scholarly journals Clinical outcome of right ventricle outflow tract management for repair of Tetralogy of Fallot with three contemporary surgical strategies

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Tariq Waqar ◽  
M. Zubair Ahmed Ansari ◽  
Kamran Khan
Keyword(s):  
Mechanical Ventilation ◽  
Operative Mortality ◽  
Pulmonary Valve ◽  
P Value ◽  
Chi Square ◽  
Surgical Strategies ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Post Hoc

Objective: To compare the early operative outcome of TOF repair with three contemporary repair strategies of RVOTO repair i.e. TAP, Mono-cusp construction (MC) in TAP and pulmonary valve repair. Methods: Study is performed at Punjab Institute of Cardiology, Lahore from May 2016 to April 2020. Retrospective analysis of data was performed for patient who underwent TOF repair by three different strategies of RVOT repairs during TOF surgery based on z scoring for pulmonary valve annulus. Group-I underwent trans-annular patch repair, while Group-II and III underwent Mono-cusp repair with autologous pericardium and pulmonary valve repair respectively. Analysis of Variance (ANOVA) and Pearson Chi-Square (PCS) statistics were used to compare the three groups for numeric and categorical variables respectively. Post-hoc t-test and Bonferroni correction were performed for numeric data to compare two groups with each other. Chi-square test was used to perform comparison between groups for categorial variables. Results: ANOVA for aortic cross clamp time, total CPB time, Post-operative mechanical ventilation time, ICU stay and hospital stay showed statistical difference among all three group with p-value less than 0.05 however post hoc T-test showed this variation is limited to post-operative mechanical ventilation only when groups compared with each other. PCS showed there was difference for incidence of difficult weaning from CPB when all three groups compared while there was no difference in operative mortality with p-value of 0.15. However, Group-II comparison with Group-I showed that weaning from CPB was superior in-Group-II with p-value of 0.016. Group-III showed the best statistics for all operative outcome variables among all three groups. Comparison of incidence of post-operative moderate pulmonary regurgitation before discharge between Group-II and Group-III showed significant difference with p-value of 0.0052. Conclusion: PV repair strategy should be employed for RVOT repair of TOF whenever feasible. MC repair showed fewer hours of postoperative mechanical ventilation and higher incidence of easy weaning from CPB when compared to TAP, however its impacts over ICU stay, Hospital stay and operative mortality is not profound in our TOF repair population. doi: https://doi.org/10.12669/pjms.37.5.3961 How to cite this:Waqar T, Ansari MZA, Khan K. Clinical outcome of right ventricle outflow tract management for repair of Tetralogy of Fallot with three contemporary surgical strategies. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.3961 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.

scholarly journals A Retrospective Study on Importance of CRP as a Predictor and To Analyse the Effectiveness of Antibiotics in the Treatment of Neonatal Sepsis at Secondary Care Hospital of Tiruppur

2018 ◽  
Vol 10 (01) ◽  
Author(s):  
Nandhakumar Jothivel ◽  
Sabitha V. P. ◽  
Sharon Jacob ◽  
S. Sonapreethi ◽  
Teres Siby ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Neonatal Sepsis ◽  
Empirical Therapy ◽  
P Value ◽  
Care Hospital ◽  
Chi Square ◽  
Group V ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Early diagnosis of sepsis in a neonate is often difficult because symptoms and signs are usually non-specific. A study was conducted to evaluate C-reactive protein (CRP) as a screening tool and the effectiveness of antibiotics in the treatment of neonatal sepsis. This retrospective study was conducted at NICU, Government District Headquarters Hospital, Tiruppur from December 2016 to June 2017, on total of 120 neonatal sepsis patients. Patients of Group I received Ampicillin + Gentamicin, Group II received Ampicillin + Gentamicin followed by Cefotaxime + Amikacin, Group III received Cefotaxime + Amikacin, Group IV received Ampicillin + Gentamicin followed by Piptaz followed by Amikacin + Ciprofloxacin and Group V received, Ampicillin + Gentamicin followed by Piptaz then by Amikacin + Meropenem and then by Ciprofloxacin. Chi-square test two side p-value and ONE WAY ANOVA followed by Tukey-Krammer Multiple Comparison Test is used for statistical analysis. Among study subjects, 18 (15%) and 102 (85%) had negative and positive CRP respectively. According to blood culture studies, 15 cases were culture positive, with the following organisms, Klebsiella pneumoniae (53.33%), Escherichia coli (20%), Staphylococcus aureus (20%) and Proteus marbilis (6.66%). Group II is an appropriate choice for empirical therapy of neonatal sepsis and was 46.96% of 66 patients. Group I, which is considered as First Line treatment was 33.33% of 66 patients.

