Topical inhalant steroid (budesonide, Pulmicort® nasal) therapy in intubation granuloma

1999 ◽  
Vol 113 (5) ◽  
pp. 427-432 ◽  
Author(s):  
Hwan-Jung Roh ◽  
Eui-Kyung Goh ◽  
Kyong-Myong Chon ◽  
Soo-Geun Wang
Keyword(s):  
Medical Treatment ◽  
Conservative Therapy ◽  
Topical Steroid ◽  
Surgical Excision ◽  
High Recurrence Rate ◽  
Complete Disappearance ◽  
Group I ◽  
First Choice ◽  
Intubation Granuloma ◽  
Group Ii

AbstractIntubation granuloma of the larynx is an iatrogenic disease which is induced by endotracheal intubation. It has basically been managed by conservative medical treatment with observation. Surgical excision can be considered as a last resort due to the high recurrence rate which subjects the patients to repeated anaesthesia. The purpose of this study is to evaluate the therapeutic effect of topical steroid in intubation granuloma, comparing the results of conservative medical treatment with, or without, surgery (Group I, 14 patients) and inhalant therapy with topical budesonide (Group II, 20 patients).In Group I, complete disappearance of granuloma occurred in six cases within a year (42.8 per cent) with conservative therapy only. Microlaryngeal surgery was performed on the eight cases of persisting granuloma after conservative therapy for a year, resulting in two cases of recurrence. In Group II, the granuloma disappeared completely in 85 per cent within six months and in 95 per cent within 12 months without any remarkable side-effects. We concluded that intubation granuloma of the larynx could be treated with topical inhalant steroid as the first choice of therapy rather than other medical treatment or surgical intervention.

scholarly journals Impaired quality of life of patients with acromegaly: control of GH/IGF-I excess improves psychological subscale appearance

2008 ◽  
Vol 158 (3) ◽  
pp. 305-310 ◽  
Author(s):  
Maria P Matta ◽  
Elisabeth Couture ◽  
Laurent Cazals ◽  
Delphine Vezzosi ◽  
Antoine Bennet ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Treatment ◽  
Positive Impact ◽  
Group I ◽  
Igf I ◽  
Group Ii ◽  
Psychological Scales ◽  
Control Criteria ◽  
Design And Methods

IntroductionAcromegaly, a chronic disease caused by GH/IGF-I excess, has a major impact on quality of life (QoL).ObjectiveTo evaluate QoL of acromegalic patients in relation to control status of the disease.Design and methodsSingle center observational study including 93 patients with acromegaly recruited to complete QoL questionnaire (AcroQol). QoL was evaluated at least 3 months after surgery and/or medical treatment. Patients were divided into two groups: controlled (I) and uncontrolled (II) according to the latest consensus acromegaly ‘control’ criteria and further subdivided into four subgroups according to the previous pituitary adenoma surgery (Ib and IIb) or without surgery (Ia and IIa).ResultsMean GH (0.81±0.47 ng/ml) and IGF-I (195±71 ng/ml) values in group I were significantly lower than in group II (GH, 7.01±12.05 ng/ml and IGF-I, 513±316 ng/ml; P<0.001). There was no difference in total AcroQol score, physical, or psychological scales between groups I and II. However, when adjusted to age and disease duration since diagnosis, patients of group I (63±20%) showed an improved psychological subscale appearance than those of group II (58±17%; P=0.035). In group II, IGF-I level was lower after surgery (IIa=588±353, IIb=410±225 ng/ml; P<0.038), and psychological subscale appearance was significantly better in subgroup IIb (64.9±18.1%) than in subgroup IIa who had medical treatment (53.9±14.3%; P=0.009).ConclusionQoL is severely impaired in acromegalic patients. Control of GH/IGF-I excess by surgery or medical treatment seems to have a positive impact on psychological subscale appearance.

scholarly journals A randomised study of management modalities in epididymal cyst

