scholarly journals Single-Dose Ibuprofen-Arginine as a Preventive for Pain, Edema, and Trismus After Impacted Lower Third Molar Surgery: A Randomized Split-Mouth Clinical Trial

2021 ◽  
Author(s):  
Edith Umasi Ramos ◽  
Luan Pier Benetti ◽  
Júlio César Silva Oliveira ◽  
Ana Paula Farnezi Bassi
Keyword(s):  
Statistical Significance ◽  
Third Molar ◽  
Wilcoxon Test ◽  
Total N ◽  
Study Results ◽  
Significant Difference ◽  
Group A ◽  
Facial Edema ◽  
Anti Inflammatory ◽  
Group B

Abstract Objective We examined if the association of ibuprofen with arginine has a better anti-inflammatory effect on pain, edema, and trismus after surgery of the impacted mandibular third molar than ibuprofen alone. Materials and Methods The study included 21 patients, 18 to 30 years of age, each with an impacted, and bilateral and symmetric third molar (total n = 21) that required transalveolar extraction. Patients were randomly assigned numbers from 1 to 21. Group A received ibuprofen-arginine as preoperative medication, while Group B received only ibuprofen. Both groups received the same postoperative medications: amoxicillin + acetaminophen. All patients were evaluated for pain at 6, 12, and 24 hours. They were evaluated for edema and trismus before surgery; immediately after surgery; and at 24, 48, and 72 hours postoperatively. Postoperative pain scores used the visual analog scale (BS-11). For facial edema and trismus, linear measurements used the method modified by Gabka and Matsumura. Statistical Analysis For the evaluation of data between Group A and Group B, we used the statistical software SPSS version 22. The Shapiro-Wilk, analysis of variance, the Bonferroni comparisons, and the Wilcoxon test were used. All tests were based on a significance level of 0.05. Results The study results reveal that the facial edema scores of Group A and Group B presented statistically significant differences (p < 0.05), while for postoperative trismus, there was no statistically significant difference (p > 0.05) between the scores of Group A and Group B. Conclusion As a conclusion, we can state that the use of ibuprofen-arginine allows for significantly better control of pain and edema, and shows a tendency toward better recovery from trismus, although without statistical significance. Based on this, we can assert that arginine improves the anti-inflammatory power of ibuprofen, thus generating better tissue healing after surgery of the impacted third molar.

scholarly journals Crossover Analysis of the Astringent, Antimicrobial, and Anti-inflammatory Effects of Illicium verum/Star Anise in the Oral Cavity

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ali A. Assiry ◽  
Mohmed Isaqali Karobari ◽  
Shaeesta Khaleelahmed Bhavikatti ◽  
Anand Marya
Keyword(s):  
Antimicrobial Properties ◽  
Microbial Count ◽  
Star Anise ◽  
Study Results ◽  
Significant Difference ◽  
Crossover Analysis ◽  
Group A ◽  
Illicium Verum ◽  
Anti Inflammatory ◽  
Group B

Introduction. Illicium verum commonly known as star anise has been widely used in many Asian countries for pharmaceutical treatment for many diseases. The aim of the present study was to investigate the anti-inflammatory, astringent, and antimicrobial properties of an Illicium verum mouthwash. Methods. The present double blinded randomized clinical trial was conducted on fifty subjects, divided into groups A and B. Illicium verum mouthwash (group A) and placebo (group B) were provided to subjects for 21 days; after 14 days, washout period mouthwashes were switched as per crossover design between groups for 21 days. The gingival index (GI), papillary bleeding index (PBI), and oral microbial count were recorded at each stage of study. Results. The significant intragroup difference was observed, before crossover in group A and after crossover in group B for GI, PBI, and oral microbial count at different stages of study. On comparing both group A and group B at the first and second follow-up for GI, PBI, and oral microbial count, a statistically significant difference ( p < 0.05 ) was observed. A statistically highly significant mean intergroup and intragroup difference was seen for all the clinical parameters at different stages of study. Conclusion. The study revealed that the Illicium verum/star anise has potent antibacterial, anti-inflammatory, and astringent properties.

