Does Presurgical Nasoalveolar Molding Have a Long-Term Effect on Nasal and Upper Airway Dimensions?

2020 ◽  
pp. 105566562098023
Author(s):  
Ashwina S. Banari ◽  
Sanjeev Datana ◽  
Shiv Shankar Agarwal ◽  
Sujit Kumar Bhandari

Objectives: To compare nasal and upper airway dimensions in patients with cleft lip and palate (CLP) who underwent nasoalveolar molding (NAM) with those without NAM during infancy using acoustic pharyngometry and rhinometry. Materials and Methods: Eccovision acoustic pharyngometry and rhinometry (Sleep Group Solutions) was used for assessment of mean area and volume of nasal and upper airway in patients with complete unilateral CLP (age range 16-21 years) treated with NAM (group 1, n = 19) versus without NAM (group 2, n = 22). Results: The mean nasal cross-sectional areas and volume were higher in group 1 compared to group 2 on both cleft ( P value <.001) and noncleft side ( P value >.05). The mean area and volume of upper airway were also significantly higher in group 1 compared to group 2 ( P value <.05). Conclusions: Nasoalveolar molding being one of the first interventions in chronology of treatment of patients with CLP, its long-term outcome on nasal and upper airway patency needs to be ascertained. The results of the present study show that the patients with CLP who have undergone NAM during infancy have better improvement in nasal and upper airway patency compared with those who had not undergone NAM procedure. The basic advantages of being noninvasive, nonionizing and providing dynamic assessment of nasal and upper airway patency make acoustic pharyngometry and rhinometry a diagnostic tool of choice to be used in patients with CLP.

Author(s):  
A.P. Voznyuk ◽  
◽  
S.I. Anisimov ◽  
S.Y. Anisimova ◽  
L.L. Arutyunyan ◽  
...  

Purpose. To evaluate the efficacy and safety of femtolaser-assisted phacoemulsification in glaucomatous eyes in the long-term follow-up. Materials and methods. A retrospective analysis of the results of the surgical treatment of patients with combined cataract and glaucoma pathology was analyzed. The patients were divided into groups depending on the method of surgical intervention: 1) phacoemulsification with femtolaser support (26 eyes, 23 patients); 2) phacoemulsification (36 eyes, 30 patients); Results. Before surgery, there were no statistically significant differences in IOP and corneal hysteresis (СН) between groups 1 and 2. The mean values of IOP cc, IOP g and СН of group 1 before surgery were 22.7±6.1 mm Hg, 20.9±6.9 mm Hg, 8.5±1.6 mm Hg; 2 group – 22.9±8.7 mm Hg, 21.6±8.9 mm Hg, 8.9±1.6 mm Hg respectively. Average values of IOP cc, IOP g and CН 5 years after the surgical treatment in group 1 were 15.3±1.2 mm Hg, 14.4±3.4 mm Hg, 9.6±4.2 mm Hg; in group 2 – 18.0±4.2 mm Hg, 16.1±4.2 mm Hg, 8.8±2.2 mm Hg respectively. In both groups, stabilization of IOP and CH indices was noted, which remained throughout the entire observation period, which shows the normalization of the biomechanical properties of the corneoscleral membrane of the eye in the long-term postoperative period. Conclusion. Femtolaser accompaniment of phacoemulsification is an effective and safe method of cataract surgery for combined pathology. Key words: femtolaser, cataract, glaucoma, phacoemulsification.


Author(s):  
Sreeveena Talasani ◽  
Pran Hitha Venkamolla ◽  
Kalpana Betha

Background: Intrauterine fetal death (IUFD) is estimated to occur in 1% of all pregnancies. The advent of prostaglandins has revolutionized the management of IUFD. There are limited studies using a combined regimen of mifepristone and misoprost for induction of labor in IUFD. Hence this study was undertaken to assess the efficacy and safety of combined regimen with misoprostol alone, in the management of IUFD.Methods: This hospital based prospective study included 60 pregnant women with IUFD admitted at Mediciti Institute of Medical Sciences, during the period January 2015 to July 2016. An ultrasound scan was performed to confirm IUFD and localize the placenta. Women were divided alternatively into 2 groups with 30 in each group (group 1- women received 200 mg mifepristone orally followed by misoprostol after 24 hours & in group 2, 100 µg misoprostol  every 6 hourly for a maximum of 4 doses between gestational age  24-26 weeks, 25-50 µg 4 hourly for a maximum of 6 doses beyond 26 weeks).Results: The mean induction to delivery interval was 10 hours in group 1 and 16.3 hours in group 2 (p value 0.007). Mean dose of misoprostol required in group 1 was 1.87 and 2.67 in group 2 (p value 0.008). With respect to side effects, the two groups did not differ significantly.Conclusions: The combined regimen was more effective than misoprostol for the induction of labour in IUFD, in terms of higher rate of successful delivery and shorter induction to delivery interval. 


