Delayed diagnosis and subsequently increased severity of acute appendicitis (compatible with clinical-pathologic grounds) during the COVID-19 pandemic: an observational case-control study

Abstract Background During a global crisis like the current COVID-19 pandemic, delayed admission to hospital in cases of emergent medical illness may lead to serious adverse consequences. We aimed to determine whether such delayed admission affected the severity of an inflammatory process regarding acute appendicitis, and its convalescence. Methods In a retrospective observational cohort case-control study, we analyzed the medical data of 60 patients who were emergently and consecutively admitted to our hospital due to acute appendicitis as established by clinical presentation and imaging modalities, during the period of the COVID-19 pandemic (our study group). We matched a statistically control group consisting of 97 patients who were admitted during a previous 12-month period for the same etiology. All underwent laparoscopic appendectomy. The main study parameters included intraoperative findings (validated by histopathology), duration of abdominal pain prior to admission, hospital stay and postoperative convalescence (reflecting the consequences of delay in diagnosis and surgery). Results The mean duration of abdominal pain until surgery was significantly longer in the study group. The rate of advanced appendicitis (suppurative and gangrenous appendicitis as well as peri-appendicular abscess) was greater in the study than in the control group (38.3 vs. 21.6%, 23.3 vs. 16.5%, and 5 vs. 1% respectively), as well as mean hospital stay. Conclusions A global crisis like the current viral pandemic may significantly affect emergent admissions to hospital (as in case of acute appendicitis), leading to delayed surgical interventions and its consequences.

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Association between CTSS gene polymorphism and the risk of acute atherosclerotic cerebral infarction in Chinese population: a case–control study

Bioscience Reports ◽

10.1042/bsr20180586 ◽

2018 ◽

Vol 38 (6) ◽

Cited By ~ 2

Author(s):

Lian Luo ◽

Mingli Zhu ◽

Jiajun Zhou

Keyword(s):

Cerebral Infarction ◽

Case Control Study ◽

Case Control ◽

Cathepsin S ◽

Control Group ◽

Study Group ◽

Nucleotide Polymorphisms ◽

Single Nucleotide ◽

Independent Risk Factors ◽

Control Study

Objective: To investigate the association between the gene polymorphisms of rs774320676, rs768437857, rs928508030, and rs2275235 loci of Cathepsin S (CTSS) and risk of acute atherosclerotic cerebral infarction. Methods: A total of 315 patients with acute atherosclerotic cerebral infarction (study group) and 220 healthy subjects (control group) were enrolled in the present study. The genetic polymorphism of rs774320676, rs768437857, rs928508030, and rs2275235 loci of CTSS of subjects was analyzed by PCR-Sanger sequencing. Results: The proportion of carriers with mutant T allele at rs774320676 locus and mutant G allele at rs928508030 locus of CTSS in study group was significantly higher than the proportion in control group (P=0.000, adjusted odds ratio (OR) = 1.332, 95% confidence interval (CI) = 1.200–1.460; P<0.001, adjusted OR = 1.185, 95% CI = 1.055–1.314; P=0.002). The T allele at rs774320676 locus and the G allele at rs928508030 locus of CTSS were independent risk factors for acute atherosclerotic cerebral infarction (OR = 2.534, 95% CI = 1.020–4.652, P=0.006; OR = 2.016, 95% CI = 1.031–4.385, P=0.031). Conclusion: The single nucleotide polymorphisms (SNPs) of rs774320676 and rs928508030 of CTSS gene were related with risk for acute atherosclerotic cerebral infarction. The T allele at rs774320676 locus and G allele at rs928508030 locus of CTSS were genetic susceptibility genes of acute atherosclerotic cerebral infarction.

