scholarly journals Bone Graft Vs Bone Substitutes in Treatment of Cavitary Benign Bone Tumors (A Systematic Review Study)

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Mostafa ◽  
S I Azmy ◽  
K S Helmy
Keyword(s):  
Bone Graft ◽  
Bone Tumors ◽  
Bone Grafts ◽  
Bone Substitutes ◽  
P Value ◽  
Benign Bone Tumors ◽  
Group A ◽  
Bone Graft Substitutes ◽  
The Difference ◽  
Group B

Abstract Background and Introduction Extended curettage is the commonest mode of treatment of cavitary benign bone tumors. If a tumor is very large and threatening to involve the joint, complete excision with joint reconstruction may be necessary. Cure rates of 90–95% have been achieved using curettage as the sole mode of treatment in benign bony lesions. However this treatment is not devoid of controversy and many authors recommend that bone defect after curettage of benign bone tumors should be filled with bone grafts or bone substitutes. Aim of the Work To compare clinical and radiological outcomes, when possible after using of synthetic bone substitutes and bone grafts in surgical treatment of cavitary benign bone tumors. Materials and Methods This systematic literature review has included 22 studies and consisting of 4 steps which are a systematic search of the literature (PubMed, SCOPUS, Cochrane Library), selection of studies , recording of study characteristics and extraction of data based on clinical outcomes and their comparisons between different surgical groups. Results This systematic review has included 1071 patients of which 742 were treated using different types of bone substitutes, while the remaining 329 were treated using bone grafts (allografts or autografts). Comparing between both groups we have found that the difference in the graft incorporation time between both groups was statistically insignificant which was 6.65 months in group A and 7.01 months in group B with P value = 0.355(NS). The difference in the postoperative fracture rate as well was statistically insignificant; 1.9% in group A and 3.9% in group B with P value = 0.294(NS). However, there was a significant difference in the postoperative infection rate between group A (2.1%) and group B (12.8%) with P value = 0.01(S) and in the recurrence rate as well, which was 10% for group A and 4.3% for group B with P value = 0.002(HS). Conclusion Synthetic bone graft substitutes have evolved in response to the downsides of autograft and allograft. No level I studies regarding their use in the treatment of bone tumors have been performed. This study indicates that all of the bone substitutes are safe and may be as effective as other bone graft options and with no limitation in their source for filling the large defects. Prospective randomized clinical trials in the treatment of bone tumors comparing bone graft substitutes versus other grafts (autograft and allograft) are necessary to properly delineate the real indications for bone grafting and to demonstrate the graft’s efficacy in this regard.

Autogenous Bone Graft Versus Bovine Bone Graft in Association With Platelet-Rich Plasma for the Reconstruction of Alveolar Clefts: A Pilot Study

2018 ◽  
Vol 56 (1) ◽  
pp. 134-140 ◽  
Author(s):  
Bruno Torres Bezerra ◽  
John Nadson Andrade Pinho ◽  
Fabrício Eneas Diniz Figueiredo ◽  
José Renato Moraes Carvalho Barreto Brandão ◽  
Lucas Celestino Guerzet Ayres ◽  
...  
Keyword(s):  
Bone Graft ◽  
Platelet Rich Plasma ◽  
Bone Grafts ◽  
Autogenous Bone ◽  
Bovine Bone ◽  
Alveolar Bone Grafting ◽  
Significant Difference ◽  
Group A ◽  
Autologous Bone ◽  
Group B

Objective: To compare the outcomes of 2 different bone graft materials: autogenous bone grafts from mandibular symphysis and bovine bone grafts associated with platelet-rich plasma (PRP). Methods: Twenty individuals met the inclusion criteria and accepted to participate in the study. Group A patients underwent alveolar bone grafting using autologous bone and group B patients using a bovine bone graft associated with PRP. Cone beam computed tomography scans were taken and reconstructed 3-dimensionally for all patients preoperatively and 1 year postoperatively. Results: A significant reduction was detected for area and volume within group A and group B. Between groups, no significant difference was found for area or volume. Conclusions: Bovine grafts associated with PRP are a good option for the reconstruction of alveolar clefts and provide good results such as autologous bone grafts.

