Ziv-aflibercept versus bevacizumab administration prior to diabetic vitrectomy: a randomised and controlled trial

2019 ◽  
pp. bjophthalmol-2018-313313
Author(s):  
Isaac Aleman ◽  
Javier Castillo Velazquez ◽  
Sloan W Rush ◽  
Ryan B Rush
Keyword(s):  
Postoperative Period ◽  
Controlled Trial ◽  
Intraoperative Complications ◽  
Secondary Outcome ◽  
Interval Group ◽  
Treatment Groups ◽  
Study Interval ◽  
Group A ◽  
Group B

PurposeTo compare the effectiveness of intravitreal ziv-aflibercept (IVZ) to intravitreal bevacizumab (IVB) administered preoperatively to patients undergoing pars plana vitrectomy (PPV) for severe manifestations of proliferative diabetic retinopathy (PDR).DesignRandomised clinical trial (RCT).MethodsTwo hundred and six patients with PDR-related complications requiring PPV were randomised into one of two treatment groups: Group A received IVZ (1.25 mg/0.05 mL) 1–10 days before PPV, while Group B received IVB (1.25 mg/0.05 mL) 1–10 days before PPV. The primary outcome was best-corrected visual acuity (BCVA) at 6 months follow-up. Secondary outcome measures were perioperative tractional retinal detachment (TRD) rates, surgical times, intraoperative and postoperative complications and incidence of unplanned PPV during the 6 month study interval.ResultsOne hundred and seventy three subjects underwent PPV and completed the 6-month follow-up interval. Group A subjects had better BCVA at 6 months (p=0.0035), shorter surgical times (p=0.0013) and were less likely to have a recurrence of vitreous haemorrhaging in the postoperative period (p=0.0101) when compared with subjects in Group B. There were no significant differences among the treatment groups with regards to baseline characteristics, perioperative TRD development, intraoperative complications and incidence of unplanned PPV during the 6 month study interval.ConclusionsThis RCT demonstrated better final visual outcomes, shorter operating times and less vitreous haemorrhage recurrences in the postoperative period when subjects received IVZ compared to IVB prior to PPV for the treatment of PDR-related complications.

scholarly journals Comparison of efficacy of needling and a combination of needling and platelet rich plasma in relieving pain and improving function in patients of tennis elbow: a prospective, randomized, double blinded, placebo controlled clinical trial

2021 ◽  
Vol 7 (2) ◽  
pp. 258
Author(s):  
Vikram Sharma ◽  
Vivek Chandak
Keyword(s):  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Lateral Epicondylitis ◽  
Secondary Outcome ◽  
Controlled Clinical Trial ◽  
Group A ◽  
Group B ◽  
Double Blinded

<p><strong>Background: </strong>Lateral epicondylitis is a common musculoskeletal disorder for which an effective treatment strategy remains unknown. Aim of the study was to examine whether a single injection of platelet-rich plasma (PRP) with needling is more effective than needling with placebo in reducing pain in adults with lateral epicondylitis. Study design used was randomized controlled trial.    </p><p><strong>Methods: </strong>A total of 66 patients with chronic lateral epicondylitis were randomized (1:1) to receive either a blinded injection of PRP (group A) or saline (placebo) group B. The primary end point was a change in pain using the VAS and patient-rated tennis elbow evaluation (PRTEE) questionnaire. The secondary outcome being improvement in function (PRTEE scores).<strong></strong></p><p><strong>Results: </strong>The VAS score and PRTEE score improved significantly in both the groups at all 3 follow-up examinations. Group A had significantly better results than the group B.</p><p><strong>Conclusions: </strong>PRP injection are safe and effective management strategy for lateral epicondylitis</p>

scholarly journals Oral Tranexamic Acid for the Treatment of Melasma

2014 ◽  
Vol 10 (4) ◽  
pp. 40-43 ◽  
Author(s):  
D Karn ◽  
S KC ◽  
A Amatya ◽  
EA Razouria ◽  
M Timalsina
Keyword(s):  
Tranexamic Acid ◽  
Controlled Trial ◽  
Severity Index ◽  
Sustained Improvement ◽  
Treatment Measures ◽  
Group A ◽  
Group B ◽  
Novel Concept ◽  
High Treatment

