Nasal Steroids Use in the Prevention of Symptomatizing Adenoid Regrowth after Adenoidectomy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Waleed F Ezzat ◽  
Tamer A. Abo Elczz ◽  
Ahmed M Marouf ◽  
Eman M Ahmed
Keyword(s):  
Treatment Duration ◽  
Controlled Clinical Trial ◽  
Adenoid Hypertrophy ◽  
X Rays ◽  
Nasal Symptoms ◽  
Group I ◽  
Significant Difference ◽  
Nasal Steroids ◽  
Intranasal Steroids ◽  
Metered Dose

Abstract Background Regrowth of the adenoids is a well-recognized entity. Intranasal steroids for children with adenoid vegetation can provide an alternative to revision surgery. Objective To assess the ol' using nasal steroids to prevent recurrence of adenoid hypertrophy and related symptoms after adenoidectomy. Methods Controlled clinical trial. One hundred patients after adenoidectomy were divided randomly into 2 groups. Group I were patients performing surgery on odd days of the month received postoperative intranasal steroid [fluticasone propionate (50 mcg/metered dose per nostril per day)] and Group Il were patients performing surgery on even days of the month received intranasal saline spray starting at postoperative week 2 after wound healing. Both medications will be adninistrated for 8 weeks postoperatively. Patients will be followed up for minimum of 6 months by using modified SNOT Score to suit children in reporting the degree of the symptoms and i!' needed nasopharyngeal lateral X-rays. Results Highly significant difference between both groups after 6 months postoperatively. Conclusion The use of intranasal steroids may obtain successful results in children to prevent adenoid regrowth and recurrence of related nasal symptoms after adenoidectomy. The most appropriate drug, the most efficient dose, and optimal treatment duration need to be investigated and determined.

scholarly journals Role of Intranasal Steroid in the Prevention of Recurrent Nasal Symptoms after Adenoidectomy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Tamer S. Sobhy
Keyword(s):  
Nasal Obstruction ◽  
Saline Group ◽  
Controlled Study ◽  
Nasal Discharge ◽  
X Rays ◽  
Group I ◽  
Significant Difference ◽  
Intranasal Steroids ◽  
Group 2

Background. Intranasal steroid provides an efficient nonsurgical alternative to adenoidectomy for theimprovement of adenoid nasal obstruction.Objective. To demonstrate the role of intranasal steroid in the prevention of adenoid regrowth after adenoidectomy.Methods. Prospective randomized controlled study. Two hundred children after adenoidectomy were divided into 2 groups. Group I received postoperative intranasal steroid and group II received postoperative intranasal saline spray. Both medications were administered for 12 weeks postoperatively. Patients were followed up for 1 year. Followup was done using the nasopharyngeal lateral X-rays, reporting the degree of the symptoms.Results. Significant difference between both groups after 6 months and after 1 year. The intranasal steroid group had significantly lower score after 6 months and after 1 year as regards nasal obstruction, nasal discharge, and snoring than the intranasal saline group. 2 weeks postoperatively, there was no difference between both groups as regards nasal obstruction, discharge, or snoring. As regards lateral radiographs, there was statistically significant difference between both groups 1 year but not 6 months postoperatively.Conclusion. Factors influencing the outcome of intranasal steroids therapy in the prevention of adenoid regrowth have not been identified. However, this treatment may obtain successful results in children to avoid readenoidectomy.

scholarly journals Regenerative Therapy Modality for Treatment of True Combined Endodontic-Periodontal Lesions: A Randomized Controlled Clinical Trial

2021 ◽  
Vol 18 (12) ◽  
pp. 6220
Author(s):  
Reham AlJasser ◽  
Sundus Bukhary ◽  
Mohammed AlSarhan ◽  
Dalal Alotaibi ◽  
Saleh AlOraini ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Endodontic Treatment ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Bony Defect ◽  
Keratinized Tissue ◽  
Group I ◽  
Significant Difference ◽  
Grafting Procedure

