scholarly journals Comparative study of endonasal dacryocystorhinostomy with and without adjunctive topical use of Mitomycin C

2017 ◽  
Vol 5 (7) ◽  
pp. 3208 ◽  
Author(s):  
Ganesh P. Kulkarni ◽  
Ashwini S. Handal
Keyword(s):  
Mitomycin C ◽  
Tertiary Care ◽  
Scar Tissue ◽  
Lateral Nasal Wall ◽  
Tertiary Care Centre ◽  
Endoscopic Dacryocystorhinostomy ◽  
Mucosal Tissues ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Endoscopic dacryocystorhinostomy has now established itself in the treatment of lacrimal obstruction. Failures in endoscopic dacryocystorhinostomy are mainly due to reclosure of the stoma in the lateral nasal wall. Mitomycin-C is an alkylating agent used in the chemotherapy of various cancers. Mitomycin-C when topically applied to mucosal tissues has been reported to inhibit excessive scar tissue and granulation tissue formation, resulting in greater success rates.Methods: To evaluate the efficacy of Mitomycin-C in preventing reclosure of the dacryocystorhinostomy stoma, we performed a prospective, randomized case control study between November 2013 and October 2015. The study was conducted at tertiary care centre. The study sample consisted of 50 patients, who were randomly assigned to two groups, Group A which received the application of Mitomycin-C topically to the dacryocystorhinostomy stomal site and Group B which did not receive this intervention. The patients were regularly followed up for 6 months.Results: 24 patients (96%) out of 25 in the Group A, had a successful surgical outcome. In Group B 23 patients (92%) out of 25 were symptom free after surgery. These results indicated no statistically significant difference between the two groups (p>0.05). Hence the results of this study did not show any significant benefit for the use of Mitomycin-C as an adjunct during primary endoscopic dacryocystorhinostomy.Conclusions: An atraumatic and meticulous surgical technique along with a good follow up care post-operatively establishes endoscopic dacryocystorhinostomy as an effective treatment modality for chronic dacryocystitis.

scholarly journals A comparative study of efficacy and safety of glucosamine plus chondroitin sulphate versus rosehip as add on therapy to NSAIDs in patients suffering from osteoarthritis

2018 ◽  
Vol 7 (11) ◽  
pp. 2254
Author(s):  
Kiranpreet Kaur ◽  
Anjleen Kaur ◽  
Prabhsimran Singh ◽  
Amandeep Singh Bakshi
Keyword(s):  
Comparative Study ◽  
Chondroitin Sulphate ◽  
Tertiary Care ◽  
Efficacy And Safety ◽  
Tertiary Care Centre ◽  
Open Label ◽  
Significant Difference ◽  
Group A ◽  
Efficacy Parameters ◽  
Group B

Background: Osteoarthritis is a chronic and debilitating disease. Management of disease is a big challenge. NSAIDS play an important role but have many adverse reactions. So, this study was designed to evaluate the efficacy and safety of natural compound rosehip versus glucosamine and chondroitin sulphate in patients of osteoarthritis.Methods: An open label, randomized, parallel group comparative study, conducted on patients of either sex with confirmed diagnosis of osteoarthritis on standard NSAIDs therapy, attending the outpatient department of orthopedics in a tertiary care centre.  150 patients were enrolled and divided into three groups (group A, group B and group C) of 50 each. Patients of group A were given Glucosamine plus chondroitin sulphate for 12 weeks. Group B was given rosehip for 12 weeks and group C placebo.  These supplements were given as add on therapy.  Patients were monitored and adverse drug reactions were noted. The data was analysed statistically using t- test for efficacy and descriptive stats for assessing the safety.Results: Efficacy was assessed by comparing mean reduction in the pain intensity between group A and B, group B gives highly significant results as compared to group A. While comparing joint tenderness, swelling around joint, mean functional capacity and improvement in the overall assessment, group B gives significant results as compared to group A. It was also observed that group A and group B were better than group C in all the efficacy parameters. All the drugs were well tolerated and systemically safe.Conclusions: There was significant difference in efficacy of rosehip compared with glaucosamine and chondroitin sulphate in patients of osteoarthritis. In comparison there was no significant difference in safety of two drugs and both were considered safe in patients.