Background Melasma poses a great challenge as its treatment is unsatisfactory and recurrence is high. Treatment of melasma using tranexamic acid (oral, topical or intralesional) is a novel concept. Objective To compare the efficacy of oral tranexamic acid with routine topical therapies for the treatment of melasma. Methods It is a prospective, interventional, randomized controlled trial conducted among 260 melasma patients. Patients were divided into two groups consisting of 130 patients each. First group (Group A) was given routine treatment measures and oral Tranexamic Acid while second group (Group B) was treated only with routine topical measures. Capsule Tranexamic Acid was prescribed at a dose of 250 mg twice a day for three months and cases were followed for three months. Response was evaluated on the basis of Melasma Assessment Severity Index (MASI). Mean scores between the two groups were then compared. Results Statistically significant decrease in the mean Melasma Assessment Severity Index from baseline to 8 and 12 weeks was observed among group A patients (11.08±2.91 vs 8.95±2.08 at week 8 and vs. 7.84±2.44 at week 12; p<0.05 for both). While among group B patients the decrease in mean score was significant at 8 weeks and insignificant at 12 weeks follow up (11.60±3.40 vs 9.9±2.61 at 8 weeks and vs. 9.26±3 at 12 weeks; p<0.05 for former but p>0.05 for later). Conclusion Addition of oral tranexamic acid provides rapid and sustained improvement in the treatment of melasma. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10993 Kathmandu Univ Med J 2012;10(4):40-43

Radiofrequency ablation for markedly incompetent perforators versus compression therapy in the management of post-phelebtic venous ulcers: A randomized controlled trial

Vascular ◽  
2021 ◽  
pp. 170853812110100
Author(s):  
Mohamed Shukri Abdelgawad ◽  
Amr M El-Shafei ◽  
Hesham A Sharaf El-Din ◽  
Ehab M Saad ◽  
Tamer A Khafagy ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Radiofrequency Ablation ◽  
Controlled Trial ◽  
Compression Therapy ◽  
Randomized Controlled ◽  
Venous Ulcers ◽  
Group A ◽  
Group B ◽  
To Receive

Background Venus ulcers developed mainly due to reflux of incompetent venous valves in perforating veins. Patients and methods In this randomized controlled trial, 119 patients recruited over two years, with post-phelebtic venous leg ulcers, were randomly assigned into one of two groups: either to receive radiofrequency ablation of markedly incompetent perforators (Group A, n = 62 patients) or to receive conventional compression therapy (Group B, n = 57 patients). Follow-up duration required for ulcer healing continued for 24 months post randomization. Results Statistically significant shorter time to healing (ulcer complete healing or satisfactory clinical improvement) between both groups (56 patients, 90.3% of cases in Group A versus 44 patients 77.2% of cases in Group B) over the follow-up period of 24 months was attained ( p  = 0.001). Also, significantly different ulcer recurrence was recorded between both groups, 8 patients (12.9%) in Group A versus 19 patients (33.3%) in Group B ( p = 0.004). Conclusion In absence of deep venous obstruction, the monopolar radiofrequency ablation for incompetent perforators is a feasible and effective method that surpasses the traditional compression protocol for incompetent perforator-induced venous ulcers in terms of time required for healing even in the presence of unresolved deep venous valvular reflux.

scholarly journals Surgical versus Conservative Management of Granular Myringitis: A single-centre Randomized Control Trial

2019 ◽  
Vol 5 (1) ◽  
pp. 64-68
Author(s):  
Ali Imam Ahsan ◽  
Nasimul Jamal ◽  
Ashfaq Ahmad ◽  
Syed Farhan Ali ◽  
Momenul Haque
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Granulation Tissue ◽  
Randomized Control Trial ◽  
Simple Random Sampling ◽  
Secondary Outcome ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Treatment of granular myringitis (GM) is diverse with no definitive management. Objective: The aim of the present study was to see the effectiveness of different interventions for treating granular myringitis. Methodology: This was a single centred, parallel, randomized control trial. This study was done at the Specialized ENT Hospital of SAHIC, Dhaka from July 2010 to June 2012. Patients presenting with granular myringitis of 18 years of age or more with both sexes were included. All patients were divided into two groups by simple random sampling method of which patients of group A were treated by surgical treatment and that of group B were treated by medical treatment. Medical treatment was given in the form of topical ear drops and surgical treatment was performed by surgical debridement of granulation tissue followed by chemical cauterization. Repeated follow up was performed up to 6 months in both groups of treated patients. The primary outcome was the resolution of granulation tissue. During follow-up the secondary outcome variables were recurrence, perforation of the TM and any other complications or complain from the patients. Results: A total number of 60 patients were studied of which 30 patients were treated medically and 30 patients were treated surgically. The cure rate was higher in surgical treatment (80%) than conservative (16.7%) (p=0.011). The recurrence rate (17.24%) is also less in surgical group compared to medical treatment group (77.27%) (p=0.001). Conclusion: Surgical treatment is a more successful treatment modality for granular myringitis. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 64-68

