Does the Suggested Lightwand Bent Length Fit Every Patient?

2003 ◽  
Vol 98 (5) ◽  
pp. 1070-1076 ◽  
Author(s):  
Tsai-Hsin Chen ◽  
Shen-Kou Tsai ◽  
Chen-Jung Lin ◽  
Cheng-Wei Lu ◽  
Tsung-Po Tsai ◽  
...  
Keyword(s):  
Success Rate ◽  
Demographic Data ◽  
Search Time ◽  
Daily Practice ◽  
Successful Intubation ◽  
Mandibular Angle ◽  
Upper Limit ◽  
Length Range ◽  
Group A ◽  
Group B

Background To date, no study has explored the effect of bent length on lightwand intubation. For successful intubation in daily practice, the authors found that bent length should be approximated to the patient's thyroid prominence-to-mandibular angle distance (TMD), but some patients have a TMD much shorter than the suggested bent length range. The purposes of this study were to understand TMD distribution in adults and to test the influence of bent length on lightwand intubation. Methods The TMD, airway, and demographic data of 379 patients were collected. To test the bent length influence, patients were enrolled in group A (158 patients, TMD </= 5.5 cm) and group B (131 patients, TMD > 5.5 cm) and were intubated randomly using the lower (6.5 cm) and upper (8.5 cm) limits of the suggested range. Success rate and lightwand search time were compared. Results In group A, the success rate was 98.8% with 6.5-cm bent length and 78.2% with 8.5-cm bent length (P < 0.05). Search times were 5.7 +/- 2.90 and 8.9 +/- 5.80 s with 6.5- and 8.5-cm bent length, respectively (P < 0.01). In group B, there was no statistical difference in success rate and search time between 6.5- and 8.5-cm bent length. Conclusion The suggested range was suitable for patients in group B (TMD > 5.5 cm). However, in group A (</=5.5 cm), the large discrepancy between the upper limit of the suggested range and this TMD caused difficulty in lightwand intubation. A 6.5-cm bent length is more suitable than an 8.5-cm bent length in these patients.

scholarly journals Increased Severity of Complications After Therapeutic ERCP in Geriatric Patients With Chronic Pancreatitis: An Observational Study

2021 ◽  
Author(s):  
Ji-Yao Guo ◽  
Wen-Bin Zou ◽  
Jia-Hui Zhu ◽  
Nan Ru ◽  
Jun Pan ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Observational Study ◽  
Success Rate ◽  
Geriatric Patients ◽  
Demographic Data ◽  
Female Gender ◽  
Control Group ◽  
Group A ◽  
Therapeutic Ercp ◽  
Group B

Abstract Background: Studies of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in geriatric patients have mainly examined patients with biliary diseases, rather than chronic pancreatitis (CP). This study aimed to evaluate the safety and success rate of therapeutic ERCP in geriatric patients with CP. Methods: This was an observational study from prospectively collected data. The medical records of patients with CP aged over 65 years (Group A) were collected in a tertiary hospital from January 2013 to December 2018. Sex-matched CP patients under 65 years (Group B) were randomly selected into the control group (matching ratio = 1:2). Collected data included demographic data, endoscopic findings, interventions, success, and complications. The success rate and the complication rate of therapeutic ERCP in two groups were compared with chi-square test. The risk factors for post-ERCP pancreatitis were investigated by univariate and multivariate analysis.Results: A total of 268 ERCPs were performed in 179 patients of Group A and 612 ERCPs in 358 patients of Group B. The success rate of ERCP in Group A was similar to that of Group B (92.16% vs 92.32%; P=0.936). The overall incidence of post-ERCP complications was 7.09% (19/268) and 5.72% (35/612) in Group A and B, respectively (P=0.436). However, geriatric patients had a significantly increased occurrence of moderate to severe complications (2.61% vs 0.16%; P=0.002). Female gender (OR=3.40; 95% CI, 1.02-11.31; P=0.046), pancreas divisum (OR=7.15; 95% CI, 1.01-50.62; P=0.049), dorsal pancreatogram (OR=7.40; 95% CI, 1.63-33.64; P=0.010), and lithotripsy (OR=0.15; 95% CI, 0.03-0.70; P=0.016) were significantly associated with risk of post-ERCP pancreatitis in geriatric patients.Conclusions: Therapeutic ERCP is safe and feasible in elderly patients with CP. However, occurrence of moderate to severe complications after ERCP increased in geriatric patients.Trial registration: retrospectively registered.