The aim of this in-vivo study was to evaluate/compare the clinical periodontal parameters in patients with true combined endo-perio lesions (EPL), treated with gutta-percha (GP) and mineral trioxide (MTA) as an obturation material alone and with addition of bone grafting in such lesions. 120 Saudi patients (mean age = 41yrs) diagnosed with true combined EPL participated in this study. Group I (control group, n = 30) was treated with conventional endodontic treatment using GP for obturation. Group II (n = 30) was treated with conventional endodontic treatment using MTA for obturation. Group III (n = 30) was treated with conventional endodontic treatment using GP for obturation + grafting procedure to fill the bony defect. Group IV (n = 30) was treated with conventional endodontic treatment using MTA for obturation + grafting procedure to fill the bony defect. Clinical parameters (Pocket depth (PD); Clinical attachment loss (CAL); keratinized tissue width (KTW); gingival phenotype (G.Ph.) and Cone Beam Computed Tomography Periapical Index (CBCTPAI)) were recorded and compared at baseline, 3, 6, 12 months’ interval. For the groups III and IV, CBCTPAI showed significant difference (p < 0.0001) with the other groups at 6 months and 1-year interval. The group with MTA + bone graft showed 76% and 90% patients with 0 score at 6 months and 1-year follow-up, respectively. Comparison of mean values of PD among study groups at 3 months, 6 months and 1 year showed significant difference at 3 months, whereas the mean PD values of subjects in GP + bone graft showed significantly higher PD values than other 3 groups (p = 0.025). Use of GP and MTA for root canal obturation along with periodontal therapy and bone augmentation helps in resolving complex endo-perio lesions. Bone grafting in addition to obturation with MTA was found to be the best treatment strategy in management of EPL cases and is recommended for clinicians who are treating EPL patients.

A Prospective Comparison of 3 Hamstring ACL Fixation Devices - Rigidfix, BioScrew and Intrafix - Randomized Into 4 Groups with a Minimum Follow-Up of 5 Years.

2021 ◽  
Author(s):  
Leena Metso ◽  
Ville Bister ◽  
Arsi Harilainen ◽  
Jerker Sandelin
Keyword(s):  
Cruciate Ligament ◽  
Interference Screw ◽  
Controlled Clinical Trial ◽  
Level Of Evidence ◽  
Tibial Fixation ◽  
Fixation Group ◽  
Prospective Comparison ◽  
Group I ◽  
Significant Difference

Abstract Background: This is a five years follow-up report of some of the new devices for graft fixation. A two years follow-up data was published previously. As there were no statistically or clinically relevant differences in the results two years postoperatively, we hypothesize that after five years of follow-up there is no difference in the outcome after either cross-pin or absorbable interference screw fixation in ACL (anterior cruciate ligament) reconstruction with hamstring tendon autografts.Methods: 120 patients were randomized into four different groups (30 each) for ACL reconstruction with hamstring tendons: group I femoral Rigidfix cross-pin and Intrafix tibial extension sheath with a tapered expansion screw; group II Rigidfix femoral and BioScrew interference screw tibial fixation; group III BioScrew femoral and Intrafix tibial fixation; group IV BioScrew fixation into both tunnels. The evaluation methods were clinical examination, knee scores, and instrumented laxity measurements. Results: In this 5 years follow-up there were 102/120 (85%) patients available, but only 77 (64,2%) attended the clinical examinations. No significant difference between the groups in the clinical results was detected. There was a significant difference in additional procedures between the 2 and 5 years follow-up, group I had six additional procedures between the 2 and 5 years follow-up (P=.041). Conclusion: There was a statistically significant difference in the additional procedures, most in group I (six). None of these procedures found problems with the ACL graft. Other statistically or clinically significant differences in the 5 years follow-up results were not found. Study design: Randomized controlled clinical trial; Level of evidence, 1.Trial registration: ISRCTN registry with study ID ISRCTN34011837. Retrospectively registered 17.4.2020.