Functional Outcomes of Bone Graft Substitutes for Benign Bone Tumors

Orthopedics ◽  
2004 ◽  
Vol 27 (1) ◽  
pp. 141-144 ◽  
Author(s):  
Steven Gitelis ◽  
Walter Virkus ◽  
David Anderson ◽  
Patricia Piasecki ◽  
Ting Kuo Yao
Keyword(s):  
Bone Graft ◽  
Functional Outcomes ◽  
Bone Tumors ◽  
Benign Bone Tumors ◽  
Bone Graft Substitutes

Bioactive glass and autogenous bone as bone graft substitutes in benign bone tumors

2008 ◽  
Vol 90B (1) ◽  
pp. 131-136 ◽  
Author(s):  
Nina C. Lindfors ◽  
Jouni T. Heikkilä ◽  
Ilona Koski ◽  
Kimmo Mattila ◽  
Allan J. Aho
Keyword(s):  
Bioactive Glass ◽  
Bone Graft ◽  
Bone Tumors ◽  
Autogenous Bone ◽  
Benign Bone Tumors ◽  
Bone Graft Substitutes

scholarly journals Comparison of Salbutamol and Salbutamol with ipratropium bromide in children with exacerbation of Asthma in terms of peak expiratory flow rate (PEFR).

2021 ◽  
Vol 28 (11) ◽  
pp. 1611-1615
Author(s):  
Sadaf Minhas ◽  
Saqib Aslam ◽  
Muhammad Azhar Farooq ◽  
Ayesha Anwar ◽  
Farhan Zahoor ◽  
...  
Keyword(s):  
Peak Expiratory Flow ◽  
Ipratropium Bromide ◽  
Controlled Trial ◽  
P Value ◽  
Significant Difference ◽  
Group A ◽  
Expiratory Flow ◽  
The Difference ◽  
Group B ◽  
Trial Setting

Objective: To compare the Salbutamol alone and Ipratropium Bromide supplemented Salbutamol in children with exacerbation of asthma in terms of PEFR. Study Design: Randomized Controlled Trial. Setting: Pediatrics Emergency, KRL Hospital Islamabad. Period: 1st August 2016 to 31 January 2017. Material & Methods: Group A patients were given only Salbutamol (0.15mg/kg per dose with minimum 2.5 mg, maximum 5 mg/dose). Group B was given Ipratropium Bromide supplemented Salbutamol (250 mcg/dose for <20 kg while 500 mcg/dose for >20kg of Ipratropium Bromide with same dose of Salbutamol as prescribed for Group A). Baseline spirometry was performed on each patient and after measurement of baseline peak expiratory flow. The outcome was measured by Peak flow meter and reassessed at 60 minutes. Results: Comparison of salbutamol alone and ipratropium bromide supplemented salbutamol in children with exacerbation of asthma in terms of PEFR shows that 40.5 + 4.28 in Group-A and 59.5 +4.75 in Group-B, P-value was calculated as 0.0001, showing a significant difference between the two groups while the difference in increase was recorded as 19%. Conclusion: We concluded that salbutamol alone is significantly less effective when compared with Ipratropium Bromide supplemented Salbutamol in children with exacerbation of asthma in terms of PEFR.

scholarly journals Airway Clearance in Bronchiectasis: A Randomized Control Trial of N-Acetylcysteine with 3% hypertonic saline

