scholarly journals Secondary Rhinoplasty: Aesthetic and Functional Concerns

2019 ◽  
Vol 27 (3) ◽  
pp. 217-222
Author(s):  
Shahriar Loghmani ◽  
Alireza Loghmani ◽  
Fatemeh Maraki
Keyword(s):  
Prospective Study ◽  
Objective Evaluation ◽  
Senior Author ◽  
Surgical Indication ◽  
Nasal Bridge ◽  
Experienced Surgeon ◽  
Secondary Rhinoplasty ◽  
The Mean ◽  
Nasal Region ◽  
Functional Complaints

Background: Aesthetic and functional concerns, especially after multiple revision rhinoplasties, continue to provide a challenge even for the experienced surgeon. Objective: This study aimed to report the results in terms of “secondary rhinoplasty,” performed by the senior author after previous rhinoplasty. Methods: This descriptive prospective study was carried on 150 patients with surgical indication of secondary rhinoplasty and they were asked to fill out the questionnaire divided into 3 parts: overall epidemiological questions, questions of patients’ aesthetic and functional complaints, and objective evaluation by the surgeon. The nasal problems in the upper and middle regions were divided into high or low, broad or narrow, crooked, irregularity of nasal bridge, or other alterations. The patients included in the study had surgical programming of secondary rhinoplasty, with mandatory aesthetic and optional functional purposes, having previous rhinoplasty with the same or different surgeon. Results: There were 136 females and 14 males with the mean age of 31.52 (6.36) years. The most common complaints were related to the nose tip with 123 cases included deviated tip and pinched (bilateral) with 25.3%, 30.7%, and 25.3%, middle nose with 78 cases included mid vault deviation, inverted V, and polly beak with 31.3%, 18%, and 9.3%, and upper nasal region with 69 cases included dorsum irregularity and wide dorsum with the rates of 22.7% and 16.7%, respectively; respiratory problem was reported in 13 cases. Conclusion: Unilateral or bilateral twisting at the nasal tip had the highest percentages, and the lowest incidence was in relation to the complaints of the upper nasal part.

scholarly journals Surgery to relieve nasal obstruction: outcome for 366 patients operated on by one senior surgeon

2021 ◽  
Author(s):  
Lars Aksel Pedersen ◽  
S. Dölvik ◽  
K. Holmberg ◽  
C. Ahlström Emanuelsson ◽  
H. Johansson ◽  
...  
Keyword(s):  
Beneficial Effect ◽  
Nasal Obstruction ◽  
General Health ◽  
Surgical Skills ◽  
Nasal Endoscopy ◽  
Experienced Surgeon ◽  
Senior Surgeon ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Abstract Background Studies of patient-rated outcome in septoplasty and turbinoplasty most frequently involve several surgeons with varying surgical skills, techniques and experience. The aim of the present study was to evaluate outcome based on one experienced surgeon. Methods Three hundred and sixty-six consecutive patients referred for nasal obstruction were included. All the patients were examined with nasal endoscopy before and after decongestion, they filled out a nose VAS and rated their overall general health before and three to six months after surgery. The patients underwent septoplasty, septoplasty plus turbinoplasty or turbinoplasty. Results The mean nose VAS for nasal obstruction (0–100) preoperatively was 64.7 for all patients. Patients undergoing septoplasty (n = 159) were younger than patients undergoing septoplasty + turbinoplasty (n = 79) or patients undergoing turbinoplasty alone (n = 128). The nose VAS for nasal obstruction improved significantly in all three groups and 25% had a normal nose VAS after surgery in the septoplasty and septoplasty + turbinoplasty groups compared to only 8% in the turbinoplasty alone group. There was no significant difference in the improvement in nasal obstruction between septoplasty and septoplasty + turbinoplasty, but the septoplasty + turbinoplasty group experienced a significantly greater improvement in general health. Conclusions In 366 patients operated on by one experienced surgeon, septoplasty and septoplasty + turbinoplasty were more effective at relieving nasal obstruction than turbinoplasty alone. Septoplasty + turbinoplasty resulted in a greater improvement in general health than septoplasty alone, despite the same improvement in nasal obstruction, indicating a beneficial effect of additional turbinoplasty in septoplasty.

