scholarly journals Management of syndactyly: a clinical study

2019 ◽  
Vol 6 (8) ◽  
pp. 2806
Author(s):  
Nagaprasad Nangineedi ◽  
Gangavaram Praveen Harish ◽  
Mohammed Rafi
Keyword(s):  
Clinical Study ◽  
Treatment Strategies ◽  
Prospective Clinical Study ◽  
Basic Principles ◽  
Operative Complications ◽  
Web Space ◽  
Almost All ◽  
Surgical Corrections ◽  
The Web

Background: Syndactyly is a congenital anomaly, basic principles of surgical release of syndactyly have been well established, each patient requires a thorough assessment of the soft-tissue and bony components in the syndactylized region. Reconstruction must be planned carefully when more than two digits are involved or when the syndactyly is a component of a systemic congenital syndrome. The aim of the treatment strategies for syndactyly is to separate the fused digits, create a functional hand, and produce an aesthetically acceptable web.Methods: The prospective clinical study is conducted in the Department of Plastic & Reconstructive surgery, between October 2016 to October 2018. Twenty six patients with congenital syndactyly and post burn syndactyly of fingers were included in this study.Results: There were no intra operative complications and no cases had any neurovascular compromise. Integrity of Dorsal and volar flaps, quality of scars, aesthetical aspects of fingers are reasonably good in almost all the cases that are operated in this study. Overall 97% of patients treated achieved good function and superior results following single surgery.Conclusions: Primary syndactyly is more common than secondary syndactyly. In this study the primary goal is separation of fused digits/toes and covering the web space with dorsal flap, and covering the separated digits/ toes with a graft and create a functional hand and produce an aesthetically web with fewest complications and fewest surgical corrections. 

scholarly journals Full in-Office Guided Surgery with Open Selective Tooth-Supported Templates: A Prospective Clinical Study on 20 Patients

2018 ◽  
Vol 15 (11) ◽  
pp. 2361 ◽  
Author(s):  
Francesco Mangano ◽  
Uli Hauschild ◽  
Oleg Admakin
Keyword(s):  
Clinical Study ◽  
Low Cost ◽  
Prospective Clinical Study ◽  
3D Printer ◽  
Guided Surgery ◽  
Operative Complications ◽  
Edentulous Patients ◽  
One Year ◽  
Single Crowns ◽  
Surgical Templates

Background: Guided implant surgery appears to have several benefits, such as the possibility of inserting flapless implants in a prosthetically driven manner, avoiding dangerous anatomical structures. However, to date, only a few surgeons routinely use guided surgery in partially edentulous patients. Aim: To present the results obtained with tooth-supported surgical templates characterized by an innovative open design with selective support, and manufactured via a full in-office procedure with a low-cost desktop 3D printer. Methods: Over a two-year period (2016–2018), all partially edentulous patients with one to three missing teeth (in maxilla and/or mandible), referred to a private dental practice for restoration with dental implants, were considered for inclusion in this prospective clinical study. An intraoral scanner (CS 3600®, Carestream Dental) and cone beam computed tomography (CS 9300®, Carestream Dental) were used to acquire the 3D information on the patients. Guided surgery software (SMOP®, Swissmeda) was used to plan the surgeries and to design open, selective, tooth-supported templates that were fabricated with a stereolithographic (SLA) desktop 3D printer (XFAB2000®, DWS). Guided implant surgeries were performed and patients were followed for a period of one year. The study outcomes were fit and stability of surgical templates, duration (time) of surgery, intra and post-operative complications, and implant stability and survival. Results: Twenty (20) partially edentulous patients (9 males, 11 females; mean age 54.4 ± 9.4 years) were included in the study; 28 open, selective, tooth-supported templates were designed with the aim of inserting 38 implants. Among the surgical templates, 24 had optimal fit and stability, three had optimal fit and sufficient stability, and only one had inadequate fit and unsatisfactory stability and was therefore not suitable for clinical use. The average time of the intervention was 15.7 ± 5.2 min per template. No intra-operative complications were reported, but one implant was not stable at placement and had to be removed. In total, 36 implants were restored with 10 two-unit fixed partial prostheses and 16 single crowns. All implants were successfully functioning at one year, even if, in two single crowns, minor prosthetic complications (abutment screw loosening) occurred. Conclusions: Full in-office guided surgery with open, selective, tooth-supported templates seem to represent a clinically predictable surgical procedure to restore partially edentulous patients. Further studies are needed to confirm these positive outcomes.