2019 ◽  
Vol 8 (3) ◽  
pp. 146-150 ◽  
Author(s):  
Muhammad Imran Shehzad ◽  
Muhammad Atiq Ul Mannan ◽  
Masood Alam ◽  
Abdul Rauf ◽  
Muhammad Imran Sharif
Keyword(s):  
Acute Exacerbation ◽  
Hypertonic Saline ◽  
Control Group ◽  
P Value ◽  
Airway Clearance ◽  
Before And After ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Background: N-Acetylcysteine and 3% hypertonic saline are being used effectively for sputum clearance in chronic cases of bronchiectasis for quite some time. However, their use in acute condition of the disease seems to be underexplored. The objective of our study is to compare the role of nebulized N-acetylcysteine and 3% hypertonic saline in clearing the airway in patients with acute exacerbation of bronchiectasis. Material and Methods: A total of 136 confirmed cases of bronchiectasis were enrolled in this study. This randomized controlled trial was done in chest ward of Nishtar Hospital Multan from January 2015 to March 2017. Sampling was done by non-probability consecutive sampling and patients were divided into two groups A and B by lottery method. Verbal informed consent was taken from all participants. Group A participants received nebulization of N acetylcysteine mixed in normal saline for ten minutes, while group B participants were nebulized with 10ml of 3% hypertonic saline for ten minutes. Group B was active control group in the study. Data was collected on pre-designed Proforma, and analyzed by SPSS version 22. Numerical variables such as saturation, weight of sputum, age and blood pressure was analyzed by using t test. These were considered significant if the p value was equal or less than 0 .05. For qualitative variables chi square test was applied. Results: The mean O2 saturation of Group A, before and after treatment, was 92.11±3.07% and 94.47±2.18%, respectively. The difference was statistically significant (p value =0.001). The sputum weight of Group A, before and after treatment, was 2.63±2.39 g and 7.41±1.38 g, respectively. The difference was statistically significant (p value =0.001). The frequency of rhonchi of Group A, before and after treatment, was 52% and 76%, respectively. The difference was statistically significant (p value =0.003). While, for Group B, the mean O2 saturation, before and after treatment, was 92.36±3.13% and 93.49±2.27%, respectively. The difference was statistically significant (p value =0.012). The sputum weight, before and after treatment, was 3.11±2.01 g and 5.56±1.02 g, respectively. The frequency of rhonchi, before and after treatment, was 45% and 74% respectively. Again, the difference was statistically significant. Conclusion: Both nebulized N-acetylcysteine and 3% hypertonic saline cause airway clearance by enhancing sputum expectoration in patients with acute exacerbation of bronchiectasis equally. Both these agents also improve oxygen saturation in acute exacerbation of bronchiectasis significantly.

scholarly journals Aesthetic Appearance of External Dacryocystorhinostomy Scar: A Comparison between W and C Shaped Incision

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Zeeshan Kamil ◽  
Qirat Qurban ◽  
Khalid Mahmood
Keyword(s):  
Case Series ◽  
Sampling Technique ◽  
Nasolacrimal Duct ◽  
P Value ◽  
Aesthetic Appearance ◽  
Group A ◽  
External Dacryocystorhinostomy ◽  
The Difference ◽  
Incision Technique ◽  
Group B

Purpose:  To compare the post-operative appearance of external Dacryocystorhinostomy scar resulting from W and C shaped incisions. Study Design:  Interventional case series. Place and Duration of Study:  Khalid eye clinic, Karachi, from July 2018 to June 2019. Methods:  We recruited ninety-six patients of nasolacrimal duct obstruction by convenience sampling technique. Age ranged from 20 to 50 years and both genders were included. Two groups were made. Group A comprised of patients who underwent external Dacryocystorhinostomy (Ex-DCR) surgery through W shaped incision and group B patients underwent Ex-DCR with curvilinear C shaped incision. Main outcome measure was to observe minimal to no visible scarring at wound site after six months of follow up. All patients were explained about the difference in incision technique and consent was obtained from each patient. Results:  Mean age was 34.3 ± 6.897 years. There were thirty-six (37.5%) males and sixty (62.5%) females. Right side was affected in forty-six (47.9%) cases whereas left side was involved in fifty (52.1%) cases. In Group A, 20 (41.6%) out of 48 patients, whereas in Group B, 38 (79.2%) out of 48 patients had no visible scar at all and it was statistically significant with a p-value of < 0.05. Suture abscess developed in four (8.3%) patients in group A, no other serious complications were observed in either group. Conclusion:  Curvilinear C shaped incision in Ex-DCR has better cosmetic outcome. Key Words:  External dacryocystorhinostomy, C shaped incision, W shaped incision.

scholarly journals CLIPPED OR CLIPLESS CHOLECYSTECTOMY

2018 ◽  
Vol 25 (06) ◽  
pp. 805-809
Author(s):  
H. Sabiha Akhtar ◽  
Zia Farooq ◽  
Hassan Rathore ◽  
Muhammad Umar Farooq ◽  
Arooj Ahmad
Keyword(s):  
Treatment Options ◽  
P Value ◽  
Surgical Removal ◽  
Biliary Leakage ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Trial Setting ◽  
Selection Of