Comparison of the effects of Dexamethasone and Ondansetron on the Reduction of Postoperative Nausea and Vomiting following Cesarean Section under Spinal Anesthesia

2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Demographic Data ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Group A ◽  
Group B

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.

Perforator-Based Flap Reconstruction after Melanoma Resection: Evaluation of Oncological, Aesthetic, and Functional Outcomes

2021 ◽  
Author(s):  
Beniamino Brunetti ◽  
Rosa Salzillo ◽  
Stefania Tenna ◽  
Bruno Brunetti ◽  
Mario Alessandri Bonetti ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Locoregional Recurrence ◽  
Demographic Data ◽  
Exact Test ◽  
Significant Difference ◽  
Chi Squared ◽  
Group A ◽  
The Aesthetic ◽  
One Year ◽  
Group B

Abstract Background Evidence in literature about the best reconstructive approach after melanoma resection is controversial, with some authors advocating that tissue rearrangement flap techniques might hinder the early detection of local relapses. The aim of the present study is to evaluate oncological, aesthetic, and functional outcomes following melanoma reconstruction using pedicled perforator-based flaps. Methods The authors reviewed all patients affected by melanoma treated during a 6-year period. Demographic data, tumor characteristics, and operative variables were evaluated. Locoregional recurrence was assessed with clinical and radiological follow-up. One-year postoperatively patients rated on a 5-point Likert scale the aesthetic and functional outcomes of the procedure. Three blind observers examined preoperative and 1-year postoperative photographs and rated the aesthetic outcome of the reconstructive procedure. Results One-hundred sixty-five patients were treated with wide excision and delayed reconstruction, including pedicled perforator-based flaps in 70 patients (group A) and primary closure in 95 patients (group B). Mean Breslow thickness was 2.972 and 2.189 mm in group A and B, respectively. There was no statistically significant difference in locoregional recurrence (chi-squared test, p = 0.8333; Fisher's exact test, p > 0.9999) between the two groups. Group A reported a higher satisfaction with both the aesthetic (mean rating 4.390 in group A and 4.094 in group B) and functional (mean rating 4.732 in group A and 4.170 in group B) outcomes of the procedure, the latter being statistically significant (p = 0.0006). Conclusion This series suggests that pedicled perforator-based flaps provide optimal aesthetic and functional outcomes in melanoma reconstruction without impairing the locoregional control of the disease.

scholarly journals STATISTICAL ANALYSIS OF THE CASUISTRY OF A SAMPLE OF METASTATIC DISEASE IN THE SPINE

2017 ◽  
Vol 16 (1) ◽  
pp. 64-66
Author(s):  
DAVID MARCELO DUARTE ◽  
RAPHAEL DE REZENDE PRATALI ◽  
ANDRÉ LUIZ PELLACANI FRANÇA ◽  
CARLOS EDUARDO ALGAVES SOARES OLIVEIRA
Keyword(s):  
Life Expectancy ◽  
Demographic Data ◽  
Spinal Metastases ◽  
Karnofsky Performance Scale ◽  
Agreement Rate ◽  
Duration Of Symptoms ◽  
Tokuhashi Score ◽  
Group A ◽  
Group B ◽  
Performance Scale

ABSTRACT Objective: The objective of this study is to present demographic data on the occurrence of spinal metastases in the service where the work was performed and to investigate the reliability of the modified Tokuhashi score in the decision making in patients with metastatic spinal cancer. Methods: We conducted a review of medical records of all cases of vertebral bone metastasis, confirmed by anatomopathological examination, from January 2009 to June 2012. Data review included demographic details, origin of the primary cancer, duration of symptoms, localization of metastases, Karnofsky performance scale and survival based on modified Tokuhashi score. We divided patients into three groups. Group A included patients with life expectancy of less than six months, group B included patients with life expectancy of between six and 12 months, and group C included patients with a life expectancy of more than 12 months. We compared the calculated survival with the current survival in the three groups with all patients followed-up to a minimum of 1 year or until death. Results: The predict survival in group A was 63.6% according to the modified Tokuhashi score, albeit group B had only 30% agreement. Conclusions: For patients in group A, the agreement rate of patient survival was better (63.4%) than that observed in patients in group B (30%). Our sample had no patient classified as group C.