scholarly journals A prospective study on effectiveness of drotaverine in acceleration of labor

2019 ◽  
Vol 2 (3) ◽  
pp. 137-141
Author(s):  
Padma Raj Dhungana ◽  
Rajesh Adhikari ◽  
Prem Raj Pageni ◽  
Apsara Koirala ◽  
Anand Nepal
Keyword(s):  
Prospective Study ◽  
Drug Administration ◽  
Active Phase ◽  
Delivery Mode ◽  
Normal Delivery ◽  
Group I ◽  
Vacuum Delivery ◽  
Drotaverine Hydrochloride ◽  
The Mean ◽  
Group Ii

Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome.  

Optimizing Outcomes in Neck Lift Surgery

2021 ◽  
Author(s):  
Thomas Gerald O’Daniel
Keyword(s):  
Surgical Planning ◽  
Planning Process ◽  
Objective Evaluation ◽  
Volumetric Analysis ◽  
Anterior Neck ◽  
Surgical Specimen ◽  
Neck Lift ◽  
Fat Reduction ◽  
The Mean ◽  
The Impact

Abstract Background In certain patients there is an imbalance between the volume of the anterior neck and the mandibular confines that require reductional sculpting and repositioning of the hyoid to optimize neck lifting procedures. Objectives A quantitative volumetric analysis of impact of the management of supraplatysmal and subplatysmal structures of the neck by comparing surgical specimen was performed to determine the impact of reduction on cervical contouring. Methods In 152 patients undergoing deep cervicoplasty, the frequency of modification of each surgical maneuver and amount of supraplatysmal and subplatysmal volume removed was measured in cubic centimeters using a volume displacement technique. Results The mean volume of total volume remove from the supraplatysmal and subplatysmal planes during deep cervicoplasty was 22.3 cm3 with subplatysmal volume representing 73%. Subplatysmal volume was reduced in 152 patients. Deep fat was reduced in 96% of patients with mean volume of 7 cm3, submandibular glands (76%) with mean volume 6.5cm, anterior digastric muscles (70%) with mean volume 2cm3, peri-hyoid fascia (32%) with mean volume <1cm3 and mylohyoid reduction (14%) with mean volume < 1cm3 in the series. The anterior digastric muscles were plicated to reposition the hyoid in 34% of cases. Supraplatysmal fat reduction was 6.3 cm3 in 40% of patients. Conclusions The study provides a comprehensive analysis of the impact of volume modification of the central neck during deep cervicoplasty. This objective evaluation of neck volume may help guide clinicians in the surgical planning process and provide a foundation for optimizing cervicofacial rejuvenation techniques.

scholarly journals Mohs micrographic surgery: a study of 83 cases

2012 ◽  
Vol 87 (2) ◽  
pp. 228-234 ◽  
Author(s):  
Flavianne Sobral Cardoso Chagas ◽  
Bruno de Santana Silva
Keyword(s):  
Cell Carcinoma ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Mohs Micrographic Surgery ◽  
Micrographic Surgery ◽  
Cross Sectional ◽  
The Mean ◽  
Nasal Region ◽  
Cure Rates ◽  
Observation Period

