scholarly journals Comparison between Transepithelial Photorefractive Keratectomy versus Alcohol-Assisted Photorefractive Keratectomy in Correction of Myopia and Myopic Astigmatism

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ashraf M. Bakhsh ◽  
Shaaban A. M. Elwan ◽  
Ahsan A. Chaudhry ◽  
Tamer M. El-Atris ◽  
Taghleb M. Al-Howish
Keyword(s):  
Healing Time ◽  
Early Postoperative Period ◽  
Photorefractive Keratectomy ◽  
Control Group ◽  
Surgical Time ◽  
Pain Scores ◽  
The Mean ◽  
The Right ◽  
Myopic Astigmatism ◽  
Epithelial Healing

Purpose. The aim of the study was to compare visual acuity, refractive results, safety, and efficacy of TPRK with AAPRK as primary outcomes and surgical time, pain scores, haze levels, and healing time as secondary outcomes in TPRK and AAPRK groups.Setting. Security Forces Hospital, Ophthalmology Department, Riyadh, Kingdom of Saudi Arabia.Design. Prospective, nonrandomized case-control comparative study.Methods. A total of 200 eyes of 100 consecutive patients were included. One hundred eyes underwent TPRK in the right eye (study group), and 100 eyes underwent AAPRK in the left eye (control group). Ablations were performed with the Schwind Amaris excimer LASER750S. Clinical outcomes during 6 months’ follow-up were compared.Results. The mean age of patients was 28.3 ± 6.3, 77 were females and 23 males. The mean surgical time was 162.17 ±  14.827 s and 243.24  ±  98.69 s, respectively. At day 1, the UDVA mean was 0.7 in 87% of eyes in the TPRK group while it was 0.5 in 45% of eyes in AAPRK; at week 1, it was 0.9 in 88% of eyes in the TPRK group and 0.6 in 60% of eyes in AAPRK. The mean pain scores were less and lower incidence of corneal haze in the TPRK. Complete epithelial healing time was shorter in TPRK, 3.20 ± 0.686 and 4.60 ± 1.969 days, respectively.Conclusions. TPRK and AAPRK produce similar results 6 months postoperatively. However, in the early postoperative period, there were significant differences in UDVA, pain score, level of haze, and complete epithelial healing time. The pain scores were lower, level of haze was less, and healing time was shorter in the TPRK group which provided patient better felling and comfort in this period. Both of procedures are effective and safe for correction of myopia and compound myopic astigmatism. This trial is registered withNCT03569423.

scholarly journals Application of a Cold Patch for Relieving Pain after Transepithelial Photorefractive Keratectomy

2015 ◽  
Vol 20 (4) ◽  
pp. 195-198 ◽  
Author(s):  
Yuan Zeng ◽  
Yi Li ◽  
Jian-Hua Gao
Keyword(s):  
Postoperative Pain ◽  
Healing Time ◽  
Photorefractive Keratectomy ◽  
Conjunctival Hyperemia ◽  
Major Drawback ◽  
Safety And Efficacy ◽  
Eyelid Edema ◽  
Pain Scores ◽  
Patch Group ◽  
Epithelial Healing

