scholarly journals An observational study comparing the effect of sphenopalatine artery block on bleeding in endoscopic sinus surgery

Author(s):  
M. N. Shankar ◽  
V. Saravana Selvan ◽  
Nigil Sreedharan

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The use of the sphenopalatine artery block to reduce bleeding during FESS, has been a debatable issue. This cross sectional observational study aims to study whether sphenopalatine artery block has any significant effect on bleeding. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">55 patients coming to the ENT department of Stanley Medical College from 2015–2016 were included in this study. All patients had bilateral nasal sinus disease and endoscopic sinus surgery was performed on both sides. 20 minutes prior to surgery one side was chosen randomly and sphenopalatine artery block was administered via the greater palatine canal approach. A mixture of lignocaine (2%) and adrenaline (1:80000) was used for infiltration. The surgery was done in an alternating fashion where the surgeon would operate for 15 minutes on one side and then moved onto the other side. The field was graded using the Wormald Grading at 30 minute intervals. The results were tabulated and the Wilcoxon Signed Rank Test was done at each time interval to see if there was a statistically significant difference in the grades of bleeding on both sides at each time interval. SPSS version 22.0 was used to analyse the data. Significance level was fixed as 5% (α=0.05).  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">It was found that for each time interval up to 120 minutes there was a significant decrease in the bleeding on the blocked side. However after 120 minutes the bleeding on both sides appeared to be same. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Sphenopalatine artery block given prior to surgery will be effective in reducing bleeding in FESS for the first 2 hours after which the effect of the block wears away.</span></p>

Author(s):  
Ruth Suzanne Maximo da COSTA ◽  
Silvia Amélia Scudeler VEDOVELLO ◽  
Vivian Fernandes FURLETTI-GÓES ◽  
William CUSTODIO ◽  
Giovana Cherubini VENEZIAN

ABSTRACT Objective: This study aimed to assess the knowledge, attitudes, and aspects of the clinical practice of orthodontists and periodontists, regarding lower fixed orthodontic retainers. Methods: The orthodontists (n=502) and periodontists (n=269) who participated in this cross-sectional observational study received, via e-mail, questions related to the type of lower fixed retainer, dental biofilm accumulation, oral hygiene, and potential periodontal changes. The data were subjected to chi-square and Fisher’s exact tests, at 5% significance level. Results: Both orthodontists (72.3%) and periodontists (58.7%) reported that hygienic retainers accumulate more dental biofilm (p< 0.05), and 64.1% of orthodontists and 58.7% of periodontists considered that modified retainers may lead to periodontal changes (p< 0.05). There was no significant difference between the dental specialties, regarding the type of lower fixed retainer considered the easiest for the patient to perform hygiene (p> 0.05), whereas 48.6% of professionals chose the modified type. Conclusion: The modified retainer accumulates a greater amount of dental biofilm and, in the perception of orthodontists and periodontists, it may cause periodontal changes.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Salma S. Al Sharhan ◽  
Mohammed H. Al Bar ◽  
Shahad Y. Assiri ◽  
Assayl R. AlOtiabi ◽  
Deemah M. Bin-Nooh ◽  
...  

Abstract Background Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients. Methods This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS. Results The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value =  < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value =  < 0.001); ear/facial symptoms (t-test = 6.34, p-value =  < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value =  < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = − 2.16, df = 66, p = 0.035). Conclusion Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life. Level of evidence Prospective observational.


2021 ◽  
Vol 10 (12) ◽  
pp. 2712
Author(s):  
Anda Gâta ◽  
Corneliu Toader ◽  
Dan Valean ◽  
Veronica Elena Trombitaș ◽  
Silviu Albu

