scholarly journals The Effect of Perineural Injection in the Treatment of Carpal Tunnel Syndrome

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Elsebaie ◽  
N H Elarousi ◽  
E A Elattar ◽  
A A Mohamed
Keyword(s):  
Sodium Bicarbonate ◽  
Negative Correlation ◽  
Nerve Conduction ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Statistical Significant Difference ◽  
Positive Correlation ◽  
Perineural Injection ◽  
Significant Difference ◽  
Before And After

Abstract Background This study was carried out to determine the effectiveness of perineural injection of dextrose 5 % buffered with sodium bicarbonate subcutaneously in treating patients with mild to moderate CTS. It was a prospective randomized study that performed on twenty cases with idiopathic CTS; they were diagnosed clinically and electrophysiologically according to AANEM criteria (2002). Objectives To study the effectiveness of perineural injection of dextrose 5 % buffered with sodium bicarbonate subcutaneously in treating patients with mild to moderate CTS. Patients and Methods It was a prospective randomized study that performed on twenty cases with idiopathic CTS; they were diagnosed clinically and electrophysiologically according to AANEM criteria (2002). All patients received PIT sessions. The injection done once weekly for 6 weeks. They were assessed before and after the treatment sessions by the following: provocative tests (Tinel, phalen and reverse phalen), clinical assessment scale (VAS and BCTQ"SSS, FSS") and nerve conduction study. Results By the end of the treatment, All provocative tests & All assessment scores showed a highly statistical significant difference (p > 0.01). Regarding sensory examination: night parethesia, hand pain and tingling &numbness showed a highly statistical significant difference (p > 0.01). Our results as regard nerve conduction studies of DML, sensory CV and DSL —difference between median and ulnar nerves showed that there was a statistical significant difference with improvement and there was a highly statistical significant difference with improvement as regard DSL and DML-difference between median and ulnar nerves. Before treatment VAS has a positive correlation with DML (r = 0.448, P < 0.05), another significant positive correlation was found between SSS and DSI (r = 0.45 , p < 0.05), but there was a negative correlation between VAS and the following MCV (r=-0.536, p < 0.05) and SCV (r= -0.462, p < 0.05). After treatment there was a negative correlation between VAS and the following SCV (r = -0.528, p < 0.05) and MCV (r= -0.618, p- 0,01 ). Conclusion Our study revealed that PIT Of D5W is an effective treatment for patients with mild to moderate CIS.

scholarly journals Total Hip Arthroplasty Using Imageless Computer-Assisted Navigation—2-Year Follow-Up of a Prospective Randomized Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1620
Author(s):  
Richard Lass ◽  
Boris Olischar ◽  
Bernd Kubista ◽  
Thomas Waldhoer ◽  
Alexander Giurea ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcome ◽  
Hip Arthroplasty ◽  
Important Determinant ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Computer Assisted ◽  
Total Hip ◽  
Significant Difference

The purpose of this study is to compare computer-assisted to manual implantation-techniques in total hip arthroplasty (THA) and to find out if the computer-assisted surgery is able to improve the clinical and functional results and reduce the dislocation rate in short-terms after THA. We performed a concise minimum 2-year follow-up of the patient cohort of a prospective randomized study published in 2014 and evaluated if the higher implantation accuracy in the navigated group can be seen as an important determinant of success in total hip arthroplasty. Although a significant difference was found in mean postoperative acetabular component anteversion and in the outliers regarding inclination and anteversion (p < 0.05) between the computer-assisted and the manual-placed group, we could not find significant differences regarding clinical outcome or revision rates at 2-years follow-up. The implantation accuracy in the navigated group can be regarded as an important determinant of success in THA, although no significant differences in clinical outcome could be detected at short-term follow-up. Therefore, further long-term follow-up of our patient group is needed.

Subvastus Exposure Compared to Parapatellar Approach in Navigated Sequential Bilateral Total Knee Arthroplasty (SBTKA): A Prospective Randomized Study

2019 ◽  
Author(s):  
Anoop Jhurani ◽  
Piyush Agarwal ◽  
Mukesh Aswal ◽  
Chetan Rasquinha ◽  
Mudit Srivastava
Keyword(s):  
Blood Loss ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Functional Score ◽  
Control Group ◽  
Subvastus Approach ◽  
Bilateral Knee ◽  
Significant Difference