Background: Cholecystectomy is the surgical removal of the inflamedgallbladder. Advancement in technology has led to many treatment options and methods ofcholecystectomy but the selection of right method depends upon severity of disease alongwith available resources and expertise. Objective: To compare the frequency of biliary leakagewith clipless versus clipped laparoscopic cholecystectomy for management of cholecystitis.Material & Methods: Study design: Randomized control trial. Setting: Unit 1, Departmentof Surgery, Jinnah hospital, Lahore. Duration: It was conducted for a period of six monthsfrom July 2016 to January 2017. Data collection: A total of 130 patients were included in thestudy using nonprobability consecutive sampling and were randomly divided in two groups byusing lottery method. In group A, clip-less Harmonic scalpel was used along with Ultrasonicshear. In group B, the conventional instruments were used with the application of clips. Patientswere called for follow-up in OPD after 1 week to assess biliary leakage through MRCP. All thedata was collected through a pre-designed proforma. The data was entered and analyzed inSPSS version 20. Results: The mean age of patients was 42.97±10.77 years with 68 (52.31%)patients were male and 62 (47.69%) patients were females. The biliary leakage was noted in29 cases i.e. 9 from clipless group and 20 were from clipped group and the difference wasstatistically significant (p-value=0.020) Conclusion: It can be concluded from this study thatthe frequency of biliary leakage is significantly higher in the clipped LC for management ofCholecystitis. Thus it is encouraging to use clipless method to avoid such complication andimprove surgical outcomes.

scholarly journals A comparative study between early enteral feeding (within 24 hours) versus conventional enteral feeding after enteric anastomosis

2012 ◽  
Vol 11 (4) ◽  
pp. 273-283 ◽  
Author(s):  
Souvik Chatterjee ◽  
Sujoy Kumar Bala ◽  
Partha Chakraborty ◽  
Rajesh Dey ◽  
Santanu Sinha ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Enteral Feeding ◽  
P Value ◽  
Early Enteral Feeding ◽  
Post Operative Period ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Post Operative Nausea

Background: Traditionally, enteric feeds are withheld for a period of 48-72 hrs, sometimes even more following enteric anastomosis depending upon return of full peristaltic sounds. This results in a period of nonstimulation   of gut –‘Gut Rest’, which was supposed to result in better anastomotic healing. But this same also deprives the intestinal mucosa of surface nutrients as well as prolongs parenteral fluid therapy, thereby   depriving the patients of adequate nutrition. Along with it, prolonged parenteral therapy also keeps the  patients bound to bed with its resultant complications like, prolonged hospital stay and increased cost of   therapy. Objectives: To compare the benefits of early enteral feeding over conventional enteric feeding following  enteric anastomosis with special regards to patients recovery and complications. Methods and  materials: The selection of patients into group A (60) and group B (60) was done after having fulfilled inclusion and exclusion criteria. Informed consent was obtained. The patients of group A were fed via   enteral route within 24 hrs of enteric anastomosis. The patients of group B were fed via enteral route after 48-72 hrs or appearance of full peristaltic sounds following enteric anastomosis. These patients were followed   in post operative period for their drain output, any nausea, vomiting or significant abdominal distension, prolonged ileus, post operative duration of shospital stay, post operative infective complications (e.g. wound infection, UTI, RTI), and different haematological and biochemical examinations. Results: This   study shows that post operative nausea-vomiting, anastomotic leakage rate, re-exploration, wound infection and RTI rates are higher in group A than those of group B. In this study, the incidence of UTI in post operative period is higher in group B. But the differences in above mentioned variables are not statistically significant. Whereas appearance of intestinal peristaltic sound is earlier in group A (42.8 ± 10.68 hours)   compare to that of group B (52.6 ± 13.46 hours). Here, the difference is statistically significant (p value = 0.000022) The duration of post operative hospital stay is shorter in group A (8.45 ± 5.143 days) than that of group B (10.533 ± 4.952 days). The difference of duration post operative hospital stay is statistically significant (p value = 0.0257). Removal of nasogastric tube, resumption of oral feeding, and passage of first flatus and/or defecation were earlier in the group A than that of the group B; the differences were statistically significant. The post operative day-5 albumin level is better in group A (3.147 ± 0.4409 gm/dl) than that of group B (2.935 ± 0.3124 gm/dl). This difference is also statistically significant (p value = 0.0029). There are three mortalities in group Awhereas one mortality in group B. This difference in mortality in two   groups is not statistically significant. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12597 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12

scholarly journals Efficacy of growth hormone in improving the pregnancy rate in poor responders in ART

