scholarly journals The Long-Term Results of ReLEX® SMILE Depending on the Degree of the Corrected Myopia

2020 ◽  
Vol 17 (4) ◽  
pp. 711-718
Author(s):  
O. A. Klokova ◽  
R. O. Damashauskas ◽  
S. V. Kostenev ◽  
E. N. Kalaidin
Keyword(s):  
Visual Acuity ◽  
Laser System ◽  
Study Groups ◽  
Individual Characteristics ◽  
Long Term Results ◽  
Efficiency Coefficient ◽  
Group Iii ◽  
Group I ◽  
Group Ii

The purpose: prospective study of the long-term refractive and visual results of ReLEx® SMILE, depending on the degree of corrected myopia.Material and methods. The three study groups included 71 patients; the mean age was 26.48 ± 5.5 years. Group I consisted of 20 patients (39 eyes) mean SE –2.62 ± 0.87 D, group II — 26 patients (51 eyes), mean SE 4.68 ± 0.74 D, Group III — 25 patients (47 eyes), mean SE 6.88 ± 0.72 D. All patients underwent femtolaser correction of myopia using the ReLEx® SMILE method with the VisuMax™ laser system (Carl Zeiss Meditec AG).Results. Uncorrected visual acuity of 09 — 1.0 was noted in 34 eyes (87.2 %) in group I, in II — in 43 eyes (84.3 %), in 37 eyes (78.7 %) in group III. The efficiency coefficient was 1.0 in groups I — II and 0.89 in group III. There was no decrease in corrected visual acuity (CVA) during the correction of mild and moderate myopia, in group III it was recorded by 0.1 in two cases (4 %), by 0.2 in one case (2 %), the safety factor in I — II groups 1.0, in III 0,89. Two years after ReLEx® SMILE, refraction of ± 0.5 D from planned in the study groups was achieved, respectively, in 94.9, 88.2, 76.6 % of cases, ± 1.0 D in 100 % of cases in I, II groups, in 97 % of cases in III group. The predictability coefficient was 0.95 in group I, 0.88 in group II, and 0.77 in group III. Refractive regression compared with the results 1 month postoperatively was 0.08 D in group I, 0.1 D in group II, and 0.16 D in group III. Analysis of the long-term results of ReLEx® SMILE allows us to conclude: the method is safe and effective, provides high predictability of refractive results in correcting various degrees of myopia. Further study of the long-term results of the operation, the creation and use of nomograms, taking into account the individual characteristics of the cornea, will improve the predictability and stability of refractive results in the correction of high myopia. 

scholarly journals The surgical correction of refractory venous trophic ulcers

2021 ◽  
pp. 38-46
Author(s):  
S. E. Katorkin ◽  
M. J. Kushnarchuk ◽  
M. A. Melnikov ◽  
A. A. Zhukov ◽  
P. F. Kravtsov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Complete Healing ◽  
Long Term Results ◽  
Group Iii ◽  
Results Of Treatment ◽  
Group I ◽  
Group Ii ◽  
Shave Therapy

Objectives. To study the effectiveness of layered dermatolipectomy and endoscopic fasciotomy in the surgical treatment of refractory venous trophic ulcers.Materials and methods. Patients (n = 105) of the C6 clinical class underwent crossectomy and short stripping. In group I (n = 35), free autodermoplasty of trophic ulcers with a perforated flap was performed. In group II (n = 36), shave therapy and autodermoplasty were performed. In group IIІ (n = 34), fasciotomy, shave therapy and autodermoplasty were performed. Long-term results of treatment were studied in the period from 1 to 12 months.Results. Complete healing of venous trophic ulcers was observed in group I at 49,4 ± 7,2, in II – at 31,4 ± 4,7, in III – at 32,1 ± 3,6 days сутки (t1-2 = 2,09; p1-2 = 0,049; t1-3 = 2,24; p1-3 = 0,024; t2-3 = 0,03; p2-3 = 0,763). Full engraftment of an autograft graft was recorded in 7 (19,4 %) patients of group I, in 27 (77,1 %) cases in group II and in 27 (79,4 %) patients of comparison group III (χ21-2 = 23,674; p1-2 = 0,001; χ21-3 = 25,173; p1-3 = χ22-3 = 0,052; p2-3 = 0,826).Conclusion. Layered dermatolipectomy with autodermoplasty and endoscopic decompression fasciotomy is an effective method for the treatment of persistent refractory venous trophic ulcers.