scholarly journals Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain

2015 ◽  
Vol 16 (12) ◽  
pp. 939-943 ◽  
Author(s):  
Leena Alsomadi ◽  
Riyad Al Habahbeh
Keyword(s):  
Pain Scale ◽  
Prophylactic Antibiotics ◽  
Post Treatment ◽  
Endodontic Treatment ◽  
Significant Difference ◽  
Group A ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Group B

ABSTRACT Aim To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. Materials and methods After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. Results Peak postoperative pain occurred at 16 hours posttreatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402). Conclusion Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. Clinical significance Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients. How to cite this article Alsomadi L, Al Habahbeh R. Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain. J Contemp Dent Pract 2015;16(12):939-943.

scholarly journals P-B02 Does the length of  alimentary limb  make a significant difference  in the weight loss in  Roux en y gastric bypass patients?

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Mayank Bhandari ◽  
Sabyasachi Chowdhary ◽  
Milind Rao ◽  
Gopinath Bussa ◽  
Julie Holm
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Statistical Significance ◽  
Limb Length ◽  
Alimentary Limb ◽  
Significant Difference ◽  
Alimentary Limb Length ◽  
Biliopancreatic Limb ◽  
Group A ◽  
Group B

Abstract Background Roux en Y gastric bypass (RYGB) surgery for morbid obesity is considered as gold standard, but there can be a difference in the length of alimentary and biliopancreatic limb to achieve optimum weight loss. Till now there is no agreed consensus on the ideal limb lengths and their effect on the weight loss. We would like to evaluate the change in the alimentary limb length on the weight loss after the gastric bypass surgery,  as a short to medium term single center study. Methods A retrospective analysis from prospectively maintained   database of 523 patients who underwent RYGB from  2012 till 2018 was done. Patient who had at least a follow up of 2 years(n = 388) were included.  At our center we use alimentary limb of 120 +/- 10 cm for Body Mass Index (BMI) &lt; 40 kg/m2 (group A)  and 150+/-10 cm for the BMI &gt;40 kg/m2  (Group B). The biliopancreatic limb length varies from 50 to 70 cm and this does not change with BMI.  The percentage excess weight(EWL) loss was measured and analyzed  at 1st  and 2nd year post operatively. We used paired t test to check for statistical significance. Results There were 172 patients in Group A and 216 in Group B. The number of females were 330 and  males were 58.   The average age was 44 years .  The mean  preoperative  BMI for the 120 cm limb group was  37.1 kg/m2 and  that for  150 cm limb was 45.3kg/m2. The EWL for the group A at 1 year and 2 year post op was a  Mean and standard deviation  of 79.3% +/- 39.4% and 78.3% +/- 35.2% respectively and for group B was 58.8% +/- 26.6% and 58.6% +/- 23.2% respectively. The difference was statistically significant (p &lt; 0.001) . The analysis and interpretation for metabolic syndrome is yet to be determined.   Conclusions In our study, Increasing the alimentary limb length for higher BMI reduced  EWL. This is consistent with few other publications regarding the same. This has resulted in a  change in our practice namely keeping the length of alimentary limb constant and varying the BP limb length. We will be analyzing  and presenting this data in future.