Although photorefractive keratectomy often results in better corneal stability and fewer corneal flap complications than LASIK, pain remains a major drawback of the procedure. The authors compared the safety and efficacy of a postoperative cold patch versus intraoperative application of a chilled balanced salt solution on transepithelial photorefractive keratectomy-related postoperative pain.BACKGROUND: A return toward toward photorefractive keratectomy has occurred due to better corneal stability and fewer corneal flap complications; however, pain remains a major drawback of the procedure. Currently, clinical pain control measures focus on the administration of pain medications, which may delay corneal epithelial healing and has, occasionally, led to serious corneal toxicity.OBJECTIVES: To investigate the safety and efficacy of a cold patch on postoperative pain and other relevant consequences of transepithelial photorefractive keratectomy.METHODS: A prospective, randomized controlled study was conducted. Forty patients (80 eyes) scheduled to undergo transepithelial photorefractive keratectomy for myopia or myopic astigmatism were randomly and equally assigned to be treated with ice-cold balanced salt solution during surgery (wash group) or to wear a postoperative cold patch on the eye for 24 h. The main outcomes were pain score on a visual analogue scale, postoperative eyelid edema, conjunctival hyperemia, epithelial healing time, haze and postoperative best-corrected visual acuity.RESULTS: All patients completed the final tests. Demographic characteristics and pain scores during surgery were similar between the two groups. The mean postoperative pain scores of patients in the cold patch group at 8 h, 16 h and 24 h were significantly lower than those of patients in the wash group. Scores for postoperative eyelid edema and conjunctival hyperemia in the cold patch group were also lower than in the wash group. Patients in the cold patch group used fewer painkillers. Epithelial healing time, haze and early recovery of visual acuity were similar between the two groups. No eyelid frostbite was observed.CONCLUSION: Wearing a cold patch on the eye after transepithelial photorefractive keratectomy effectively relieved pain and inflammation, and reduced the use of painkillers without any side effects.

scholarly journals Randomized controlled study comparing 2 surgical techniques for decompressive craniectomy: with watertight duraplasty and without watertight duraplasty

2018 ◽  
Vol 129 (4) ◽  
pp. 1017-1023 ◽  
Author(s):  
Eduardo Vieira ◽  
Thiago C. Guimarães ◽  
Igor V. Faquini ◽  
Jose L. Silva ◽  
Tammy Saboia ◽  
...  
Keyword(s):  
Wound Infection ◽  
Decompressive Craniectomy ◽  
Surgical Complications ◽  
Test Group ◽  
Csf Leak ◽  
Control Group ◽  
Surgical Time ◽  
Randomized Controlled ◽  
The Mean ◽  
Fluid Collections

OBJECTIVEDecompressive craniectomy (DC) is a widely used procedure in neurosurgery; however, few studies focus on the best surgical technique for the procedure. The authors’ objective was to conduct a prospective randomized controlled trial comparing 2 techniques for performing DC: with watertight duraplasty and without watertight duraplasty (rapid-closure DC).METHODSThe study population comprised patients ranging in age from 18 to 60 years who were admitted to the Neurotrauma Service of the Hospital da Restauração with a clinical indication for unilateral decompressive craniectomy. Patients were randomized by numbered envelopes into 2 groups: with watertight duraplasty (control group) and without watertight duraplasty (test group). After unilateral DC was completed, watertight duraplasty was performed in the control group, while in the test group, no watertight duraplasty was performed and the exposed parenchyma was covered with Surgicel and the remaining dura mater. Patients were then monitored daily from the date of surgery until hospital discharge or death. The primary end point was the incidence of surgical complications (CSF leak, wound infection, brain abscess, or subgaleal fluid collections). The following were analyzed as secondary end points: clinical outcome (analyzed using the Glasgow Outcome Scale [GOS]), surgical time, and hospital costs.RESULTSFifty-eight patients were enrolled, 29 in each group. Three patients were excluded, leaving 27 in the test group and 28 in the control group. There were no significant differences between groups regarding age, Glasgow Coma Scale score at the time of surgery, GOS score, and number of postoperative follow-up days. There were 9 surgical complications (5 in the control group and 4 in the test group), with no significant differences between the groups. The mean surgical time in the control group was 132 minutes, while in the test group the average surgical time was 101 minutes, a difference of 31 minutes (p = 0.001). The mean reduction in total cost was $420.00 USD (a 23.4% reduction) per procedure in the test group.CONCLUSIONSRapid-closure DC without watertight duraplasty is a safe procedure. It is not associated with a higher incidence of surgical complications (CSF leak, wound infection, brain abscess, or subgaleal fluid collections), and it decreased surgical time by 31 minutes on average. There was also a hospital cost reduction of $420.00 USD (23.4% reduction) per procedure.Clinical trial registration no.: NCT02594137 (clinicaltrials.gov)

Effects of Ultra-Purified Alginate Gel Implantation on Meniscal Defects in Rabbits

