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 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 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>

Vestibular Rehabilitation: Useful but not Universally so

2003 ◽  
Vol 128 (2) ◽  
pp. 240-250 ◽  
Author(s):  
E. Krebs David ◽  
M. Gill-Body Kathleen ◽  
W. Parker Stephen ◽  
V. Ramirez Jose ◽  
Wernick-Robinson Mara
Keyword(s):  
Tertiary Care ◽  
Vestibular Rehabilitation ◽  
Primary Outcome Measure ◽  
Gait Velocity ◽  
Care Hospital ◽  
Double Blind ◽  
Large Tertiary Care ◽  
Group A ◽  
Group B ◽  
Few Data

OBJECTIVE: Although vestibular rehabilitation (VR) is gaining popularity, few data support its utility in improving locomotor stability, and no good predictors exist of whom will benefit most. STUDY DESIGN AND SETTING: A double-blind, placebo-controlled randomized trial of vestibular rehabilitation was conducted at a large tertiary care hospital on 124 patients (59 ± 18 years old) with unilateral (n = 51) or bilateral (n = 73) vestibular hypofunction, of whom 86 completed a 12-week intervention. Of these 86, 27 returned for long-term (1-year) follow-up testing. The primary outcome measure was locomotor stability. RESULTS: Group A (6 weeks of VR) significantly ( P < 0.01) increased their gait velocity and stability compared with group B (6 weeks of strengthening exercise), but there was a smaller difference ( P = 0.05) between groups at 12 weeks, when both had had VR; there were no group differences at 1 year. Of the 86 who completed the intervention, 52 (61%) had clear locomotor gains. CONCLUSION AND SIGNIFICANCE: VR is helpful for most patients in providing locomotor stability, but further work is needed to determine the factors that prevent VR from being effective for all patients with vestibulopathy.

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 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 Randomized trial for fungal corneal ulcer- A comparison of outcome between two regimes of medical treatment with topical natamycin and topical voriconazole in a tertiary care Centre

2021 ◽  
Vol 11 (2) ◽  
pp. 289-296
Author(s):  
Piyali Sarkar ◽  
Kumaresh Chandra Sarkar ◽  
Tridib Ranjan Naskar ◽  
Shashwat Bhattacharyya ◽  
Mukul Chandra Biswas
Keyword(s):  
Vision Loss ◽  
Tertiary Care ◽  
Significant Risk ◽  
Effective Control ◽  
P Value ◽  
Rapid Progression ◽  
Tertiary Care Centre ◽  
Male Predominance ◽  
Group A ◽  
Group B

Inflammation of the cornea is known as keratitis. Microbial keratitis is a great challenge for the physicians due to its varied presentation, overlapping symptoms and rapid progression. Though bacterial keratitis is the most prevalent in developing countries but recent increasing trend of fungal keratitis carries a significant risk factors and one of the leading causes of vision loss. Early diagnosis and treatment are the cornerstone for its effective control. Purpose: To determine the outcome and efficacy of treatment with topical natamycin and topical voriconazole in different groups. It was a randomised, prospective, comparative, experimental study. The study populations were selected according to inclusion and exclusion criteria after proper evaluation. The study populations were divided into Group A (treated with 1% topical natamycin) and group B (treated 5% topical voriconazole. The patients were followed up subsequently. Data were collected, tabulated in Excel sheet and analyzed in percentage, proportion, t-test and chi square (χ2) test. The statistically significant was considered if p value &#60;0.05. The average age of the study populations was 39.32 ± 14.99 years. Topical voriconazole was found better against primary fungal ulcer than natamycin but not statistically significant (χ2=0.283, p=0.59). The mean healing times of group A and group B were 25.42 ± 4.59 and 24.92 ± 3.99 days respectively. This study concluded that it had male predominance, commonly involved younger people and poor socioeconomic agricultural workers. Both drugs were found effective against primary ulcer but voriconazole was slightly better.

scholarly journals A Crossover Comparative Study to Assess Efficacy of 5% vs. 20% Albumin in the Treatment of Anasarca in Children with Idiopathic Nephrotic Syndrome