Background: Odontogenic sinusitis (ODS) is frequently encountered in ENT practice; however, there are no guidelines regarding its management. This study aims to analyse the results of endoscopic sinus surgery versus dental treatment in ODS. Additionally, we aim to demonstrate the benefit of associating endoscopic sinus surgery (ESS) to surgical closure of chronic oroantral fistulas (OAF) by comparing mean time to healing in patients who opted or not for concurrent ESS. Methods: Records of patients with ODS were reviewed. Group one consisted of patients with ODS caused by periapical pathology undergoing either endoscopic sinus surgery (ESS) or dental treatment. Resolution of ODS was considered treatment success and was compared between the two treatment strategies. Group two included patients with ODS and associated chronic oroantral communication. Time to healing was compared between patients undergoing OAF closure alone versus patients receiving associated ESS, using the Log-Rank test to correlate Kaplan–Meier curves. Results: 25 patients from a total of 45 in group one underwent dental treatment alone, and 20 opted for exclusive ESS treatment. The failure rate was 40% for patients treated with ESS compared to 4% (one patient) for dental treatment. ODS resolved in all patients in the second group, but the mean time to healing was half (10 days) when ESS was complementary to OAF closure. Conclusion: The present study represents the first estimator of the role ESS plays in OAF treatment. Nonetheless, it provides proof of the importance of first addressing dental problems in odontogenic sinusitis.


2021 ◽  
pp. 194589242198915
Author(s):  
David C. Moffatt ◽  
Robert A. McQuitty ◽  
Alex E. Wright ◽  
Tawanda S. Kamucheka ◽  
Ali L. Haider ◽  
...  

Background Previous studies and meta analyses have led to incongruent and incomplete results respectively when total intravenous anesthesia (TIVA) and inhalational anesthesia (IA) are compared in endoscopic sinus surgeries in regards to intraoperative bleeding and visibility. Objective To perform a more comprehensive meta-analysis on randomized controlled trial (RCTs) comparing TIVA with IA in endoscopic sinus surgery to evaluate their effects on intraoperative bleeding and visibility. Methods A systematic review and meta-analysis of studies comparing TIVA and IA in endoscopic sinus surgery for chronic rhinosinusitis was completed in May 2020. Utilizing databases, articles were systematically screened for analysis and 19 studies met our inclusion criteria. The primary outcome included intraoperative visibility scores combining Boezaart, Wormald and Visual Analogue Scale (VAS). Secondary outcomes included rate of blood loss (mL/kg/min), estimated total blood loss (mL), Boezaart, Wormald scores, VAS, heart rate, and mean arterial pressure (MAP). Results 19 RCTs with 1,010 patients were analyzed. TIVA had a significantly lower intraoperative bleeding score indicating better endoscopic visibility (Boezaart, VAS, and Wormald) than IA (−0.514, p = 0.020). IA had a significantly higher average rate of blood loss than TIVA by 0.563 mL/kg/min (p = 0.016). Estimated total blood loss was significantly lower in TIVA than IA (−0.853 mL, p = 0.002). There were no significant differences between TIVA and IA in the mean heart rate (−0.225, p = 0.63) and MAP values (−0.126, p = 0.634). The subgroup analyses revealed no significant difference between TIVA and IA when remifentanil was not utilized and whenever desflurane was the IA agent. Conclusion TIVA seemed to have superior intraoperative visibility scores and blood loss during endoscopic sinus surgery when compared to IA. However, the results are not consistent when stratifying the results based on the use of remifentanil and different inhaled anesthetics. Therefore, the conclusion cannot be made that one approach is superior to the other.


Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 936
Author(s):  
Milan Kojić ◽  
Branka Protić Gava ◽  
Milan Bajin ◽  
Marko Vasiljević ◽  
Jasmina Bašić ◽  
...  

Background: The research objective of the study is to determine the differences in the manifestation of the motor status of normally fed preschool test subjects, classified into groups according to foot status. Methods: This is a simple, comparative observational study. Preschool children included in this study have been subjected to anthropometric measurements in order to determine BMI, tests for motor skills assessment (running at 20 m from a high start, standing broad jump, backwards polygon, rectangular seated forward bend, plate tapping, sit-ups for 60 s, and bent arm hang), and a determination of foot status. The total sample was comprised of 202 test subjects who attended a regular sports program, aged 3.9 to 6.5 years of decimal age (M = 141; Age = 5.3 ± 0.74; Height = 117.3 ± 7.1; Weight = 22 ± 3.7; F = 61; Age = 5.1 ± 0.73; Height = 114.9 ± 7.4; Weight = 21.2 ± 3.8), of which 153 (75.7%) were normally fed, 6 (3%) were undernourished, 30 were overweight (14.9%), and 13 were obese (6.4%). Results: In the total sample, 30 (14.9%) subjects had normal arch feet, 90 (44.6%) high arched feet, and 41 (20.3%) flat feet. We found 41 (20.3%) subjects who had different left and right foot statuses within this sample. The data were processed by means of nonparametric tests (the Kruskal–Wallis and Mann–Whitney U tests) at a significance level p ≤ 0.05. Conclusion: The results show that there is a statistically significant difference between groups of subjects with different foot statuses in the manifestation of motor status in most tests, with a significance level of p ≤ 0.01, and in tests of sit-ups for 60 s and the bent arm hang, there is a statistically significant difference, the level of which is p ≤ 0.05. It is only in the inclination test of rectangular seated forward bend that no statistically significant difference was displayed.