2019 ◽  
Vol 6 (2) ◽  
pp. 340
Author(s):  
Bhavinder Kumar Arora ◽  
Rachit Arora ◽  
Akshit Arora
Keyword(s):  
Surgical Excision ◽  
Treatment Modalities ◽  
Cyst Size ◽  
Randomised Study ◽  
Group Iii ◽  
Sclerosing Agent ◽  
Group I ◽  
Effective Treatment Modality ◽  
Teenagers And Young Adults ◽  
Group Ii

Background: Epididymal cysts are common in teenagers and young adults. They can present as unilocular or multilocular swelling. These cysts are generally present on one side but can be bilateral. Small epididymal cyst are asymptomatic but are detected on ultrasound examination of scrotum. This study was done with aim of treating epididymal cyst with different modalities based on size of the epididymal cyst.Methods: A total of 124 patients of epididymal cyst were included in this study. Scrotal ultrasonography was done in these patients. The clinical presentations of these patients were asymptomatic detected on ultrasound, orchialgia, scrotal swelling and physical examination. Based on the size of epididymal cyst patients were divided into three groups. The treatment modalities used these were natural involution, aspiration, aspiration and sclerosing agent and surgical excision.Results: The group I consisted of cyst size less than 10mm having 73 patients. The group II consisted of patients with cyst size 11-20mm having 39 patients; and group III patients were with cyst size 21-50mm having 12 patients. Natural involution was most effective treatment modality in group I and group II. Aspiration was the second was most effective. Only a few patients required aspiration and sclerosing agent. Surgical excision was done in majority of group III patients and failed aspiration in group II.Conclusions: The results of present study show that asymptomatic and small epididymal cyst can be cured by natural regression in 77.42%. The cysts 11 to 20mm are amenable to aspiration alone, only a few need repeat aspiration and instillation of a sclerosing agent. These conservative approaches save the cost. Excision should be reserved for very large cysts and in which conservative approach fails.

Disposition of Chloramphenicol in Low Birth Weight Infants

PEDIATRICS ◽  
1980 ◽  
Vol 66 (4) ◽  
pp. 573-578
Author(s):  
John P. Glazer ◽  
Michele A. Danish ◽  
Stanley A. Plotkin ◽  
Sumner J. Yaffe
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Drug Disposition ◽  
Serum Levels ◽  
Age Group ◽  
Low Birth Weight Infants ◽  
Dosage Regimens ◽  
Group I ◽  
First Choice ◽  
Group Ii

Although infrequently an antibiotic of first choice for neonates, chloramphenicol (CL) may be indicated in selected instances of infection caused by aminoglycoside-resistant enterobacteriaciae, anaerobes, and ampicillin-resistant Haemophilus influenzae. Use of CL in neonates has been limited since the recognition that vascular collapse may occur as a consequence of dosage regimens tolerated by adults. With an assay that detects only active CL, we studied drug disposition in 13 low birth weight infants, eight between 1 and 8 days of age (group I), and five between 11 days and 8 weeks of age (group II). Peak serum CL concentrations ranged from 11.2 to 36.2 µg/ml in group I and from 10.0 to 36.2 µg/ml in group II, at doses ranging from 15 to 50 mg/kg/day, and 25 to 50 mg/kg/day, in groups I and II, respectively. Serum CL half-lives (T½) ranged from 10 to 36 hours in four of the eight group I patients; three of the remaining patients had T½ greater than 48 hours and the fourth patient accumulated CL in the interval between doses. T½ in group II ranged from 5.5 to 15.7 hours. Observed differences in T½ between groups I and II were statistically significant (P = .05) and could not be accounted for by factors other than postnatal age. These preliminary data suggest that although there appears to be an inverse relationship between CL T½ and postnatal age, there is sufficient variability in serum levels that monitoring must be performed in low birth weight infants treated with this drug.

scholarly journals Role of dinoprostone gel in induction of labour

2021 ◽  
Vol 10 (3) ◽  
pp. 1017
Author(s):  
Meet S. Patel ◽  
Shashwat K. Jani ◽  
Babulal S. Patel ◽  
Akshay C. Shah
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Western India ◽  
Group I ◽  
First Choice ◽  
Acceptable Method ◽  
Group Ii