Prospective Evaluation of Intravitreal Triamcinolone Acetonide Injection in Macular Edema Associated with Retinal Vascular Disorders

2005 ◽  
Vol 15 (5) ◽  
pp. 619-626 ◽  
Author(s):  
H.K. Tewari ◽  
P. Sony ◽  
R. Chawla ◽  
S.P. Garg ◽  
P. Venkatesh
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Macular Thickness ◽  
Intravitreal Triamcinolone ◽  
Group Iii ◽  
Vein Occlusion ◽  
Group I ◽  
Group Ii

Purpose To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity and macular thickness using optical coherence tomography (OCT) in macular edema associated with various retinal vascular disorders. Methods This prospective nonrandomized clinical interventional study included 81 eyes (76 patients) comprised of Group I, 57 eyes (51 patients) with diabetic macular edema; Group II, 10 eyes (10 patients) with branch retinal vein occlusion; and Group III, 13 eyes (13 patients) with central retinal vein occlusion. All eyes received an intravitreal injection of 4 mg triamcinolone acetonide (with the solvent) in the operation theater under sterile conditions. Results Mean preinjection central macular thickness was 531.84±132 μm in Group I, 458.4±149 μm in Group II, and 750.81±148 μm in Group III. All groups showed a statistically significant decrease in mean central macular thickness at 1 month (300.7±119 μM in Group I, 218.2±99 μm in Group II, and 210.5 ±56 μm in Group III) and 3 months (253.19±109 μm in Group I, 187±47 μm in Group II, and 182±50 μm in Group III) after injection (p<0.05). Mean follow-up was 22±2.4 weeks. Mean visual acuity increased in all three groups (preoperative visual acuity in Group I, 1.2±0.4 logMAR units; Group II, 1.24±0.5 logMAR units; Group III, 1.1 ±0.4 logMAR units; 1 month postinjection in Group I, 0.88±0.3 logMAR units; Group II, 0.67±0.3 logMAR units; Group III, 0.86±0.4 logMAR units; 3 months postinjection in Group I, 0.84±0.4 logMAR units; Group II, 0.59±0.3 logMAR units; Group III, 0.82±0.5 logMAR units) (p<0.05). Forty-one eyes completed 6 months and 20 eyes completed 9 months follow-up. Twelve of 20 (41%) eyes in Group I, 2/6 (33%) eyes in Group II, 3/6 (50%) eyes in Group III, and 8/15 (53%) eyes in Group I, 1/3 (33%) eyes in Group II, and 2/2 (100%) eyes in Group III developed recurrence of macular edema with worsening of visual acuity at 6 and 9 months, respectively. Thirty-three (40.7%) eyes developed IOP elevation (at least one reading > 24 mmHg). One eye developed infective endophthalmitis. Conclusions Intravitreal injection of triamcinolone acetonide may be considered as an effective treatment for reducing macular thickening due to diffuse diabetic macular edema, venous occlusion associated macular edema, and may result in increase in visual acuity at least in the short term. Further follow-up and analysis is required to demonstrate its long-term efficacy.

scholarly journals Remifentanil and Propofol Sedation for Retrobulbar Nerve Block

2002 ◽  
Vol 30 (4) ◽  
pp. 433-437 ◽  
Author(s):  
V. Rewari ◽  
R. Madan ◽  
H. L. Kaul ◽  
L. Kumar
Keyword(s):  
Adverse Effects ◽  
Respiratory Depression ◽  
Study Groups ◽  
Group Iv ◽  
Control Group ◽  
Group Iii ◽  
Group I ◽  
Retrobulbar Block ◽  
Significant Movement ◽  
Group Ii

We studied remifentanil and propofol for analgesia and sedation during the placement of an ophthalmic block. Eighty ASA I or II patients undergoing elective cataract surgery under a retrobulbar block in a rural camp setting were included in the study. Patients were randomly divided into four groups and received different drug combinations as follows: Group I—remifentanil 1 μg/kg, Group II—remifentanil 0.5 μg/kg and propofol 0.5 mg/kg, Group III— remifentanil 1 μg/kg with propofol 0.5 mg/kg and Group IV—saline 0.1 ml/kg. Patients were observed for degree of movement, sedation, pain, recall and respiratory depression. No patient in the study groups reported pain or displayed movement whereas most of the patients in the control group had significant pain during the placement of the block. Also, seven (35%) patients in the control group showed significant movement which may have led to failure of block in two patients and retrobulbar haemorrhage in one patient. Incidence of significant respiratory depression was maximum in Group III patients (60%), followed by Group I (20%) and least in Group II (5%). All patients in the study groups remained cooperative and obeyed commands except four patients in group III (OAA/S-4). Postoperatively, other than the control group, recall was maximum in Group I (55%) and least in Group II (5%). Hence, a combination of remifentanil 0.5 μg/kg with propofol 0.5 mg/kg as a bolus was considered to provide excellent relief of pain and anxiety with least adverse effects for the placement of ophthalmic blocks.