Calcium dobesilate and oxerutin: effectiveness of combination therapy

2010 ◽  
Vol 25 (2) ◽  
pp. 66-71 ◽  
Author(s):  
B Akbulut
Keyword(s):  
Combination Therapy ◽  
Venous Insufficiency ◽  
Statistical Significance ◽  
Symptomatic Relief ◽  
Antioxidant Properties ◽  
Erythrocyte Aggregation ◽  
Calcium Dobesilate ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objectives Chronic venous insufficiency (CVI) is an important cause of discomfort and inability to work. Hydroxyethylrutosides (Venoruton®; 0-[beta-hydroxyethyl]-rutosides) has been used for decades for the treatment of CVI. Studies have reported symptomatic relief and a decreased capillary filtration after the administration of the oral preparations. Calcium dobesilate is a synthetic venoactive drug acting on several levels. It inhibits capillary permeability; it has antioxidant properties; and it inhibits the synthesis of prostaglandins and thromboxanes, reducing platelet and erythrocyte aggregation, as well as blood viscosity. The aim of this study is to determine whether the combination of both drugs is more effective in decreasing patients' complaints. Methods One hundred and fifty patients with primary venous insufficiency were randomized into three groups: Group A receiving calcium dobesilate only, Group B receiving oxerutin only and Group C receiving both calcium dobesilate and oxerutin. Patients were evaluated with a questionnaire before and four weeks after treatment regarding following parameters: itching, fatigue, heaviness, numbness, cramp, swelling and sensitiveness. Patients rated their symptoms from 0 to 4 (0: absent; 1: mild; 2: moderate; 3: severe; 4: very severe). Results Complaints, which were scored by patients before and after treatment, decreased. Among the single-drug groups, itching score decreased more in Group B, whereas scores of fatigue, heaviness, numbness, cramp and swelling decreased more in Group A. But the difference was not significant, statistically. But all complaints decreased significantly in Group C. Difference of scores after treatment revealed no statistical significance in Group A and B, but scores of Group C produced a significant difference when compared with Group A and B. Conclusion Results demonstrate that a combination of calcium dobesilate and oxerutin shows a better improvement of complaints. These observations have to be confirmed in larger series with objective tests. Changes of quality of life after a combination therapy might also be of interest.

scholarly journals Comparative Evaluation of the Embrasure Wire versus Arch Bar Maxillomandibular Fixation in the Management of Mandibular Fractures: Are Arch Bars Replaceable?

2018 ◽  
Vol 11 (2) ◽  
pp. 118-123
Author(s):  
Sanjay Rastogi ◽  
Tousif Ahmed ◽  
Kolli Giri ◽  
Ramakant Dandriyal ◽  
Indra B. Niranjana Prasad ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Demographic Data ◽  
Study Data ◽  
Mandibular Fractures ◽  
Intermaxillary Fixation ◽  
Maxillomandibular Fixation ◽  
Arch Bar ◽  
Significant Difference ◽  
Group A ◽  
Group B

The aim of this prospective study was to appraise the role of embrasure wiring in the treatment of mandibular fractures over the arch bar as adjunctive techniques of maxillomandibular fixation (MMF). This study was conducted on 40 patients who were surgically treated for mandibular fractures with accessory use of MMF (embrasure: group A vs. arch bars: group B). All patients were evaluated for demographic data, etiology, and location of fracture. Characteristically, the complications, including wire injury, infection, and malocclusion, were recorded. The data were analyzed using Student's t-test and chi-square test as appropriate. Statistical significance was set at p < 0.05). In this study, data from 40 patients were included. In group A (embrasure wiring), time required for placement of MMF was significantly less than (7.85 ± 0.81 minutes) that in group B, and also there was less incidence of wire prick to the operator in group A than in group B ( p < 0.05). However, in terms of wire prick and malocclusion, no statistically significant difference was noted in groups A and B ( p > 0.05). Patient treated with embrasure wiring intermaxillary fixation had better outcomes especially in terms of time of placement and less incidence of wire prick injury when compared with arch bar.

scholarly journals Comparison of Intralesional Meglumine Antimonite along withoral Itraconazole to Intralesional Meglumine Antimonitein the treatment of Cutaneous Leishmaniasis

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Uzma Bashir ◽  
Moizza Tahir ◽  
Muhammad Irfan Anwar ◽  
Faisal Manzoor
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Clinical Cure ◽  
Statistical Significance ◽  
Military Hospital ◽  
P Values ◽  
Meglumine Antimoniate ◽  
Significant Difference ◽  
Group A ◽  
Oral Itraconazole ◽  
Group B