Background: Labour induction is one of the most common intervention in obstetric practice. A simple application of PGE2 intracervical gel can ripen the cervix effectively and improve Bishop’s score there by helping in successful vaginal delivery. Considering its good performance, the dinoprostone slow-release vaginal insert is the first choice for elective induction of labour in postdate pregnancy and in patients with term pregnancy of premature rupture of membranes.Methods: This was a single year retrospective study conducted in a tertiary care center of western India from May 2019 to May 2020.Results: In group I women who delivered within 24 hours were included, in group II women who required re-instillation were included. The most common indication for induction in both the groups was past dates (accounting for 36.1% in group I and 47.3% in group II). The success rate in group I was 68.1% while in group II was 36.8%.  The rate of cesarean delivery in group I was 25.9%, while in Group II, it was 60.1%. Negligible maternal and neonatal complications were seen in both the groups.  Conclusions: The study showed that intracervical application of prostaglandin E2 is an effective, safe and acceptable method for induction of labor in women with unfavorable cervix and indications for induction. All these effects were achieved without increasing maternal and neonatal morbidity 

scholarly journals Comparison of Intra-Articular Bupivacaine and Neostigmine with Bupivacaine and Fentanyl for Post-Operative Analgesia in Arthroscopic Knee Surgeries

2020 ◽  
Vol 5 (1) ◽  
pp. 109-113
Author(s):  
Prachi Singh ◽  
Sandeep Kumar Yadav ◽  
Sumit Kumar ◽  
Manoj Tripathi ◽  
Deepak Malviya
Keyword(s):  
Statistical Analysis ◽  
Pain Perception ◽  
Study Drug ◽  
Surgical Excision ◽  
Rescue Analgesia ◽  
Randomised Study ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Arthroscopic Knee

Background: The post-operative pain in knee arthroscopy procedures can be attributed to irritation of free nerve endings of synovial tissue, anterior fat pad, and joint capsule during surgical excision and resection1.  In the recent years, new interest has focused on the cholinergic system that modulates pain perception and transmission. The present study is designed to compare the efficacy of intra- articular Bupivacaine and Neostigmine with Bupivacaine and Fentanyl for pain relief following arthroscopic surgeries.Subjects and Methods:Prospective, Interventional, Randomised study was conducted over 90 patients scheduled for elective arthroscopic knee surgery, who were randomly allocated into three equal groups of 30 patients each. Group I-Bupivacaine with Neostigmine, Group II-Bupivacaine with Fentanyl and Group III-Bupivacaine alone. The study drug combinations were administered Intra-articularly at the conclusion of surgery. Hemodynamic variables and Pain were observed immediately after completion of surgery (Baseline) and thereafter at fixed intervals. The duration of effective analgesia was measured from the “baseline” until the first use of rescue analgesic. The number of rescue analgesics given in 24 hours were also recorded. The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0 statistical Analysis Software.Results:Requirement for first analgesia was significantly earlier in Group III (146.00±71.66 minutes) as compared to Group II (236.00±111.34 minutes) and Group I (648.00±228.55 minutes). Majority of patients of Group I (90.0%) required rescue analgesia only once while in was twice in Group II (90.00%) and thrice in Group III (86.67%).Conclusion:Intra-articular administration of Neostigmine in combination with Bupivacaine provided a better post-operative analgesic effect with a lower incidence of side effects and lesser requirement of rescue analgesia.

Perineural Platelet-Rich Plasma for Diabetic Neuropathic Pain, Could It Make a Difference?