scholarly journals Use of mitomycin c versus gentamicin and dexamethasone in endonasal endoscopic dacrocystorhinostomy

2017 ◽  
Vol 3 (4) ◽  
pp. 857
Author(s):  
Aniket R. Buche ◽  
Sachin H. Garud ◽  
Surendra H. Gawarle ◽  
Gaurav A. Chamania
Keyword(s):  
Mitomycin C ◽  
Tertiary Care ◽  
Nasolacrimal Duct ◽  
Local Application ◽  
Tertiary Care Centre ◽  
Double Blind ◽  
Group A ◽  
Insignificant Difference ◽  
Group B ◽  
Double Blinded

<p class="abstract"><strong>Background:</strong> Dacrocystorhinostomy (DCR) is the procedure done to drain the lacrimal sac in cases of nasolacrimal duct obstruction or in chronic dacrocystitis. New advancements in nasal endoscopic surgeries have given results comparable to external DCR. This is a prospective, case control, randomized, double blinded study to compare efficacy of mitomycin c local application versus gentamicin + dexamethasone local application intraoperatively.</p><p class="abstract"><strong>Methods:</strong> Fifty two patients who underwent endonasal endoscopic DCR at our Tertiary care centre between October 2015 and February 2017. All patients were operated by a single surgeon with double blind method of assigning case. In 26 patients pledgets soaked with 0.4 mg/ml mitomycin C were kept over operative site for 10 min and in other 26 patients pledgets soaked with gentamicin and dexamethasone. Post operatively patients were assessed after 1<sup>st</sup> and 2<sup>nd</sup> week and 1<sup>st</sup> and 3<sup>rd</sup> month after surgery; post-operative complaints of epiphora were graded.  </p><p class="abstract"><strong>Results:</strong> Maximum patients belonged to the age group of 31-60 yrs (78%), females constituted the majority with n=36 (69%). At the end of the study Group A had 92% success and Group B had 85% relief in complaints.</p><p><strong>Conclusions:</strong> We have found statistically insignificant difference between the outcome of local application of Mitomycin C and Gentamicin and dexamethasone. Thus it can be used as substitute or adjuvant with mitomycin C in the intraoperative procedure.</p>

scholarly journals A comparative study in the use of topical mitomycin-C versus nasolacrimal stent in endoscopic dacryocystorhinostomy for chronic dacryocystitis

2017 ◽  
Vol 4 (1) ◽  
pp. 176 ◽  
Author(s):  
Vikas Gupta ◽  
Inderdeep Singh ◽  
Gunjan Dwivedi ◽  
Sunil Goyal ◽  
Manoj Kumar ◽  
...  
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
P Value ◽  
Lacrimal Sac ◽  
Endoscopic Dacryocystorhinostomy ◽  
Chronic Dacryocystitis ◽  
Significant Difference ◽  
Silicone Stent ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Inflammation of the lacrimal sac and duct is a common and unpleasant condition, leading to troublesome epiphora and recurrent dacryocystitis. Surgery is the preferred treatment modality of chronic dacryocystitis which can be performed by external approach or endoscopic nasal approach. Endoscopic dacrycocystorhinostomy (EnDCR) is now a well-established procedure to relieve nasolacrimal duct obstruction, becoming ENT surgeons’ domain. The aim of this study is to assess the efficacy and compare results of intraoperative use of nasolacrimal stent in comparison of mitomycin-C (MMC) in endoscopic dacryocystorhinostomy.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 56 patients with acquired NLDO with epiphora and recurrent dacryocystitis who were evaluated and managed between Oct 2014 and Oct 2016. All patients were offered surgical line of management by endoscopic route. They were randomly assigned into two groups-mitomycin-C group (Group A) and silastic nasolacrimal stenting (Group B). 46 patients who matched inclusion criteria’s were included in the study after formal evaluation by ENT surgeon and Ophthalmologist. 26 patients underwent endoscopic dacryocystorhinostomy with Mitomycin-C application intra – op, 20 patients underwent nasolacrimal silicone stent placement.  </p><p class="abstract"><strong>Results:</strong> At 6-month follow-up visit, the management was considered successful if the lacrimal sac irrigation succeeded with relief of symptoms. The success rate in Group A was 92.30%. Group B had 85% success rate. However, no significant (p value=0.37) was noticed between two groups.</p><p><strong>Conclusions:</strong> Despite, no significant difference in outcome between two modalities, there is a trend towards the better outcome with use of mitomycin-C. Mitomycin-C is a safe, effective, and economical adjuvant in endoscopic DCR assisting in improved outcomes of surgery. </p>