scholarly journals Time out: should vitamin D dosing be based on patient's body mass index (BMI): a prospective controlled study

2021 ◽  
Vol 10 ◽  
Author(s):  
Mir Sadat-Ali ◽  
Khalid W. AlTabash ◽  
Haifa A. Al-Turki ◽  
Sulaiman A. AlMousa ◽  
Hasan N. AlSayed
Keyword(s):  
Vitamin D ◽  
Vitamin D3 ◽  
Standard Dose ◽  
Demographic Data ◽  
Controlled Study ◽  
Daily Dose ◽  
Calcium Phosphorus ◽  
Group A ◽  
Pre Treatment ◽  
Group B

Abstract The recommended daily dose of vitamin D is 2000 IU was found to be insufficient in many patients. The objective of the present study is to find whether the daily dose of vitamin D should be based on BMI. Two hundred and thirty patients with an established vitamin D deficiency (serum level of 25 Hydroxy vitamin D3 (25OHD3) of ≤20 ng/ml) and patients with BMI ≥30 kg/m2 were included in the study. Demographic data, comorbidities and BMI were recorded. Pre-treatment and post-treatment serum 25OHD3, calcium, phosphorus and parathyroid hormone (PTH) were tested at 0-, 3- and 6-month periods. Patients were treated with a standard dose of 50 000 IU of vitamin D weekly and 600/1200 mg of calcium a day. Once their level of 25OHD3 reached ≥30 ng/ml, patients were randomised into two groups. Group A received a standard recommended maintenance dose of 2000 IU daily and Group B patients received 125 IU/kg/m2 of vitamin D3. The data were entered in the database and analysed. The mean age of Group A was 50⋅74 ± 7⋅64 years compared to 52⋅32 ± 7⋅21 years in Group B. In both groups, pre-treatment vitamin D level was ≤15 ng/ml and increased to 34⋅6 ± 2⋅6 and 33⋅7 ± 2⋅4 ng/ml at the end of 3 months treatment with a dose 50 000 IU of vitamin D3 and calcium 600/1200 mg once a day for group A and group B, respectively. At 6 months, patients in Group A 25OHD3 level was 22⋅8 ± 3⋅80 and in Group B was 34⋅0 ± 1⋅85 ng/ml (P < 0⋅001). This preliminary study suggests that obese patients need higher dosage of vitamin D than the recommended dose. It is prudent that the dosage should be based on the BMI to maintain normal levels for a healthy musculoskeletal system.

scholarly journals Comparison of marsupialization under nasal endoscopy versus Lacrimal probing for treatment of congenital dacryocystoceles: a report of 40 cases

2019 ◽  
Author(s):  
Yanhui Cui ◽  
Peng Sun ◽  
Lixing Tang ◽  
Chengyue Zhang ◽  
Qian Wu ◽  
...  
Keyword(s):  
Success Rate ◽  
Reoperation Rate ◽  
Nasal Endoscopy ◽  
Efficacy And Safety ◽  
Group A ◽  
Group B

Abstract Introduction This study was performed to compare the efficacy of marsupialization under nasal endoscopy versus Lacrimal probing in the treatment of congenital dacryocystocele. Methods Forty neonates (43 eyes) diagnosed with congenital dacryocystoceles were divided into Group A (nasal endoscopic marsupialization) and Group B (Lacrimal probing). The patients were followed up for 1 year after surgery. The efficacy, incidence of complications, and reoperation rate were compared between the two groups. Results The male:female ratio was 25:15 patients (27:16 eyes). In Group A, the success rate was 100%, the incidence of complications was 5%, and the reoperation rate was 0%. In Group B, the success rate was 90%, the incidence of complications was 20%, and the reoperation rate was 30%. Conclusion Compared with Lacrimal probing, marsupialization under nasal endoscopy provides greater efficacy and safety for congenital dacryocystoceles.