AbstractSubvastus approach preserves the quadriceps mechanism and may lead to improved early functional outcomes as compared with a parapatellar approach in primary knee arthroplasty. We performed a prospective randomized study to test the hypothesis if subvastus approach improves patient- and physician-reported outcomes in navigated sequential bilateral knee arthroplasty when compared with the standard parapatellar approach. A total of 93 patients were allotted in each group after power analysis and randomization done by computer-generated sequence: group S by subvastus approach and control group P by parapatellar approach. The patient's ability to walk without an aid, range of motion, blood loss, tourniquet time, complications, Knee Society Score (KSS), Knee Society Functional Score (KSFS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), High Flexion Knee Score (HFKS), and visual analog scale (VAS) for pain were recorded preoperatively and postoperatively at 2 and 6 weeks and 3, 6, and 12 months. Final follow-up was done at 2 years. There was no statistical difference in the patient's ability to achieve a straight leg raise (p = 0.88), walk without an aid (p = 0.25), leaving pain medication (p = 0.48), and mean duration of hospital stay (p = 0.58) between both groups. There was no difference in KSS, FS, KOOS, WOMAC, HFKS, and VAS at 2 weeks and later follow-ups. There was no significant difference in range of motion or lateral retinacular release in both groups. Blood loss was significantly less in group S (p < 0.05), but there was a higher rate of proximal wound dehiscence and delayed healing in subvastus group (p = 0.03). Subvastus approach does not improve patient- and physician-reported outcome measures except blood loss in computer-navigated sequential bilateral knee arthroplasty and has an increased incidence of wound healing problems. The Level of evidence for the study is I.

Autologous embryo–cumulus cells co-culture and blastocyst transfer in repeated implantation failures: a collaborative prospective randomized study

Zygote ◽  
2011 ◽  
Vol 20 (2) ◽  
pp. 173-180 ◽  
Author(s):  
M. Benkhalifa ◽  
A. Demirol ◽  
T. Sari ◽  
E. Balashova ◽  
M. Tsouroupaki ◽  
...  
Keyword(s):  
Embryo Development ◽  
Randomized Study ◽  
Cumulus Cell ◽  
Cumulus Cells ◽  
Prospective Randomized Study ◽  
Human Embryos ◽  
Feeder Cells ◽  
Positive Role ◽  
Significant Difference

SummaryIn repeated implantation failure, the co-culture of human embryos with somatic cells has been reported to promote the improvement of embryos quality, implantation and pregnancy rate. It was reported that feeder cells can be more beneficial to the oocyte and embryo by detoxifying the culture medium and supporting embryo development via different pathways. In this study, 432 patients, each with a minimum of three repeated implantation failures, were accepted for a prospective randomized study with or without autologous cumulus cell embryo co-culture and transfer at day 3 or day 5–6. We also investigated the expression of leukaemia inhibitor factor (LIF) and platelet activating factor receptor (PAF-R) on day 3 confluent cumulus cells. The statistic analysis of the data showed significant difference of implantation and clinical pregnancy rates between classical culture and day 3 compared with co-culture and day 5–6 transfer. The molecular analysis showed that cumulus cells express the LIF and the PAF-R genes and confirmed the possible positive role of growth factors and cytokines in early embryo development. Embryo co-culture systems with autologous cells can be beneficial in routine in vitro fertilization for embryo selection and implantation improvement. More molecular investigations need to be done to improve elucidation of the complex dialogue between the embryo and feeder cells prior to implantation and to understand the involved biological function and molecular process during embryo development.

Post-tonsillectomy pain with selective diathermy haemostasis

1996 ◽  
Vol 110 (5) ◽  
pp. 446-448 ◽  
Author(s):  
H. L. Tay
Keyword(s):  
Randomized Study ◽  
Prospective Randomized Study ◽  
Tonsillar Fossa ◽  
Post Operative Period ◽  
Significant Difference ◽  
Two Sides

AbstractA prospective randomized study was carried out to assess the post-tonsillectomy morbidity of the selective diathermy technique as opposed to the ligation technique. One hundred and five patients had one tonsillar fossa haemostasis secured by unipolar diathermy and the opposite side by ligation technique. There was significantly less pharyngeal pain on the diathermy side in the first post-operative day. However, there was no significant difference between the two sides, both in pharyngeal discomfort and otalgia for the rest of the post-operative period. There was no difference in the incidence of haemorrhage between the two techniques.

scholarly journals A comparison of subtraction MRI with the standard contrast-enhanced imaging in Perthes’ disease

2019 ◽  
Vol 13 (1) ◽  
pp. 82-88 ◽  
Author(s):  
K. Jamil ◽  
T. Walker ◽  
E. Onikul ◽  
C. F. Munns ◽  
D. G. Little
Keyword(s):  
Femoral Head ◽  
Randomized Study ◽  
Perfusion Index ◽  
Perthes Disease ◽  
Diagnostic Study ◽  
Subtraction Technique ◽  
Level Of Evidence ◽  
Enhanced Mri ◽  
Significant Difference ◽  
Before And After