2020 ◽  
Vol 7 (48) ◽  
pp. 2847-2851
Author(s):  
Sreenivasulu Uppara ◽  
Bhagyamma Sollapurappa Narayanaswamy ◽  
Rama Kishore Akula Venkata ◽  
Thanuja Ramanna ◽  
Shyam Prasad B.R

BACKGROUND The multi-organ disorder, diabetes mellitus (DM) continues to be one of the commonest and challenging health-related problems in the 20th century, prevalent in about 9.3 % of the world's population in 2019 and likely to affect 10.2 % by 2030. Diabetes mellitus is a group of chronic metabolic disorders of multiple aetiology, characterized by chronic hyperglycaemia due to derangement in carbohydrate, fat and protein metabolism. Electrolytes are crucial in maintaining various metabolic functions and play a pivotal role in maintaining a healthy state's body. Diabetic patients are more prone to and frequently develop a constellation of electrolyte disorders due to hyperglycaemia, polydipsia and polyuria. METHODS Our study comprised a total of 70 subjects in the age group of 35 - 60 years with age and sex-matched controls. They were grouped into two groups; the first group, group-1 (healthy controls) and the second group was group-2 (patients of diabetes mellitus on oral hypoglycaemic agents with poor control). 5 ml of fasting venous blood was collected in a plain vacutainer tube in the morning after a zerocalorie overnight 08 hours fast. Post collection, the blood sample was used as serum or plasma or whole blood to estimate plasma glucose, blood urea, serum creatinine, serum sodium, serum potassium, serum chloride by kit methods using an auto analyser. RESULTS Among the various parameters tested, the mean value of fasting plasma glucose, blood urea, serum creatinine, serum potassium, serum chloride were higher in group-2 (diabetic patients) compared to group-1 (healthy controls) with a p-value of < 0.0001. The value of the mean of serum sodium was lower in group-2 (diabetes mellitus) compared to group-1 (healthy controls) with a p-value of < 0.0001. CONCLUSIONS We conclude that electrolyte abnormalities are present in diabetic patients and maybe a root cause for associated morbidity or mortality. These disturbances are generally seen in decompensated Diabetes Mellitus patients, elderly individuals and in the presence of renal impairment. KEYWORDS Diabetes Mellitus, Serum Electrolytes, Fasting Blood Glucose


Author(s):  
Poonam Samyal ◽  
Rama Thakur ◽  
Rohini Rao ◽  
Gian Chauhan ◽  
Sharad Kaushik ◽  
...  

Background: Labour is one of the most painful experiences women encounter during their lifetime and the experience is different for each women. Aim of the study was to evaluate the effect of low dose intrathecal labour analgesia using fentanyl, bupivacaine and morphine on maternal and fetal outcome.Methods: 100 parturients with uncomplicated pregnancy in spontaneous or induced labor at cervical dilatation 4-6cm were enrolled for the study. They were randomized into two groups of 50 each, using computer based block randomization. Group 1 (N=50) received intrathecal labor analgesia using. Fentanyl (25µg), bupivacaine (2.5mg) and morphine (250µg) and Group 2 (N=50) received programmed labor. The two groups were well matched in terms of age, weight, height, parity, baseline vitals and mean cervical dilatation at the time of administration of labor analgesia . Progress of labor, duration of analgesia, and neonatal APGAR score were recorded. Feto-maternal and neonatal outcomes were studied and compared between the two groups.Results: The mean duration of analgesia in group1 was 238.96±21.888 min whereas the mean duration of analgesia in group 2 was 98.4±23.505 min. The difference was significant P value 0.00. One out of 50 (2%) of the parturients required rescue analgesia in Group 1. On the contrary all 44 parturients in Group 2 required rescue analgesia. Difference was significant (p value=0.00) However duration of the stages of labor, operative and instrumental deliveries and APGAR score did not differ in the two groups.Conclusions: Single shot intrathecal labor analgesia is a safe, effective, reliable, cheap and satisfactory method of pain relief for labor and delivery. Moreover, it is devoid of major side effects.