2018 ◽  
Vol 47 (3) ◽  
pp. 640-650 ◽  
Author(s):  
WooYoung Kim ◽  
Tomohiro Onodera ◽  
Eiji Kondo ◽  
Yasuyuki Kawaguchi ◽  
Mohamad Alaa Terkawi ◽  
...  
Keyword(s):  
Clinical Relevance ◽  
Medial Meniscus ◽  
Meniscal Repair ◽  
Control Group ◽  
Histological Score ◽  
Biopsy Punch ◽  
Biomechanical Evaluation ◽  
The Mean ◽  
The Right ◽  
Spontaneous Repair

Background: Many tissue-engineered methods for meniscal repair have been studied, but their utility remains unclear. Hypothesis: Implantation of low-endotoxin, ultra-purified alginate (UPAL) gel without cells could induce fibrocartilage regeneration on meniscal defects in rabbits. Study Design: Controlled laboratory study. Methods: Forty-two mature Japanese White rabbits were divided into 2 groups of 21 animals each. In each animal, a cylindrical defect measuring 2 mm in diameter was created with a biopsy punch on the anterior horn of the medial meniscus. In the control group, no treatment was applied on the left medial meniscal defect. In the UPAL gel group, the right medial meniscal defect was injected with the UPAL gel and gelated by a CaCl2 solution. Samples were evaluated at 3, 6, and 12 weeks postoperatively. For biomechanical evaluation, 6 additional samples from intact animals were used for comparison. Results: The macroscopic score was significantly greater in the UPAL gel group than in the control group at 3 weeks (mean ± SE: 5.6 ± 0.82 vs 3.4 ± 0.83, P = .010), 6 weeks (5.9 ± 0.72 vs 2.5 ± 0.75, P = .026), and 12 weeks (5.2 ± 1.21 vs 1.0 ± 0.63, P = .020). The histological score was significantly greater in the UPAL group than in the control group at 3 weeks (2.1 ± 0.31 vs 1.2 ± 0.25, P = .029) and 12 weeks (2.2 ± 0.55 vs 0.3 ± 0.21, P = .016). The mean stiffness of the reparative tissue in the UPAL gel group was significantly greater than that in the control group at 6 weeks (24.325 ± 3.920 N/mm vs 8.723 ± 1.190 N/mm, P = .006) and at 12 weeks (27.804 ± 6.169 N/mm vs not applicable [because of rupture]). Conclusion: The UPAL gel enhanced the spontaneous repair of fibrocartilage tissues in a cylindrical meniscal defect in rabbits. Clinical Relevance: These results imply that the acellular UPAL gel may improve the repair of traumatic meniscal injuries.

Location of the middle cranial fossa dural plate in patients with chronic otitis media

2014 ◽  
Vol 128 (1) ◽  
pp. 60-63 ◽  
Author(s):  
S Genc ◽  
M G Genc ◽  
I B Arslan ◽  
A Selcuk
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Middle Cranial Fossa ◽  
Control Group ◽  
Adjacent Structures ◽  
Cranial Fossa ◽  
The Mean ◽  
Bone Scans ◽  
The Right ◽  
And Control

AbstractAim:This study aimed to determine whether or not the middle cranial fossa dural plate is located lower (i.e. more caudally) in patients with chronic otitis media, relative to adjacent structures.Methods:The authors retrospectively investigated computed tomography temporal bone scans of 267 ears of 206 patients who had undergone surgery with a diagnosis of chronic otitis media, together with scans of 222 ears of 111 patients without chronic otitis media. The depth of the middle cranial fossa dural plates was recorded.Results:The mean depth of the middle cranial fossa dural plate was 4.59 mm in the study group and 2.71 mm in the control group (p < 0.001). The middle cranial fossa dural plate was located lower in the right ear in both the study and control groups.Conclusion:The middle cranial fossa dural plate was located lower in patients with chronic otitis media, and in the right ears of both patients and controls. Surgeons should take this low location into consideration, and take extra care, during relevant surgery on patients with chronic otitis media.

scholarly journals Effect of mean ocular perfusion pressure on primary open angle glaucoma

