scholarly journals Biological dressing is a paradigm shift in children’s scald burn: our experience

2021 ◽  
Vol 8 (11) ◽  
pp. 3339
Author(s):  
Madhusoodan Gupta ◽  
Deepti Varshney
Keyword(s):  
Paradigm Shift ◽  
Skin Color ◽  
Burn Injury ◽  
Cost Effective ◽  
Hot Water ◽  
Frequent Change ◽  
Gauze Dressing ◽  
A Prospective Study ◽  
Early Wound

Background: Burn injury has multiple causes but scald burn is the most common type of burn in children. Prototype of scald burn is hot water burn. Change of burn dressing in children is challenging. Biological collagen dressing has totally changed the management of scald burn or it is a paradigm shift in the management of scald burn in children. Aim of this study was to achieve early wound healing with less complication and to prevent change of frequent dressings in children.Methods: A prospective study was done in 30 patients of scald burn under 12 years of age between November 2020 to July 2021. Meticulous debridement and deroofing of all blisters and removal of dead skin were performed. Bovine meshed wet collagen dressing was thoroughly rinsed with normal saline three times to remove the preservative isopropyl alcohol. After that collagen dressing applied over the raw area. Paraffin with chlorhexidine impregnated gauze dressing applied over the collagen. First dressing was changed at post operative day five.Results: All burn wounds healed well between 10-14 days without any complications. In follow up no hypertrophy of skin and almost same skin color had noted.Conclusions: We conclude that collagen dressing is a paradigm shift in the management of scald burn. It is cost effective, pain less, requires less frequent change of dressing with good match of skin color.

scholarly journals The efficacy of collagen based dressings for treatment of scald burns in under 5 years paediatric population: a non-comparative, prospective single centre experience

2018 ◽  
Vol 5 (10) ◽  
pp. 4298
Author(s):  
Mohammed Fahud Khurram ◽  
MohdMohd Tafazul Sheikh ◽  
Imran Ahmad ◽  
Sudheer Kumar Maurya ◽  
Vivek Ambedkar ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Cost Effective ◽  
Paediatric Population ◽  
Frequent Change ◽  
Burn Wounds ◽  
Single Centre Experience ◽  
Healing Of Wounds ◽  
Gauze Dressing ◽  
A Prospective Study ◽  
Burnt Areas

Background: One of the major challenges faced worldwide is management of burn wounds, particularly among the pediatric population. Immense research is going on to overcome the challenges associated with survival of these patients and healing of burnt areas. Newer dressing materials are being developed and one of them is collagen. The collagen is biocompatible. The aim was to achieve earlier and better healing of wounds, and to obviate the need for frequent change of dressings; which besides being painful, is quite troublesome in pediatric population.Methods: A prospective study was conducted in 38 patients of scald burns under-5 years of age, from October 2016 till July 2017. After thorough cleaning of burn wounds and thorough rinsing of collagen sheets with normal saline, the wounds were covered with sheets of collagen. Paraffin with chlorhexidine impregnated gauze dressing was applied over the sheet of collagen followed by dry gauze, cotton and bandage application. First dressing was opened after 5 days and then after 3 to 4 days.Results: The wounds healed in 10 to 14 days in most of them. Infection developed in one case, warranting removal of collagen sheet. None developed any adverse reaction to the application of collagen dressing.Conclusions: We conclude that collagen based dressing is a very good modality of treatment for the burn wounds with advantages of being cost effective, requiring lesser number of dressings and blood transfusions, and shorter duration of hospital stay.

A Prospective Study of Clinical Outcomes in Laryngopharyngeal Reflux Diseases Following Treatment with Proton Pump Inhibitors in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (28) ◽  
pp. 2538-2543
Author(s):  
Binu Raju George ◽  
Ajayan P.V ◽  
Saify Samad
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Laryngopharyngeal Reflux ◽  
Cost Effective ◽  
Reflux Symptom ◽  
P Value ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
A Prospective Study