Assessment of Preoperative and Postoperative Changes in Corneal Astigmatism after Pterygium Excision by Different Techniques

2020 ◽  
Vol 9 (2) ◽  
pp. 1-4
Author(s):  
Madhavi Chevuturu
Keyword(s):  
Visual Acuity ◽  
Amniotic Membrane ◽  
Surgical Techniques ◽  
Corneal Astigmatism ◽  
Group Iii ◽  
Conjunctival Autograft ◽  
Postoperative Changes ◽  
Group I ◽  
Pterygium Excision ◽  
Group Ii

Background: Pterygium causes visual problems due to induced corneal astigmatism or direct encroachment onto the visual axis. The present study was conducted to compare preoperative and postoperative changes in corneal astigmatism after pterygium excision by different techniques. Subjects and Methods: The present study was conducted from May 2018 to August 20018 on 69 patients of age range 20-55 years of primary Pterygium. Patients were divided into three groups of 23 each. Group I was treated with bare sclera (BS) technique, Group II with conjunctival autograft (CAG) technique and Group III with amniotic membrane graft (AMG) technique. All the patients were preoperatively assessed for visual acuity, anterior and posterior segments, autorefraction, and autokeratometry. After surgery, the patients were recalled on day 5, 1 month, and 3 months for the analysis. Results: Uncorrected visual acuity (UCVA) preoperatively was 0.57, on the 5th day was 0.45 after 1 month was and after 3 months was 35. The mean preoperative astigmatism value in group I was 3.45, in group II was 3.52 and in group III was 3.49. Postoperative astigmatism value in group I was 1.60, in group II was 0.92 and in group III was 0.81. The difference was significant (P< 0.05). Conclusion: Authors found that amniotic membrane graft and a conjunctival autograft is better surgical techniques than bare sclera in reducing astigmatism.

scholarly journals EFFICACY OF ATRIAL FIBRILLATION DETECTION IN CRYPTOGENIC STROKE ACCORDING TO DATA OF IMPLANTABLE LOOP RECORDERS: PILOT STUDY

2019 ◽  
Vol 34 (2) ◽  
pp. 47-53
Author(s):  
S. E. Mamchur ◽  
E. A. Ivanitskiy ◽  
O. M. Polikutina ◽  
T. Yu. Chichkova ◽  
I. N. Mamchur ◽  
...  
Keyword(s):  
Recurrent Stroke ◽  
Cryptogenic Stroke ◽  
Ecg Monitoring ◽  
Group Iii ◽  
External Monitoring ◽  
Group I ◽  
Monitoring Group ◽  
Group Ii

Aim. To estimate the efficacy of invasive and non-invasive long-term ECG monitoring in comparison with conventional follow-up for the detection of silent atrial fibrillation (AF)/atrial flutter (AFL)/atrial tachycardia (AT) in patients with a cryptogenic stroke.Methods. The randomized, prospective, two-center study enrolled 36 patients who suffered cryptogenic stroke (CS) or transient ischemic attack (TIA) without past history of AF/AFL/AT. Patients were randomized in a 1:1:1 ratio to one of the three ECG monitoring strategies: standard arrhythmia monitoring (group I, n=12), ECG-monitoring with implantable loop recorder (group II, n=12), and ambulatory noninvasive ECG monitoring (group III, n=12). The primary endpoint was the time to the first detection of AF/AFL/AT. Patients, assigned to the group I, underwent an assessment at scheduled and unscheduled visits and received ambulatory ECG monitoring 28 days and 1 year after randomization. Patients in the group II underwent implantation of Reveal XT (Medtronic, USA) with the daily remote data transmission to CareLink Network. In the group III, for long-term external monitoring, Spyder system (WEB Biotechnology, Singapore) was used for up to 28 days.Results. During the first 28 days of observation, there were no significant differences in AF detection rates between groups I, II, and III: 0 (0%), 1 (8%), and 2 (17%) cases, respectively, р=0.537. During the year of observation, AF/AFL/AT episodes were detected in 1 case (8%) in the group I, 6 cases (50%) in the group II, and 2 cases (17%) in the group III, p=0.0486. The mean time from enrollment into the study to detection of the first AF/AFL/AT episode was 67 days (15; 97) in all groups. In the groups II and III, the first arrhythmia episodes were detected by monitoring devices on days 24 and 6, respectively. In most cases, arrhythmia episodes detected by long-term monitoring were asymptomatic. Recurrent stroke or TIA events occurred in group I and III (1 case in each group), but not in the group with implantable cardiac monitors. Subgroup analysis showed that significantly higher AF/AFL/AT detection rate was associated with stroke, CHA2DS2VASc score ≥2, and the presence of hypertension. For the 12 months of follow-up, the mean AF burden in the group II was 0.4 (0.2; 0.5) hours per day (1.6%). In the patients with recurrent stroke, AF burden was 3.2% compared to 0.9% in the rest of patients.Conclusion. Detection of silent AF with implantable cardiac monitors is superior to standard and long-term external monitoring in cryptogenic stroke patients.

