A Foxtail-Shaped Vermilion Flap to Reconstruct the Medial Tubercle in Asymmetric Bilateral Cleft Lip With Contralateral Lesser Form Defect

2019 ◽  
Vol 56 (8) ◽  
pp. 1052-1057
Author(s):  
Yuta Nakajima ◽  
Shunsuke Yuzuriha ◽  
Fumio Nagai ◽  
Kenya Fujita ◽  
Masahiko Noguchi
Keyword(s):  
Cleft Lip ◽  
Primary Repair ◽  
Tertiary Care ◽  
Senior Author ◽  
The Body ◽  
University Hospital ◽  
Bilateral Cleft Lip ◽  
Group A ◽  
Cleft Lip Repair ◽  
Group B

Objective: There have been few reports addressing asymmetric bilateral cleft lip repair with contralateral lesser form defects. Two studies have described the thin medial tubercle as the most common remaining labial deformity. In this study, we aimed to evaluate the use of a foxtail-shaped vermilion flap to reconstruct the median tubercle in primary repair. Design: A blinded retrospective study of photography and chart review. Setting: Shinshu University Hospital, tertiary care. Private practice. Patients: Forty-nine patients with asymmetric bilateral cleft lip with lesser form defects treated using a primary “unilateral” repair by the senior author (S.Y.) between 2007 and 2017. Interventions: The foxtail-shaped vermilion flap was applied at the time of the primary nasolabial repair. This flap is similar to Noordhoff laterally based triangular vermilion flap but with modifications to the shape and length. The body of the flap is wider than the pedicle to add tissue to the center of the vermilion, and the length is sufficiently elongated to reach the lesser side. Main Outcome Measure: Lip shape was graded on a 4-point scale when patients were 1 year old. Results: Twenty-two patients were treated with the foxtail-shaped vermilion flap (group A) and 27 patients with Noordhoff triangular vermilion flap (group B). Group A had a better lip shape than group B ( P = .006). Conclusions: The foxtail-shaped vermilion flap is useful to reconstruct the median tubercle in asymmetric bilateral cleft lip repair with contralateral lesser form defects.

Energy-Based Devices Affect the Aesthetic Outcome of Cervical Thyroidectomy and Parathyroidectomy. A Retrospective Study

2021 ◽  
Vol 39 ◽  
Author(s):  
Antonella Pino ◽  
◽  
Lorenzo Gasco ◽  
Daqi Zhang ◽  
Paolo Carcoforo ◽  
...  
Keyword(s):  
Body Dysmorphic Disorder ◽  
The Body ◽  
University Hospital ◽  
Aesthetic Outcome ◽  
Aesthetic Result ◽  
Scar Assessment ◽  
Number Of Patients ◽  
Group A ◽  
Group B ◽  
The Impact

Introduction: Thyroid and parathyroid diseases are very common. Most of these cases are in women and may be amenable to surgery. The patient’s perception that these are not life-threatening diseases leads them to expect an excellent aesthetic result, since the surgical incision area is clearly visible. Objective: To evaluate different scarring outcomes using three different energy-based devices (Harmonic Focus®, Johnson & Johnson, New Brunswick, NJ; Thunderbeat Open Fine Jaw®, Olympus Medical, Tokyo, Japan; LigaSure Small Jaw®, Medtronic, Dublin, Ireland) and to determine the impact of post-thyroidectomy/parathyroidectomy scars on the patient’s quality of life. Methods: One hundred female patients who underwent thyroidectomy or parathyroidectomy between September 2017 and September 2019 at the Endocrine and Minimally Invasive Surgery Department of Messina University Hospital were recruited. A retrospective analysis assessed the thickness of the cervical scar via ultrasound imaging, and the patient’s degree of satisfaction through the Patient and Observer Scar Assessment Scale (POSAS) and the Body Dysmorphic Disorder Questionnaire (BDDQ). Results: The patients were divided into three groups according to the energy-device used: group A (LigaSure SJ (n=38), group B (Harmonic F, n=32) and group C (Thunderbeat OFJ, n=30). The three groups were homogeneous with respect to number of patients, age and surgical procedures. The best aesthetic result, which correlated with the lowest scar thickness, was observed in group A; these patients were more satisfied than those in the other two groups. Moreover, correlations between scar thickness and quantitative variables (such as age or BMI) were not found in any of the groups. Conclusions: Based on the data collected and our experience, the LigaSure Small Jaw® (Medtronic) seems to offer the best aesthetic outcome in patients who undergo transverse cervicotomy for thyroid and parathyroid diseases. However, further prospective studies involving a greater number of cases are needed.