Background & Objective: Cutaneous leishmaniasis (CL) is endemic in developing countries like Pakistan. Pentavalent antimonials are still drug of choice, despite being toxic and intolerable for patients. Second line treatments have been extensively studied but the results of their efficacy are conflicting. This, to our knowledge, will be the first study in this regard. Our objective was to  determine if combination of oral itraconazole with intralesional (IL) meglumine antimoniate (MA) reduces the duration of treatment for cutaneous leishmaniasis, as compared to intralesional MA alone. Methods: A randomized controlled trial (single blinded) was carried out from August 2017 till December 2017 on 69 patients who fulfilled inclusion criteria. They were assigned to Group-A or B by lottery method. Group-A patients received IL MA once a week while Group-B received oral itraconazole 200mg, once daily, for six weeks along with similar regimen of IL MA as Group-A. The patients were assessed every three weeks by the blinded assessor till clinical cure was achieved. A follow up visit, two months after clinical cure was done to look for relapse of the disease. Results: Thirty patients in Group-A and 35 patients in Group-B completed the study. At 3, 6, 9 and 12 weeks the patients were assessed for: no, partial or complete response and results of the two groups were compared for statistical significance. The p-values of 0.20, 0.57 and 0.11 at 3, 6 and 9 weeks, respectively, depict that there was no significant difference at any step of assessment between the two groups in terms of healing. The p values of each t test was >0.05 refuting the hypothesis. Conclusion: Combination of oral itraconazole with intralesional MA offered no benefit over intralesional MA alone in the management of cutaneous leishmaniasis in terms of duration of therapy.  Abbreviations Used: IL = Intralesional,  MA = Meglumine Antimoniate, LD = Leishmania Donovan, CL = Cutaneous leishmaniasis, CMH = Combined Military Hospital. doi: https://doi.org/10.12669/pjms.35.6.363 How to cite this:Bashir U, Tahir M, Anwar MI, Manzoor F. Comparison of Intralesional Meglumine Antimonite along with oral Itraconazole to Intralesional Meglumine Antimonite in the treatment of Cutaneous Leishmaniasis. Pak J Med Sci. 2019;35(6):1669-1673.   doi: https://doi.org/10.12669/pjms.35.6.363 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Effect of abdominal compression on target movement and extension of the external boundary of peripheral lung tumours treated with stereotactic radiotherapy based on four-dimensional computed tomography

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yuanjun Qi ◽  
Jianbin Li ◽  
Yingjie Zhang ◽  
Qian Shao ◽  
Xijun Liu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lower Lobe ◽  
Target Volume ◽  
Wilcoxon Test ◽  
External Boundary ◽  
Abdominal Compression ◽  
Significant Difference ◽  
Target Volumes ◽  
Group A ◽  
Group B

Abstract Background This study aimed to investigate the effect of abdominal compression on tumour motion and target volume and to determine suitable planning target volume (PTV) margins for patients treated with lung stereotactic body radiotherapy (SBRT) based on four-dimensional computed tomography (4DCT). Methods Twenty-three patients diagnosed to have a peripheral pulmonary tumour were selected and divided into an all lesions group (group A), an upper middle lobe lesions group (group B), and a lower lobe lesions group (group C). Two 4DCT scans were performed in each patient, one with and one without abdominal compression. Cone beam computed tomography (CBCT) was performed before starting treatment. The gross target volumes (GTVs) were delineated and internal gross target volumes (IGTVs) were defined. IGTVs were generated using two methods: (1) the maximum intensity projections (MIPs) based on the 4DCT were reconstructed to form a single volume and defined as the IGTVMIP and (2) GTVs from all 10 phases were combined to form a single volume and defined as the IGTV10. A 5-mm, 4-mm, and 3-mm margin was added in all directions on the IGTVMIP and the volume was constructed as PTVMIP5mm, PTVMIP4mm, and PTVMIP3mm. Results There was no significant difference in the amplitude of tumour motion in the left–right, anterior–posterior, or superior-inferior direction according to whether or not abdominal compression was applied (group A, p = 0.43, 0.27, and 0.29, respectively; group B, p = 0.46, 0.15, and 0.45; group C, p = 0.79, 0.86, and 0.37; Wilcoxon test). However, the median IGTVMIP without abdominal compression was 33.67% higher than that with compression (p = 0.00), and the median IGTV10 without compression was 16.08% higher than that with compression (p = 0.00). The median proportion of the degree of inclusion of the IGTVCBCT in PTVMIP5mm, PTVMIP4mm, and PTVMIP3mm ≥ 95% was 100%, 100%, and 83.33%, respectively. Conclusions Abdominal compression was useful for reducing the size of the IGTVMIP and IGTV10 and for decreasing the PTV margins based on 4DCT. In IGTVMIP with abdominal compression, adding a 4-mm margin to account for respiration is feasible in SBRT based on 4DCT.