Maxillary Protraction Therapy in Class III Patients With and Without Cleft Lip and Palate: An Interim Report of a Prospective Comparative Study

2020 ◽  
pp. 105566562095405
Author(s):  
Yifan Lin ◽  
Zhen Fu ◽  
Runzhi Guo ◽  
Lian Ma ◽  
Weiran Li
Keyword(s):  
Treatment Duration ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Controlled Clinical Trial ◽  
Class Iii ◽  
Lower Incisor ◽  
Maxillary Protraction ◽  
Average Treatment ◽  
Significant Difference ◽  
Before And After

Objective: To investigate and compare the effects of maxillary protraction therapy on Class III patients with unilateral cleft lip and palate (UCLP) and Class III patients with noncleft. Design: Prospective controlled clinical trial. Patients: Twenty-six Class III patients with UCLP (mean age: 10.32 ± 1.29 years) and 26 Class III patients with noncleft (mean age: 9.82 ± 1.03 years) were included and treated with maxillary protraction therapy. Interventions: Maxillary protraction therapy was performed with an intraoral Hyrax appliance and extraoral facemask. Cone beam computed tomography scans were taken before and after treatment. Pretreatment skeletal and dental characteristics and treatment changes were analyzed and compared. Results: The average treatment duration was 18.44 ± 4.16 months in the UCLP group, which was substantially longer than the 12.46 ± 4.03-month average treatment duration in the noncleft group ( P < .001). No significant difference was found in the maxillary changes (length, advancement of point A, and SNA angle) and improvement of intermaxillary relationship (ANB angle) between the 2 groups. The UCLP group had 1.40° more mandibular clockwise rotation ( P = .034). Regarding dental changes, the UCLP group had more upper incisor proclination ( P = .006) and less lower incisor retroclination ( P = .023). Conclusions: Approximately extended maxillary protraction therapy in patients with UCLP could be as effective as in patients with noncleft. Further study is required to follow patients until completion of growth to elucidate the long-term stability of the treatment.

scholarly journals Treatment of Peri-implantitis—Electrolytic Cleaning Versus Mechanical and Electrolytic Cleaning—A Randomized Controlled Clinical Trial—Six-Month Results

2019 ◽  
Vol 8 (11) ◽  
pp. 1909 ◽  
Author(s):  
Schlee ◽  
Rathe ◽  
Brodbeck ◽  
Ratka ◽  
Weigl ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Autogenous Bone ◽  
Controlled Clinical Trial ◽  
X Rays ◽  
Natural Bone Mineral ◽  
Significant Difference ◽  
Bone Gain ◽  
Regeneration Of Bone ◽  
Defect Morphology ◽  
Complete Regeneration

Objectives: The present randomized clinical trial assesses the six-month outcomes following surgical regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and electrolytic method (PEC). Materials and Methods: 24 patients with 24 implants suffering from peri-implantitis with any type of bone defect were randomly treated by EC or PEC. Bone defects were augmented with a mixture of natural bone mineral and autogenous bone and left for submerged healing. The distance from implant shoulder to bone was assessed at six defined points at baseline (T0) and after six months at uncovering surgery (T1) by periodontal probe and standardized x-rays. Results: One implant had to be removed at T1 because of reinfection and other obstacles. None of the other implants showed signs of inflammation. Bone gain was 2.71 ± 1.70 mm for EC and 2.81 ± 2.15 mm for PEC. No statistically significant difference between EC and PEC was detected. Significant clinical bone fill was observed for all 24 implants. Complete regeneration of bone was achieved in 12 implants. Defect morphology impacted the amount of regeneration. Conclusion: EC needs no further mechanical cleaning by powder spray. Complete re-osseointegration in peri-implantitis cases is possible.

The Efficacy of Turbinate Surgery for the Relief of Nasal Obstruction

1993 ◽  
Vol 7 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Charles P. Kimmelman ◽  
Robert D. Jablonski
Keyword(s):  
Nasal Obstruction ◽  
Nasal Septum ◽  
Subjective Perception ◽  
Nasal Airway ◽  
X Rays ◽  
Deviated Nasal Septum ◽  
Group Iii ◽  
Group I ◽  
Significant Difference