BACKGROUND Laryngopharyngeal reflux (LPR) is found to be a common disease encountered in Otolaryngology practice. LPR presents clinically with symptoms of laryngeal irritation, frequent throat clearing, cough, and hoarseness of voice. The main diagnostic methods currently used are Fiber-optic laryngoscopy and in some centers pH monitoring. Proton pump inhibitors (PPIs) are used and found to be cost-effective and useful for the treatment of LPR. The main objective of this study was to study the effectiveness of PPIs in alleviating the symptoms assessed using Reflux Symptom Index (RSI) score and Reflux Finding Scores (RFS). METHODS A prospective study was carried out on 100 patients attending the ENT OPD of Government Medical College and Hospital, Thrissur, Kerala. Patients were evaluated for improvement in symptoms of Laryngopharyngeal reflux disease following use of proton pump inhibitors, using Reflux symptom index and Reflux finding scores using 70 degree / flexible nasopharyngolaryngoscopy. Patients with clinical findings of LPRD with RSI score > 13 and RFS score > 7 were given a standard treatment protocol followed in our ENT department using Tab. Pantoprazole 40 mg twice daily before food and the treatment response was assessed by proper follow up at 6 weeks and 12 weeks. On each follow up visit, improvement in RSI and RFS scores with Proton pump inhibitor therapy was assessed. Data collected was then tabulated and analysed. RESULTS The study was conducted in 100 patients, 59 % of whom were females and 41 % males. Mean RSI score changed from 18.9 at the beginning to 14.5 at 6 weeks of treatment and 9.0 at 12 weeks of treatment with Proton pump inhibitor. Mean RFS score changed from 10.7 at the beginning to 8.7 at 6 weeks of treatment and to 5.9 at 12 weeks of treatment. Comparison of mean Reflux Symptom Index and mean Reflux Finding Scores before and after treatment revealed improvement and the result was statistically significant (p value < 0.001). CONCLUSIONS The use of RSI and RFS scores in the assessment of PPIs at fixed intervals is cost effective and avoids time consuming and cost intensive examinations. These scores also help in early diagnosis and long term follow up of LPR patient. Fixed time interval PPI treatment significantly improved RSI and RFS scores in LPR patients. The mean RSI score changed from 18.9 at the beginning of treatment to 14.5 at 6 weeks after treatment (p value < 0.001) and 9.0 after 12 weeks of treatment; (p value < 0.001) The mean RFS score changed from 10.7 at the beginning of treatment to 8.7 at 6 weeks after treatment (p value < 0.001) and 5.9 after 12 weeks of treatment; (p value < 0.001). KEYWORDS Laryngopharyngeal Reflux, Reflux Symptom Index, Reflux Finding Score

scholarly journals STEENBEEK FOOT ABDUCTION BRACE FOR CLUBFOOT: COST EFFECTIVE BUT IS IT EFFECTIVE? A PROSPECTIVE STUDY

2017 ◽  
Vol 10 (5) ◽  
pp. 99 ◽  
Author(s):  
Thatikonda Sai Dinesh ◽  
Prem Kotian
Keyword(s):  
Cost Effective ◽  
Ponseti Method ◽  
Exact Test ◽  
Pirani Score ◽  
Proven Efficacy ◽  
The Status ◽  
Cost Effective Alternative ◽  
A Prospective Study ◽  
Fischer Exact Test

Introduction: Foot Abduction Brace is recommended to prevent recurrence after casting phase in Ponseti method. Various types of braces are described, most current braces with proven efficacy are costly(100-300$) and difficult to acquire especially for the common man in India. Steenbeek brace can be made with locally available materials and is very simple to make and is cost effective(10$). Its efficacy is largely untested.Aim: To evaluate effectiveness of Steenbeek foot abduction brace to maintain correction achieved and to study the reasons for failure and complications associated with the brace.Materials and Methods: In KMC Mangalore and allied hospitals between Jun’2014-Aug’2016 25patients (38feet) who were treated by Ponseti method of cast application were given the Steenbeek foot abduction brace and followed up for a minimum duration of 1 year. The Status of foot was assessed using Pirani score before brace application and at every follow-up. Compliance with the brace protocol was assessed and Compliance defined as brace application for 23 hours/day for the first three months, and nap time brace application for rest of the duration of study.Results: In 36 of 38 feet on the brace the correction was maintained(94.7% effective). In two patients(feet) there was worsening of the Pirani score after brace application and recurrence was seen. The reason for failure was found to be non compliance. The correlation between noncompliance and recurrence was significant(p <0.001) using Fischer Exact Test. Pirani score improved significantly in compliant group with significant worsening noted in noncompliant group. There were no other brace related complications.Conclusions: The significant correlation between noncompliance and recurrence shows that Steenbeek FAB is effective in maintaining correction and can be a cost-effective alternative to the more costly braces, for use in developing countries.