scholarly journals 1379. Comparison of Inpatient Tuberculosis Screening Methods and Their Effect on Patient Duration in Airborne Isolation

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S501-S501
Author(s):  
Mary Katherine. Theoktisto ◽  
Delvina Ford ◽  
Omar Khan ◽  
Kelly R Reveles ◽  
Jose Cadena
Keyword(s):  
Statistical Significance ◽  
Nucleic Acid Amplification ◽  
Health Concern ◽  
Smear Microscopy ◽  
Screening Methods ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Crude Analysis

Abstract Background Tuberculosis (TB) remains a significant public health concern, and exposure in healthcare settings is prevalent. Current guidelines recommend testing for TB by acid-fast bacilli (AFB) smear microscopy with 3 sputum samples and/or using nucleic acid amplification test (NAAT), and mycobacterium culture. The purpose of this project is to compare how different TB diagnostic tests affect the duration of stay in respiratory isolation. Methods This study was conducted at the Veteran Affairs South Texas hospital, which includes a total of 437 beds. Data were collected retrospectively from medical records. Eligibility included patients admitted to the hospital and placed in airborne isolation for TB screening and diagnosis, had 3 sputum samples collected 8 hours apart and/or had 2 PCR MTB/RIF. Patients were excluded if they had TB or were not undergoing evaluation for TB. Three time periods analyzed included, 3 AFB sputum samples analyzed in-house from December 2012 to January 2014 (Group A), 3 AFB sputum samples analyzed at outside facility during 2013 to 2014 as well as 2 months in 2012 (Group B), and 2 MTB PCR/RIF in house during 2017 and 2018 (Group C). Duration of isolation was compared between groups using the Kruskal–Wallis test. A total number of 815 patients were screened, leaving 105 patients for analysis after exclusion. There were 49 patients analyzed from Group A, 28 from Group B, and 28 from Group C. Results Crude analysis of the data showed numerical differences in the total number of days and hours in isolation between the 3 groups. The average (mean) days in isolation were 4.2 for Group A, 7.4 for Group B, and 5.5 for Group C. There was no statistically significant difference in either days or hours of airborne precautions by “rule out” method. Days of isolation in airborne precautions (median IQR) was 4 for all groups (P = 0.3313). Likewise, hours of airborne precautions had a median IQR of 96 for all groups P = 0.4347. Conclusion Although there was no statistical significance between the groups, crude analysis did show a numerical difference in the mean total airborne days and hours. Lack of statistical difference may be due to low number of patients, timing of order placement for in-house PCR, and longer than expected stay in airborne precautions. Disclosures All authors: No reported disclosures.