scholarly journals Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

2019 ◽  
Vol 8 (10) ◽  
pp. 2197
Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig
Keyword(s):  
Tertiary Care ◽  
Nausea And Vomiting ◽  
Research Centre ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
First Line Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

scholarly journals Evaluation of therapeutic effectiveness of vitamin D3 injections in common warts in a tertiary care centre

2019 ◽  
Vol 5 (3) ◽  
pp. 462
Author(s):  
Sushmalatha Banoth
Keyword(s):  
Vitamin D3 ◽  
Normal Saline ◽  
Tertiary Care ◽  
Treatment Session ◽  
Tertiary Care Centre ◽  
Cutaneous Manifestations ◽  
Multiple Modalities ◽  
Common Warts ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Warts or verrucae are the benign cutaneous manifestations caused by human papilloma virus. The treatment of wart possess a therapeutic challenge, as a result multiple modalities are existing for the treatment of cutaneous warts, which is cumbersome and may result in cosmetic disfigurement, chances of recurrences. The aim of the present study was to determine the resolution of common warts in response to vitamin D3 injections and to compare the resolution of common warts in the group receiving vitamin D3 with placebo group receiving normal saline.</p><p class="abstract"><strong>Methods:</strong> A total of 26 patients were enrolled and divided into Group A- received lesional injection of 0.2 ml vitamin D3 every 3 weeks for 3 months for the improvement in the size of warts. Group B- received 0.2 ml of normal saline injections as a control. The maximum of three sessions were carried in both groups. Clinical assessment was done by photographic evaluation at baseline, before each treatment session, and after completion of treatment.<strong></strong></p><p class="abstract"><strong>Results:</strong> In group A, 76.92% (10) of the patients showed complete clearance of wart with vitamin D3 injection, while in group B 8% (1) of patients with normal saline showed partial response. This therapy was well tolerated except for the minimal side effects like pain, redness and swelling at the site of injection.</p><p class="abstract"><strong>Conclusions:</strong> Intralesional Vit D3 injections may be a treatment option for warts, which has a good cosmetical acceptance and simple, well tolerated easily administrated in outpatient clinic rather than conventional treatment.</p>

Treatment of Major Laparoscopic Bile Duct Injury: A Long-Term Follow-up Result

2011 ◽  
Vol 77 (12) ◽  
pp. 1584-1588 ◽  
Author(s):  
Xiao Dong Xu ◽  
You Cheng Zhang ◽  
Pen Gao ◽  
Farah Bahrani-Mougeot ◽  
Ling Yi Zhang ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Duct Injury ◽  
Tertiary Care ◽  
Secondary Operation ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Group D

The goal of this study is to present the multiple institutions experience comparing the outcome of management between initial laparoscopic cholecystectomy (LC) surgeon and specialist as well as the outcome of different operative procedures to major bile duct injury (BDI) after LC. We have retrospectively collected data of 77 cases of perioperatively detected major BDI in LC at 15 general surgical institutions from 1997 to 2007. We classified 42 cases treated by an experienced biliary surgeon as Group A and 35 cases treated by the initial LC surgeon as Group B. Forty-eight cases were treated with duct-to-duct anastomosis as Group C and 29 cases were treated with Roux-en-Y choledochojejunostomy as Group D. The median duration of follow-up was 62 months. The outcome of groups was compared. In Group A, 7 of 42 (16.7%) patients developed a failure. Two of seven (28.6%) patients were treated by a secondary operation. In Group B, 24 of 35 (68.6%) patients developed a failure. Seventeen of 24 (70.8%) patients were treated by a secondary operation. One of 35 (2.85%) patients died. The significant differences were observed in failure and secondary operations (16.7 vs 68.6%, P < 0.01 and 28.6 vs 70.8%, P < 0.01). There is no significant difference Group C and Group D in failure rate (28.5 vs 11.7%, P > 0.05). A multiple institutional cooperative methodology between the local surgical institution and tertiary care centers provided a good way to limit further operations, failure. The reconstructive strategy is important and should be selected according to the type of injury and the diagnosed status of major BDI.