Purpose Perthes’ disease (PD) results from loss of blood supply to the hip and can progress to femoral head deformity. MRI in the early course of the disease can provide data on the initial extent of infarct. Vascularity of the femoral head is assessed by gadolinium-enhanced MRI (contrast MRI), which may be improved by the digital subtraction technique (subtraction MRI). We hypothesized that gadolinium-enhanced MRI without subtraction was comparable with subtraction MRI in depicting the femoral head perfusion. Methods In all, 34 patients (34 hips) with unilateral PD had gadolinium-enhanced MRI as part of a prospectively randomized study. Nine patients had three MRIs, 15 had two and ten had a single MRI. Measurement of perfusion of the femoral head (MRI perfusion index) was obtained using digital image analysis on all the MRIs, including both before and after subtraction. A paired sample t-test was performed to compare the measurements. Results The mean age of the patients was 8.9 years (sd 1.6). At the time of diagnosis, the subtraction MRI did not elicit a statistically significant difference in MRI perfusion index measurements when compared with the contrast MRI (p = 0.19). The same findings were found when including all patients at various stages of the disease (p = 0.30). Qualitatively, although some subtraction MRI images showed superior delineation of epiphysis, there are no significant differences throughout the whole series. Conclusion Although the current literature supports the increasing role of the subtraction MRI for PD management, our study proposed that the contrast MRI without subtraction technique appears adequate in assessing femoral head perfusion. Level of Evidence: Level I - Diagnostic study

Timing of operation for ruptured supratentorial aneurysms: a prospective randomized study

1989 ◽  
Vol 70 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Juha Öhman ◽  
Olli Heiskanen
Keyword(s):  
Aneurysmal Subarachnoid Hemorrhage ◽  
Anterior Part ◽  
Controlled Trial ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Double Blind ◽  
Content Type ◽  
Acute Surgery ◽  
Significant Difference ◽  
Fine Print

✓ A total of 216 patients with a ruptured aneurysm of the anterior part of the circle of Willis were enrolled into this prospective randomized study of timing of the operation after aneurysmal subarachnoid hemorrhage (SAH). Only patients in clinical Grades I to III (according to the classification of Hunt and Hess) who were admitted and randomly assigned to a treatment group within 72 hours after the SAH were included in the trial. The patients were randomly assigned to one of three operation groups: acute surgery (AS: 0 to 3 days after the SAH; day of SAH = Day 0), intermediate surgery (IS: 4 to 7 days after the SAH), or late surgery (LS: 8 days to an indefinite time after the SAH). Three patients (4.3%) in the IS group and six patients (8.6%) in the LS group died before surgery was undertaken. At 3 months post-SAH, 65 patients (91.5%) from the AS group were classified as independent compared to 55 (78.6%) from the IS group and 56 (80.0%) from the LS group. The management mortality rate in the AS group was 5.6% compared to 12.9% in the LS group. Of the 216 patients enrolled in the timing study, 159 were randomly assigned to an independent double-blind placebo-controlled trial of nimodipine in Grade I to III patients. A total of 79 patients received nimodipine and 80 placebo. When the nimodipine group and the no-nimodipine group (the 80 placebo-treated patients plus the 52 patients who were not entered into the nimodipine trial) were analyzed separately, a significant difference was seen in the outcome of the no-nimodipine group (dependent AS vs. dependent IS, p = 0.01). Nimodipine treatment was associated with a significant reduction of delayed ischemic deterioration (all operation groups combined, nimodipine vs. no nimodipine p = 0.01; LS with nimodipine vs. LS with no nimodipine, p = 0.03).

Oral versus Intraperitoneal Application of Clindamycin in Tunnel Infections: A Prospective, Randomized Study in Capd Patients

1997 ◽  
Vol 17 (5) ◽  
pp. 486-492 ◽  
Author(s):  
Joerg Plum ◽  
Suzan Artik ◽  
Theo Busch ◽  
Kurtulus Sahin ◽  
Bernd Grabensee
Keyword(s):  
Randomized Study ◽  
Fluid Collection ◽  
Oral Route ◽  
Study Entry ◽  
Prospective Randomized Study ◽  
Exit Site ◽  
Exit Site Infection ◽  
Significant Difference ◽  
Oral Group ◽  
Intraperitoneal Treatment