Bridging the gap between perioperative pelvic floor training and urologic surgeries with risk of incontinence by digital technologies: a survey. (Preprint)

2020 ◽  
Author(s):  
Jan Niclas Mumm ◽  
Lucas Bohn ◽  
Lennert Eismann ◽  
Alexander Buchner ◽  
Theresa Vilsmaier ◽  
...  
Keyword(s):  
At Risk ◽  
Pelvic Floor ◽  
Digital Technologies ◽  
Preventive Treatment ◽  
Final Analysis ◽  
Chi Square ◽  
Group Iii ◽  
Pelvic Floor Training ◽  
Group I ◽  
Group Ii

BACKGROUND Pelvic floor training (PFT) is the gold standard for conservative treatment of male stress urinary incontinence. OBJECTIVE To evaluate patients´ perspective at risk of incontinence on PFT and application of digital technologies for PFT. METHODS Patients undergoing transurethral surgery of the prostate (group I), radical prostatectomy (group II) or treatment at a specialized incontinence outpatient clinic (group III) were surveyed anonymously. Chi-Square test and Kruskal-Wallis-analysis were used for statistical analysis. RESULTS 180 patients were included in the final analysis. In group I (n=35) no patient underwent PFT prior to transurethral surgery. 23.5% of patients in group II (n=51) and 95.7% of patients in group III (n=94) performed PFT. 11.4% in group I, 80.4% in group II and 91.5% in group III have been advised to perform PFT by their urologist. Regarding the information level on PFT, patients from group I (median 1, range 0-5) are less satisfied than patients from group II (median 3, 0-9) or group III (median 5, range 0-10, p<0.001). 88.6% of patients from group I are willing to perform PFT as preventive treatment or to avoid incontinence surgery, 100% from group II and 68.4% from group III (p<0.001). The likelihood to use digital PFT is higher in group I (median: 9, range 0-10) and II (median: 9, range 0-10) than in group III (median: 4, range 0-10, p<0.001). CONCLUSIONS Patients at risk of incontinence currently have limited access to PFT, although they are willing to perform PFT. Digital PFT is highly accepted by patients preoperatively and might be a valuable tool to increase PFT participation.

scholarly journals The prognostic role of inflammatory markers in COVID 19 patients – A retrospective analysis.

2021 ◽  
Author(s):  
Shivkumar Gopalakrishnan ◽  
sangeetha kandasamy ◽  
S.Malini ◽  
S.Peer Mohamed ◽  
k.velmurugan
Keyword(s):  
Inflammatory Markers ◽  
Severe Disease ◽  
Radiation Hazard ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
D Dimer