2020 ◽  
Vol 40 (3) ◽  
pp. 157-163
Author(s):  
Ajoy Kumar Garg ◽  
Suprita Kalra ◽  
Ashutosh Kumar ◽  
Madhuri Kanitkar
Keyword(s):  
Nephrotic Syndrome ◽  
Urine Output ◽  
Tertiary Care ◽  
Randomised Trial ◽  
Tertiary Care Centre ◽  
Group I ◽  
Duration Of Illness ◽  
Percentage Weight ◽  
Group A ◽  
Group B

Introduction: Co-administration of albumin and furosemide has shown better response than furosemide alone in managing anasarca among children with nephrotic syndrome. There are different concentrations of albumin available. The aim of this study was to compare diuretic response to co-administration of either 5% or 20% albumin with furosemide in these children. Methods: It was a crossover randomised trial conducted on children with nephrotic syndrome with moderate to severe oedema at a tertiary care centre. They were  randomised to two groups; Group A (n = 14) received 5% albumin along with furosemide in midway followed by 20% albumin after washout period of 48 hrs and group B (n = 10) received albumin vice versa. Baseline and post therapy vitals, fluid intake, urine output and biochemistry were noted. Primary outcomes were increase in urine output and reduction in weight following co-administration of albumin with furosemide. For analysis of primary outcomes, two interventional arms were formed; group I (5% Albumin co-administered with furosemide) and group II (20% albumin co-administered with furosemide). Results: Total children were 24 in each arm i.e. group I and II. Eighteen (75%) were males. Mean (range) age at enrolment and duration of illness were 55.3 (15 - 144) and 18.6 (1 - 120) months respectively. Mean difference (SD) in urine output were 1.52 (1.11) and 1.66 (0.95) ml/kg/hr (p = 0.12) and mean percentage weight loss were 2.25% (2.12) and 3.68% (3.84) in group I and II respectively (p = 0.64). On further comparing, urine output was significantly better when 5% albumin was co-administered with furosemide during first period than in second period. Conclusions: Co-administration of either 5% or 20% albumin with furosemide is equally safe and effective in increasing urine output in children with anasarca.

scholarly journals Original research The Efficacy & Safety of 0. 3% Acetylcysteine eyedrops in Filamentary keratitis

2020 ◽  
Vol 35 (4) ◽  
pp. 263-270
Author(s):  
Sameera Irfan
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Tear Film ◽  
Randomised Clinical Trial ◽  
Primary Outcome Measure ◽  
Original Research ◽  
Tertiary Care Centre ◽  
Ocular Surgery ◽  
Group A ◽  
Group B

Purpose: To determine the safety and efficacy of 0. 3% Acetylcysteine eyedrops for the resolution of symptoms and signs of filamentary keratitis. Study design:A Randomised Clinical Trial (RCT). Place & Duration of study:This study was conducted at a tertiary care centre for a period of two and a half years, from April 2016toOctober 2018. Method:This was a prospective,interventionalstudy in which 52 consecutive cases (104 eyes) with mild to severe filamentary keratitis (classification criteria given below), between the ages of 9-72 years(mean 49±8.6) were included. Cases with an active ocular surface infection, uveitis, recent ocular surgery (< one month) and pregnant / lactating patients were excluded.All cases were prescribed lubricants, anti-inflammatory therapy (Tacrolimus skin cream 0.03%) and tetracycline eye ointment for the MGD. The alternate cases were divided into two equal groups of 26 cases; Group A received acetylcysteine eyedrops 0.3%, four times daily, Group B cases received placebo eyedrops (distilled water in a bottle).Clinical symptoms (OSDI),corneal filaments, corneal fluorescein staining,Tear Film BUT and Schirmer’s test were recorded at the beginning of study,and everytwo weeks,for the next 12 weeks. Results: Primary Outcome Measure was a reduction of symptoms (OSDI score) and absence of filament formation after treatment with 0.3% Acetylcysteine eyedrops. The patients were followed-up for a mean duration 12 ± 2weeks. There was a marked subjective as well as objective improvement in all cases within 2-4 weeks of therapy with Acetylcysteine 0.3% eyedrops as compared to the placebo group. Conclusion:Acetylcysteine 0.3% eyedrops efficiently dissolve filaments and offer quick resolution of symptoms even in severe cases of filamentary keratitis.