BACKGROUND: Mohs micrographic surgery can achieve high cure rates in the treatment of skin cancer and remove a minimum of healthy tissue. OBJECTIVES: To characterize patients undergoing Mohs micrographic surgery and study issues related to the number of surgical stages. METHODS: A descriptive, retrospective, cross-sectional study was conducted in a micrographic surgery reference center for the period of 2004 to 2010. Data was collected from medical records of 79 patients (83 surgeries). RESULTS: We studied 43 women and 36 men. The mean age was 57.5 ± 14,6 years. Skin types II and III were the most frequent, accounting for 41% and 36.1%, respectively. The most frequent tumor was the basal cell carcinoma (89.1%), and the solid subtype was the most common (44.6%), followed by sclerodermiform histological subtype (32%).The most frequent location was the nasal region (44.6%). The large majority of the operated tumors were recurrent lesions (72.7%). Half of the tumors measured 2 cm or more. In 68.7% of the cases two or more surgical stages were necessary for the removal of the tumors. The observation period was 2 or more years in 75% of the tumors. There was 01 post-Mohs recurrence and 02 patients had metastases during the observation period (both with squamous cell carcinoma). CONCLUSION: The findings coincide with those of the literature, recurrent tumors and tumors larger than 2cm needed more surgical stages for their removal, although there was no statistic difference (p=0,12 and 0,44 respectively).

scholarly journals A Prospective Study of Single Breath Vital Capacity Inhalation Induction with High Concentration of Sevoflurane (Sbvc-Hc) for LMA Insertion in Adults for Short Surgical Cases

2020 ◽  
Vol 5 (1) ◽  
pp. 30-33
Author(s):  
Kailash Prabhudev ◽  
Naveen Kumar K
Keyword(s):  
Prospective Study ◽  
Short Duration ◽  
Gas Flow ◽  
Vital Capacity ◽  
Randomized Study ◽  
High Concentration ◽  
Inhalation Induction ◽  
Inhalation Anesthesia ◽  
Volatile Anesthetic Agent ◽  
The Mean

Background: Sevoflurane is a new volatile anesthetic agent with rapid induction and recovery. A randomized study was carried to access conditions for LMA insertion using Sevoflurane in 25 ASA I & II patients undergoing short duration surgeries.Subjects and Methods:This prospective study was conducted at Department of Anesthesiology and Critical Care, SVS Medical College and Hospital, Mahabubnagar, Telangana, India. After obtaining the institutional ethics committee and written informed consent from the patients, 25 subjects of either sex were included in this study. Age of the subjects was 18 to 60 years. Patients received injection Fentanyl 1 – 2mcg/kg prior to induction. All patients were pre-oxygenated for 3 min with 100% oxygen using a fresh gas flow of 81/min. All patients received inhalational induction with 8% Sevoflurane and O2 flow at 8 L/min with single vital capacity breathe technique. Loss of verbal contact was considered as the desired endpoint for induction, which was assessed by the response to calling out the patient’s name. Then the time of loss of eyelash reflex and jaw relaxation was assessed by anesthesiologist. After adequate jaw relaxation, LMA insertion was attempted.Results:The mean loss of verbal contact was 65.40±9.67second, while the mean for time for loss of eyelash reflex and jaw relaxation were found to be 81.20±9.39 seconds and 103.20 ±12.07 seconds respectively. The mean time for LMA insertion was 122.00±15.61 and the mean attempts for successful LMA insertion was 1.12±0.33. LMA insertion was easy in 23 cases as against difficult in 2 cases. In 2 cases transient cough and biting were recorded. LMA insertion was excellent and satisfactory in 88.0 and 12 percent. However, the mean heart rate at 5 minute after induction showed a significant fall at 5 minutes after induction. The mean values of SBP, DBP and MAP did not differ significantly at pre and induction. However, a significant decrease in SBP was noticed at 1, 2 and at 5 minutes.Conclusion:Sevoflurane is an smooth inhalation anesthesia with rapid onset with adequate jaw relaxation for insertion of LMA in Adults for short duration surgeries. Sevoflurane has got good hemodynamic profile with lesser complications owing to choice of inhalation agent for insertion of LMA.

scholarly journals Prevalence of Pre-Existing Corneal Astigmatism in Age Related Cataract Patient

