Laparoscopy is the technique of using the "pneumoperitoneum" process to 

extend and examine the abdominal cavity using CO2. Laparoscopic and other 

procedures produce pain, which varies in intensity, duration, and type. 

Crystalloid fluid types, for instance, Normal saline (NS) and Ringer's lactate 

(RL) solution, aid in reducing laparoscopic pain. Therefore, the research 

explores intraperitoneal crystalloid solutions in reducing post-laparoscopic 

surgery shoulder pain. The research adopted a prospective, single-blind study 

based on a single-center, randomized, and parallel research design. A total of 

80 diagnosed patients (40 subjects in each arm) with laparoscopic surgery 

were randomly recruited at Zintan Medical Center, Alzintan, Libya. Patients 

were equally divided into Group A (crystalloid solutions) and Group B (routine 

measures) and were assessed through self-administered pain scores. 

Through the numeric rating scale (NRS), the research findings revealed 

significant pain intensity differences between Groups A and B at 6, 12, 24, 

48, and 72 hours. In contrast, no significant difference in pain was observed 

between groups A and B on the fourth and fifth days. Additionally, lower pain 

intensity was observed in group A than in group B; at 6 hours, the mean pain 

score for group A and B measured 2.55 and 6.40 at 6 hours, respectively. The 

intraperitoneal crystalloid solutions infusion aids in reducing pain severity 

among laparoscopic surgery patients. Future research should address 

extended follow-up periods to determine the effects of NS and RL 

interventions. Moreover, stakeholders should implement Ringer's lactate 

solution (RL) to reduce post-laparoscopic complications

Abstract

Thyroidectomy is a commonly performed surgical procedure for various thyroid diseases. 

Despite advances in surgical techniques, postoperative hypocalcaemia remains one of the most 

frequent complications, particularly following total thyroidectomy.

The aim of this study was to estimate the incidence of postoperative hypocalcaemia and to 

evaluate its characteristics and outcomes among patients undergoing thyroid surgery.

A descriptive retrospective study was conducted using thyroidectomy records from Benghazi 

Medical Center between 2010 and 2016. The study included patients operated on for non-toxic 

goiter, toxic goiter, recurrent goiter, Hashimoto’s thyroiditis, thyroid malignancy, and Graves’ 

disease. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 

23.0.

A total of 74 patients were included in the study. Postoperative hypocalcaemia occurred in 

27.7% of cases. The majority of patients were female, and hypocalcaemia was more common 

among women than men. Higher incidence rates were observed in patients who underwent total 

thyroidectomy and in those with retrosternal extension.

Postoperative hypocalcaemia remains a relatively common complication following 

thyroidectomy. Careful surgical technique and close postoperative monitoring of serum 

calcium levels are essential to reduce its incidence.

Background: Gastrointestinal stromal tumors (GISTs) are the major mesenchymal tumors of the gastrointestinal 

tract (GIT), which progress due to the mutation in TKI and PDGFR-α receptors. It shows asymptomatic conditions 

however, become malignant due its large size and produce abdominal pain. Several surgical managements have 

been applied to diagnose patients with GIST, but these increase the risk of tumor recurrent rate. Therefore, 

adjuvant therapies contribute to preventing this challenge with several side effects and post-operative 

complications. A 42-year-old male patient from Libya with acute abdomen and GIST in small bowel (Jejunum) 

was diagnosed with complete excision besides lymph node dissection..Aim: To investigate numerous case reports 

through literature analysis regarding GIST along with a case presentation of the patient. Method: This research 

employed a literature-based study design. Previous case reports were screened from various online research 

platforms, including the National Center for Biotechnology Information (NCBI) and PubMed. A total of 37 cases 

were included through the search phrase "Case report on Gastrointestinal stromal tumor” .. Results: The findings 

revealed patient mean age (56.35) with most of the small intestine GIST (6.42 cm) site of origin, antibodies 

expression, and maximum mitotic cell counts.. Conclusion: The cases reported a risk of recurrence among GIST 

patients due to high mitotic counts and tumor size. Future researchers should address immune markers to reduce 

tumor recurrence among GIST patients. Stakeholders should implement proper treatment procedures with 

effective diagnostic methods. 