2018 ◽  
Vol 11 (4) ◽  
pp. 286-290
Author(s):  
Pallab Kumar Sen ◽  
Nazneen Khan ◽  
Md. Shafiqul Islam
Keyword(s):  
Odds Ratio ◽  
Primary Open Angle Glaucoma ◽  
Perfusion Pressure ◽  
Open Angle Glaucoma ◽  
Control Group ◽  
Open Angle ◽  
Ocular Perfusion Pressure ◽  
Ocular Perfusion ◽  
The Mean ◽  
The Right

Primary open angle glaucoma is the most common form of glaucoma and it remains asymptomatic until the late stage of the disease. The purpose of this study is to compare the mean ocular perfusion pressure with the primary open angle glaucoma. A total of 60 study subjects were divided into two following groups: a) newly diagnosed patients with primary open angle glaucoma (case) and b) age and sex-matched healthy volunteers (control). The intraocular pressure and blood pressure were measured 3 hourly from 8:00 am to 11:00 pm. The mean ocular perfusion pressure of the right eyes in untreated primary open angle glaucoma was 39.9 ± 7.5 mm Hg whereas it was 47.7 ± 7.7 mm Hg in the control. The odds ratio was 6.6 (95% CI, 2.1-20.5; p=0.002). The right eyes of untreated primary open angle glaucoma had 6.6 times more risk compared to the control group. The mean ocular perfusion pressure of left eyes in untreated primary open angle glaucoma was 39.9 ± 7.5 mm Hg and 48.6 ± 4.0 mm Hg in the control group. The odds ratio was 5.7 (95% CI, 1.8-17.5; p=0.004). The left eyes of untreated primary open angle glaucoma had 5.7 times more risk compared to control group. The findings revealed the evidence of vascular mechanism in glaucoma pathogenesis: Reduction of mean ocular perfusion pressure ≤48 mm Hg, may lead to daily repetitive ischemic insult to the optic nerve.

scholarly journals Caudal Blockade for Postoperative Analgesia: A Useful Adjunct to Intramuscular Opiates following Emergency Lower Leg Orthopaedic Surgery

1991 ◽  
Vol 19 (4) ◽  
pp. 551-554 ◽  
Author(s):  
A. McCrirrick ◽  
D. T. O. Ramage
Keyword(s):  
Orthopaedic Surgery ◽  
Epidural Injection ◽  
Lower Leg ◽  
Control Group ◽  
Double Blind ◽  
Pain Scores ◽  
The Mean ◽  
Blind Manner ◽  
Effective Adjunct ◽  
Caudal Blockade

The efficacy of a single caudal epidural injection of bupivacaine 20 ml 0.5% following emergency orthopaedic surgery to the lower leg and ankle was investigated. Forty adult patients were studied, randomised to either the caudal or control group. The mean 24 hour postoperative papaveretum consumption was significantly reduced in the caudal group. Analogue pain scores as assessed in a double-blind manner were also significantly reduced in this group. The duration of analgesia after caudal blockade was approximately eight hours as estimated by the average time to the first dose of papaveretum. Our study demonstrates that caudal blockade represents an effective adjunct to intramuscular opiates following this type of surgery.

Effect of exogenous gonadotrophins on ovarian morphology and oocyte maturation in the southern hairy nosed wombat Lasiohinus latifrons during the breeding season

2006 ◽  
Vol 18 (4) ◽  
pp. 477 ◽  
Author(s):  
C. H. McDonald ◽  
D. A. Taggart ◽  
W. G. Breed ◽  
G. V. Druery ◽  
G. A. Shimmin ◽  
...  
Keyword(s):  
Oocyte Maturation ◽  
Follicular Development ◽  
Germinal Vesicle ◽  
Control Group ◽  
Antral Follicles ◽  
Nuclear Maturation ◽  
Significant Difference ◽  
Ovarian Morphology ◽  
The Mean ◽  
The Right