Impact of crown fracture treatment on oral health-related quality of life of children, adolescents, and their families: A prospective clinical study

2018 ◽  
Vol 29 (1) ◽  
pp. 86-93 ◽  
Author(s):  
Marcela Baraúna Magno ◽  
Lucas Alves Jural ◽  
Ayla do Valle Nogueira ◽  
Michele Machado Lenzi ◽  
Matheus Melo Pithon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Study ◽  
Oral Health ◽  
Prospective Clinical Study ◽  
Fracture Treatment ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Resistance-Guided Treatment of Gonorrhea: A Prospective Clinical Study

2020 ◽  
Author(s):  
Jeffrey D Klausner ◽  
Claire C Bristow ◽  
Olusegun O Soge ◽  
Akbar Shahkolahi ◽  
Toni Waymer ◽  
...  
Keyword(s):  
Single Dose ◽  
Clinical Study ◽  
Scale Up ◽  
Treatment Strategies ◽  
Prospective Clinical Study ◽  
Dose Oral ◽  
Novel Treatment Strategies ◽  
Oral Ciprofloxacin ◽  
Culture Positive

Abstract Background Novel treatment strategies to slow the continued emergence and spread of antimicrobial resistance in Neisseria gonorrhoeae are urgently needed. A molecular assay that predicts in vitro ciprofloxacin susceptibility is now available but has not been systematically studied in human infections. Methods Using a genotypic polymerase chain reaction assay to determine the status of the N. gonorrhoeae gyrase subunit A serine 91 codon, we conducted a multisite prospective clinical study of the efficacy of a single oral dose of ciprofloxacin 500 mg in patients with culture-positive gonorrhea. Follow-up specimens for culture were collected to determine microbiological cure 5–10 days post-treatment. Results Of the 106 subjects possessing culture-positive infections with wild-type gyrA serine N. gonorrhoeae genotype, the efficacy of single-dose oral ciprofloxacin treatment in the per-protocol population was 100% (95% 1-sided confidence interval, 97.5–100%). Conclusions Resistance-guided treatment of N. gonorrhoeae infections with single-dose oral ciprofloxacin was highly efficacious. The widespread introduction and scale-up of gyrA serine 91 genotyping in N. gonorrhoeae infections could have substantial medical and public health benefits in settings where the majority of gonococcal infections are ciprofloxacin susceptible. Clinical Trials Registration NCT02961751.

Current approaches in the treatment of malignant ascites in Germany and Austria.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20670-e20670
Author(s):  
Diana Lueftner ◽  
Susanne Küpferling ◽  
Gülten Oskay-Özcelik ◽  
Christian Jehn
Keyword(s):  
Quality Of Life ◽  
Poor Prognosis ◽  
Systemic Chemotherapy ◽  
Diuretic Therapy ◽  
Treatment Strategies ◽  
Healthcare Facility ◽  
Malignant Ascites ◽  
Almost All ◽  
Volume Substitution

e20670 Background: Malignant Ascites (MA) is a common manifestation of advanced cancer associated with a poor prognosis and decreased quality of life. Currently there are no evidence based guidelines for the management of MA and only one agent is approved for its treatment. We conducted a survey with physicians throughout Germany and Austria, to get an overview of current approaches and opinions in the treatment of MA. Methods: 128 medical oncologists (MO), gastroenterologists (GE) and gynecologists (GYN) completed an electronic questionnaire consisting of 33 questions. Answers were evaluated with descriptive statistics. Results: 90% of the physicians were from Germany, 10% from Austria. 48% of those were MO, 30% were GYN and 14% were GE. Most physicians treated an average of 34 pts/year with MA. 26% of these pts suffered from ovarian, 20% from pancreatic, 17% from gastric and 14% from colorectal cancer. The majority of the physicians associated MA with poor prognosis (92%) and significant reduction in quality of life (87%). One third felt MA was a contraindication for full dosing of systemic chemotherapy. Paracentesis (P) was performed in 70% of pts with with symptom relieve and quality of life being the main reasons. Almost half of the pts required 3-5 P, 50% even more than 5 P during the course of their disease. Only 15% of pts needed multiple P per week, the majority (79%) needed the procedure either once a week or every 14 days. In 61% of pts 3-5 l ascites fluid was drained. Only in 8%, 5 l and more were removed. Volume substitution with IV albumin was performed in 40% of pts. Most pts (55%) had to stay 1-3h in a healthcare facility for the procedure. However 21% had to stay > 1 day. While almost all physicians (89%) performed a P at some point in the treatment of MA, 75% felt that a systemic chemotherapy and 55% thought a concomitant diuretic therapy were a necessary adjunct. 7% of the pts received a targeted treatment with catumaxomab. Conclusions: Even though repeated P is the main pillar of treatment of MA, its effect is only temporary, must be performed multiple times, requiring hospital resources. Further treatment strategies have to be evaluated in prospective studies. Targeted therapies like catumaxomab should be integrated into these.