Abstract Background. Approximately 5% of COVID-19 patients suffer near fatal disease. Clinical and radiologic features may predict severe disease albeit with limited specificity and radiation hazard. Laboratory biomarkers are eyed as simple, specific and point of care triage tools to optimize management decisions.This study aimed to study the role of inflammatory markers in prognosticating COVID-19 patients.Methodology. A hospital based retrospective study was conducted on COVID-19 adult inpatients classified into three groups as mild disease-recovered [Group I], severe disease-recovered [Group II] and dead [Group III]. Categorical outcomes were compared using Chi square test. Univariate binary logistic regression analysis was performed to test the association between the explanatory and outcome variables. Unadjusted OR along with 95% CI was calculated. The utility of lab parameters (Ferritin, LDH, D dimer, N/L ratio and PLT/L ratio) in predicting severity of COVID-19 was assessed by Receiver Operative Curve (ROC) analysis. P value < 0.05 was considered statistically significant.Results. The mean age was 49.32 +/- 17.1 years. Among study population, 378 were Group I, 66 Group II, and 56 Group III. Median levels of Ferritin among the 3 groups were 62ng/mL, 388.50 ng/mL and 1199.50 ng/mL. Median value of LDH were 95U/L, 720 and 982.50(p <0.001). D-dimer values of 3 groups were 23.20ng/mL, 104.30 ng/mL and 197.10 ng/mL (p <0.001). CRP done qualitatively was positive in 2 (0.53%), 30 (45.45%) and 53 (94.64%) of patients. The odds of patients suffering severe COVID-19 rose with rising values of ferritin, LDH and D-dimer [unadjusted OR 1.007, 1.004 &1.020]Conclusion. One time measurement of serum ferritin, LDH, D-dimer and CRP is promising to predict outcomes for COVID 19 inpatients. Single qualitative CRP was equally good but more cost effective than quantitative CRP. The most specific combination was NLR, Lymphocyte percentage and D-dimer levels done between 7th – 10th day of symptoms.

scholarly journals The Relationship Between Dental Caries and YKL-40 Levels in Saliva

2020 ◽  
Author(s):  
Gülsüm Duruk ◽  
Esra Laloglu
Keyword(s):  
Dental Caries ◽  
Group Iii ◽  
Group I ◽  
Pufa Index ◽  
Icdas Ii ◽  
Significant Difference ◽  
Group Ii ◽  
And Gender ◽  
Post Hoc ◽  
The Relationship

Abstract Objective : YKL-40, a new biomarker of localized inflammation, is secreted by macrophages and regulates inflammation and immune responses. The aim of this study was to investigate YKL-40 levels in saliva and compare the level of this mediator in healthy and unhealthy oral cavity. Methods: 85 children (46 girls, 39 boys), aged 6-15 (mean±SD: 9.15±2.16) were included in this study. The children were divided into three groups: Group-I (control, n=25, DMFT/dmft=0), Group-II (n=30, exist of localized dental caries) and Group-III (n=30, exist of localized advanced dental caries). Gingival index (GI), plaque index (PI), DMFT/dmft, DMFS/dmfs, and the number of advanced dental caries according to the ICDAS II and PUFA/pufa index were recorded. Saliva was collected and YKL-40 concentrations were measured. One-way ANOVA with Tukey post hoc, Kruskal-Wallis, multiple regression analysis, and Sperman’s correlation tests were used for statistical analysis. Results: The highest level of YKL-40 was obtained in group III , followed by groups II and I , respectively (p<0.01). In Group II, DMFT/dmft scores and the number of caries (DT/dt) were higher than in group III (p<0.01). In group III, there was a statistically significant correlation between YKL-40 levels in saliva and the number of advanced dental caries. In addition, there was no statistically significant difference in terms of age and gender (p>0.05). Conclusion: Advanced dental caries, rather than DMFT/dmft score, may play an important role in the increasing levels of YKL-40 in saliva.