2013 ◽  
Vol 8 (1) ◽  
pp. 02-04
Author(s):  
Md Abdur Rashid ◽  
KH Anowar Hossain ◽  
AKM Rafiqul Islam
Keyword(s):  
Prospective Study ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Corneal Astigmatism ◽  
Normal Vision ◽  
College Hospital ◽  
Medical College ◽  
Cataract Patient ◽  
Age Related ◽  
The Mean

Cataract surgery is no more a blind rehabilitation surgery, it absolutely gives normal vision. In the era of modern cataract surgery patients expectations are also high about visual outcome. This prospective study was carried out to investigate the magnitude and pattern of pre-existing corneal astigmatism in age related cataract patient at Faridpur Medical College Hospital, Faridpur and Agha Yusuf Adhunik Hospital, Kustia, from July 2009 to June 2012. We examined 850 eyes of 730 patients who underwent cataract surgery. The mean age at the time of surgery was 61.9±8.1 (40 to 70) years. Corneal astigmatism was measured by Auto Refracto Keratometer at least two times for each patient. Astigmatism was calculated from diopteric difference of vertical reading from horizontal reading. With the rule (WTR) astigmatism was considered when steep meridian at 90°± 20°. Against the rule (ATR) astigmatism was considered when steep meridian at 180°±20°. Astigmatism is in other direction is defined as oblique. On keratometry, when vertical reading (k1) was found greater than horizontal (k2) was considered WTR astigmatism and the reverse reading for ATR astigmatism. The percentage of corneal astigmatism was 1D or less was 69.6%, more than 1D and less than 1.5D, 27.6% and more than 1.5D and less then 2D 2.8%. Prevalence of ATR astigmatism was more than WTR astigmatism and prevalence of ATR astigmatism increases significantly with age. Approximately two third of pre-operative patient had 1D or less astigmatism and one third had more than 1D corneal astigmatism. DOI: http://dx.doi.org/10.3329/fmcj.v8i1.16887 Faridpur Med. Coll. J. 2013;8(1): 02-04

scholarly journals Acute benign myositis of childhood: Results of a prospective study performed in a pediatric emergency department

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Vanuza Rosa ◽  
Gabriela Kuzma ◽  
Luana Hornung ◽  
Márcia Bandeira
Keyword(s):  
Emergency Department ◽  
Prospective Study ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Care Providers ◽  
Study Objective ◽  
Gait Abnormality ◽  
The Mean ◽  
A Prospective Study ◽  
Musculoskeletal Involvement

OBJECTIVE: Benign acute childhood myositis is characterized by acute musculoskeletal involvement leading to transient limitations on deambulation followed by a viral illness. Our study objective to evaluate clinical and laboratory features of patients in a pediatric emergency department. METHODOS: We conducted a prospective study in patients with symptoms and laboratory findings compatible with viral myositis in the period of August 2017 to August 2018. RESULTS: We assessed 20 patients in the period of twelve months. The mean age was 8,25 years. Of these, 83,3% had infectious symptoms in the week before the musculoskeletal involvement. By the time of the diagnosis, the symptoms were: calf pain, reluctance to walk, gait abnormality, diffuse myalgia and calf weakness. The most relevant laboratory finding was the elevation of CPK (mean 3359,556U/L) level, followed by AST (mean 131U/L) and ALT (mean 64,66U/L) elevation. The mean time for symptom relief was 3 days and in 7 days all exams were normal. CONCLUSION: Though the exact incidence of this condition remains undetermined, the lower extremity pain and the gait abnormality is of concern of both parents and health care providers. We emphasize the importance of knowing this condition to avoid unnecessary exams and the delay in the diagnosis of severe conditions.