Pain Medicine ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 757-765
Author(s):  
Manal Hassanien ◽  
Abdelraheem Elawamy ◽  
Emad Zarief Kamel ◽  
Walaa A Khalifa ◽  
Ghada Mohamed Abolfadl ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Clinical Effect ◽  
Platelet Rich Plasma ◽  
University Hospital ◽  
Pain Clinic ◽  
Diabetic Neuropathic Pain ◽  
Group I ◽  
Scale Scores ◽  
Peripheral Nerve Function ◽  
Group Ii

AbstractObjectiveTo evaluate the clinical effect of perineural platelet-rich plasma (PRP) injection for pain and numbness alleviation in diabetic peripheral neuropathy (DPN).Study DesignA randomized prospective clinical trial.SettingPain clinic and Rheumatology and Rehabilitation Departments, Assiut University Hospital.MethodsSixty adult patients with type II DM accompanied by DPN of at least six months’ duration were assessed by modified Toronto Clinical Neuropathy Score (mTCNS) and randomly allocated into two groups. Group I underwent ultrasound-guided perineural PRP injection and medical treatment, and Group II received medical treatment only. Patients were followed up at months 1, 3, and 6 with regard to pain and numbness visual analog scale (VAS) and mTCNS scores.ResultsSignificant improvement was recorded in pain and numbness VAS scale scores in group I vs group II (P ≤ 0.001 during the whole study period for both parameters); at the same time, mTCNS improved in group I in comparison with group II with P = 0.01, 0.001, and &lt;0.001 at months 1, 3, and 6, respectively.ConclusionsPerineural PRP injection is an effective therapy for alleviation of diabetic neuropathy pain and numbness and enhancement of peripheral nerve function.

scholarly journals Central anticholinergic syndrome following general anaesthesia: prevention and treatment with galantamine

2018 ◽  
Vol 10 (1) ◽  
pp. 43-48
Author(s):  
M. S. Danilov ◽  
K. M. Lebedinskii ◽  
I. S. Kurapeev
Keyword(s):  
General Anaesthesia ◽  
Treatment Effectiveness ◽  
Anticholinergic Syndrome ◽  
Group Iii ◽  
Central Anticholinergic Syndrome ◽  
Group I ◽  
First Choice ◽  
Inhalational Agent ◽  
German Speaking ◽  
Group Ii

Prolonged emergence, excitation and shivering after general anaesthesia are well-known, though only in German-speaking countries they are considered to be forms of single central anticholinergic syndrome (CAS), while in others this term is not associated with general anaesthesia. In Russia the problem is augmented with lack of physostigmine — the first choice for CAS in Germany. We present our analysis of implementing galantamine instead of physostigmine for CAS prevention and management while administering this drug for decurarization. 130 patients undergoing general anaesthesia were divided into three groups depending on decurarization — group I (n = 54) without decurarization, in group II (n = 29) we used galantamine, in group III (n = 47) — neostigmine. In all the groups we assessed CAS incidence and its galantamine treatment effectiveness. Diagnostic criteria for CAS comatose form was unconsciousness 5 min later reaching inhalational agent zero end-expiratory concentration. Using the criteria we found CAS incidence in group I was 26,9%, in group II there were no cases of the syndrome, in group III the incidence was 14,9%. Thus, galantamine 0,3–0,4 mg · kg–1 (max 0,78 mg · kg–1) IV not only prevents CAS but is also effective in its treatment.

scholarly journals Treatment of Serous Otitis Media

2017 ◽  
Vol 23 (1) ◽  
Author(s):  
D. T. Orishchak ◽  
N. V. Vasyliuk ◽  
O. R. Orishchak ◽  
H. V. Khrebtiuk ◽  
R. M. Fishchuk
Keyword(s):  
Allergic Rhinitis ◽  
Otitis Media ◽  
Bypass Surgery ◽  
Conservative Therapy ◽  
Central City ◽  
Tympanic Cavity ◽  
Auditory Tube ◽  
Group I ◽  
Group Ii ◽  
Serous Otitis Media