Frequency of Post Dural Puncture Headache with Quincke 25g and Quincke 27g Spinal Needle after Spinal Anaesthesia

2021 ◽  
Vol 15 (11) ◽  
pp. 3116-3118
Author(s):  
Gulsher . ◽  
Riffat Zahid ◽  
Syed Mehmood Ali ◽  
Muhammad Naveed Shahzad ◽  
Amer Latif ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Dural Puncture ◽  
P Value ◽  
Chi Square ◽  
Post Dural Puncture Headache ◽  
Group I ◽  
Chi Square Test ◽  
Randomized Control ◽  
Group Ii ◽  
The Difference

Objective: To compare the frequency of post dural puncture headache with Quincke 25G and Quincke 27G of spinal needles for spinal anesthesia. Design of the Study: It’s a Randomized control trial. Study Settings: This study was carried out Department of anesthesiology and Intensive Care Unit, Shaikh Zayed Hospital Lahore from 29-08-2020 to 01-03-2021. Material and Methods: In this prospective study 100 patients were enrolled who were decided to undergo spinal anesthesia. Two groups were made by randomization. In patients of group I, anesthesia was administered by using 25G quincke needle while 27G quincke needle was used for patients in group II. Evaluation of patients was with regard to development of postoperative PDPH within 3-days. Groups were compared by using Chi-square test and a P-value<0.05 was taken statistically significant. Results of the Study: PDHD was seen in 14 (28%) patients in group I and in 4 (8%) patients in group II. Statistically, the difference between the two groups was significant (p<0.05).. Conclusion: Due to less frequency of PDPH with 27G needle, it should be given preference for applying spinal anesthesia over 25G needle. Keywords: Spinal anesthesia, post dural puncture headache; quincle needle.

scholarly journals A COMPARATIVE STUDY OF EFFICACY AND SAFETY AMONG METFORMIN WITH SITAGLIPTIN, METFORMIN WITH VOGLIBOSE, AND METFORMIN WITH GLIMEPIRIDE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

2017 ◽  
Vol 10 (12) ◽  
pp. 313
Author(s):  
Kala P ◽  
Jamuna Rani R ◽  
Kumar Js
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Plasma Glucose ◽  
P Value ◽  
Efficacy And Safety ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Objective: Type 2 diabetes mellitus (DM) is a most common metabolic disorder. The present study aimed to compare the efficacy and safety among metformin with sitagliptin, metformin with voglibose, and metformin with glimepiride in patients with type 2 DM. Methods: This study was a prospective, randomized clinical trial study, conducted in patients attending the diabetology outpatient department of SRM Medical College Hospital and Research Center, Potheri, Kancheepuram, Tamil Nadu, from January 2013 to January 2014. The patients were randomized into three groups with 40 patients in each group. Fasting plasma glucose (FPG), 2 hrs postprandial plasma glucose (PPG), and hemoglobin A1c (HbA1c) level were assessed in all the patients before starting the treatment. In Group I, patients were prescribed metformin 500 mg with sitagliptin 50 mg, in Group II, patients were given metformin 500 mg with voglibose 0.2 mg, and in Group III, patients were put on metformin 500 mg with glimepiride 1 mg in the fixed combination. The outcome of the therapy was based on the level of improvement in the blood parameters. Results: There was a significant reduction of FPG level seen in all three groups (p value - Group I <0.0001, Group II < 0.005, and Group III <0.0001). Group I and III showed significant reduction of PPG with p value <0.0001. There was a significant reduction of HbA1c seen in all the three groups (p<0.0001). Conclusion: From the results of this study, it could be concluded that all the three groups were comparable in their efficacy.

scholarly journals IMPACT OF DIFFERENT ORAL HYGIENE AIDS FOR THE REDUCTION OF MORNING BAD BREATH AMONG DENTAL STUDENTS: A CROSSOVER CLINICAL TRIAL

2016 ◽  
Vol 89 (4) ◽  
pp. 525-533
Author(s):  
Shaijal Godha ◽  
Pralhad L Dasar ◽  
Sandesh N ◽  
Prashant Mishra ◽  
Sandeep Kumar ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Dental Students ◽  
Group Iv ◽  
Tooth Brushing ◽  
P Value ◽  
Plaque Score ◽  
Group Iii ◽  
Group I ◽  
Bad Breath ◽  
Group Ii

