scholarly journals Comparative study of endoscopic tympanoplasty and conventional tympanoplasty

2020 ◽  
Vol 6 (10) ◽  
pp. 1804
Author(s):  
Priyanka Aggarwal ◽  
Barjinder Singh Sohal ◽  
J. P. Goyal
Keyword(s):  
Success Rate ◽  
Cost Effective ◽  
Patient Comfort ◽  
Hearing Improvement ◽  
Post Operation ◽  
Group A ◽  
Group B ◽  
The Cost ◽  
Results Of Surgery ◽  
Endoscopic Tympanoplasty

<p><strong>Background:</strong> To compare the results of endoscopic tympanoplasty with that of conventional tympanoplasty and to evaluate and compare the graft uptake in both of these methods. The study was done to evaluate the improvement in hearing after tympanoplasty and the problems faced while doing the endoscope assisted tympanoplasty.</p><p><strong>Methods: </strong>Between July 2010 to June 2013, 50 patients underwent tympanoplasty, 25 were endoscope assisted (group A) and 25 were microscope assisted (group B). Results of surgery were compared at the end of three and six months post operation.</p><p><strong>Results: </strong>The success rate in terms of graft uptake rate was 88% with endoscope assisted tympanoplasty and 84% with other microscope assisted tympanoplasty. Overall success rate was 86.0%. Mean hearing improvement was (16.24±10.21 dB) and (14.28±7.10 dB) in group A and group B respectively.</p><p><strong>Conclusions: </strong>Tympanoplasty with its visualization of hidden corners, justifies tympanoplasty by using endoscope in selected cases with comparable improved results in the literature. Furthermore, the cost of the endoscope is much less (about 10%) in comparision to operating microscope, making it more cost effective in developing countries. However, the endoscope cannot be employed in every case as one hand is blocked. In terms of Patient comfort, the endoscope assisted outnumbers the benefits of other conventional methods.<strong></strong></p>

scholarly journals A Comparative Study of Diclofenac with Paracetamol versus Diclofenac with Serratiopeptidase in Pain Associated with Soft Tissue Injury

2021 ◽  
Vol 9 (8) ◽  
pp. 2740-2744
Author(s):  
Dr. S. E. Gowtham
Keyword(s):  
Soft Tissue ◽  
Pain Intensity ◽  
Proteolytic Enzyme ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Cost Effective ◽  
Care Hospital ◽  
Group A ◽  
Group B ◽  
The Cost

Abstract: The point of the executives is to ease the pain rapidly and improve practical capacity. NSAIDs are the primary line treatment. Serratiopeptidase is the proteolytic enzyme. The challenge lies in deciding whether only NSAIDs or NSAIDs with proteolytic enzyme will give more prominent indicative help, while additionally being savvy. the primary goal is to think about the adequacy of diclofenac with paracetamol and diclofenac with serratiopeptidase in the administration of delicate tisssue injury. This prospective, open label, observational study was conducted at a tertiary care hospital. Patients over 18 years of age and presenting with soft tissue injury pain (elbow pain, knee pain, general pain, back pain ) of less than 6 weeks duration were enrolled in the study. Forty patients with soft tissue injury pain were randomized into two groups: Group A got diclofenac with paracetamol (50mg/325mg) double a day and Group B got diclofenac with serratiopeptidase (50mg/10mg) double a day for 1 week. The Numerical Rating Scale (NRS) determined the clinically significant results. The decrease in pain intensity in Group B was (MEAN= 3.76), while in Group A it was (MEAN= 3.93). The average cost-effectiveness ratio indicated that diclofenac wit paracetamol was the dominant treatment over diclofenac with serratiopeptidase. Therefore, diclofenacc with paracetamol was found to be the cost-effective option for soft tissue injury pain relief in for 1 week. Both diclofenac wit paracetamol and diclofenac with serratiopeptidase. were clinically effective in reducing the pain intensity and in improving functional ability. H owever, diclofenac wit paracetamol was found to be the cost-effective intervention. Keywords: Paracetamol, diclofenac, Serratiopeptidase, soft tissue injury, pain.

scholarly journals Anti-Plaque and Anti-Gingivitis Efficacy of 0.25% Lemongrass Oil and 0.2% Chlorhexidine Mouthwash in Children