2016 ◽  
Vol 21 (4) ◽  
pp. 73-79 ◽  
Author(s):  
Guilherme Thiesen ◽  
Bruno Frazão Gribel ◽  
Keila Cristina Rausch Pereira ◽  
Maria Perpetua Mota Freitas

ABSTRACT Introduction: Facial skeletal asymmetry is commonly found in humans and its main characteristic is menton deviation. The literature suggests that occlusal and masticatory problems arising from tooth absence could be related to the development of such asymmetries. Objective: The aim of this cross-sectional study was to estimate the prevalence of mandibular skeletal asymmetries and to investigate its association with posterior tooth absences. Methods: Tomographic images of 952 individuals aged from 18 to 75 years old were used. Asymmetry was the analyzed outcome, and it was categorized into three groups according to gnathion displacement in relation to the midsagittal plane (relative symmetry, moderate asymmetry, and severe asymmetry). Patients were sorted by the presence of all posterior teeth, unilateral posterior tooth absence, or bilateral posterior tooth absence. Chi-square test with a significance level of 5% was used to verify the association between posterior tooth absence and asymmetry. Results: Results show relative symmetry present in 55.3% of the sample, as well as the prevalence of 27.3% for moderate mandibular asymmetry and 17.4% for severe asymmetry. Moderate and severe mandibular asymmetries occurred in a higher proportion in patients with unilateral posterior tooth absence. However, there was no statistically significant difference between the analyzed groups (p = 0.691). Conclusions: In this study, mandibular asymmetries did not present any association with the absence of teeth on the posterior area of the arch.


2010 ◽  
Vol 138 (11-12) ◽  
pp. 746-751
Author(s):  
Momcilo Mirkovic ◽  
Snezana Simic ◽  
Jelena Marinkovic ◽  
Sladjana Djuric

Introduction. For health assessment, beside the data of routine health statistics, it is necessary to include and data obtained by a health survey of the citizens. Objective. The aim of this study was to establish how northern Kosovska Mitrovica adults assess their health and which diseases are most common among the population, as well as to investigate differences in relation to demographic and socioeconomic characteristics, the characteristics of social interaction and health behavior and habits. Methods. The research was conducted as a cross-sectional study conducted on the representative sample of adult citizens in northern Kosovska Mitrovica in 2006. Two hundred-eighteen respondents were included in the survey. In the research we used a questionnaire identical to the Health Survey conducted in Serbia in 2006. The significance of differences in responses about self-rated health and chronic diseases in relation to the characteristics of respondents? responses were determined by X2-test with the significance level of 0.05. Results. Over half of the respondents (54.7%) assessed their health condition as good or very good. There was a significant difference in self-rated health in relation to the respondents? age (?2=202.036; p=0.000), education (?2=72.412; p=0.000), social support (?2=12.416; p=0.015), smoking (?2=11.675; p=0.020) and physical activity (?2=61.842; p=0.000). The leading health problems among the respondents were high blood pressure, rheumatologic diseases of joints, ulcer of the duodenal or gastric ulcer, gall bladder disease and high blood fat. Conclusion. Adult residents of northern Kosovska Mitrovica assessed their health as better than the residents of Serbia without Kosovo and Metohia. The diseases in which stress plays the major role among etiological factors are in the leading position. The obtained data on the population level of specific areas represent the basis in the planning of health education and health promotion activities.