Background and aim. To assess and compare the effects of different oral hygiene procedures on the reduction of morning bad breath, plaque and gingival status in healthy subjectsMethods. A four step cross-over trial was performed on 32 study subjects. They were allocated into four groups: Group I: tooth brushing; Group II: tooth brushing and tongue scraping; Group III: tooth brushing and mouth washing; and Group IV: tooth brushing, tongue scraping and use of mouthwash. A washout interval of 7 days was employed. At the beginning and at the end of all intervention periods, breath score was measured by hand held sulfide monitor (Breath Alert) at four time intervals. The Plaque and Gingival status was evaluated using Plaque and Gingival Index.Results. The highest reduction in mean breath score (2.12±0.65), plaque score (0.75±0.47) and gingival score (0.67±0.41) were found in the Group IV followed by Group II and Group III. A significant positive correlation was observed between plaque scores and gingival scores before intervention (r=0.443; p value<0.001) and after intervention (r=0.846; p value<0.001).Conclusion. The study findings suggest that mechanical aids in conjunction with chemical regimens are considered as the most effective method for reducing the morning bad breath in healthy subjects and should be incorporated in daily oral hygiene practices.

scholarly journals Role of Apo B and Apo A1 Levels in Relation to Conventional Lipid Profile in Patients of Ischaemic Heart Disease with or without Type II Diabetes Mellitus

2021 ◽  
Author(s):  
Hardik N Javia ◽  
Milav H Bhavsar ◽  
Bhavesh R Sadariya ◽  
Amitkumar V Maheshwari ◽  
Hariom Sharma
Keyword(s):  
Diabetes Mellitus ◽  
Lipid Profile ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
P Value ◽  
Type Ii ◽  
Apo B ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Introduction: Ischaemic Heart Disease (IHD) or Coronary Artery Disease (CAD) is the most prevalent chronic disease and the main leading cause of death in the world, with more than half a million newly diagnosed IHD patients each year. Central to this are disorders of lipoprotein metabolism. Apolipoprotein B (Apo B) and Apolipoprotein A1 (Apo A1) are structural and functional components of lipoprotein particles that serve as transporters of cholesterol. Apo B and Apo A1 are among the emerging markers for Cardiovascular Diseases (CVD). Routine conventional lipid profile does not incorporate these markers. Aim: To determine the level of Apo A1 and Apo B in patients of IHD with or without Type II Diabetes Mellitus (T2DM) and analyse the significance of these parameters over the conventional lipid profile. Materials and Methods: The case-control study was conducted at Government Medical College, Bhavnagar, Gujarat, India from July 2013 to December 2013. The study consists of 100 participants including 50 having IHD only (Group I), 50 having IHD with T2DM (Group II) as study groups and 50 healthy individuals (Group III) as control. Various biochemical parameters including Apo B and Apo A1 were analysed and statistically evaluated to come to conclusion. Results: The demographic details of the participants which shows no significant different in age and gender among groups I, II and III. Apo B and A1 were elevated in group I and II and were found highly significant (p-value <0.0001) as compared to the group III. There was positive correlation of serum Apo B levels with total cholesterol (r=0.495, p-value <0.0001), Low-Density Lipoproteins (LDL-C) (r=0.526, p-value <0.0001) and Apo A1 (r=0.685, p-value <0.0001) in group I and LDL-C (r=0.468, p-value=0.001) and Apo A1 (r=0.754, p-value <0.0001) in group II. Similarly, Apo A1 levels were positively correlated with Apo B (r=0.685, p<0.0001) in group I and LDL-C (r=0.305, p-value=0.031) and Apo B (r=0.754, p-value <0.0001) in group II. Conclusion: As the Apo B and Apo A1 cover both atherogenic and antiatherogenic lipid parameters respectively, it can be used as a better predictor of development of IHD with and without T2DM in comparison to conventional parameters of lipid profile.

scholarly journals Tympanic membrane perforation: correlation of hearing loss with its site and size