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Glisson’s capsule cauterisation is associated with increased postoperative pain after laparoscopic cholecystectomy: a prospective case–control study

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0068 ◽

2017 ◽

Vol 99 (6) ◽

pp. 485-489 ◽

Cited By ~ 3

Author(s):

F Basak ◽

M Hasbahceci ◽

A Sisik ◽

A Acar ◽

Y Ozel ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Pain ◽

Case Control Study ◽

Gallbladder Disease ◽

Case Control ◽

Control Group ◽

Study Group ◽

Pain Scores ◽

Standard Laparoscopic Cholecystectomy ◽

Control Study

INTRODUCTION Postoperative pain after laparoscopic cholecystectomy has three components: parietal, visceral and referred pain felt at the shoulder. Visceral peritoneal injury on the liver (Glisson’s capsule) during cauterisation sometimes occurs as an unavoidable complication of the operation. Its effect on postoperative pain has not been quantified. In this study, we aimed to evaluate the association between Glisson’s capsule injury and postoperative pain following laparoscopic cholecystectomy. METHODS The study was a prospective case–control of planned standard laparoscopic cholecystectomy with standardized anaesthesia protocol in patients with benign gallbladder disease. Visual analogue scale (VAS) abdominal pain scores were noted at 2 and 24 hours after the operation. One surgical team performed the operations. Operative videos were recorded and examined later by another team to detect presence of Glisson’s capsule cauterisation. Eighty-one patients were enrolled into the study. After examination of the operative videos, 46 patients with visceral peritoneal injury were included in the study group, and the remaining 35 formed the control group. RESULTS VAS pain score at postoperative 2 and 24 hours was significantly higher in the study group than control (P = 0.027 and 0.017, respectively). CONCLUSIONS Glisson’s capsule cauterisation in laparoscopic cholecystectomy is associated with increased postoperative pain. Additional efforts are recommended to prevent unintentional cauterisation.

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Negative Interaction between Lithium and Electroconvulsive Therapy – A Case-Control Study

The British Journal of Psychiatry ◽

10.1192/bjp.168.2.241 ◽

1996 ◽

Vol 168 (2) ◽

pp. 241-243 ◽

Cited By ~ 48

Author(s):

A. K. Jha ◽

G. S. Stein ◽

P. Fenwick

Keyword(s):

Adverse Effects ◽

Case Control Study ◽

Case Control ◽

Control Group ◽

Study Group ◽

Negative Interaction ◽

Retrospective Case ◽

Concurrent Use ◽

Control Study ◽

Age And Sex

BackgroundConcurrent use of lithium and ECT is suspected to increase neurotoxicity.MethodA retrospective case-control study over an eight-year period was conducted to investigate the adverse effects of a combined lithium/ECT treatment Thirty-one subjects with combined lithium/ECT treatment were compared with a control group (ECT only) of 135 cases matched for age and sex.ResultsMost cases in both groups had no adverse effects. Three (10%) study group subjects and 15 (11 %) controls experienced brief delirium. Three controls and none of the subjects developed a prolonged confusion. There were no significant differences in the profile of other adverse effects between the two groups.ConclusionPrescription of lithium together with ECT was not associated with higher frequency of adverse effects.

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Efficacy of small-volume gastrografin videofluoroscopic screening for detecting pharyngeal leaks following total laryngectomy

The Journal of Laryngology & Otology ◽

10.1017/s0022215120000596 ◽

2020 ◽

Vol 134 (4) ◽

pp. 350-353

Author(s):

M Narayan ◽

S Limbachiya ◽

D Balasubramanian ◽

N Subramaniam ◽

K Thankappan ◽

...

Keyword(s):

Total Laryngectomy ◽

Small Volume ◽

Case Control Study ◽

Case Control ◽

Control Group ◽

Study Group ◽

Retrospective Case ◽

Control Study ◽

Pharyngocutaneous Fistulae

AbstractObjectivesPharyngocutaneous fistulae are dreaded complications following total laryngectomy. This paper presents our experience using 3–5 ml gastrografin to detect pharyngeal leaks following total laryngectomy, and compares post-operative videofluoroscopy with clinical follow-up findings in the detection of pharyngocutaneous fistulae.MethodsA retrospective case–control study was conducted of total laryngectomy patients. The control group (n = 85) was assessed clinically for development of pharyngocutaneous fistulae, while the study group (n = 52) underwent small-volume (3–5 ml) post-operative gastrografin videofluoroscopy.ResultsIn the control group, 24 of 85 patients (28 per cent) developed pharyngocutaneous fistulae, with 6 requiring surgical correction. In the study group, 24 of 52 patients (46 per cent) had videofluoroscopy-detected pharyngeal leaks; 4 patients (8 per cent) developed pharyngocutaneous fistulae, but all cases resolved following non-surgical management. Patients who underwent videofluoroscopy had a significantly lower risk of developing pharyngocutaneous fistulae; sensitivity and specificity in the detection of pharyngocutaneous fistulae were 58 per cent and 100 per cent respectively.ConclusionSmall-volume gastrografin videofluoroscopy reliably identified small pharyngeal leaks. Routine use in total laryngectomy combined with withholding feeds in cases of early leaks may prevent the development of pharyngocutaneous fistulae.