Quality of Life Assessment after Laparoscopic and Open Fundoplications Results of a Prospective, Clinical Study

1996 ◽  
Vol 31 (11) ◽  
pp. 1052-1058 ◽  
Author(s):  
A. Blomqvist ◽  
H. Lönroth ◽  
J. Dalenbäck ◽  
M. Ruth ◽  
I. Wiklund ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Study ◽  
Life Assessment ◽  
Prospective Clinical Study ◽  
Quality Of Life Assessment

An exploratory prospective clinical study to assess the combined effect of Virechana and Raktamokshana in Vicharchika - A Case Study.

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Paresh Katariya ◽  
Mayur Pawaskar ◽  
Nikhil Joglekar ◽  
Yogesh Katariya ◽  
Arati Datye
Keyword(s):  
Clinical Study ◽  
Skin Disease ◽  
Marked Improvement ◽  
Lower Extremities ◽  
Combined Effect ◽  
Prospective Clinical Study ◽  
Choice Of Treatment ◽  
Almost All

Vicharchika is one of the Kshudra Kushta (skin disease). Kashyapa mentioned it as Sadhya Vyadhi. Almost all symptoms are Vata-Pitta or Kapha-Pitta predominant and even Tridosha involvement and it is specifically located at lower extremities. The choice of treatment is Virechana (purgation) and Raktamokshan (bloodletting). We can use this modality as per requirement. Kandu (itching), Pidika (pimples), Bahusrava (discharge) get relieved completely (100%) after Virechana. Mild effect was noticed in Shyava (blackish discoloration) and Rukshata (dryness) i.e. (33.33%). Highly significant result found after both the therapies (Virechana and Raktamokshana) and marked improvement was seen in Shyava and Rukshata after Raktamokshana. It shows over all Ayurvedic modality gives very good result in Vicharchika..

scholarly journals Complications associated with splenectomy in thalassemia

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Farogh Zahra ◽  
Muhammad Ashraf ◽  
Muhammad Aslam ◽  
Qaim Deen ◽  
Javeria Mannan
Keyword(s):  
Clinical Study ◽  
Study Design ◽  
Perioperative Management ◽  
Late Complications ◽  
Prospective Clinical Study ◽  
Massive Splenomegaly ◽  
Study Materials ◽  
Operative Complications ◽  
Post Operative Complications

Aims and Objectives: The study aims at investigating the complications associated with splenectomy in thalassemic patients Study Design: It was a prospective clinical study. Materials and Method: Sixty Splenectomies were preformed electively after pre-operative preparation in Sir Ganga Ram Hospital, Lahore during the year Jan 2003 to Sep 2005. Results: Complications were categorized into per-operative, early post-operative and late complications. The frequency of per-operative complications was 3%, early post-operative complications were 10% and late complications were 1.6%. Interpretation and Conclusion: The rate of complications has decreased markedly as the patients are well prepared and improved post operative carp has also reduced the post-operative complications. With good perioperative management, splenectomy in children with massive splenomegaly is both safe and effective.

scholarly journals The Effect of Endoscopic Sinus Surgery on Quality of Life: A Prospective Clinical Study

2015 ◽  
Vol 1 (1) ◽  
pp. 14
Author(s):  
Zeynep SAYAR ◽  
Mehmet Haksever ◽  
Davut AKDUMAN ◽  
Sündüs Aslan ◽  
Fevzi Solmaz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Study ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Prospective Clinical Study
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