Serous otitis media is a serosal inflammation of the mucous membrane of the auditory tube and the tympanic cavity which develops on the background of Eustachian tube dysfunction. It is characterized by the presence of seromucous exudate in the tympanic cavity. The disease occurs more often in children than adults.The objective of the research was to compare the effectiveness of different methods of treating serous otitis media.Materials and methods. The study included 46 patients with serous otitis media at the age of 22-55 years. There were 26 females and 20 males who were treated as inpatients and outpatients in the department of microsurgery of ENT-organs in Ivano-Frankivsk Central City Clinical Hospital during 2012-2016. Disease duration ranged from 10-15 days to 1 month. In all the patients, serous otitis media developed on the background of persistent allergic rhinitis. All the patients underwent comprehensive examination: their complaints as well as anamnestic data were analyzed, ENT examination including the endoscopic examination of the nasal cavity and the nasopharynx, otoscopy, audiometry, impedancemetry and laboratory investigations was performed. All patients were divided into 2 groups: Group I included 21 patients receiving conservative therapy for allergic rhinitis and serous otitis media; Group II comprised 25 patients receiving conservative therapy for allergic rhinitis and treatment of serous otitis media applying myringotomy and bypass surgery of the tympanic cavity.Results. The analysis of the study revealed that in 9 patients of Group I, an improvement in hearing occurred on the third-fourth days after treatment. In 12 patients, treatment was ineffective. 14 patients of Group II who underwent myringotomy with the evacuation of the fluid from the tympanic cavity and subsequent injection of glucocorticoids into the tympanic cavity noted an improvement in hearing immediately after the procedure or the day after. In 11 patients of Group II, a thick mucous exudate was obtained during myringotomy. These patients underwent bypass surgery. The shunt was removed after a thorough cleaning of the tympanic cavity as well as the restoration of the auditory tube function.Conclusions. Myringotomy is more effective and rational method of treating serous otitis media. Myringotomy with subsequent bypass surgery is recommended for patients with a thick mucous exudate in the tympanic cavity in order to prevent chronic adhesive otitis as well as to perform a complete sanation of the tympanic cavity and to restore the auditory tube function.

Perianal abscess and fistula-in-ano in children – evaluation of treatment’s efficacy. Are we able to avoid the recurrence?

2020 ◽  
Vol 92 (1) ◽  
pp. 1-5
Author(s):  
Katarzyna Bałaż ◽  
Agata Trypens ◽  
Dariusz Polnik ◽  
Katarzyna Pankowska-Woźniak ◽  
Piotr Kaliciński
Keyword(s):  
Antibiotic Therapy ◽  
Recurrence Rate ◽  
Perianal Abscess ◽  
High Recurrence Rate ◽  
Invasive Approach ◽  
Incision And Drainage ◽  
Surgical Interventions ◽  
Fistula In Ano ◽  
Group I ◽  
Group Ii

AIM Perianal abscess and fistula-in-ano are common findings in infants and children. The perianal abscess is usually a manifestation of the fistula-in-ano. Experience of our center indicates a general lack of knowledge of the abscess’s origin therefore it is usually treated by incision and drainage which leads to numerous recurrence. We aimed to present the optimal management of the fistula-in-ano and perianal abscess to lower or even eliminate recurrences. METHOD The retrospective study consisted of 24 infants treated in our center with perianal abscess from 2013 to 2015. The patients were divided into two groups: group I (50%) was primary treated in our center, group II had prior surgical interventions in other hospitals. Fistula-in-ano was intraoperatively identified in all patients (100%) and fistulotomy was performed. RESULTS No recurrence of the perianal abscess or fetal incontinence were observed in any patient. In the group II, the ailment was associated with severe inflammation, some patients underwent an additional surgical intervention such as incision and drainage of the extensive buttock’s abscess; the patients required longer antibiotic therapy and longer hospitalization. CONCLUSION Low-invasive approach (hip-bath, antibiotic therapy, puncture or incision and drainage of the abscess) seems to be tempting due to its simplicity and no need of general anesthesia but it is associated with high recurrence rate. Fistulotomy and fistulectomy, which are slightly more invasive procedures, significantly lower the recurrence rate of fistula-in-ano and perianal abscess.

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