Evaluation of the Efficacy of Ultrasound Therapy in the Treatment of Patients with Carpal Tunnel Syndrome

2019 ◽  
Vol 11 (1) ◽  
pp. 24-27
Author(s):  
Nadia Siddiquee ◽  
Farzana Akonjee Mishu ◽  
Monzur Ahmed ◽  
Shaila Sharmin Shahnewaz ◽  
Hashina Bilkish Banu ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Controlled Trial ◽  
Ultrasound Therapy ◽  
Symptom Severity Scale ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B ◽  
Wrist Splint

This randomized controlled trial was conducted in Department of Physical Medicine and Rehabilitation of Bangabandhu Sheikh Mujib Medical University, Dhaka during the period from March 2014 to August 2014 to evaluate the effect of ultrasound therapy (UST) on patients of carpal tunnel syndrome. Total 110 subjects were participated in this study and they were selected randomly divided in two groups by lottery. Group-A was treated with UST, Exercise, Wrist splint, non steroidal anti inflammatory drugs (NSAIDs) and group-B received Exercise, Wrist splint and NSAIDs. Treatment continued for a period of 6 weeks. Group-A were compared to group B by both Visual Analog Scale (VAS) and Levine Symptom severity scale(LSSS) after 3 weeks and 6weeks of treatment. The result showed mean VAS at pretreatment (W0) in group-A was 6.42 ±1.23 and in group-B was 6.17±0.74. Group-A was 1.82±0.43 and in group-B was 3.1±0.23 in their follow up after 3 weeks (W 3) In Group-A was 1.71(±0.52) and in group-B was 2.52(±0.49) at 2nd follow up (W6) after 6 weeks. Mean LSSSat pretreatment (W0),1st follow up after 3 weeks (W 3), 2nd follow up (W 6) after 6 weeksin group-A was 31.64±1.55, 14.32 ± 2.29 and 14.31 ±1.12 respectively,and in group-B was 31.3±0.74,18.51±0.92and 18.31 ± 0.42 respectively.This study revealed that continuous mode of US therapy with exercise, wrist splint, NSAIDs have better outcome in case of Carpal tunnel syndrome patients. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 24-27

scholarly journals Induction of Labor Using Misoprostol With or Without Mifepristone in Intrauterine Deat

2014 ◽  
Vol 52 (194) ◽  
pp. 785-790 ◽  
Author(s):  
Ajay Agrawal ◽  
Pritha Basnet ◽  
Achala Thakur ◽  
Pappu Rizal ◽  
Rubina Rai
Keyword(s):  
Fetal Death ◽  
Controlled Trial ◽  
Induction Of Labor ◽  
Intrauterine Fetal Death ◽  
Secondary Outcome ◽  
Group A ◽  
Pre Treatment ◽  
Vaginal Misoprostol ◽  
Group B ◽  
Rapid Expulsion

Introduction: Rapid expulsion of fetus in intrauterine fetal death is usually requested without any medical grounds for it. So an efficient, safe method for induction of labor is required. The objective of this study is to determine if pre-treatment with mifepristone followed by induction of labor with misoprostol in late intrauterine fetal death is more efficacious. Methods: We conducted a randomized controlled trial in 100 patients in B.P.Koirala Institute of Health Sciences, Nepal from June 2011 to May 2013. Group A women received single oral dose of 200 mg mifepristone, followed by induction with vaginal misoprostol after 24 hours. Group B women were induced only with vaginal misoprostol. In each group, five doses of misoprostol was used four hourly. If first cycle was unsuccessful, after break of 12 hour, second course of misoprostol was started. The primary outcome was a measure of induction to delivery time and vaginal delivery within 24 hours. Secondary outcome was to measure need of oxytocin and complications. Results: Maternal age, parity and period of gestation were comparable between groups. Number of misoprostol dose needed in group A was significantly less than group B. Mann Whitney U test showed, women in group A had significantly earlier onset of labor, however total induction to delivery interval was not significant. In group A, 85.7% delivered within 24 hours of first dose of misoprostol while in group B 70% delivered within 24 hours (p=0.07). More women in Group B required oxytocin. Conclusions: Pretreatment with mifepristone before induction of labor following late intrauterine fetal death is an effective and safe regimen. It appears to shorten the duration of induction to onset of labor.  Keywords:  induction of labor; intrauterine fetal death; mifepristone; misoprostol. 