scholarly journals Comparison of primary repair with healing by secondary intention for the treatment of pilonidal sinus, at a Tertiary Care Hospital in Karachi, Pakistan.

2019 ◽  
Vol 26 (08) ◽  
pp. 1306-1310
Author(s):  
Muhammad Ghayasuddin ◽  
Fareya Usmani ◽  
Amtullah Sheikh ◽  
Hamid Raza
Keyword(s):  
Pilonidal Sinus ◽  
Primary Repair ◽  
Tertiary Care ◽  
Healing Time ◽  
Random Allocation ◽  
Care Hospital ◽  
Secondary Intention ◽  
Group A ◽  
The Mean ◽  
Group B

The aim of our study is to assess the surgical outcome of healing by primary intention and compare it with primary repair for the treatment of pilonidal sinus. Study Design: Randomized controlled trial. Setting: Tertiary Care Center in Karachi Pakistan. Period: Two years from April 2015 to April 2017. Materials and Methods: 60 patients were divided into two groups by utilizing a Random Allocation Software. All the patients involved in the study signed a duly informed consent. The inclusion criteria were patients who presented to us with a pilonidal sinus and agreed to participate in the study. All the procedures were performed by the same team of surgeons. Patient follow up was bi-weekly at the outpatient. Data were collected in a predesigned proforma with various variables such as patient demographics, clinical findings, treatment option used, postoperative results, complications (if any), healing time, length of hospital stay and time for a return to function among others. The data were analyzed using IBM SPSS version 21.0. A p value of less than 0.05 was considered to be statistically significant. Results: N= 60 patients were included in the study. There were n= 51 men (85%) and n= 9 women (15%). The mean age of patients in group A was 26.45 +/- 5.81 years and the mean age of participants in group B was 27.10 +/- 5.75 years. Symptoms lasted for 6.52 +/- 2.03 days, the most common presenting complaint was pain in 51.66% of patients followed by discharge in 40% and swelling in 33.33% respectively. The mean length of stay at the hospital for both the groups was 4.40 +/- 2.11 days (4.09 +/- 1.96 days in group A and 4.85 +/- 2.33 days in group B), mean time to return to normal functioning was 17.88 +/- 8.46 days (14.50 +/- 7.30 days in group A and 23.80 +/- 6.50 days in group B). The mean healing time postoperatively for both the groups was 39.98 +/- 24.46 days (21.90 +/- 10.15 days in group A and 67.30 +/- 9.09 days in group B. Early postoperative infection was found in n=7 (11.66%) patients, wound necrosis was found in n= 2 (3.33%) patients, and recurrence of the pilonidal sinus was found in n= 3 (5%) of the patients respectively. Conclusion: According to the results of our study primary closure technique provides better outcomes in terms of early return to functioning, shorter duration of wound healing and lower rates of wound infection as compared to excision and healing by secondary intention.

Evaluation of the cervical vertebral anomalies in patients with cleft lip and palate in Aegean region of Turkey

2020 ◽  
pp. 1-9
Author(s):  
Ege Dogan ◽  
Gulen Ozses Ergican ◽  
Servet Dogan
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Posterior Arch ◽  
Bilateral Cleft Lip ◽  
Bilateral Condition ◽  
Group A ◽  
Vertebral Anomalies ◽  
Group B ◽  
And Control