2018 ◽  
Vol 16 (1) ◽  
pp. 2-6
Author(s):  
Grisuna Singh ◽  
Farhat Banu ◽  
Husneyera Haque

Introduction: Post operative pain following caesarean section delivery can negatively affect early wound healing, proper breast feeding to the new born baby and therefore impair mother to child bonding. Combination of non steroidal anti inflammatory drugs (NSAIDS) and opioids has most commonly been used in pain management. The combination of regional anesthetic techniques like Transversus Abdominis Plane (TAP) block reduces pain and the dose of total analgesics consumed and therefore helps to prevent opioid related side effects. Objective: To evaluate the analgesic efficacy of Transversus Abdominis Plane block for management of postoperative pain in the first 24 hours after caesarean section. Methodology: It is a prospective randomized controlled single blinded study involving 60 patients of ASA II done in Nepalgunj Medical College Teaching Hospital over a period of 2 months. They are divided into two groups of 30 patients each. Group 1 received 20 ml of 0.25% isobaric bupivacaine in the triangle of Petit bilaterally. Group 2 received IV analgesics (NSAIDS and Tramadol 50 mg with Phenargan 25 mg). VAS score was taken every 6 hourly for 24 hours post operatively. Results: The mean VAS score of the patients in group 2 at 0-6 hours, 6-12 hours, 12-18 hours and 18-24 hours was 6.73(SD±0.69), 6.63(SD±0.610), 6.40(SD±0.56) and 6.43(SD±0.57) respectively. The mean VAS score of the patients who received block is significantly less as compared to those who did not receive the block with a p value of <0.001. The mean time to first analgesic request in group 1 was 10.83(SD±2.95) and in group 2 was 4.87(SD±0.68) with a p value of <0.001. In group 1, 70% patients received single dose of analgesics, 23.3% received two doses and 6.7% received three doses of analgesics. In group 2 all the patients received four doses of analgesics. Conclusion: Transversus Abdominis Plane Block can be used as a part of multimodal analgesic therapy for the management of post operative pain after caesarean section as it is technically less demanding, safe and economical. It reduces the side effects related with opioid analgesics and encourage early mobility, wound healing and proper mother to child bonding.


2017 ◽  
Vol 22 (5) ◽  
pp. 75-82 ◽  
Author(s):  
Ezgi Atik ◽  
Tülin Taner

ABSTRACT Objective: The aim of this study was to compare the longitudinal stability of the conventional straight-wire system after the use of a quad-helix appliance with Damon self-ligating system in patients with Class I malocclusion. Methods: 27 adolescent patients were evaluated at three different periods: pre-treatment (T1), post-treatment (T2) and three years post-treatment (T3). Group 1 included 12 patients (with a mean age of 14.65 year) treated with Damon 3MX bracket system; and Group 2 included 15 patients (with a mean age of 14.8 year) who underwent orthodontic treatment with Roth prescribed brackets after expansion with Quad-Helix appliance. Relapse was evaluated with dental cast examination and cephalometric radiograph tracings. Statistical analysis was performed with IBM-SPSS for Windows software, version 21 (SPSS Inc., Chicago, IL). A p-value smaller than 0.05 was considered statistically significant. Results: There were significant increases in all transverse dental and postero-anterior measurements (except for UL6-ML mm in Group 1) with active treatment. There was some significant relapse in the long-term in inter-canine width in both groups and in the inter-first premolar width in Group 2 (p< 0.05). Significant decrease in all frontal measurements from T2 to T3 was seen for both groups. Upper and lower incisors significantly proclined in T1-T2 (p<0.05), however no relapse was found for both groups. When two systems were compared, there was no significant difference for the long-term follow-up period. Conclusion: Conventional (quad-helix appliance with conventional brackets) and Damon systems were found similar with regard to the long-term incisor positions and transverse dimension changes of maxillary arch.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 404.2-404
Author(s):  
L. Garzanova ◽  
L. P. Ananyeva ◽  
O. Koneva ◽  
O. Desinova ◽  
O. Ovsyannikova ◽  
...  