scholarly journals PCI in patients with ostium coronary artery lesions: three-year follow-up

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Maximkin ◽  
Z Shugushev ◽  
A Chepurnoy ◽  
O Safonova ◽  
A Mambetov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Target Lesion ◽  
Long Term Results ◽  
Coronary Artery Lesions ◽  
Total Frequency ◽  
Stent Restenosis ◽  
Group I ◽  
Group Ii

Abstract Aims To increase the effectiveness of percutaneous coronary interventions (PCI) in patients with ostium coronary artery lesions. Methods 170 patients were included in the study. Inclusion criteria: ostium atheroslerotic lesions of left arterial descending (LAD) or left circumflex (LCx) &gt;70% according to angiography and intravascular ultrasound (IVUS); myocardial ischemia according stress test and FFR measurement. All patients were randomized into 2 groups. In I group (n=85) according to IVUS, atherosclerotic plaque spread from the ostium of LAD and/or LCx to the left main coronary artery (LMCA), and in group II (n=85) - the plaque did not spread into the LMCA. In Group I all patients were initially treated with “Provisional T” stenting of the LMCA, and in Group II – precision stenting of the ostium LAD or LCx. Long-term results were evaluated on 24 and 48 months. Primary endpoints: frequency of MACE (death, MI, revascularizations). Results During hospitalization of complications associated with PCI was not, survival was 100% in all groups. The conversion to complete bifurcation stenting were in 5 patients from Group I and conversion to provisional stenting were in 3 patients from Group II. The long-term results after 24 months was observe in 70 patients from Group I and 72 patients, from Group II. Nonfatal myocardial infarction (MI) was observed in 2 (2.7%) of patients from group II and not in Group I. The incidence of hemodynamic significant stent restenosis and was observed in 4 patients (5.7%) in Group I, and in 7 patients (9.8%) in Group II (p&lt;0.05). The target lesion revascularization (TLR) was performed in 4 patients (5.7%) in Group I, and in 9 patients (12.5%) in Group II (p&lt;0.05). The total frequency of MACE in groups I and II was 4 (5.7%) and 9 (12.5%), respectively (p&lt;0.05). The survival was 100% in both groups. The long-term results after 48 months was observe in 58 patients from Group I and 54 patients, from Group II. All type of death registration in 1 patient from Group I and 2 patients from Group II. Nonfatal myocardial infarction (MI) was observed in 1 patient (1.7%) and 2 patients from Group II (3.7%) (p&gt;0.05). The incidence of hemodynamic significant stent restenosis was observed in 3 patients (5.7%) in Group I, and in 5 patients (9.3%) in Group II (p&lt;0.05). The target lesion revascularization (TLR) was performed in 4 patient (6.9%) in Group I, and in 7 patient (13%) in Group II (p&lt;0.05). The total frequency of MACE in groups I and II was 5 (8.6%) and 10 (18.5%), respectively (p&lt;0.05). The freedom from cardiac events (Kaplan-Maier analysis) was significant difference (92.5 in Group I and 84.5 in Group II (p&lt;0.05). Conclusions IVUS analysis of ostium stenosis of coronary arteries can help in choosing the optimal stenting technique, as well as reliably improve long-term PCI results. Patients after precision stenting of the ostium have worse long-term results, compared with patients after provisional T-stenting. Funding Acknowledgement Type of funding source: None

scholarly journals Interleukin-1β, interleukin-6 and tumour necrosis factor-alpha levels in blood and saliva in hypothyroidism accompanied with periodontitis