Objective To evaluate the potential superiority of either oral or intraperitoneal treatment of catheter tunnel infections (TI), using clindamycin as a first-Iine antibiotic and ultrasound as a diagnostic tool. Design This was a prospective, randomized study in continuous ambulatory peritoneal dialysis patients. From August 1993 until August 1995, 16 clinically and ultrasound-proven episodes of TI were randomly assigned to either an oral or an intraperitoneal (IP) treatment (100 patients, 1414 patient-months). Main criteria for TI diagnosis were purulent drainage from the exit site and/or a positive ultrasound (pericatheter fluid collection of at least 2 mm, 7.5 MHz transducer). Initially, clindamycin (20 mg/kg body weight) was given via the oral (three times per day) or intraperitoneal route (four times per day). In the case of incompatibility or resistance to clindamycin, either oxacillin orciprofloxacin were used orally or IP. Results Based on ultrasound criteria, the mean time until a ≥50% reduction of pericatheter abscess diameter was 26 days (median) (range: 8 28 days) in the oral, and 15 days (8 27 days) in the IP group (p ≤ 0.05). Showing no significant difference of pericatheter fluid at study entry with 4 mm (median) (range: 2 -6 mm) in the oral group and 4 mm (2 -4 mm) in the IP group, the IP treatment resulted in a decrease to 0 mm (0 2 mm) after 28 days (p < 0.05), while the diameter was still 2 mm (0 10 mm) (NS) in the oral group. Disappearance of exit-site infection was also somewhat earlier in the intraperitoneal group (51 vs 15 days, NS). Catheter removal had to be done once in the IP group and twice in the oral group within 6 months after study entry. Conclusions The results give evidence for greater efficacy of the IP application of clindamycin as a first -Iine antibiotic compared to the oral route for the treatment of tunnel infections.

Simple Decompression versus Anterior Submuscular Transposition of the Ulnar Nerve in Severe Cubital Tunnel Syndrome: A Prospective Randomized Study

Neurosurgery ◽  
2005 ◽  
Vol 56 (1) ◽  
pp. 108-117 ◽  
Author(s):  
Olga Gervasio ◽  
Giuseppe Gambardella ◽  
Claudio Zaccone ◽  
Damiano Branca
Keyword(s):  
Ulnar Nerve ◽  
Randomized Study ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Prospective Randomized Study ◽  
Significant Difference ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B ◽  
Simple Decompression

Abstract OBJECTIVE: The authors report the results of a clinical series of selected patients with severe cubital tunnel syndrome. The degree of ulnar nerve compression was evaluated by use of a grading system that includes measurements of motor and sensitive function. The submuscular transposition with flexor-pronator mass Z lengthening was compared with simple decompression through a prospective randomized study. METHODS: From February 1998 to June 2003, 70 patients with severe cubital tunnel syndrome were included in this study: 35 patients were submitted to simple decompression (Group A), and 35 patients were treated by anterior deep submuscular transposition (Group B). The preoperative status was determined by use of Dellon's classification. The selected patients had Dellon's Grade 3 (severe syndrome). The mean follow-up period after surgery was 47 months for Group A and 46.94 months for Group B. RESULTS: Postoperative clinical and electrophysiological outcomes were assessed 6 months after surgery in all 70 patients. According to the Bishop scoring system, 19 patients (54.3%) of Group A were clinically graded as excellent, 9 (25.7%) were graded as good, and 7 (20%) were graded as fair; in Group B, 18 patients (51.43%) were graded as excellent, 11 (31.43%) as good, and 6 (17.14%) as fair. Neither severe complications nor recurrences were observed in the two groups. CONCLUSION: No statistically significant difference was found between the two groups with regard to the clinical or the electrophysiological outcome. The surgical treatment gains in Group A and B were 80% and 82.86%, respectively (good to excellent results).

A study of haemostasis following tonsillectomy comparing ligatures with diathermy

1993 ◽  
Vol 107 (8) ◽  
pp. 711-715 ◽  
Author(s):  
M. G. Watson ◽  
P. J. D. Dawes ◽  
P. R. Samuel ◽  
H. F. Marshall ◽  
C. Rayappa ◽  
...  
Keyword(s):  
English Language ◽  
Randomized Study ◽  
Operating Time ◽  
Convincing Evidence ◽  
Prospective Randomized Study ◽  
Day Case ◽  
English Language Literature ◽  
Significant Difference ◽  
Language Literature

AbstarctThe use of diathermy to achieve haemostasis after tonsillectomy remains controversial. We have reviewed the English language literature, and found no convincing evidence that diathermy is any more likely to cause post-operative haemorrhage than the use of ligatures. The results of a prospective, randomized study of 1036 consecutive tonsillectomies are presented. No significant difference was found in post-operative haemorrhage rates when either diathermy or ligatures were used. Diathermy was found to reduce operating time compared to ligatures. The possibilities for day-case tonsillectomy are discussed.

Sign in / Sign up

Export Citation Format

Share Document