Abstract Objective: To identify the cervical vertebral anomalies in patients with cleft lip and palate, and to compare unilateral and bilateral cleft lip and palate. Methods: The retrospective cohort study was conducted in 2018 at Department of Orthodontics, Ege University, Izmir, Turkey, and comprised non-deteriorated lateral cephalometric radiographs of non-syndromic patients which showed the entire cervical spine. The radiographs were divided into two groups, with group A having those of patients with cleft lip and palate exposure, and control group B having those with non-exposure.  Within group A, unilateral and bilateral cleft lip and palate cases were compared. Data was analysed using SPSS 22. Results: Of the 220 subjects, 110(50%) were in group A with a mean age of 15±6.3 years, and 110(50%) were in group B with a mean age of 15±2.1 years. Within group A, 56(50.9%) subjects had unilateral and 54(49.1%) had bilateral cleft lip and palate. Cervical vertebral anomalies were found in 71(64.5%) patients and 45(40.9%) controls (p<0.001). Among those with bilateral condition, it was found in 41(75.9%) and in unilateral 56(56.6%) (p<0.05). Occipitalisation was 21(38.9%) in bilateral and 4(7.1%) in unilateral cases (p<0.001). Fusion was higher in bilateral patients 16(63%) compared to 23(41.1%) unilateral (p<0.05). Posterior arch deficiencies were found in 30(27.3%) patients in group A and 18(16.4%) controls in group B (p<0.05). Fusion was seen in 57(51.8%) group A patients and 33(30%) group B controls (p<0.001). Conclusion: Cervical vertebral anomalies were mostly found in patients with cleft lip and palate. Continuous....

Transverse Maxillary Development in Complete Cleft Patients: Comparison of 2 Treatment Strategies by Longitudinal and Cross-Sectional Model Analysis

2018 ◽  
Vol 56 (5) ◽  
pp. 610-618 ◽  
Author(s):  
Natalie Loomans ◽  
Oona Decombel ◽  
Klara Goethals ◽  
Maurice Y. Mommaerts
Keyword(s):  
Cleft Lip ◽  
Treatment Strategies ◽  
Transverse Dimension ◽  
Scar Tissue ◽  
University Hospital ◽  
Cross Sectional ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Matched Study

Objective: This study aimed to compare differences in the maxillary transverse dimension following cleft repair using 2 protocols involving a 2-staged palatal closure with similar timing but different techniques. Design: Retrospective study. Two matched study samples, each containing 10 patients. Setting: Cleft center A is a university hospital. Cleft Center B is a general teaching hospital. Patients: Patients with cleft lip alveolus and palate (CLAP) were matched by cleft type, gender, age, and palatal morphology at the age of 1 month. Differences in the transverse dimension were measured at 4 ages in 2 matched groups (A and B from center A and B), each including 5 patients with unilateral CLAP (UCLAP) and 5 patients with bilateral CLAP (BCLAP). Interventions: Orthodontic/orthopedic expansion treatment began at 8 and 5 years of age at centers A and B, respectively. Results: The mean intercanine distance decreased by 8 mm (standard deviation [SD] = 1.6; P = .030) in group A patients with UCLAP between 1 and 5 years (SD = 1.6; P = .030) and by 6.3 mm (SD = 3.2; P = .016) in group B patients with BCLAP. The mean intermolar distance increased by 4 mm (SD = 3.4; P = .076) in patients with BCLAP. A trend toward improved canine positioning was observed in patients with BCLAP by 12 years of age, with improvement occurring between 4 and 12 years. Conclusion: The type of palatal closure (inducing scar tissue at the bony level) and the late installment of orthodontic/orthopedic expansion probably reduced the intercanine width in bilateral complete clefts.

scholarly journals 2405. Clinical Characteristics and Prognostic Factors for Extraintestinal Infection Caused by Clostridium difficile: An Analysis of 62 Consecutive Cases

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S830-S831
Author(s):  
Hyemin Chung ◽  
Eunbeen Cho ◽  
Seongman Bae ◽  
Min Jae Kim ◽  
Yong Pil Chong ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Clostridium Difficile ◽  
Tertiary Care ◽  
Clinical Specimen ◽  
Polymicrobial Infection ◽  
University Hospital ◽  
Care Hospital ◽  
Analysis Group ◽  
Group A ◽  
Group B