scholarly journals Aspiration sclerotherapy: a novel and cost-effective approach to the management of hydroceles in a developing country

2017 ◽  
Vol 4 (12) ◽  
pp. 3884
Author(s):  
Arijit Roy ◽  
Vijay Jain ◽  
Jahar Majumdar
Keyword(s):  
Success Rate ◽  
Indirect Costs ◽  
Cost Effective ◽  
Prophylactic Antibiotics ◽  
Chi Square ◽  
Cost Effective Approach ◽  
High Satisfaction ◽  
Chi Square Test ◽  
A Prospective Study

Background: The present study was carried out with an aim to perform a prospective study to establish the role of sodium tetradecyl sulfate (3 %) (STDS) as a safe and effective sclerosant in the management of primary hydroceles.Methods: Sclerotherapy was performed with 3 % STDS on an outdoor basis. The amount of sclerosant injected depended on the amount of fluid drained. All patients were given prophylactic antibiotics. Patients were clinically reassessed at 1 week, 1 month, 3 months, and 6 months and earlier if complications occurred. All patients were given prophylactic antibiotics.  The data were analyzed using Statistical Package for Social Sciences Version 15.0. The data have been represented as frequencies and percentages. Chi-square test was used to compare the data. A total of 57 patients with primary vaginal hydrocele gave consent for being enrolled in the study. The age of patients ranged from 18 to 65 years with a mean age of 35.72±13.18 years.Results: The success rate at the end of the study was observed to be 84.2 %. As regards patient satisfaction, in present study, in a limited time period of follow up, all the patients who had a successful procedure were satisfied.Conclusion: Overall, sclerotherapy was observed to be a relatively cost-effective (including both direct and indirect costs) procedure with low complications, high satisfaction, faster return to work and a high success rate within the limited period of follow-up.

Submental Island Flap Combined With Reconstruction Titanium Plate: A New Way to Treat Mandibular Osteoradionecrosis

2020 ◽  
pp. 155335062094589
Author(s):  
Jin Li ◽  
Lu Nie ◽  
Lei Wang ◽  
Xiangyang Xu ◽  
Shiwei Liu ◽  
...  
Keyword(s):  
Cost Effective ◽  
Bone Defects ◽  
Safe Procedure ◽  
Titanium Plate ◽  
Immediate Reconstruction ◽  
Partial Necrosis ◽  
Submental Flap ◽  
Gauze Dressing ◽  
Submental Island Flap

Objective. The purpose of this study was to investigate the effect of reconstruction for bone defects in patients with mandibular osteoradionecrosis using submental flap combined with reconstructive titanium plate. Methods. A total of 23 patients with mandibular osteoradionecrosis were included. All patients underwent surgical resection and immediate reconstruction with submental flap combined with reconstructive titanium plate. The postoperative effects and flap success rate were evaluated with a 6- to 18-month follow-up. Results. Twenty-two flaps were successful; 1 flap suffered from partial necrosis in the distal end, but the patient was treated with hyperbaric oxygen therapy and iodoform gauze dressing, and no plate exposure was found after operation in the follow-up period. Conclusion. The use of submental flap combined with reconstructive titanium plate for treating the patients with osteoradionecrosis is a feasible, cost-effective, simple, and safe procedure.

scholarly journals Functional outcome of JESS fixation and bone grafting in distal tibial plafond-pilon fracture: a prospective study

2018 ◽  
Vol 4 (4) ◽  
pp. 659
Author(s):  
Reji Varghese ◽  
Shajimon Samuel
Keyword(s):  
Functional Outcome ◽  
Bone Grafting ◽  
Cost Effective ◽  
Type Ii ◽  
Pilon Fracture ◽  
Type Iii ◽  
Tibial Plafond ◽  
Loss Of Reduction ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> The Pilon fractures are one of the most difficult to treat. Fracture known as “orthopedicians nightmare”. The incidence of complications following ORIF of pilon ranges from 10-55% and other complication are infection, loss of reduction, secondary arthrosis. In these circumstances JESS and Bone grafting is cost effective and less hospitalization. Our aim was to evaluate in the functional outcome of JESS fixation and bone grafting in distal tibial plafond- pilon fracture using Olerud and Molander score.</p><p class="abstract"><strong>Methods:</strong> The JESS fixation and bone grafting was used for pilon fracture in 30 patients, 24 male and 6 female. Mean age 44 years range (18-60 years). Fractures caused by fall and RTA. All were treated with JESS fixation and bone grafting. the patients were assessed clinically and radiographically at regular interval of 1 month and later 2 months interval. Outcome was assessed using Olerud and Molander score. Complications were recorded.<strong></strong></p><p class="abstract"><strong>Results:</strong> 12 patients had Ruedi and Allgower type II fracture and 18 patients had type III fracture. After 9 month of follow up midterm OMAS score- 11.766 was achieved. Outcomes were good in 71.25% and fair results in 50.83% respectively. The complication seen was residual ankle pain in 6.66% patients and implant failure in 13.33%.</p><p><strong>Conclusions:</strong> Fixation of pilon fracture with JESS and bone grafting is associated with good functional outcome in type II and fair in type III pilon fracture. The incidence of complications high in type III pilon fracture. </p>