scholarly journals Comparative study of endoscopic tympanoplasty and conventional tympanoplasty

2020 ◽  
Vol 6 (10) ◽  
pp. 1804
Author(s):  
Priyanka Aggarwal ◽  
Barjinder Singh Sohal ◽  
J. P. Goyal
Keyword(s):  
Success Rate ◽  
Cost Effective ◽  
Patient Comfort ◽  
Hearing Improvement ◽  
Post Operation ◽  
Group A ◽  
Group B ◽  
The Cost ◽  
Results Of Surgery ◽  
Endoscopic Tympanoplasty

<p><strong>Background:</strong> To compare the results of endoscopic tympanoplasty with that of conventional tympanoplasty and to evaluate and compare the graft uptake in both of these methods. The study was done to evaluate the improvement in hearing after tympanoplasty and the problems faced while doing the endoscope assisted tympanoplasty.</p><p><strong>Methods: </strong>Between July 2010 to June 2013, 50 patients underwent tympanoplasty, 25 were endoscope assisted (group A) and 25 were microscope assisted (group B). Results of surgery were compared at the end of three and six months post operation.</p><p><strong>Results: </strong>The success rate in terms of graft uptake rate was 88% with endoscope assisted tympanoplasty and 84% with other microscope assisted tympanoplasty. Overall success rate was 86.0%. Mean hearing improvement was (16.24±10.21 dB) and (14.28±7.10 dB) in group A and group B respectively.</p><p><strong>Conclusions: </strong>Tympanoplasty with its visualization of hidden corners, justifies tympanoplasty by using endoscope in selected cases with comparable improved results in the literature. Furthermore, the cost of the endoscope is much less (about 10%) in comparision to operating microscope, making it more cost effective in developing countries. However, the endoscope cannot be employed in every case as one hand is blocked. In terms of Patient comfort, the endoscope assisted outnumbers the benefits of other conventional methods.<strong></strong></p>

scholarly journals Comparison of the Functional Success of Fat Myringoplasty and Perifascial Areolar Tympanoplasty in Transcanal Endoscopic Ear Surgery

2020 ◽  
pp. 014556132094726
Author(s):  
Chien-An Ko ◽  
Chao-Hui Yang ◽  
Ching-Nung Wu ◽  
Pingche Huang ◽  
Chung-Feng Hwang
Keyword(s):  
Success Rate ◽  
Subcutaneous Fat ◽  
Type I ◽  
Graft Material ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Group A ◽  
Graft Success ◽  
Group B ◽  
Tissue Grafts

Objectives: We compared the functional outcomes of fat myringoplasty and areolar tympanoplasty through a small postauricular incision in patients who underwent transcanal endoscopic ear surgery (TEES). Methods: The study included patients who underwent myringoplasty or type I tympanoplasty using TEES in our Department of Otolaryngology between April 2016 and May 2019. The patients were divided into 2 groups according to the type of graft material used, which was selected based on the available amount of subcutaneous fat and the surgeon’s experience. Results: In total, 63 patients received fat tissue grafts (group A) and 77 received areolar tissue grafts (group B). The median operative time was significantly longer in group B (132 minutes) than in group A (65 minutes); perforations were significantly larger in group B than in group A (61.0% vs 29.7% of the eardrum surface). The postoperative air conduction threshold, air–bone gap, and speech reception threshold values were significantly lower than the preoperative values in both groups. The graft success rate did not significantly differ between groups A (96.8%, 61/63) and B (96.1%, 74/77). In group A, the perforation was > 35% of the eardrum surface in 27.0% (17/63) of the patients; the graft success rate was 100% (17/17). In the remaining 46 patients (perforation > 35%), the graft success rate was 95.7% (44/46); this difference was not statistically significant. Conclusions: Transcanal endoscopic ear surgery increases the usefulness of fat myringoplasty for the repair of perforations > 35% of the eardrum surface. Postauricular fatty and areolar tissues are suitable for this simple and rapid technique, which yields excellent outcomes.