scholarly journals Role of medical expulsive therapy in lower ureteral calculus

2018 ◽  
Vol 5 (10) ◽  
pp. 3234
Author(s):  
Rohit G. Rangaiah ◽  
Ananth J. Kamath ◽  
Ashok Kumar Saini
Keyword(s):  
Controlled Trial ◽  
Tertiary Care ◽  
Control Group ◽  
Ureteral Calculus ◽  
Tertiary Care Centre ◽  
Expulsion Rate ◽  
Medical Expulsive Therapy ◽  
Group A ◽  
Group B

Background: Urolithiasis is a chronic disease with a significant burden on the healthcare system. The aim of this study was to evaluate the role of medical expulsive therapy (tamsulosin alone or in combination with deflazacort) in the treatment of lower ureteric calculi.Methods: This was a prospective, randomized, controlled trial conducted at a tertiary care centre between November 2015 and October 2017. Patients aged more than 18 years solitary ureteral calculus 5-10 mm in size, located at distal ureter were randomized (1:1:1) to receive tamsulosin 0.4 mg once-daily (OD), deflazacort 6 mg twice-daily (BD) and analgesic OD (Group A); tamsulosin 0.4 mg and analgesic OD (Group B); or only analgesic OD (Group C, control Group) for 7 days. The treatment duration was extended to 28 days or until the expulsion of stone. Patients were followed-up weekly during the treatment period.Results: A total of 105 patients were enrolled in the study. Overall, 51.5% of patients in Group A, 48.5% of patients in Group B and 54.3% of patients in Group C had calculus size 7-10 mm. Patients allocated to Group A (80%) and Group B (74.3%) showed higher stone expulsion rate as compared to those in Group C (48.6%).  The mean time taken for stone expulsion was around 12 days in Group A, whereas around 15 days in Group B and C.Conclusions: The combination of tamsulosin and deflazacort resulted in higher stone expulsion rate in patients with lower ureteral calculus.

scholarly journals Arrugas Bone Trephine Assisted Flapless Dacryocystorhinostomy with Circumosteal – Mitomycin C Versus External Dacryocystorhinostomy: A Hospital Based Comparative Study

2021 ◽  
Vol 13 (2) ◽  
pp. 169-176
Author(s):  
Gyan Bhaskar ◽  
Anita Ambastha ◽  
Nilesh Mohan ◽  
Shalini Sinha ◽  
Srishti Shree
Keyword(s):  
Mitomycin C ◽  
Surgical Outcome ◽  
Complete Resolution ◽  
Nasolacrimal Duct ◽  
Surgical Time ◽  
Duct Obstruction ◽  
Group A ◽  
External Dacryocystorhinostomy ◽  
One Year ◽  
Group B

Introduction: Primary acquired nasolacrimal duct obstruction is a common ophthalmic condition and has conventionally been managed by external dacryocystorhinostomy. However this procedure is time consuming and involves making mucosal flaps. The aim of this study was to compare the surgical outcome in Arrugas bone trephine-assisted flapless dacryocystorhinostomy with Circumosteal - Mitomycin C versus conventional external dacryocystorhinostomy. Materials and methods: This is a retrospective non-randomized study of  surgical outcome in patients of primary acquired nasolacrimal duct obstruction  who underwent an Arrugas bone trephine assisted  flapless dacryocystorhinostomy with Circumosteal - Mitomycin C (group A)  versus  those  who underwent conventional external dacryocystorhinostomy (group B)  in a teaching hospital in North India. Patients with previously failed dacryocystorhinostomy, lacrimal fistula, canalicular and common canalicular obstruction were excluded. Success was defined as patent syringing at the end of one year. Surgical time was calculated from skin incision to skin suturing. Results: There was complete resolution of epiphora with patent syringing in 43 out of 52 patients in  group A, while in group B, 47 out of 55 patients had complete resolution of epiphora with patent syringing at the end of one year (p= 0.77). Mean surgical time was significantly  lower in Group A than in Group B (p=<.05). Scarring and closure of the ostium was the most common cause of failure in both groups (Group A, n=5, 9.6%; Group B, n= 3, 5.45%). Conclusion: Arrugas bone trephine-assisted flapless dacryocystorhinostomy with Circumosteal - Mitomycin C is a viable alternative to conventional external dacryocystorhinostomy with comparable success rate and shorter surgical time and a faster learning curve.

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