Keywords: Gastro-Intestinal Stromal Tumors (GISTs), Perforation, Imatinib, Acute abdomen, Tyrosine Kinase 

Inhibitor (TKI), Small Bowe

Abstract

Purpose In this literature review, functional outcomes such as Disability of Arm, Shoulder and Hand (DASH) score and the visual analog scale (VAS) of pain along with clinical outcomes such as range of movement and grip strength of treated distal radius fractures (DRF) accompanied with ulnar styloid fractures (USF) will be compared with those with isolated DRF. Materials and Methods We analyzed articles from MEDLINE, Embase, and CINAHL that met our predetermined inclusion and exclusion criteria as per the Preferred Reporting Items for Systematic Reviews and Meta-analysis statements. This resulted in the identification of 464 articles with 18 potentially eligible studies of which 6 were included at the full-text screening stage. The primary outcomes were wrist pain, range of motion, functional outcome and satisfaction, such as VAS, and the DASH questionnaire along with radiological assessment and incidence of complications. Results These studies involved 796 participants with DRF and 806 wrists with DRF; 444 (55%) of DRF had an associated USF. Three studies did not report any statistically significant difference in DASH scores between the DRF patients with or without USF. Two studies reported worse DASH scores in the group with associated USF. Wrist pain was reported to be statistically significantly worse in patients with associated USF in two studies. Grip strength did not exhibit a statistically significant difference in any groups in four studies. On assessing the range of motion of the wrist and forearm, only one study reported a statistically significant difference in flexion at 2 years follow-up, with less flexion in patients with USF. Conclusion This review suggests that there is no significant correlation between a USF and the functional and clinical outcomes of DRF treatment, albeit wrist pain and less flexion were reported in some studies to be associated with USF. There is a need for more robust evidence from large randomized controlled trials to specifically look at the effects of fixation versus nonfixation of USF on DRF, or large prospective cohort studies assessing DRF with and without USF, with a minimum of 12 months follow-up. Level of Evidence Level II-therapeutic.

Abstract

Introduction: The calcific tendinitis is a common to happen around the shoulder, calcific tendinitis of tendons adjacent to the hip is not common like the shoulder. It can present either as acute hip pain and limitation of movement or chronic hip pain. We present two patients one with acute presentation and the other one chronic.

Case report: We present a case series of two patients with calcific tendinitis of the gluteus medius muscle. One patient a 37-year-old male presented with acute severe hip pain associated with a raised temperature, prompting concern about septic arthritis. The second patient presented with chronic hip pain. Calcification of the soft tissues adjacent to the greater trochanter was evident on plain radiographs in both patients. CT and MRI scans excluded septic or inflammatory arthritis in the patient with an acute presentation, the patient's condition settled with analgesia and NSAIDs.

Conclusion: An unusual combination of symptoms and finding mimicking septic arthritis should be considered in patients presenting with acute calcific tendinitis of the hip gluteus medius muscle.

This is an unusual presentation of complete loosening of an infected femoral component of a knee arthroplasty and expulsion of the metal foreign body out of the body.

Abstract

The present report concerns a 23-year-old woman who sustained an injury to her right knee while playing 10-pin bowling on a Nintendo Wii video game console. She presented to our orthopaedic outpatients clinic 3 months later with history and examination findings suggestive of a medial meniscal tear, which was confirmed by MRI scan. She underwent arthroscopic partial medial meniscectomy and made an uneventful recovery.

Removal of hardware in orthopaedic surgery is usually encountered in revision fracture surgery for non union, mal union, infection and peri-implant failure. If the hardware has broken this can make revision surgery even more demanding. Numerous techniques have been described to facilitate implant removal. A broken femoral nail is not an uncommon presentation of a delayed union or a non union. We describe a simple and innovative technique to remove the distal portion of broken intramedullary nails without causing any further trauma. This technique can be extended to include most hollow intramedullary nails.

Transmissible blood-borne infection can occur at muco-cutaneous membranes. During trauma and orthopaedic surgery, the use of power tools increases spraying of bodily fluid, hence resulting in an increased risk of infectious splash injury to the face. This prospective study involved 25 patients. The visors worn by the operating team were examined postoperatively to identify any visible blood, fat and body tissue splashes. Eleven patients underwent knee arthroplasty. Splash counts to the surgeon’s mouth/lip, nose/cheek and eye regions were 217, 105, and 62 respectively ; they were 258, 147, and 82 for the assistant. Fourteen patients had hip replacement ; splash counts to the surgeon’s mouth/lip, nose/cheek and eye regions were 214, 90, and 53 respectively, and 137, 39 and 27 for the assistant. To conclude, the face is vulnerable to material and fluid strikes during joint arthroplasty surgery. The visor is a reliable barrier to blood, fat and body tissue splashes and minimises the risk of exposure to bloodborne viruses. Therefore, a visor should be worn during all joint arthroplasty procedures and any procedure that involves the use of power tools.