scholarly journals Comparison of early versus standard timing for silicone stent removal following External Dacrocystorhinostomy under local anaesthesia

2019 ◽  
Vol 11 (1) ◽  
pp. 24-28
Author(s):  
Ben Limbu ◽  
Hannah S Lyons ◽  
Mohan Krishna Shrestha ◽  
Geoffrey C Tabin ◽  
Rohit Saiju
Keyword(s):  
Success Rate ◽  
Financial Burden ◽  
Controlled Trial ◽  
Nasolacrimal Duct ◽  
Complication Rates ◽  
Tube Removal ◽  
Significant Difference ◽  
Silicone Stent ◽  
Group A ◽  
Group B

Introduction: The first line treatment for nasolacrimal duct obstruction (NLDO) is external dacrocystorhinostomy (DCR). Following DCR, patients are required to return to Tilganga Institute of Ophthalmology (TIO) six weeks postoperatively for the removal of a silicone stent. As the majority of patients travel large distances at significant cost to reach TIO, most often patients remain within Kathmandu during this six weeks interval. This places a large financial burden on patients. Methods: A randomized controlled trial was designed to compare patient outcomes after early (two weeks postoperatively) versus standard (six weeks postoperatively) removal of silicone stents. 50 selected patients were randomized into two equal groups. Results: At the time of publication, 31 patients (14 in group A and 17 in group B) had completed three months follow up. A success rate of 92.9% was noted in Group A and a success rate of 94.1% observed in group B. No significant difference was found between the two groups for success rate and rate of complications. Conclusion: Early tube removal post DCR appears to cause no significant difference in outcome or complication rates compared to standard tube removal.

scholarly journals A COMPARITIVE STUDY BETWEEN EPIDURAL BUTORPHANOL, NALBUPHINE AND FENTANYL FOR POSTOPERATIVE ANALGESIA IN LOWER ABDOMINAL SURGERIES

2017 ◽  
Vol 10 (5) ◽  
pp. 383
Author(s):  
Swarna Banerjee ◽  
Shaswat Kumar Pattnaik
Keyword(s):  
Side Effects ◽  
Demographic Data ◽  
Age Groups ◽  
Study Drug ◽  
Sensory Block ◽  
Lower Abdomen ◽  
Post Operative Pain ◽  
Catheter Group ◽  
Group A ◽  
Group B

Background: Achieving satisfactory post-operative analgesia with neuraxial administration of narcotics has been the subject of much research. The use of epidural opioids had become an increasingly popular technique for management of acute post-operative pain in recent times. This study evaluates post-operative analgesic benefits in patients administered epidural butorphanol, nalbuphine, and fentanyl as adjuvants with local anesthetics postoperatively for surgery under epidural anesthesia.Methods: A total of 75 patients belonging to age groups 18-60 years who were scheduled for surgeries of lower abdomen were randomly divided into groups of 25 each. Epidural technique was adopted for surgery of the lower abdomen for all patients with 0.5% bupivacaine. In the post-operative period, the study drug was given through epidural catheter. Group A received butorphanol 2 mg, Group B received fentanyl 100 μg, and Group C received nalbuphine 10 mg with 0.125% bupivacaine diluted to 10 ml in normal saline each. Onset, duration, quality of analgesia, hemodynamic changes, and side effects – such as sedation, pruritus, nausea, vomiting, respiratory depression, and urinary retention - were recorded and compared.Results: The demographic data were comparable in all three groups. The onset of sensory block was significantly earlier in Group B (fentanyl) than other two groups. Duration was significantly longer in Group A (butorphanol). No serious cardiorespiratory side effects were noted in any of groups.Conclusion: Fentanyl produces the faster onset of analgesia with adverse effects like pruritus. Butorphanol administered epidurally has the advantage of longer duration of analgesia than fentanyl or epidural nalbuphine with side effects such as nausea, vomiting, and sedation.Keywords: Epidural analgesia, Butorphanol, Fentanyl, Nalbuphine.

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