scholarly journals A comparative study for the effectiveness of Tamsulosin alone versus Tamsulosin plus Tadalafil combination as an expulsive medical treatment in the management of lower ureteric calculous in Al-Diwaniyah teaching hospital

2019 ◽  
Vol 10 (2) ◽  
pp. 1551-1555
Author(s):  
Ahmed Abdulameer Alwan ◽  
Hussain T. Ajeel ◽  
Ahmed Hamza Abd
Keyword(s):  
Medical Treatment ◽  
Equal Treatment ◽  
Expulsion Rate ◽  
Treatment Groups ◽  
Ureteric Calculi ◽  
Group A ◽  
Male Patients ◽  
Group B ◽  
Urology Clinic

To evaluate the efficacy & safety of tamsulosin alone versus tamsulosin plus tadalafil combination as expulsive medical treatment of distal ureteric calculus. From March 2015 utile March 2017, two hundred patients (one hundred thirty males and seventy females), who attended the outpatient urology clinic and presented with stones size 5 to 10 mm in distal ureteric part, have been randomly allocated into two equal treatment groups. Group A treated with tamsulosin alone, and group B treated with tamsulosin plus tadalafil. Both treatments were given for a maximum of six weeks’ duration. The rate and time to the calculous passage, type of analgesic use, adverse effects of the drugs, number of outpatient urology clinic visits for pain, and follow-up were noted. Both treatment groups have higher expulsion rate with a lower time to expulsion with no statistically significant differences between them (p=0.350, p=0.074, respectively). Group B showed a significantly lower rate in admission to the hospital for pain and need for analgesia than in group A. no dangerous adverse events had been observing in both groups. Additional benefit seen in group B was the improvement in erectile function regarding male patients. Using tamsulosin and tadalafil as an expulsive medical treatment for distal ureteric calculous is safe and efficacious. Such combination therapy may provide additional advantages in cases of erectile dysfunction co-exist with distal ureteric calculi.

scholarly journals COMPARISION OF CEMENTED VERSUS UNCEMENTED HEMIARTHOROPLASTY OF THE HIP.

2019 ◽  
Vol 26 (07) ◽  
pp. 1057-1061
Author(s):  
Dr. Hafiz Salman Saeed ◽  
Farhad Alam ◽  
Muhammad Yousaf ◽  
Iqra Fayyaz
Keyword(s):  
Controlled Trial ◽  
P Value ◽  
Orthopaedic Department ◽  
Residual Pain ◽  
Uncemented Hemiarthroplasty ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Trial Setting

The objective of this study was to compare the mean residual pain after cemented versus uncemented hemiarthroplasty of hip. Study Design: Randomized Controlled Trial. Setting: Orthopaedic Department, Allied Hospital, Faisalabad. Period: September 2016 to October 2017. Materials and Methods: Total 150 patients were admitted in orthopedic Department of Allied Hospital Faisalabad according to inclusion & exclusion criteria. After taking informed written consent, all patients were divided into two groups randomly. Cementedhemiarthroplasty was done in Group A patients and uncemented hemiarthroplasty was done in group B patient. All procedures were done by surgeon who has minimum 5yrs post fellowship experience. Monthly Follow up was done and residual pain was noticed at the end of 6th month. All the data was analyzed by using SPSS version 20.0. Results: In this study, in Group-A the patients between 65-75 years of age were 57.33% (n=43) and between 76-85 of age were 42.67% (n=32). In Group B the patients between 65-75 years of age were 56%(n=42) and between 76-85 years were 44% (n=33). The mean+sd was calculated and it is 73.49+4.99 years in Group-A patients and 73.73+4.74 years in Group-B patients. In Group A, males were 61.33% (n=46) and female were 38.67% (n=29). In Group B, males were 57.33% (n=43) and female were 42.67% (n=32). When we compared the residual pain after cemented versus uncemented hemiarthroplasty of the hip, it shows 1.69+0.35 in Group-A patients and 2.62+0.30 in Group-B patients. When we calculated p-value it was 0.0001 showing a significantdifference. Conclusion: It is concluded that residual pain in cemented hemiarthroplasty is lower than uncemented hemiarthroplasty. 