2018 ◽  
Vol 4 (2) ◽  
pp. 397 ◽  
Author(s):  
Arvinder Singh Sood ◽  
Pooja Pal ◽  
Amit Kumar
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Linear Correlation ◽  
Tympanic Membrane Perforation ◽  
P Value ◽  
Cross Sectional ◽  
Group Iii ◽  
Group I ◽  
Membrane Perforation ◽  
Group Ii

<p class="abstract"><strong>Background:</strong> The objectives of the study were <span lang="EN-IN">correlation of hearing loss with size and site of tympanic membrane perforation. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A cross-sectional prospective study of 100 patients of both sex and age between 11-60 years with perforated tympanic membrane was conducted in the department of Otorhinolaryngology (ENT). Size and site of TM perforation was assessed using otoscope and otomicroscope. Size of perforation was measured with 1 mm thin wire loop and vernier caliper. Patients were divided into three groups according to size; Group I (0-9 mm), Group II (9-30 mm), Group III (&gt;30 mm). The tympanic membrane was divided into five segments anterosuperior, posterosuperior, anteroinferior, posteroinferior and central for the localization of the site of perforation. Data thus collected was statistically analysed.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Patients with Group I perforation had an average hearing loss of 31.42±7.15 decibel. Group II had an average hearing loss of 39.42±8.97 decibel. Group III had an average hearing loss of 48.91±7.38 decibel. Maximum hearing loss was noted in patients with central perforation with an average hearing loss of 39.34±9.47 decibel. Average hearing loss was found higher in posterior perforations than anterior quadrant perforations. This difference was however not statistically significant with ‘p’ value of ‘0.689’. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Linear correlation was found between size of tympanic membrane perforation and degree of hearing loss. No linear correlation between site of tympanic membrane perforation and hearing loss was found. We found no correlation between duration of disease and size of tympanic membrane perforation with degree of hearing loss.</span></p>

scholarly journals Effectiveness of Combination Irrigant Technique for Debris Removal in Simulated Canal Irregularities: An in vitro Study

2019 ◽  
Vol 4 (2) ◽  
pp. 79-84
Author(s):  
S Dhivyalakshmi ◽  
◽  
N Velmurugan ◽  
G Lakshmanan ◽  
L Karthik ◽  
...  
Keyword(s):  
Digital Camera ◽  
In Vitro Study ◽  
Combination Group ◽  
P Value ◽  
Chi Square ◽  
Group Iii ◽  
Group I ◽  
Intergroup Comparison ◽  
Before And After

Aim: To evaluate the debridement efficacy of different irrigation systems in simulated canal irregularities. Study Design and Setting: About sixty maxillary central incisors were selected and after chemomechanical preparation were split longitudinally into two halves. Each groove and depression were filled with dentine debris mixed with 2.5 % NaOCl to simulate a situation where dentine debris accumulates in the un-instrumented extensions of the root canal. Materials and Methods: The specimens were randomly divided into 4 experimental groups as follows: Group I - Conventional Needle Irrigation, Group II - Apical Negative Pressure Irrigation (EndoVac), Group III - Passive Ultrasonic Irrigation and Group IV - Combination Irrigation (EV+PUI). 9 ml of 2.5 % NaOCl, 9 ml of 17 % EDTA and 9 ml of saline was used for the final irrigation protocol. Images were taken before and after irrigation using PRIMA DNT surgical microscope with digital camera. Statistical Analysis: The intergroup and individual comparison of percentage reduction of debris in groove and depressions were carried out by using Kruskal-Wallis and Mann-Whitney U tests respectively. The intergroup comparison for different scoring criteria was compared using Pearson’s chi-square tests. Differences were considered statistically significant at P value < 0.05. Results: The combination group, EV group and PUI group showed better removal of debris in Groove and Depressions than Conventional needle irrigation group. The Combination group had significant reduction of debris at 2 mm level when compared to all the other groups. Conclusion: The effectiveness of this combination irrigant delivery system for smear layer removal and antibacterial efficacy have to be evaluated further in future clinical studies

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