Background:Anti-B-cell therapy is seen as a promising therapeutic option for systemic sclerosis (SSc). The study of antinuclear antibody levels during treatment with rituximab (RTX) in patients (pts) with SSc could have theoretical and practical interest.Objectives:To assess the changes in ANA, anti-topoisomerase-1 (Scl-70) levels and B-lymphocytes (B-lymph) count during RTX therapy during prospective observation.Methods:This prospective study included 88 pts with SSc, 83% of them had interstitial lung disease and 75% had positive Scl-70 autoantibody. The mean age was 47 yrs (17-71), female-73 pts (83%), the diffuse cutaneous subset of the disease had 50 pts (57%). The mean disease duration was 5,9±4,8 yrs. The mean follow-up period was 27 months (12-42). The cumulative mean dose of RTX was 2,9±1,1grams. All patients received prednisolone at a dose of 11,7±4,4 mg, immunosuppressants received 42% of them. Patients were divided into groups depending on the duration of the disease: group 1 (n=33) - up to 3 yrs, group 2 (n=25) - from 3 to 6 yrs, group 3 (n=30) - more than 6 years (6-18yrs). The results are presented in the form of mean values, median, upper and lower quartiles.Results:Parallel to clinical improvement in most patients (96%) we found positive changes in many parameters at the end of the study compared to the baseline. The Rodnan skin score decreased from 11,21±9,33 to 6,19±4,74 (p<0,001). The disease activity index (EScSG-AI) decreased from 2,9±1,74 to 1,36±1,15 (p<0,001). Forced vital capacity, % predicted, increased from 76,35±19,65 to 84,37±21,04 (p<0,001). Diffusing capacity for carbon monoxide, % predicted, increased from 45,56±17,72 to 47,62±16,96 (p<0,019). The dose of prednisolone decreased from 11,7±4,4 to 9,2±3,2 mg (p<0,001). The absolute number of B-lymph decreased from 0,224±0,19 to 0,0175±0,058 (p<0,001). The pts of the group 1 showed the highest values of B-lymph at baseline and level of B-lymph decreased from 0,326±0,22 to 0,008±0,01 (Δ 0,318) at the end of the study. In group 2 depletion was less pronounced (from 0,197±0,14 to 0,026±0,07 (Δ 0,171) and the lowest depletion was observed in group 3 (from 0,151±0,16 to 0,019±0,07 (Δ 0,131), p<0,001 for all groups. An initially positive ANA was found in 92% of pts (range 1/320-1/1280). During observation, the number of pts with high (1/640-1/1280) ANA titers decreased from 70 to 41 (p<0,001), and the average level of ANA decreased by 30-40% in all groups. At baseline 63 pts (75%), had positive Scl-70 with equal levels in all groups. At the end of the study level of Scl-70 decreased from 125,02±89,12 to 108,6±86,89 units/ml (p<0,007). A negative correlation was found between the duration of the disease and ANA (r = -0,54; p<0,003) and Scl-70 (r = -0,44; p<0,017).Conclusion:In our study a clinical improvement was shown in most pts at the long-term complex therapy, including RTM. We found a significant decrease in the absolute number of B-lymph, as well as decrease of ANA and Scl-70 levels. Initially pts with a short duration of the disease had a higher level of B-lymph and in these pts depletion was more pronounced, compared to those with a longer duration of the disease. However, the level of Scl-70 and ANA decreased both to those who started RTX therapy at an early stage of the disease (<3yrs) and to those who had a long disease duration.Disclosure of Interests:None declared


2021 ◽  
Vol 62 (8) ◽  
pp. 1029-1035
Author(s):  
Zee Yoon Byun ◽  
Jung Hyun Lee ◽  
Sang-Mok Lee ◽  
Daniel Duck-Jin Hwang

Purpose: To compare the long-term changes in surgically induced astigmatism (SIA) in patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together with patients who underwent cataract surgery only.Methods: We retrospectively reviewed SIA changes for 1 year after surgery in patients who received only cataract surgery using phacoemulsification (group 1) and patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together (group 2). Flat keratometry (K1), steep keratometry (K2), and astigmatism axis were measured with automatic keratometry before and after the surgery. Vector analysis was used to calculate SIA at 1, 3, 6, and 12 months postoperatively. We then examined whether the SIA values at each time point were different between the two groups.Results: A total of 86 eyes were included in this study (group 1, n = 45; group 2, n = 41). The mean SIA values calculated at 1, 3, 6, and 12 months after surgery in group 1 were 0.83 ± 0.37, 0.69 ± 0.39, 0.60 ± 0.33, and 0.59 ± 0.33, respectively. In group 2, the values were 0.82 ± 0.47, 0.69 ± 0.38, 0.62 ± 0.28, and 0.61 ± 0.30, respectively. Over time, SIA decreased in both groups (all p < 0.001). There was no significant difference in the mean SIA between the two groups at each follow-up time point after surgery (p = 0.296, p = 0.728, p = 0.361, and p = 0.356, respectively).Conclusions: When 23-gauge sutureless vitrectomy and cataract surgery were performed together, the astigmatism change caused by surgery did not show a significant difference compared with that of the group who received cataract surgery only. Thus, 23-gauge sutureless vitrectomy may not significantly affect corneal astigmatism.