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Higher frequency of Congenital Hypothyroidism among Newborns, District Dera Ghazi Khan-Punjab, Pakistan: A case control study

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.5.4086 ◽

2021 ◽

Vol 37 (5) ◽

Author(s):

Abdul Rehman Khokhar ◽

Abdul Majeed Cheema

Keyword(s):

Sample Size ◽

Congenital Hypothyroidism ◽

Case Control Study ◽

Sampling Technique ◽

Case Control ◽

Control Group ◽

Study Group ◽

Serum Tsh ◽

Control Study ◽

Tsh Levels

Objectives: The study objective was to establish serum TSH cut off value for diagnosis of new case of congenital hypothyroidism and to estimate frequency of Congenital Neonatal Hypothyroidism. Methods: A case control study was conducted at DHQ Teaching Hospital of DG Khan Medical College, Dera Ghazi Khan during 2020 to establish reference values of TSH and T4 for study population. Sample size was calculated by classical sample size calculation formula Cochran WG 1977 sampling technique. A group of 30 neonates of normal, healthy, euthyroid mothers was taken as Neonatal Control Group to estimate levels of TSH and total T4 in normal neonates. Neonatal Study Group was neonates of hypothyroid mothers (n=75). Simple random sampling technique was applied. Results: Mean (mean ± SD) Serum TSH levels of Neonatal Control Group were found to be 3.58 ± 03.09 mIU/l. Mean Serum TSH levels among Neonatal Study Group were found to be 6.88 ±12.95 mIU/l and serum total T4 were found to be 16.78 ± 6.96ug/dl on 3-7 days of life. Serum total T4 (mean ± SD) levels of Neonatal Control Group were 9.73 ± 03.39 ug/dl. Neonatal serum TSH more than 15mIU/l was taken as cut off value to diagnose a case of CNH. So, frequency of CNH was 8% among neonates of study group. Conclusions: The TSH cut off value of >15mIU/l was established for case detection of CNH. Our findings of CNH in district Dera Ghazi Khan (8%) are the highest frequency of CNH reported so far in Pakistan. doi: https://doi.org/10.12669/pjms.37.5.4086 How to cite this:Khokhar AR, Cheema AM. Higher frequency of Congenital Hypothyroidism among Newborns, District Dera Ghazi Khan-Punjab, Pakistan: A case control study. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4086 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Effectiveness of Pentoxifylline in the treatment of oral submucous fibrosis patients: a case-control study

Applied Cancer Research ◽

10.1186/s41241-019-0084-1 ◽

2019 ◽

Vol 39 (1) ◽

Cited By ~ 1

Author(s):

Annette M. Bhambal ◽

Ajay Bhambal ◽

U. S. Shukla ◽

Aashna Dhingra

Keyword(s):