2020 ◽  
Vol 56 (1) ◽  
pp. 1
Author(s):  
Nur Hafiz Ramadhona ◽  
Aucky Ginting ◽  
Hamdani Lunardhi

Infertility is the inability of a partner to get pregnant after regular sexual intercourse without contraception for 12 months. Based on the cause, male infertility is caused by genetic, hormonal, infectious, sexual, and unexplained infertility. However, many infertile couples are classified into unexplained infertility without an antisperm antibody (ASA) immunological examination. This study aimed to prove that couples classified as unexplained infertility can be caused by ASA wives. This was an observational study with a cross sectional study design. The sample consisted of 2 groups, in which the first group consisted of 36 fertile couples and the second group consisted of 35 unexplained infertility couples. All samples were carried out indirect MAR test to obtain the ASA value of the wife. If the wife's ASA value was >40%, the ASA results were positive. Conversely, if the ASA value was <40%, the ASA results were negative. From these 2 groups, there was a statistically significant difference (p<0.0001) that the wife's ASA value in the unexplained infertility group was significantly higher than that in the fertile group. This study concluded that the positive ASA results from the indirect MAR test were significantly found in the unexplained infertility sample.


2021 ◽  
Vol 10 (1) ◽  
pp. 14-14
Author(s):  
Zohreh Tajabadi ◽  
Matineh Sadat Miri ◽  
Soliman Ahmadi ◽  
Matineh Pourrahimi ◽  
Mojtaba Abdi ◽  
...  

Background: Students are considered part of the capital of each country. Several factors can affect their educational status and, as a result, contribute to their academic failure. The current study seeks to investigate the relationship between students’ academic failure and the affecting factors with the Iranian Educational Ranking of Universities. Methods: This is a descriptive cross-sectional study. The required sample size was calculated using Cochran’s formula. A researcher-made questionnaire with 5 parts was used to collect data. Kruskal Wallis and Spearman’s analysis of variance was used for analysis. The significance level was considered as 0.05. Results: A total of 1215 people participated; 13.7% of students had had an academic failure and 2.0% of them were on academic probation. There was a correlation between university RAD rank and academic failure (r = -0.098 and P = 0.0001) as well as student satisfaction (r = 0.264 – P = 0.0001). There was a significant difference between an academic drop and academic grade in three ranks of university (Pv= 0.0001), and, interestingly, having moved from Rank 1 to 3, having academic grade increases, and having academic failure decreases. Conclusion: According to the findings of this study, the higher ranked the college campus is on the RAD scale, the higher the academic failure rate. For annual assessment of universities, it is proposed that assessment of academic failure and grades be used as a benchmark.


CoDAS ◽  
2021 ◽  
Vol 33 (6) ◽  
Author(s):  
Silvia Márcia Andrade Campanha ◽  
Roberta Lopes de Castro Martinelli ◽  
Durval Batista Palhares

ABSTRACT Purpose Verify the position of lips and tongue at rest in newborns with and without ankyloglossia. Methods Cross-sectional study, carried out with 130 newborns in University Hospital. Data collection was performed by the researcher and speech-language pathologists from the Hospital. Information on gestational age, sex, weight, height and days of life was collected. The position of the lips and tongue at rest was evaluated through visual inspection with the newborns asleep. After the newborns were awakened, Neonatal Screening of the validated Protocol for the evaluation of the lingual frenulum for infants was performed to detect the alteration of the lingual frenulum. The data obtained were described and submitted to statistical analysis using the Chi-Square test to verify the association between the position of the lips with the tongue and to compare the position of the lips and tongue with and without ankyloglossia. The Mann-Whitney test was used to verify the behavior of the variables the differed between newborns with and without ankyloglossia. The significance level of 5% was adopted. Results When comparing the data, a significant difference was found between: weight and height with and without ankyloglossia; position of lips and tongue. An association between the position of the tongue and lips with and without ankyloglossia was also found. Conclusion Newborns without alteration of the lingual frenulum have a tendency to remain with their lips closed and their tongue elevated during rest and newborns with ankyloglossia have a tendency to keep their lips parted and their tongue low during rest.


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