2021 ◽  
Vol 15 (7) ◽  
pp. 1607-1609
Author(s):  
Aneeqa Ilyas ◽  
Bilal Rafique Malik ◽  
Rehan Anwar

Background:Post-caesarean wound infection is a frightful complication of cesarean delivery and increase burden on health care system. Prevention of post-cesarean wound infection must be the priority in any healthcare center in developing countries. Amoxicillin is an antibiotic often used for the treatment of a number of bacterial infections. Aim: To compare the frequency of wound infection with ceftriaxone versus amoxicillin in females undergoing cesarean section at term Study design: Randomized Controlled Trial Setting & duration: Department of Medicine and Gynecology, SIMS, Lahore from 01-07-2020 to 31-12- 2020. Methods: After fulfilling the selection criteria, 250 females were enrolled and were divided randomly into two equal groups. Group 1 was given intravenous amoxicillin and group 2 was given intravenous ceftriaxone. Then cesarean was done under spinal anesthesia. Post-op wound infection was noted in all the females. The data was analyzed in SPSS. Results: The mean age of the females of amoxicillin group was 28.09±6.01 years whereas the mean age of the ceftriaxone group females was 29.38 ± 6.41 years. The mean gestational age of the females in amoxicillin group was 38.98 ± 0.85 weeks whereas the mean gestational age in ceftriaxone group was 38.94±0.79 weeks. The mean BMI of the females in amoxicillin group was 26.58 ± 6.27 kg/m2 whereas the mean BMI in ceftriaxone group was 29.32±6.36kg/m2. The post-cesarean wound infection was found in 2(1.6%) females in amoxicillin group while in 8(6.4%) females in ceftriaxone group. This difference was statistically insignificant i.e. p-value=0.0.053. Conclusion: The amoxicillin is more effective from prevention of post-op wound infection than to ceftriaxone in females underwent cesarean section. Keywords: Amoxicillin, Ceftriaxone, cesarean section, post-cesarean wound infection


2017 ◽  
Vol 5 (5_suppl5) ◽  
pp. 2325967117S0018
Author(s):  
Peter Myers ◽  
Ahmed Mahmoud ◽  
Jamie Young

Objectives: Meniscal allograft transplantation (MAT) is indicated to relieve pain and improve function and hopefully to delay the onset of osteoarthritis in patients with meniscus deficiency. The purpose of this study was to compare the effect of perioperative cartilage status on survivorship and whether this is influenced by a concurrent tibial osteotomy. Methods: We reviewed a consecutive series of 45 MATs in 42 patients with a minimum post-surgical time of four years. Patients were divided into two groups using the Outerbridge Cartilage Score (OSC) to group 1 (minimal cartilage damage of grade 0-2) and group 2 (severe cartilage damage of grade 3-4). Pre- and post-operative outcome scores were collected using the Lysholm, Tegner, Oxford Knee Score (OKS) and International Knee Documentation Committee (IKDC) subjective knee form. Survival end points were transplant removal and knee arthroplasty. Results: The mean post-surgical follow-up for patients in group 1 (n=14, age 32.0 +/- 9.8) and group 2 (n=31, age 36.2 +/- 10) was 10.6 years (SD +/-3.35) and 7.1 (SD+/-3.34) respectively. There was no significant difference in the mean age between the two groups (p-value 0.221, CI -2.62 to 11). Patients in group 1 demonstrated no failures of the MAT over the time frame evaluated. Group 2 (n=31) had a 74.2% survival of MATs. The clinical outcomes improved in all groups with no significant difference between group 1 and group 2. Those patients in the osteotomy group did not have a statistically significant different survival (Mantel-cox test p-value of 0.922) or clinical outcome. Conclusion: Patient with minimal cartilage status have improved MAT survivorship but both groups benefit clinically. Tibial osteotomy, when indicated, does not influence the outcome of MAT.


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