Abstract Background Whereas Clostridium difficile enterocolitis has been well studied, data regarding extraintestinal C. difficile infection remain scarce and anecdotal. We investigated characteristics and prognostic factors in patients with extraintestinal C. difficile infection at a large university hospital over a recent 20-year period. Methods We conducted a retrospective cohort study of patients at a 2,700-bed tertiary care hospital from January 1997 through December 2018 whose extraintestinal clinical specimen revealed C. difficile. Gastrointestinal (GI) disruption was defined as compromised integrity of the GI tract by abdominal surgery, perforation, malignancy, or bleeding. Patients were divided into 3 groups: group A (GI disruption with malignancy, n = 15); group B (GI disruption without malignancy, n = 23); group C (No GI disruption or malignancy, n = 24). The main outcome was 30-day all-cause mortality. Results A total of 62 patients were enrolled, and the incidence of extraintestinal C. difficile infection was 2.81 per 100,000 admissions. Median age was 56 years and 36 (58.1%) of the patients were men. Seven patients (11.3%) had confirmed C. difficile enterocolitis, and 38 patients (61.3%) had a polymicrobial infection. C. difficile bacteremia was identified in 22 patients (35.5%) and was significantly more common in group A (60.0% [9/15]) than groups B (43.5% [10/23]) or C (12.5% [3/24]) (P = 0.01). Thirty-day mortality rates were also significantly higher in group A than groups B or C (60.0% [9/15] vs. 13.0% [3/23] and 16.7% [4/24], respectively; P < 0.001) (Figure 1). C. difficile bacteremia (P = 0.16), polymicrobial infection (P = 0.91), and antimicrobial therapy for C. difficile (P = 0.48) were not significantly associated with 30-day mortality. In a multivariate analysis, group A was an independent risk factor for 30-day mortality. (adjusted odds ratio; 7.29 [95% confidence interval; 1.68–31.68], P = 0.01). Conclusion Extraintestinal C. difficile infection was not commonly associated with C. difficile enterocolitis. Extraintestinal C. difficile infection accompanied by GI disruption with malignancy was associated with significantly poorer outcomes. Disclosures All authors: No reported disclosures.

scholarly journals Effectiveness of Animation Videos as an Auxiliary Tool to Conventional Lectures for Teaching Paediatric Surgery – An Interventional Study, Kozhikode, Kerala

2021 ◽  
Vol 8 (24) ◽  
pp. 2094-2099
Author(s):  
Nirmal Bhaskar ◽  
Sarath Kumar Narayanan ◽  
Somnath Prathap
Keyword(s):  
Cleft Lip ◽  
Teaching Method ◽  
Tertiary Care ◽  
Paediatric Surgery ◽  
Undergraduate Medical Students ◽  
Interventional Study ◽  
Feedback Questionnaire ◽  
Evaluation Group ◽  
Group A ◽  
Group B

BACKGROUND At present, concepts of basic paediatric surgical disorders by undergraduate medical students is limited, which is likely due to deficiencies of traditional teaching methods. This therefore results in delay in identifying situations that mandate initial management and timely referrals. The primary objective of this study is to determine the efficacy of animation videos in conjunction with conventional lectures while teaching paediatric surgical disorders. METHODS This is an interventional study involving 60 final year MBBS students at a tertiary care institution. They were divided into two comparable groups of 30 each. One group (Group A) was educated using animation videos and conventional lectures that included three crucial topics in paediatric surgery - malrotation, intussusception and cleft lip/palate. The other group (Group B) was taught the same topic by means of conventional techniques alone (power point, pictures and usage of black board). The same teacher took these sessions (six exposures, 3 each in two groups) for both the groups, on consecutive days. After conclusion of the session, two sets of assessments (multiple choice questions) were provided to students, one soon after class and another two weeks later. Appropriate statistical methods were employed to compare scores obtained by them and their feedback through a questionnaire. RESULTS On immediate evaluation, Group A (N = 30) achieved a mean score of 21.8 ± 1.1 in comparison to 17.8 ± 1.3 achieved by Group B. On statistical analysis with independent t test, the positive difference was statistically significant (P < 0.0001). At 2 weeks’ evaluation, Group A achieved a mean score of 20.5 ± 1.3, and Group B 17.9 ± 1.5. This difference was also found to be significant (P = 0.006). On assessing feedback questionnaire responses, majority of students found the video assisted teaching method with animation video practical and valuable. CONCLUSIONS The teaching method using animation videos in conjunction with conventional lecture is more effective in paediatric surgery than teaching with conventional lectures alone. The students have also shown a favourable perception towards this method of teaching. KEYWORDS Animation Videos, Conventional Lecture, Teaching, Paediatric Surgical Disorders