To study the role of turbinate surgery 60 consecutive patients complaining of nasal airway obstruction were evaluated. All patients had a deviated nasal septum and turbinate hypertrophy and had received medical therapy of at least 8 weeks duration. Plain x-rays or computerized tomography scans of the paranasal sinuses excluded sinusitis. Each patient was randomized into one of three groups. Group I underwent septoplasty for correction of the deviated nasal septum. Group II underwent bilateral anterior turbinectomy, and Group III underwent both septoplasty and bilateral anterior turbinectomy. All patients were evaluated preoperatively and on at least one postoperative visit for their subjective perception of improvement or worsening of nasal obstruction. Likewise, all patients underwent anterior rhinomanometry preoperatively and postoperatively. The data revealed no significant difference in reduction of the nasal airway resistance as measured by rhinomanometry for Groups I and II. The patients’ own perceptions of improvement, however, were augmented when turbinectomy was performed (Groups II and III). We conclude that anterior turbinectomy is a useful operation in alleviating the sense of nasal obstruction in patients with hypertrophied inferior turbinates.

Efficacy of alternate day dosing of atorvastatin

Open Medicine ◽  
2008 ◽  
Vol 3 (2) ◽  
pp. 163-166 ◽  
Author(s):  
Kamran Aghasadeghi ◽  
Didar Zare
Keyword(s):  
Creatine Kinase ◽  
Liver Function ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Liver Function Tests ◽  
Controlled Clinical Trial ◽  
Duration Of Action ◽  
Function Tests ◽  
Group I ◽  
Significant Difference

AbstractAtorvastatin is a synthetic inhibitor of 3-hydroxy 3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor. It has a longer half life and longer duration of action than that of all other available HMG-CoA inhibitors. We evaluated the efficacy of alternate-day dosing of atorvastatin in comparison with the standard one-daily dose on total cholesterol, low and High-density lipoprotein (LDL and HDL) and triglycerides. This study is a randomized, blinded, and controlled clinical trial. Sixty-six patients with LDL cholesterol of more than 100 mg/dl were enrolled. Baseline fasting lipid profile (total cholesterol, LDL, HDL and triglyceride), liver function tests and creatine kinase were drawn. Patients were randomized to three atorvastatin dose groups. Group I received 10 mg of atorvastatin every day, group II received 20 mg of atorvastatin every day, and group III received 20 mg every other day. After 6 weeks of treatment with atorvastatin, fasting lipid profiles, liver function tests and creatine kinase concentrations were re-taken. Compliance to treatment was assessed at each visit. Of the sixty-six patients enrolled, sixty completed the study. All three regimens significantly reduced total cholesterol and LDL compared to baseline. No statistically significant difference existed between the three groups in regards to total or a percentage decrease in total cholesterol and LDL cholesterol at 6 weeks compared to baseline. All regimens were well tolerated and none of the patients showed significant elevation of liver enzyme or creatine kinase during the course of the study. In conclusions the alternate-day dosing of atorvastatin is an efficacious and safe alternate to daily dosing and yet inexpensive.

scholarly journals Role of Intranasal Steroid in the Prevention of Recurrent Nasal Symptoms after Adenoidectomy

2013 ◽  
Vol 6 (2) ◽  
pp. 80-83
Author(s):  
Tamer S Sobhy
Keyword(s):  
Nasal Obstruction ◽  
Respiratory Infections ◽  
Upper Respiratory Infections ◽  
Nasal Symptoms ◽  
Obstructive Sleep ◽  
Nasal Steroids ◽  
Intranasal Steroids ◽  
Upper Respiratory ◽  
Clinically Significant

ABSTRACT Nasal obstruction is one of the main symptoms of adenoid hypertrophy, as they are also presented with chronic rhinorrhea, snoring, hyponasal speech and obstructive sleep disorder. Adenoidectomy can reduce both nasal obstructions and upper respiratory infections. Some patients display clinically significant persistent nasal symptoms even after surgery. Symptoms, such as nasal obstruction or recurrent upper respiratory infections, persist in 19 to 26% of patients. Factors influencing the outcome of intranasal steroids therapy have not been identified. The treatment with nasal steroids may obtain successful results in children to avoid surgery for adenoid recurrence. How to cite this article Sobhy TS. Role of Intranasal Steroid in the Prevention of Recurrent Nasal Symptoms after Adenoidectomy. Clin Rhinol An Int J 2013;6(2):80-83.