Laparoscopic Cholecystectomy for Acute Cholecystitis: Indication, Risk, and Outcome

2021 ◽  
Vol 8 (06) ◽  
pp. 5508-5513
Author(s):  
Dr. Shiladitya Shil ◽  
Dr. Ashutosh Deb Sarma ◽  
Dr. Md. Alomgir Islam ◽  
Dr. Md. Abdullah-Hel-Baki Abdul ◽  
Dr.Monira Begum
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Prospective Observational Study ◽  
The Other ◽  
Surgical Indication ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
The Mean ◽  
Good Treatment Option

Background: A laparoscopic cholecystectomy is a fundamental approach to treating acute cholecystitis, and the timing of performing this given treatment is associated with clinical outcomes. It is unknown whether surgical indication, risk, and consequences of laparoscopic cholecystectomy for acute cholecystitis differ from those for the chronic form, making it questionable whether urgent laparoscopic cholecystectomy is the best approach even in severe acute cases. Objective: This study aimed to evaluate surgical indication, risk, and outcomes of laparoscopic cholecystectomy for acute cholecystitis. Methods: This prospective observational study was carried out at Bangladesh Medical College Hospital (Uttara Campus) from July 2006 to November 2008. A total of 103 acute cholecystitis patients were observed to evaluate the safety, risk, and outcomes (includes hospital stay, joining to routine daily works) of laparoscopic cholecystectomy. Result: Male and female ratio is 1:4, and the mean age in our series is 47 years. Acute calculas cholecystitis ultra-sonogram feature shows the highest percentage (85.4%) compare to the other four parts. The study also confirmations around 69% did not get any complications, and bleeding was the most frequently observed (16%) complication. The overall outcomes in this research were observed around 75% of total operated patients did not experience any difficulty and said they fit entirely. The other 19% who had some complications include Pain, RTI, Seroma, Jaundice, Cholangitis, Wound infection). Conclusion: Regarding bile duct injury and prolonged complications, laparoscopic surgery is not a very good treatment option for acute cholecystitis.

Comparison of Self-Hypnosis and Propranolol in the Treatment of Juvenile Classic Migraine

PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 593-597
Author(s):  
Karen Olness ◽  
John T. MacDonald ◽  
Donald L. Uden
Keyword(s):  
Statistical Analysis ◽  
Prospective Study ◽  
Specific Treatment ◽  
The Self ◽  
Objective Measures ◽  
Headache Frequency ◽  
Entire Study ◽  
Headache Severity ◽  
The Mean ◽  
A Prospective Study

In a prospective study we compared propranolol, placebo, and self-hypnosis in the treatment of juvenile classic migraine. Children aged 6 to 12 years with classic migraine who had no previous specific treatment were randomized into propranolol (at 3 mg/kg/d) or placebo groups for a 3-month period and then crossed over for 3 months. After this 6-month period, each child was taught self-hypnosis and used it for 3 months. Twenty-eight patients completed the entire study. The mean number of headaches per child for 3 months during the placebo period was 13.3 compared with 14.9 during the propranolol period and 5.8 during the self-hypnosis period. Statistical analysis showed a significant association between decrease in headache frequency and self-hypnosis training (P = .045). There was no significant change in subjective or objective measures of headache severity with either therapy.

A Prospective Study of Dietary Calcium and Other Nutrients and the Risk of Symptomatic Kidney Stones

2021 ◽  
pp. 189-192
Author(s):  
Michael S. Borofsky ◽  
Vincent G. Bird
Keyword(s):  
Observational Study ◽  
Prospective Study ◽  
Kidney Stones ◽  
Calcium Intake ◽  
Dietary Calcium ◽  
Stone Disease ◽  
Dietary Calcium Intake ◽  
History Of ◽  
The Mean ◽  
A Prospective Study

This chapter reviews the results of an important observational study seeking to establish how, in individuals without a history of nephrolithiasis, dietary calcium intake is associated with the risk of symptomatic stone disease. The study found that the mean daily dietary calcium intake was lower in the group who formed stones compared to those who did not and that, after adjusting for covariates, high daily dietary calcium intake was strongly associated with decreased risk of stones.

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