An experiment was conducted to investigate effect of garri on growth and economic performance of local turkeys as an alternative feed ingredient to maize. A total of one hundred and thirty-five day- old unsexed local poults were used for the study. Birds were randomly allotted to five dietary treatments with three replicates in a completely randomized design (CRD). Each treatment group had twenty-seven poults with nine poults per replicate. The experiment lasted for 16 weeks, 0-8 weeks and 9-16 weeks for the starter and grower phases respectively, during which starter and grower diets were fed. garri replaced dietary maize at 0, 25, 50, 75 and 100% in the diets designated T1, T2, T3, T4, and T5 respectively. Feed and water offered ad libitum throughout the experiment. Results indicated that at the starter phase 75 and 100 garri significantly (P<0.05) reduced live weight, feed intake and produced poor feed: gain ratio. There was no significant difference (P>0.05) in live weight, feed intake and feed: gain ratio between control, 25 and 50% garri. During the grower phase 75 and 100% reduced (P<0.05) live weight, but there was no difference in feed intake and feed: gain ratio. Replacing maize with 75 and 100% garri significantly (P<0.05) reduced gross margin. Therefore 50% garri could be used to replace maize in diets of local turkeys.

Introduction
There are factors that constitute a hindrance to the fast expansion of intensive poultry production in Nigeria, they are majorly the high cost of feeds and feedstuffs and insufficient supply of feed at the proper quality and quantity to the birds [1]. Feed constitutes about 70%- 80% of the total production cost in poultry business [1]. However, among cereal grains, maize is a common feedstuff of choice for energy in monogastric diet and its inclusion in diets ranges from 50%-70% [2,3]. This is not sufficiently available due to competition between livestock, human consumption and industrial uses. This scarcity has led to a rise in the cost of maize and would invariably, lead to increase in cost of animal feed and consequently animal protein [4]. Cassava (Manihot esculenta, Crantz) is one of the most vital food crops in the humid tropics, since it is naturally suited to condition of low nutrient availability and has the potency to survive in a drought situation. Cassava as a crop is mostly cultivated in most countries in the tropical regions of Africa. The crop has served as an alternative energy source and its inclusion in diets for poultry has been extensively studied [5]. Cassava remains the most vital food in terms of carbohydrates and can be processed into various forms such as garri, fufu and tapioca

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