Is Gastrectomy Safe in the Elderly? A Single Institution Review

2011 ◽  
Vol 77 (4) ◽  
pp. 488-492 ◽  
Author(s):  
Eric S. Hager ◽  
Hamid Abdollahi ◽  
Albert G. Crawford ◽  
Neil Moudgill ◽  
Ernest L. Rosato ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Hospital Mortality ◽  
Gastric Resection ◽  
Tertiary Care ◽  
The Elderly ◽  
The United States ◽  
Mortality Rates ◽  
Significant Difference ◽  
Group A ◽  
Group B

The population of the United States is aging. Studies within the last several years have demonstrated that major abdominal operations in elderly patients can be done safely, but with increased rates of complications. We set out to determine the rates of morbidity and mortality in elderly patients undergoing gastric resection at a tertiary care university hospital. A retrospective analysis was performed of 157 consecutive gastric resections between January 1998 and July 2007. Group A (n = 99) consisted of patients < 75-years-old at surgery, whereas group B (n = 58) included patients who were ≥ 75 years of age at time of surgery. These two groups had their clinical and demographic data analyzed. Postoperative length of hospital stay, perioperative major morbidity, and in-hospital mortality were analyzed using analysis of variance, χ2, and multivariate analyses. The average age of patients in group A was 57 years, compared with 81 years in group B. We found no significant difference in the percentage of gastric resections for malignancy (group A, 49% vs group B, 62%) or emergency surgery (group A, 10% vs group B, 10%) between age groups. There was a significant increase in length of stay in the older patients (11.7 days vs 17.6 days; P = 0.032), as well as major complications (11.1% in group A vs 27.6% in group B; P = 0.008). The in-hospital mortality rates approached significance (group A, 4% vs group B, 12%; P = 0.057). Gastric resection in elderly patients carries with it longer hospital stays, higher risk of complications, and in-hospital mortality rates despite similarity in patient disease. This information is imperative to convey to the elderly patients in the preoperative period before gastric resection.

scholarly journals Comparison of prophylactic versus regular use of antibiotics in elective major obstetrical and gynecological surgeries

2019 ◽  
Vol 8 (2) ◽  
pp. 580
Author(s):  
Ramya Sreevarshni Shunmugha Sundharam ◽  
Hiremath P. B. ◽  
Sankareswari R.
Keyword(s):  
Tertiary Care ◽  
Prophylactic Antibiotic ◽  
Mean Value ◽  
Controlled Study ◽  
Therapeutic Drug ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Surgical site infections better prevented by parenteral antibiotic in sufficient doses generally should be given before the operation which helps to achieve the therapeutic drug level both in the blood and related tissue during the operation. Ceftriaxone, when administered together as a prophylaxis can fulfil the above criteria of a good antibiotic. Thus, this study was planned to assess the efficacy of prophylactic antibiotic usage to that of regular antibiotics usage in patients undergoing elective surgeries.Methods: This randomized controlled study was conducted in a tertiary care teaching hospital during the study period of June 2017 to April 2018 with 140 cases. Group A received a single dose of Injection Ceftriaxone 1g. Group B, received Injection Ceftriaxone 1 gm and Injection Metronidazole 500 mg for five days. The data was entered in excel sheet and analyzed using SPSS (Version 16).Results: The mean age group in Group A and Group B was found to be 34.24±10.5 and 35.97±11.89, respectively. There was no statistical significance between group A and B for incidence of infection in the post-operative period and duration of hospital stay. The mean value in group A for duration of surgery was found to be 67.5±13.5 and in group B mean value was 72.1±14.9. (p value <0.05).Conclusions: This study demonstrated that administration of prophylactic antibiotic rather than conventional antibiotic at caesarean and gynecological surgeries are not associated with significant difference in post-operative morbidities.

scholarly journals An Epidemiological Study of Cut Throat Injury During COVID-19 Pandemic in a Tertiary Care Centre