COMPARISON OF EFFECTIVENESS OF MOBILIZATION AND SELF-EXERCISES IN ADHESIVE CAPSULITIS OF SHOULDER

2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad
Keyword(s):  
Pain Intensity ◽  
Adhesive Capsulitis ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
T Test ◽  
P Value ◽  
Group A ◽  
Group B

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.

Effect of Sample Storage Conditions on Body Burden Analysis of Organic Contaminants in Unionid Mussels

1992 ◽  
Vol 27 (4) ◽  
pp. 833-844 ◽  
Author(s):  
Micheline Hanna
Keyword(s):  
Organic Contaminants ◽  
Body Burden ◽  
Storage Conditions ◽  
The Body ◽  
Sample Storage ◽  
Pcb Congeners ◽  
Unionid Mussels ◽  
Group A ◽  
The Difference ◽  
Group B

Abstract In order to quantitatively assess the effect of sample storage conditions on the body burden analysis of organic contaminants, a comparative analysis was carried out on the unionid mussel Elliptic complanata. The mussels were divided into two groups, each with distinct storage conditions, while Group A was kept in the freezer at −20°C, Group B was kept in the refrigerator for five days at 5°C. All the compounds present in the control were also present in Group B samples. Analysis of the organic contaminants in each of these two groups showed that for total PCB concentrations, the two treatments were not significantly different; however when compared individually 6 of the 13 PCB congeners showed significant differences. The observed differences were relatively small for individual PCB congeners (7.1 to 15.3%), higher for chlorobenzenes (10.5 to 36.4%), and yet higher for HCE (44.1%); the difference for HCE, although large is nevertheless not significant, even if only marginally so.

scholarly journals Comparative study between fascia lata and temporalis fascia in myringoplasty

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ayman Ali Abdel Fattah ◽  
Abdel Hay Rashad Elasy ◽  
Ahmed Helmy Hoseini ◽  
Tarek Abdel Rahman Abdel Hafez
Keyword(s):  
Tympanic Membrane ◽  
Good Alternative ◽  
Fascia Lata ◽  
The Body ◽  
Temporalis Fascia ◽  
Fascia Graft ◽  
Fascia Lata Graft ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background Repair of a perforated tympanic membrane (myringoplasty) can facilitate normal middle ear function, resist infection, and help re-establish normal hearing. Autogenous graft materials are the most popular graft materials used in myringoplasty because of their easy acceptability by the body. This study is conducted to compare between temporalis fascia graft and fascia lata graft in myringoplasty for patients with tubo-tympanic dry perforation. Results A total of 60 patients with persistent dry tympanic membrane perforation were included in our study during the period from January 2018 to May 2020. Patients underwent myringoplasty with temporalis fascia (30 patients as group A) or fascia lata (30 patients as group B). Patients were scheduled for follow-up visits concerning graft status, ear discharge, and audiograms. The mean postoperative air-bone gap in group A was 17.5 ± 4 after 1 month and 8.6 ± 6.9 after 3 months, while in group B, the mean postoperative air-bone gap was 17.6 ± 4.9 after 1 month and 9.4 ± 7.5 after 3 months. There was 90% success in graft uptake in group A, while there was 80% success in group B. Conclusion Using temporalis fascia is still the best and most trustworthy technique of myringoplasty compared to fascia lata graft. However, fascia lata can be a good alternative to temporalis fascia especially in cases of revision myringoplasty, ears having large perforation, or near-total perforation where the chances of residual perforation are high because of the limited margin of remnant tympanic membrane overlapping the graft.

scholarly journals Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
P Value ◽  
Care Hospital ◽  
Intravenous Lidocaine ◽  
Operative Outcomes ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

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