The effect of the exogenous administration of porcine follicle-stimulating hormone (pFSH) and pregnant mare serum gonadotrophin (PMSG) on ovarian follicular development and oocyte maturation in the southern hairy nosed wombat Lasiorhinus latifrons was investigated. Three experimental groups were administered pFSH at various doses and for different treatment lengths, followed by 25 mg porcine luteinising hormone (pLH) 12 h after the last dose of pFSH. Another group was given PMSG followed 72 h later by 25 mg pLH. Animals were killed 24 h after pLH. The left ovary was fixed for histology and the morphology of the antral follicles was determined, whereas follicular oocytes in the right ovary were aspirated, fixed, stained with 4′,6′-diamidino-2-phenylindole, and viewed for nuclear maturation. There was no significant difference in the mean number of ovarian follicles >1 mm, or in the size class of follicles assessed between control and experimental groups. However, a trend was observed suggesting a possible increase in follicles >3.0 mm in experimental groups compared with control animals. In all females administered exogenous porcine gonadotrophins, but not controls, some of the mural granulosa cells of large tertiary antral follicles had markedly enlarged nuclei (approximately 14 µm in diameter). All oocytes from the control group remained at the germinal vesicle stage, whereas approximately 40% of oocytes retrieved from the pFSH groups and 82.4% retrieved from the PMSG-primed animals had undergone germinal vesicle break down, with a small number reaching meiosis II. The present study shows that exogenous administration of either pFSH or PMSG to hairy nosed wombats can induce follicular growth and oocyte maturation. Such findings could be useful in the development of reproductive technology in this species.

Short-term undernutrition and prenatal mortality in young and mature Merino ewes

1975 ◽  
Vol 84 (1) ◽  
pp. 113-117 ◽  
Author(s):  
A. J. Mackenzie ◽  
T. N. Edey
Keyword(s):  
Ovulation Rate ◽  
Control Group ◽  
Corpora Lutea ◽  
Short Term ◽  
Embryo Survival ◽  
Body Weights ◽  
Cycle Lengths ◽  
The Mean ◽  
Group 2 ◽  
The Right

SUMMARYPrenatal mortality was examined in 74 primiparous Merino ewes which, after hand mating to fertile rams on the second oestrus following synchronization, were allocated to two groups. One group of 38 ewes was confined to yards and restricted to approximately 30% of their maintenance requirement for 14 days while the other group of 36 remained at pasture. The degree and timing of prenatal loss was assessed by corpora lutea counts, pregnancy diagnosis about day 40, returns to service and lambing records.The mean ovulation rate was 1·06 and the 19-day non-return rate was 87·8%. Pregnancy failed in a higher proportion of the underfed ewes (45·0%) than in the control ewes (30·8%) but this difference did not reach significance. Of the ewes returning to service, significantly more did so with cycles longer than 19 days in the underfed group (9/12) than in the control group (2/8), indicating that in the latter stages, the treatment may have been detrimental to embryo survival.In a second experiment, ovulation rate and prenatal mortality, assessed as in the first experiment, were studied in 85 mature Merino ewes subjected to the following nutritional treatments: HH, control; HL, 30% submaintenance feeding for 14 days following mating; LH, 15% submaintenance feeding for 7 days prior to mating; LL, both submaintenance treatments.Acute undernutrition prior to mating (LH) had no effect on ovulation rate or prenatal mortality. Ovulation rates were low over all groups (mean 1·09) and thus precluded any valid examination of ovulation rate and body weight relationships. The right ovary was significantly more active in producing ova than the left in all groups (P < 0·05). Although ova wastage was apparently higher in. the post-mating undernutrition groups (HL, 44%; LL, 48%; LH, 50%) than in the control group (HH, 35%), the differences were not significant. An increased incidence of extended (> 19 days) first-return cycle lengths in group LL provided some evidence of induced prenatal mortality.In so far as the experiments can be considered together, they indicate that if body weights are comparable, primiparous 1½-year-old ewes are not necessarily more susceptible than mature ewes to prenatal mortality induced by severe short-term undernutrition.

scholarly journals HEARING EVALUATION OF NIGERIAN PRISON INMATES: A CROSS-SECTIONAL SURVEY