2020 ◽  
Author(s):  
Souvagini Acharya ◽  
Rajat Kumar Dash ◽  
Aurobinda Das ◽  
Madhusmita Hota ◽  
Chittaranjan Mohapatra ◽  
...  
Keyword(s):  
Social Stigma ◽  
Tertiary Care ◽  
Vulnerable Groups ◽  
Temporal Association ◽  
Tertiary Care Centre ◽  
Online Data ◽  
Common Mode ◽  
Group A ◽  
Group B ◽  
Source Of Information

Abstract To find out incidence, prevalence, various modes and pattern of cutthroat injury during COVID-19 pandemic and compare with prior non pandemic period. To find out the various factor influencing the suicidal cutthroat and establish the temporal association of suicidal cutthroat with COVID-19 pandemic. It is a retrospective study of cutthroat patients who were managed in ENT Dept. VIMSAR, Burla, Sambalur, Odisha, India from 1st September 2019 to 31st August 2020. Source of information are casualty, IPD and OT registers and online data. Total cases were divided into group-A (prior to COVID-19 pandemic) and group-B (during COVID-19 pandemic) and analysed. Total 24 cutthroat injury cases were treated over 1 year in department of ENT, VIMSAR, Burla, which was 0.054% of total cases attended at casualty and 2.371% of total IPD patients treated. In GROUP-A, total 10 cases with M:F = 9:1,suicidal 4 cases (40%), homicidal 6 cases (60%), and no accidental cases were recorded. While in GROUP-B, total 14 case with M:F = 14:0, suicidal 9 cases (64.28%), homicidal 3 cases (21.42%) and accidental 2 (14.28%) cases were recorded. In our study majority of cases were male with M:F = 23:1. Common age group belongs to 20–30 years with LSES and farmer by occupation. Zone II injury had incidence of 70.83%. Homicide cases proportionally high during non-COVID period while suicide cases high during COVID-19 pandemic. Association of COVID-19 pandemic with suicidal cut throat injury is seems to be significant. Among predisposing risk factors for suicidal, depression during COVID-19 pandemic had seen in 53.84% of total suicidal cases. Incidence and prevalence of Cut throat injury is comparatively high in western odisha which again increases during months of July and August parallel to COVID-19 pandemic. The common mode of cutthroat injury is homicidal, which suddenly changes to suicidal during COVID-19 pandemic. More vulnerable groups were young unemployed male, farmers and labours. Cutthroat injury cases definitely increases during COVID-19 pandemic with most common mode of injury being suicidal attempt, which may be due to economical and psychological imbalances, due to loss of job and fear and social stigma for COVID-19 diseases.

scholarly journals Comparing efficacy of Rifaximin plus Lactulose vs. Lactulose alone in treating Hepatic Encephalopathy

2020 ◽  
Vol 24 (4) ◽  
pp. 339-343
Author(s):  
Tanveer Hussain ◽  
Misbah Sattar ◽  
Sara Mustafa ◽  
Uzma Batool ◽  
Shafqat Iqbal ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Local Population ◽  
Tertiary Care ◽  
Simple Random Sampling ◽  
Complete Recovery ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Hepatic Encephalopathy is a syndrome observed in patients with liver cirrhosis. Various treatment modalities are in use for treatment of Porto Systemic Encephalopathy (PSE). Our study aimed to compare the efficacy of Rifaximin plus Lactulose vs.Lactulose alone in treating Hepatic Encephalopathy in local population. Materials & Methods: The study was conducted at a tertiary care hospital recruiting decompensated chronic liver disease(DCLD) patients with PSE. Using simple random sampling, patients were divided in two groups (A & B). Patients in group A received Lactulose plus Rifaximin while group B received Lactulose alone. Efficacy of treatment was assessed as return of the conscious level to pre-encephalopathy state as per clinical examination within 1 week after  start of the treatment. Results: A total of 124 patients were included in the study with each group (A & B) containing 62 patients. Frequency and percentage of efficacy among group A (Rifaximin plus Lactulose) verses group B (Lactulose alone) in treating Hepatic encephalopathy was 45 (72.6%) and 32 (51.6%) respectively. Conclusion: The study concluded that there is a significant difference in proportions of patients showing complete recovery from Hepatic encephalopathy treated with Lactulose plus Rifaximin as compared to Lactulose alone.

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