2017 ◽  
Vol 6 (7) ◽  
pp. 2883
Author(s):  
Nisha E. ◽  
Sunitha H. B. ◽  
Vidya V. Bhat ◽  
K. M. Guddy
Keyword(s):  
Growth Hormone ◽  
Pregnancy Rate ◽  
Statistical Significance ◽  
Pregnancy Rates ◽  
P Value ◽  
Poor Responders ◽  
High Dose ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Poor responders impose a great challenge to ART clinicians. Research to improve their pregnancy rate is going on. This study was conducted to analyze the effect of growth hormone in poor responders in ART.Methods: This study was done from January 2015 to December 2015. It was a retrospective, single centre, cohort study in which 36 poor responders were selected and allotted into group A (18) with growth hormone and group B (18) without growth hormone. High dose of gonadotrophins was used for ovarian stimulation and antagonist protocol was followed in all patients. Group A received 4 IU of growth hormone along with usual treatment from day 2 till ovulation trigger with HCG injection, group B usual protocol.Results: Statistical analysis was done with independent T test, and p value <0.05 was considered significant. Higher number of mature oocytes and pregnancy rates were observed in growth hormone group. Number of MII oocytes was 5.8, on an average in group A and 3.7 in group B, the difference was statistically significant (p 0.0000001).  Clinical pregnancy rates were 27.7% in group A and 16.6% in group B, statistical significance (p 0.02).Conclusions: Addition of growth hormone shows increase in number of oocytes retrieved and pregnancy rates in poor responders in ART patients.

scholarly journals Comparison of Outcome of Decompressive Craniectomy with Wide Dural Flap Duraplasty Versus Dural Slits in the Management of Post Traumatic Acute Subdural Hematoma in Terms of Postoperative CSF Leak

2019 ◽  
Vol 23 (3) ◽  
pp. 163-169
Author(s):  
GHAYUR ABBAS ◽  
RIFFAT ULLAH KHAN ◽  
USAMA BIN ZUBAIR ◽  
SAJID NAZEER BHATTI
Keyword(s):  
Decompressive Craniectomy ◽  
Acute Subdural Hematoma ◽  
Csf Leak ◽  
P Value ◽  
Chi Square ◽  
Csf Leakage ◽  
Group A ◽  
Post Traumatic ◽  
The Difference ◽  
Group B

Objective: To compare the frequency of postoperative cerebrospinal fluid (CSF) leak after decompressive craniectomy with wide dural flap duraplasty versus dural slits in patients with post traumatic acute subdural hematoma.Material and Methods: The study was conducted from August 2017 to February 2018 in the Department of Neurosurgery, PIMS, Islamabad. A total of ninety-two (n = 92) adult patients of either gender between age 15-55 years presented with isolated, unilateral traumatic acute sub dural hematoma (ASDH) with midline shift of 5mm were categorized into 2 groups; Group A (DC with open dural flap) and Group B (DC with dural slits). Patients were observed for CSF leakage for four weeks.Results: Results showed that the overall frequency of CSF leak was not significantly different in both groups and revealed that the CSF leak was observed in 10.9% (n = 5/46) in group A (DC plus open dural flap) and in 21.7% (n = 10/46) in group B (DC plus dural slits) (P = 0.158). The difference was not significant in terms of frequency of CSF leak in both groups when results were stratified with respect to gender, age, duration of trauma and baseline GCS. P value (chi-square) was found to be > 0.05 in all cases.Conclusions: The postoperative CSF leak was observed in higher percentages in patients who underwent DC with dural slits as compared to the patients who underwent DC with open dural flaps for surgical management of ASDH. The difference, however, was not statistically significant.

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