The Effect of Postoperative KT-1000 Arthrometer Score on Long-Term Outcome After Anterior Cruciate Ligament Reconstruction

2017 ◽  
Vol 45 (7) ◽  
pp. 1522-1528 ◽  
Author(s):  
Andrew D. Goodwillie ◽  
Sarav S. Shah ◽  
Malachy P. McHugh ◽  
Stephen J. Nicholas
Keyword(s):  
Postoperative Period ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Long Term Follow Up ◽  
Kt 1000 ◽  
Group A ◽  
Anterior Cruciate ◽  
Group B

Background: Many long-term studies have looked at outcomes after anterior cruciate ligament reconstruction (ACLR), but none have correlated long-term outcomes with postoperative laxity greater than 5 mm. It has been stated previously that more than 5 mm of postoperative graft laxity constituted a procedural failure. Purpose: To directly compare tight grafts (<3 mm) and loose grafts (>5 mm) to determine the effect of graft laxity, as measured by KT-1000 arthrometer, after ACLR on long-term clinical outcomes. Study Design: Cohort study; Level of evidence, 2. Methods: The study included 171 consecutive patients who had undergone transtibial bone–patellar tendon–bone ACLR between 1992 and 1998. At 6, 12, and 24 months postoperatively (the immediate postoperative period), patients were evaluated. Group A included patients with a maximal side-to-side (STS) difference in the immediate postoperative period of less than 3 mm (tight grafts), and group B included patients with a maximal STS difference of greater than 5 mm (loose grafts). Any patient with a history of ipsilateral or contralateral ACLR or ACL injury, meniscectomy, or cartilage restoration was excluded. Patients were prospectively followed to long-term follow-up, when a telephone interview was conducted regarding knee function and to document Lysholm, Tegner, Knee injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) subjective outcome scores. Results: Eighty-seven patients met inclusion criteria: 66 tight grafts (group A) and 21 loose grafts (group B). The mean ± SD time to follow-up was 16.3 ± 1.5 years in group A (n = 46) and 16.8 ± 1.3 years in group B (n = 15). Tegner ( P = .77), Lysholm ( P = .85), KOOS ( P = .96), and IKDC ( P = .42) were found to have no statistically significant difference between groups at long-term follow-up. Both Tegner and Lysholm scores significantly improved in tight and loose grafts in the immediate postoperative period as well as at long-term follow-up compared with preoperatively. There were 2 ACL revisions in group A and none in group B. Eleven of 46 patients (24%) in group A required subsequent procedures versus 1 of 15 patients (6.7%) in group B ( P = .146). Conclusion: Postoperative laxity of greater than 5 mm STS difference as measured by KT-1000 arthrometer does not appear to place patients at a worse clinical outcome at long-term follow-up, nor does it lead to significantly more subsequent procedures. In addition, transtibial ACLR can provide excellent clinical results at long-term follow-up.

A Comparison of Acupuncture with Advice and Exercises on the Symptomatic Treatment of Osteoarthritis of the Hip – a Randomised Controlled Trial

2001 ◽  
Vol 19 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Roisin Haslam
Keyword(s):  
Controlled Trial ◽  
Randomised Trial ◽  
Symptomatic Treatment ◽  
Post Treatment ◽  
Control Group ◽  
Group A ◽  
Pre Treatment ◽  
Group B ◽  
Randomised Controlled

Acupuncture is becoming a common technique within the physiotherapy profession as a treatment modality for pain relief; however, few randomised controlled trials have been undertaken to assess the effectiveness of acupuncture, particularly in the treatment of osteoarthritis (OA) of the hip. Therefore, a randomised trial to compare the effectiveness of acupuncture with advice and exercises on the symptomatic treatment of OA of the hip was carried out. Thirty-two patients awaiting a total hip arthroplasty were randomly allocated to either the experimental group, (A), to have six sessions of acupuncture each lasting up to 25 minutes, or the control group, (B), to be given advice and exercises for their hip over a six week period. Group A consisted of three men and 13 women, and group B consisted of four men and eight women. The average age in group A was 66 years and in group B it was 68 years. Patients were assessed for pain and functional ability, using a modified version of the WOMAC questionnaire, pre-treatment, immediately post-treatment and at eight weeks post-treatment. The pre-treatment WOMAC scores in the two groups were similar (p=0.85). There was a significant improvement in group A (decrease in WOMAC score) immediately post-treatment (p=0.002) and this was maintained at the eight-week follow-up (p=0.03). There were no significant changes in group B. When the changes in WOMAC scores were compared between groups, a significantly greater improvement was found between pre-treatment and immediately post-treatment in group A, compared with group B (p=0.02). The changes between pre-treatment and the eight-week follow-up also showed a significant improvement in group A compared with group B (p=0.03). In conclusion, this trial supports the hypothesis that acupuncture is more effective than advice and exercises in the symptomatic treatment of OA of the hip.

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