scholarly journals SYNDESMOSIS FIXATION IN BIMALLEOLAR WEBER C ANKLE FRACTURES;

2008 ◽  
Vol 15 (01) ◽  
pp. 49-53
Author(s):  
SAJID EJAZ RAO ◽  
SOHAIL MUZAMMIL ◽  
ABDUL HAFEEZ KHAN
Keyword(s):  
Objective Assessment ◽  
Military Hospital ◽  
Controlled Clinical Trial ◽  
P Value ◽  
Ankle Motion ◽  
Group I ◽  
Loss Of Reduction ◽  
Significant Difference ◽  
The Difference ◽  
Randomised Controlled

Objective: To study the influence of size of screws for syndesmosis fixationin bimalleolar Weber C ankle fracture. Design: A prospective randomised controlled clinical trial. Place and Durationof Study: Orthopaedic Department at Combined Military Hospital Malir. Period: From October 2002 to September2005. Patients and Methods: 17 consecutive young active patients with Weber type C bimalleolar ankle fractureshaving syndesmotic injuries treated with open reduction and internal fixation were randomly allocated to two groups.1 2 In group I (n = 9) 3.5mm small fragment and in group II (n =8) 4.5mm large fragment AO cortical screws were usedfor syndesmotic fixation. All patients were followed up for 12 months. Fracture healing or loss of reduction ofsyndesmosis was taken as the study end point. Hardware loosening or breakage and need for hardware removal werethe outcome measures. Subjective and objective assessment with Olerud-Molander Ankle (OMA) scores , range of 1motion and radiographic criteria was done. Results: Loss of reduction was not seen in any patient in both groups.Comparing two groups using paired sample t-test, there was no difference in screw loosening and breakage (p values> 0.05). We did not find a statistically significant difference between range of motion (p = 1.08) and OMA score (p-value= 0.805). Conclusion: Size of the syndesmotic screw does not appear to influence healing of syndesmotic injury.Screw loosening, which can result in reduced range of ankle motion postoperatively was more common in smallerscrew group though the difference was not significant.

scholarly journals Sinus Membrane Elevation with Heterologous Cortical Lamina: A Randomized Study of a New Surgical Technique for Maxillary Sinus Floor Augmentation without Bone Graft

Materials ◽  
2018 ◽  
Vol 11 (8) ◽  
pp. 1457 ◽  
Author(s):  
Antonio Scarano ◽  
Pablo de Oliveira ◽  
Tonino Traini ◽  
Felice Lorusso
Keyword(s):  
Maxillary Sinus ◽  
Randomized Study ◽  
Collagen Membrane ◽  
Controlled Clinical Trial ◽  
Graft Material ◽  
Sinus Augmentation ◽  
Group I ◽  
Significant Difference ◽  
Time Required ◽  
Window Approach

Background: The aim of this randomized controlled clinical trial was to compare the efficacy of two different techniques for maxillary sinus augmentation using a lateral window approach: Heterologous cortical lamina without any grafting material versus 100% collagenated granular collagen porcine bone. Methods: Twenty-three healthy patients with not relevant past medical history (14 women and 9 men, non-smokers, mean age 52 years, range 48–65 years) were included. In Group I, the sinus was filled with collagen porcine bone (Geno-os, OsteoBiol, Turin, Italy) and a collagen membrane (Evolution, OsteoBiol, Turin, Italy) was used to close the lateral window of the sinus. In Group II, the sinus was treated with heterologous cortical lamina only (Lamina, OsteoBiol, Turin, Italy). Results: There was a statistically significant difference in the surgical time required to complete the augmentation procedures: 18.3 ± 2.1 min for lamina treated sites versus 12.5 ± 3.1 min for porcine bone treated sites. In Group I, the mean volume of the graft was 3101 ± 321 mm3 in the immediate postoperative examination (5–7 days), while after a six-month healing period it was 2716.7 ± 432 mm3. Conclusion: This study demonstrates that the use of heterologous cortical lamina is a valid technique for the mechanical support of sinus membranes resulting in only bone tissue formation and not mixed with the graft. The graft material was biocompatible and not completely resorbed after six months, although the remains were integrated into the bone.

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