2019 ◽  
Vol 10 (2) ◽  
pp. 1361-1366
Author(s):  
Sahar H. Al-Hindawi ◽  
Batool Hassan Al-Ghurabi
Keyword(s):  
Immune Response ◽  
Periodontal Disease ◽  
Study Groups ◽  
Control Group ◽  
Necrosis Factor Alpha ◽  
Group Iii ◽  
Group I ◽  
Salivary Level ◽  
Tnf Α ◽  
Group Ii

Relationship between thyroid dysfunction and periodontal disease has been mediated through an immune response. Cytokines are implicated in the initiation, consequences of immune response and a crucial role in the pathogenesis of thyroid disease, directly target thyroid follicular cells; and in the development and progression of periodontitis. This study aimed to detect cytokines levels which known to be associated with periodontitis in serum and saliva, to test the hypothesis that hypothyroidism influences the levels of biomarkers of periodontitis. Samples were collected from sixty patients with hypothyroid age ranged (20-64) years, thirty of patients were without periodontitis (group I) and 30 with periodontal disease (II); moreover, 30 subjects considered as control (group III) with age (20-53) years. Detection of cytokines was performed by ELISA. The results showed a significant elevation in serum and salivary levels of IL-1β (P<0.001) among patients’ groups (I and II) as compared to group III, as well IL-1β increase significantly in group II (P<0.001) than in group I and also than group III. There are non-significant differences (P>0.05) in serum level of IL-6 and TNF-α and salivary levels of TNF-α among all study groups. Nevertheless, the salivary level of IL-6 is increased significantly (P<0.05) in group II as compared with group I and group III, and their non-significant differences (P<0.05) between groups I and III. The present finding proposed that hypothyroidism might encourage periodontitis development; as well as serum and salivary levels of IL-1β, with salivary IL-6 may represent important biomarkers for the early detection of periodontitis in hypothyroid patients.

scholarly journals Human polyclonal anti-hepatitis B surface antigen immunoglobulin reduces the frequency of acute rejection after liver transplantation for chronic hepatitis B

2001 ◽  
Vol 43 (6) ◽  
pp. 335-337 ◽  
Author(s):  
Claudia Alves COUTO ◽  
Paulo Lisboa BITTENCOURT ◽  
Alberto Queiroz FARIAS ◽  
Margareth Pauli LALLEE ◽  
Eduardo Luiz Rachid CANÇADO ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis B ◽  
Surface Antigen ◽  
Hepatitis B Surface Antigen ◽  
Protective Role ◽  
Group Iii ◽  
Group I ◽  
B Virus ◽  
Group Ii

BACKGROUND: Use of polyclonal anti-hepatitis B surface antigen immunoglobulin (HBIg) has been shown to reduce hepatitis B virus (HBV) recurrence after liver transplantation (LT) and to decrease the frequency of acute cellular rejection (ACR). However, the protective role of HBIg against ACR remains controversial, since HBV infection has been also associated with a lower incidence of ACR. AIM: To assess the relationship between HBIg immunoprophylaxis and the incidence of rejection after LT. METHODS: 260 patients (158 males, 43 ± 14 years old) submitted to LT were retrospectively evaluated and divided into three groups, according to the presence of HBsAg and the use of HBIg. Group I was comprised of HBsAg-positive patients (n = 12) that received HBIg for more than 6 months. Group II was comprised of HBsAg-positive patients that historically have not received HBIg or have been treated irregularly for less than 3 months (n = 10). Group III was composed of 238 HBsAg-negative subjects that have not received HBIg. RESULTS: HBIg-treated patients (group I) had significantly less ACR episodes, when compared to group II and III. No differences between groups II and III were observed. CONCLUSIONS: Long-term HBIg administration contributes independently to reduce the number of ACR episodes after LT.