scholarly journals Study of acceptance of intra caesarean IUCD as method of contraception

2017 ◽  
Vol 6 (11) ◽  
pp. 5033
Author(s):  
Deepti Gupta ◽  
Swati Sharma ◽  
Anjali Kanhere ◽  
Ishrat Jahan
Keyword(s):  
Family Planning ◽  
Prospective Study ◽  
Unmet Needs ◽  
Cost Effective ◽  
Contraceptive Device ◽  
Postpartum Family Planning ◽  
Intrauterine Contraceptive ◽  
Long Acting ◽  
A Prospective Study

Background: Worldwide around 115 million women have unmet needs of family planning. Increasing rates of institutional deliveries create opportunities for providing quality postpartum family planning services thus helps to overcome the unmet needs. PPIUCD appears an ideal method for limiting and spacing births. The present study was a prospective study, undertaken to assess the efficacy, safety and outcome of Postpartum Intrauterine Contraceptive Device (PPIUCD) in cesarean case.Methods: A prospective study was done on 50 patients undergoing cesarean section for various indications after getting approval from the Ethical Committee of the institution This study was conducted at CMCH hospital Bhopal, India from August 2016 to July 2017. Women were counseled and those who fulfilled the medical eligibility were provided the PPIUCD services. IUCD was placed after delivery of placenta in case of caesarean section. These clients were followed at 6 weeks, 3 months and 6 months interval.Results: Total acceptance rate in our study was 44%. Majority belonged to age group of 21-30 years (76%) with mean age of 25.5 years, 54% were para 2, 94% of clients were literate, 86% urban and only 70% of the clients were familiar with the intracaesarean IUCD, 54.5% cases returned for follow-up while 18.2% of cases were lost to follow-up and expulsion was the main problem (27.3).Conclusions: Intracaesarean IUCD seems to be a safe long acting highly effective, easily accessible, reversible and cost effective contraceptive method for most postpartum women specially lactating women.

Microcirculation of the fingers in Raynaud’s syndrome

2005 ◽  
Vol 44 (01) ◽  
pp. 29-32 ◽  
Author(s):  
I. Garai ◽  
J. Varga ◽  
G. Szücs ◽  
Z. Galajda ◽  
C. András ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Quantitative Data ◽  
Cost Effective ◽  
Semiquantitative Analysis ◽  
Perfusion Scintigraphy ◽  
Visual Evaluation ◽  
Raynaud’S Syndrome ◽  
Raynaud's Syndrome ◽  
Primary Form

Summary Aim: We investigated the circulatory characteristics of patients suffering of primary and secondary Raynaud’s syndrome. Patients, methods: We examined 106 patients presenting with the classical symptoms of Raynaud’s syndrom (47 primary, 59 secondary) by hand perfusion scintigraphy developed by our Department of Nuclear Medicine. After visual evaluation we analyzed the images semiquantitatively, using the finger to palm ratio. We statistically compared the patients with primary and those with secondary Raynaud’s syndrome. Results: By visual evaluation we constated regional perfusion disturbances in 42 from 59 patients with secondary Raynaud’s syndrome. However, this was observed in only 3 from 47 patients with the primary form of this disease. This difference was statistically significant (p <0.001). Semiquantitative analysis showed that the finger/palm ratios (FPR) were significantly lower (p <0.05) for the patients with primary Raynaud’s syndrome. No differences in the FPR values concerning sex or right and left side. Conclusion: The hand perfusion scintigraphy with 99mTc-DTPA is a noninvasive, cost effective diagnostic tool, which objectively reflects the global and regional microcirculatory abnormalities of the hands, and provides quantitative data for follow-up.

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