2020 ◽  
Vol 14 (2) ◽  
pp. 106-114
Author(s):  
Abdullahi Musa Kirfi ◽  
◽  
Mohammed Bello Fufore ◽  
Garba Mohammed Mainasara ◽  
Abdulrazak Ajiya ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Hearing Threshold ◽  
Pure Tone Audiometry ◽  
Control Group ◽  
Prison Inmates ◽  
Impaired Hearing ◽  
Cross Sectional ◽  
The Mean ◽  
The Right

Background: Prisoners, due to confinement are isolated from contact with the society and access to many of the facilities, including medical care. This study aimed to evaluate the hearing threshold of inmates of Kaduna convict prison. Method: It was a cross-sectional study of prison inmates at the Kaduna convict prison between April 2017 and February 2019. Ethical approvals were obtained from relevant bodies and all consented inmates aged 18 – 55years in the Kaduna convict prison were enrolled. Equal number of control matched for age and gender were enrolled from the communities in Kaduna North Local Government Area. Data were collated using a structured questionnaire. A diagnostic Pure Tone Audiometry was performed to assess their hearing threshold. Statistical Package for Social Sciences (SPSS) version 20.0 was used for analysis. Results: Four hundred and thirty inmates and equal number of control group were enrolled. The mean age for the inmates and controls were 30.2±7.5 and 30.4±8.02 years respectively. There were 383 males and 47 females in both groups. Among the 860 ears of the inmates, 238(27.7%) ears had hearing loss while in the control group, 95/ (11.1%) ears had impaired hearing. Conductive hearing loss was the commonest among the inmates 111(46.6%) while sensorineural was commoner among the controls 57(60.0%). The mean pure tone average among the inmates was 25.6±11.3dBHL and 26.1±11.2dBHL on the right and left ears respectively while in the control group, it was 18.4±7.8dBHL on the right and 17.9±7.9dBHL on the left. Conclusion: This study revealed that hearing loss was more prevalent among prison inmates than the general population. In majority of the inmates, the hearing loss was mild, conductive and mostly affecting all the frequencies.

The Use of Paravertebral Analgesia in the Management of Pain in the Elderly Patient With Rib Fractures

2020 ◽  
pp. 000313482093355
Author(s):  
Tarik Wasfie ◽  
Adam Howell ◽  
N Cwalina ◽  
Raquel Yapchai ◽  
Jennifer Hille ◽  
...  
Keyword(s):  
Elderly Patients ◽  
The Elderly ◽  
Rib Fractures ◽  
Morbidity Rate ◽  
Control Group ◽  
High Morbidity ◽  
Pain Scores ◽  
High Morbidity Rate ◽  
Significant Difference ◽  
The Mean

Background Elderly patients with rib fractures carry a high morbidity rate, particularly due to pulmonary complications as decreased respiratory efforts ensue secondary to pain. Risk of bleeds in the elderly on anticoagulant therapy is high. The effort to reduce narcotic use in patients is now a health care priority. We propose that the use of paravertebral analgesia (PVA) pumps is an alternative pain control method with less risk and easy placement. Methods Two hundred and seventy-nine patients were admitted with multiple fractured ribs to the Trauma Center of Community Hospital and treated with the application of continuous PVA via a pump (72 patients). Pain scores were recorded before and after the initiation of the pump. These patients were compared with a group of the remaining 207 patients who received intravenous narcotics only. Results The mean change from baseline in pain scores for all patients was 1.43 (SD = 2.75). The mean change in pain for the treatment group was 1.93 (SD = 2.60), and the change in pain for the control group was 1.24 (SD = 2.79). Change in pain differed between groups (1.3 vs 1.8; P = .01) although it was a small difference. After adjusting for age, gender, Injury Severity Score, Glasgow Coma Scale, number of fractures, and comorbid conditions, there was no significant difference in pain post-procedure (odds ratio = 0.75; P = 0.39) with an effect size of 30% and total sample size of 279. Conclusion The PVA pump using bupivacaine is an effective safe and alternative method for managing elderly patients with rib fractures eliminating the serious side effects associated with narcotics.

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