Comparison of Alveolar Osteitis (AO) occurrence after impacted mandibular third molar removal with and without post-extraction socket irrigation

2021 ◽  
Vol 17 (3) ◽  
pp. 211-215
Author(s):  
Fatema Awan ◽  
Manahil Rahat ◽  
Muhammad Jamal ◽  
Saniya Sohail ◽  
Khalid Mahmood Siddiqi ◽  
...  
Keyword(s):  
Third Molar ◽  
Extraction Socket ◽  
Dry Socket ◽  
Number Of Patients ◽  
Mandibular Molar ◽  
Significant Difference ◽  
Alveolar Osteitis ◽  
Group A ◽  
Group B ◽  
Mandibular Third Molars

Objective: We wanted to see whether impacted third mandibular molar extractions resulted in Alveolar Osteitis if post-extraction socket irrigation was used or not. Methodology: A randomized control experiment on 70 patients study was conducted from July 2019 to January 2020 at Islamabad Dental Hospital's OMFS department. Patients presenting with the mandibular third molars fulfilling the inclusion criteria had their teeth extracted with and without socket irrigation using the computer lottery method. In cases of dry socket, clinical diagnosis was made between the 3rd, 5th, and 7th postoperative days. Results: 70 patients/sockets were evaluated with 35 having been irrigated and 35 non-irrigated. The age range was 16-50years with a mean of 29.49 and most patients were between the 16-35 age group. There were 48.6% males and 51.4% females. Dry Socket was evaluated on the 3rd, 5th, and 7th day between groups (A=irrigation, B=Non-irrigation). On the 3rd postop day, 14 (40%) patients in group A and 15(42.9%) patients were diagnosed as dry Sockets. A similar number of patients in both groups (20%) exhibited symptoms of dry socket on the fifth and seventh postoperative days, as did 5 (14.3 %) in group A, 3 (8.6 %) in group B, and 1(2.9 %t) in group A, all on the fifth postoperative day. Conclusion: On the third, fifth, and seventh postoperative days, there was no significant difference in the result of Alveolar Osteitis between the groups.

scholarly journals Impact of smartphone digital photography, email, and media communication on emergency room visits post-hypospadias repair

2017 ◽  
Vol 11 (3-4) ◽  
pp. 134 ◽  
Author(s):  
Michael E. Chua ◽  
Megan A. Saunders ◽  
Paul R. Bowlin ◽  
Jessica M. Ming ◽  
Roberto Iglesias Lopes ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Digital Photography ◽  
Hypospadias Repair ◽  
Chi Square ◽  
Email Communication ◽  
Media Communication ◽  
Group Assignment ◽  
Significant Difference ◽  
Group A ◽  
Group B

Introduction: Advances in communication technology are shaping our medical practice. To date, there is no clear evidence that this mode of communication will have any effect on unnecessary postoperativeemergency room (ER) visits. We aim to evaluate the effect of email and media communication with application of smartphone digital photography on post-hypospadias repair ER visit rates.Methods: This prospective cohort study included all patients who underwent hypospadias repair performed by a single surgeon from October 2014 to November 2015. Patients were categorized intotwo groups: Group A consented for smartphone photography and email communication and Group B declined. Reason for ER visits within 30 days postoperatively was assessed by another physician, who was blinded of patient group assignment. The reasons were categorized as: unnecessary ER visit, indicated ER visit, or visit unrelated to hypospadias surgery. Chi-square test and T-test were used for statistical analysis. Relative risk (RR) and corresponding 95% confidence interval (CI) were also calculated. Statistical significance was set at p<0.05.Results: Over a 14-month period, 96 patients underwent hypospadias repair (81 in Group A, 15 in Group B 5). No significant difference was noted between groups for overall ER return rate (RR 0.46, 95% CI 0.21, 1.0). However, the number of ER visits for wound check not requiring intervention was significantly lower in Group A than in Group B (RR 0.14, 95% CI 0.035, 0.56); likewise, a higher number of ER visits requiring intervention was noted in Group A compared with Group B, although statistically this was not significant (RR 1.67, 95% CI 0.23, 12.21).Conclusions: Email communication with the use of smartphone digital photography significantly reduced the number of unnecessary ER visits for post-hypospadias wound checks.

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