Case Control Study ◽

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Case Control ◽

Control Group ◽

Study Group ◽

Base Line ◽

Submucous Fibrosis ◽

U Value ◽

Control Study

Abstract Background Oral submucous fibrosis (OSMF) is a potentially malignant disorder largely seen in the South-Asian countries where areca nut is found to be the main predisposing factor. Pentoxifylline, a methylxanthine derivative, has vasodilating properties and is believed to increase the vascularity of the mucosal layer. This study was designed to determine the effect of pentoxifylline (Trental) on the clinical progression of oral submucous fibrosis. Aim: The present study was aimed to evaluate the effectiveness of drug pentoxifylline in the management of OSMF and to correlate the clinical parameters evaluated before and after treatment. Methods Study Design: This investigation was conducted as a case-control study incorporating a Control Group in comparison to a Study Group where pentoxifylline 400 mg was administered 3 times daily, as coated, sustained-release tablets for prescribed for 3 months. The stipulated period for the study was 8 months and a total of 80 cases of oral submucous fibrosis (40 test subjects and 40 controls) were included in this study and 100% acquiescence was reported at the end of the test period. Results Mild dizziness and gastric irritation were the only untoward symptoms reported in 2 of the volunteers in the study group during this trial. These were managed by diet protocols. A review of the patients and controls was done at an interval of every 4 weeks for 3 months. The subjective and objective measurements were recorded. The follow-up data at each visit concerning each other and to base-line values were calibrated using nonparametric tests of the Chi-Square test and Mann-Whitney. Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (u value =1.137, p = 0.260), tongue protrusion (u value = 0.262, p = 0.794 and cheek flexibility (u value =0.990, p = 0.326). Subjective symptoms of burning sensation of mouth (U value = 2.673, p = 0.008), pain on opening the mouth (U value = 4.320, p < 0.0001), difficulty in swallowing and difficulty in the speech were also recorded. Conclusion This study showed the effectiveness of pentoxifylline as an additional therapy in the routine management of oral submucous fibrosis.

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Trabeculectomy with Healaflow versus Trabeculectomy for the Treatment of Glaucoma: A Case-Control Study

Journal of Ophthalmology ◽

10.1155/2015/836269 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Dimitris Papaconstantinou ◽

Andreas Diagourtas ◽

Petros Petrou ◽

Alexandros Rouvas ◽

Athanasios Vergados ◽

...

Keyword(s):

Case Control Study ◽

Group Versus ◽

Study Groups ◽

Case Control ◽

Control Group ◽

Study Group ◽

Safe Procedure ◽

Mean Values ◽

Control Study

Purpose. To compare the outcomes of trabeculectomy with and without Healaflow (Anteis S.A, Geneva, Switzerland), a high molecular weight viscoelastic gel, in patients requiring glaucoma surgery.Methods. This was a retrospective, comparative, interventional case-control study. Forty patients formed two matched study groups and were analyzed (trabeculectomy alone (control) versus trabeculectomy with Healaflow (study)).Results. The postoperative levels of mean IOP were statistically significantly lowerP<0.05than preoperatively in both groups, for all time intervals. There was no statistical difference, at the end of the follow-up period, between the two groups in the mean values of the IOP (14.9 ± 3.2 mmHg for the study group versus 14.8 ± 3.3 mmHg for the control group). The number of antiglaucoma drugs used in the study group was reduced from a preoperative mean of 3.4 ± 0.75 to a 6-month postoperative mean of 0.6 ± 0.8P<0.001and in the control group from 3.6 ± 0.59 to 0.55 ± 0.9P<0.001.Conclusions. Although trabeculectomy with Healaflow appears to be a safe procedure, we failed to identify any significant advantages in the use of Healaflow when compared with trabeculectomy alone, at the end of the 6-month follow-up period.

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Family history of disease and risk of glioma occurrence: Results of the case-control study

Vojnosanitetski pregled ◽

10.2298/vsp191127001a ◽

2020 ◽

Vol 77 (4) ◽

pp. 413-417

Author(s):

Ana Azanjac-Arsic ◽

Gordana Toncev ◽

Svetlana Miletic-Drakulic ◽

Katarina Vesic ◽

Dejan Aleksic ◽

...

Keyword(s):

Family History ◽

Cardiovascular Diseases ◽

Case Control Study ◽

Malignant Gliomas ◽

Case Control ◽

Control Group ◽

Study Group ◽

Malignant Diseases ◽

History Of ◽

Control Study

Background/Aim. Malignant gliomas represent a heterogenaus group of tumors. They occur in all age groups, predominatly in males in older age. The purpose of this case-control study was to examine the association between risk for developing glioma and family history of diseases. Methods. The case-control study included 100 pathologically confirmed cases of glioma at the Clinical Centre Kragujevac, Serbia, between 2015 and 2016, and 200 ageand sex-matched controls without glioma and other malignant diseases in personal and family history at the same institution. After signing the informed consent all the patients filled out an epidemiological questionnaire. Multivariate logistic regression analysies was used in statistical data processing. Results. Malignant diseases in family history were more common in the study group than in the control group [odds ratio (OR) = 1.821, 95% confidence interval (CI) 1.004?3.305; p = 0.049]. The most common malignant tumor in the study group were cancer of the uterus (7%) and colon cancer (6%), while in the control group the most common cancer were lung cancer (6%) and cancer of the uterus (7%). Diabetes mellitus in family history was more common among control individuals than among glioma patients (OR = 0.520, 95% CI = 0.271? 0.995; p = 0.048). Also, our results showed that cardiovascular diseases in family history were more common in the control group than among patients of the study group (OR = 0.557, 95% CI = 0.325?0.953; p = 0.033). Conclusion. In this case-control study, we observed a statistically significant relation between family history of malignant diseases and glioma. Also, we found statistically significant inverse relation between family history of cardiovascular diseases and diabetes and glioma.