Long-Term Follow-Up of Treatment for Acute Myeloid Leukemia with Allogeneic Hematopoetic Cell Transplantation Using BuCy2 as Preparation.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3370-3370
Author(s):  
Shubham Pant ◽  
Pamela Ann Crilley ◽  
Anthony J. Dodds ◽  
Jeffrey Szer ◽  
Brian J. Bolwell ◽  
...  
Keyword(s):  
Myeloid Leukemia ◽  
Chronic Gvhd ◽  
Group Iii ◽  
Late Failure ◽  
Group I ◽  
First Remission ◽  
Group Ii ◽  
Acute Myeloid

Abstract In 1991, we reported the results of 127 patients with Acute Myeloid Leukemia (AML) who underwent conditioning for allogeneic transplant with busulfan, 4 mg/kg on each of 4 days and cyclophosphamide 60 mg/kg on each of 2 days. In the current abstract, we report data on 295 patients, including the initial cohort, who underwent allogenic transplantation for AML from 1984 to 1995 at 7 participating institutions. Median age of patients is 33. One hundred forty nine men and 126 women underwent transplant. All patients received marrow from related HLA-identical donors. One hundred seven patients (36%) remain alive. One hundred forty one patients were transplanted in first remission (group I), 43 in second remission (group II) and 111 patients were in > 2nd remission or had refractory disease (group III). The median follow-up of patients in the initial study was 3 years and is 12 years in the current study. Seventy-five percent of patients surviving 3 years after transplantation are estimated survivors 12 years after transplant. Relapse (20), chronic GVHD (5) and infection (3) were the major causes of death in patients who died more than 3 years after transplantation. The estimated relapse rate for group I at 3 and 12 years is 18%(95% CI: 2–32%) and 29% (95% CI 11–47%) for group II is 40% (95% CI: 8–72%) and 52% (95% CI: 16–84%), and group III is 59% (95% CI: 37–81%) and 69% (95% CI: 45–93%) respectively. The estimated leukemia-free survival (LFS) for group I at 3 and 12 years is 60% (95% CI: 44–76%) and 47% (95% CI: 29–65%), for group II is 47% (95% CI: 17–77%) and 34% (95% CI: 4– 64%)and group III is 22% (95% CI: 6–38%) and 15% (95% CI: 1–29%) respectively. Remission stage was predictive of long-term LFS (P<0.001), with patients transplanted in first remission doing better than the rest. Older age was a risk factor for late failure (death or relapse beyond 3 years, P=0.05). Remission stage at transplant (p=0.44), chronic GVHD (P=0.08) and acute GVHD (P=0.12) were not significantly predictive of late failure. In conclusion a vast majority of patients alive and well at 3 years post transplant seem destined to be cured. A proportion of patients do fail beyond 3 years, but the remission stage of disease at transplant is not predictive of late failure.

scholarly journals Silodosin versus Tamsulosin as Medical Expulsive Therapy for Children with Lower-Third Ureteric Stones: Prospective Randomized Placebo-Controlled Study

2021 ◽  
pp. 1-6
Author(s):  
Mohamed G. Soliman ◽  
Osama El-Gamal ◽  
Samir El-Gamal ◽  
Ali Abdel Raheem ◽  
Ahmed Abou-Ramadan ◽  
...  
Keyword(s):  
Randomized Study ◽  
Study Groups ◽  
Controlled Study ◽  
Expulsion Rate ◽  
Medical Expulsive Therapy ◽  
Group Iii ◽  
Group I ◽  
Younger Age ◽  
Significant Difference ◽  
Group Ii

<b><i>Aim:</i></b> To compare the efficacy and safety of silodosin versus tamsulosin as medical expulsive therapy for stones of lower-third ureter in children. <b><i>Patients and Methods:</i></b> This prospective single-blind placebo-controlled randomized study included 167 pediatric patients who presented with distal ureteric stone (DUS) less than 1 cm. Patients were randomized into 3 groups; group I received silodosin 4 mg once daily, and group II received tamsulosin 0.4 mg while those in group III had placebo. The side effects of the used drugs, both rate and time of stone expulsion, and number of pain episodes were compared among the study groups for a maximum of 4 weeks. <b><i>Results:</i></b> Follow-up data of our patients after treatment revealed that the stone expulsion rate was significantly higher and the time to stone expulsion was significantly shorter in group I (89.3%, 12.4 ± 2.3 days) and group II (74.5%, 16.2 ± 4.2 days) compared to group III (51.8%, 21.2 ± 5.6). However, a statistically significant difference between silodosin and tamsulosin groups in favor of the former one was reported regarding the 2 studied items. Meanwhile, pain episodes requiring analgesia were statistically fewer in group I and II in contrast to placebo group. Adverse events were comparable among all groups. <b><i>Conclusion:</i></b> Silodosin provides significantly better stone expulsion rate and shorter expulsion time than tamsulosin for treatment of DUS. Both medications showed good safety profiles in children. However, further studies are required on a larger scale to confirm our results. Assessment of drug safety on younger age-group is still needed.

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