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N-acetylcysteine treatment in viral-induced acute liver failure

International Journal of Clinical Trials ◽

10.18203/2349-3259.ijct20193213 ◽

2019 ◽

Vol 6 (3) ◽

pp. 106

Author(s):

Tauseef Nabi ◽

Nadeema Rafiq

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Hospital Stay ◽

Case Control Study ◽

Length Of Hospital Stay ◽

Case Control ◽

Control Group ◽

Duration Of Hospital Stay ◽

Baseline Characteristics ◽

Control Study

Background: Acute liver failure (ALF) is characterized by acute derangement of liver function and carries high mortality. Viral hepatitis is still one of the main causes of ALF in the India as well in world. A prospective case control study was carried with the aim to determine the effect of N-acetylcysteine (NAC) on survival of viral-ALF patients.Methods: 37 patients with a diagnosis of viral-ALF were included in the study. 18 patients received NAC infusion for 72 hrs whereas 19 patients in control group received placebo. The variables evaluated were demographic, biochemical, outcome and length of hospital stay.Results: Out of 37 viral-ALF patients, acute HEV-induced ALF (48.6%) was most common followed by HBV (24.3%) and HAV (21.6%). The two groups were comparable for the various baseline characteristics (age, INR, bilirubin, ALT, creatinine, albumin, grade of encephalopathy, mean grade of coma etc.). Use of NAC was associated with a shorter length of hospital stay of survived patients (p=0.024). A total of 20 of 37 (54.1%) patients died with ALF complications; 7 (38.9%) patients belonged to NAC group and 13 (68.4%) patients to control group (p=0.079). HEV induced ALF showed significant improved in survival than Non HEV induced ALF with NAC administration (p=0.022).Conclusions: HEV was the most frequently cause of viral-ALF. Overall survival was not improved by NAC. HEV induced ALF showed significant improved in survival than Non HEV induced ALF with NAC administration. NAC reduced duration of hospital stay.

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A case-control study on thyroid surgery in geriatric patients

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213272 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1403

Author(s):

Rita Gama ◽

Mónica Teixeira ◽

Pedro Oliveira ◽

Fernanda Castro ◽

Artur Condé

Keyword(s):

Thyroid Surgery ◽

Thyroid Disease ◽

Geriatric Patients ◽

Case Control Study ◽

Imaging Finding ◽

Case Control ◽

Control Group ◽

Study Group ◽

Thyroid Pathology ◽

Control Study

Background: With the progressive aging of the population, thyroid pathology with surgical indication occurs at increasingly advanced ages. The authors aim was to analyze the forms of presentation of thyroid disease and rate of complications of thyroid surgery performed in geriatric patients and to compare it to the same parameters in younger patients.Methods: This was a 7 year retrospective case-control study, with patients who underwent thyroid surgery. The study group included patients above 65 years old and a control group under 65 years old, who underwent thyroidectomy.Results: A total of 81 patients were included. The mean volume of thyroid nodules at presentation was significantly higher in the study group compared to the control group, regarding the disease presentation, it was an accidental imaging finding in 59% of patients of the study group, while in the control group there were more compressive symptoms at presentation. The rate of postoperative complications in geriatric patients was 29% versus 20% in the control group, a difference that was not statistically significant.Conclusions: Given the high number of comorbidities presented by geriatric patients, the symptoms of thyroid disease can be undervalued, explaining the greater number of accidental imaging findings and the greater volume of nodules at the time of surgery. Our results show that geriatric thyroid surgery is safe and has acceptable postoperative morbidity. The detection of thyroid pathology in these patients is a greater challenge, which can obscure symptoms, delay diagnosis and worsen prognosis.

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