2021 ◽  
Author(s):  
Akula S ◽  
Nagarathna J ◽  
S K Srinath
Keyword(s):  
Oral Hygiene ◽  
Cost Effective ◽  
Healthy Children ◽  
Plaque Ph ◽  
Lemongrass Oil ◽  
Group A ◽  
Plaque Control ◽  
Group B ◽  
The Cost ◽  
Post Hoc

Objectives: Research is ongoing to find safe and effective oral hygiene aids for oral self‑care in children. Mouthwashes are used to complete the process of mechanical plaque control. Lack of affordability and side effects of most commercially available mouthwashes limit their use in children. Hence, the cost-effective and easily available essential oil, lemongrass oil, when formulated as a mouthwash, may possibly serve as an adjunct to oral hygiene maintenance. The main objective of this study was to compare the efficacy of lemongrass oil and chlorhexidine (CHX) mouthwash in children. Materials and Methods: Sixty healthy children between 9-12 years were selected. During the initial visit, the plaque pH, plaque index (PI), and gingival index (GI) were assessed, and oral prophylaxis was performed. The patients were randomized into three groups (n=20) and received 0.25% lemongrass oil mouthwash (group A), 0.2% CHX mouthwash (group B), and oral prophylaxis alone (group C). The patients were recalled after 14 and 21 days. ANOVA with post-hoc Bonferroni and paired t-test were used to analyze the results by SPSS software. Results: Intragroup comparison of PI and GI showed a significant decrease between 14 and 21 days in groups A and B (P≤0.05). Intragroup comparison of the mean plaque pH in group A showed a significant increase at day 21 compared with baseline (P=0.028). Conclusion: The results showed that the lemongrass oil mouthwash was effective in reducing PI and GI in children. Thus, it may be used as a good herbal alternative to CHX mouthwash.

scholarly journals Assessment of the outcome of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of chronic otitis media

2020 ◽  
Vol 6 (11) ◽  
pp. 2001
Author(s):  
Sreeshma Balan ◽  
Prakash M. D.
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
P Value ◽  
Hearing Improvement ◽  
Cortical Mastoidectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is an inflammatory process in the middle ear space that results in long-term changes in the tympanic membrane including atelectasis, dimeric-membrane formation, perforation, tympanosclerosis, retraction pocket or cholesteatoma. COM can be classified into healed, inactive (mucosal or squamosal), active (mucosal or squamosal). Myringoplasty is tympanoplasty without ossicular reconstruction. Cortical mastoidectomy is usually accompanied by tympanoplasty. Aim was to assess and compare the efficacy of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of COM, in terms of graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> A prospective study, where 30 patients each of wet and dry mucosal-type COM were included. Patients underwent myringoplasty with cortical mastoidectomy. All were followed up for 6 months, both the groups were statistically compared.  </p><p class="abstract"><strong>Results:</strong> In our study, mean age of patients in group A (wet COM) was 34.13 years and group B (dry COM) was 33.36 years. Group A had success rate of 90% and group B had success rate of 86.6%. There was no statistical significance (p value- 0.53) on comparing both groups with respect to graft uptake. There was significant hearing improvement post-operatively in both the groups (p&lt;0.05). However, there was no significant difference between the groups (p value- 0.66). This shows that presence of discharge at the time of surgery does not interfere with the results of cortical mastoidectomy with myringoplasty.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that, there is good outcome in both wet and dry COM following myringoplasty with cortical mastoidectomy with respect to graft uptake and hearing improvement.</p>

scholarly journals COMPARISON BETWEEN TRAGAL CARTILAGE WITH PERICHONDRIUM AND TEMPORALIS FASCIA GRAFT BY UNDERLAY ENDOSCOPIC TYMPANOPLASTY

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S622-25
Author(s):  
Muhammad Tahir ◽  
Asim Abbass ◽  
Faiz Ul Hassan Nawaz ◽  
Syed Asad Shabir ◽  
Atif Rafique
Keyword(s):  
Success Rate ◽  
Tertiary Care ◽  
Care Hospital ◽  
Temporalis Fascia ◽  
Tympanic Membrane Perforations ◽  
Fascia Graft ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Endoscopic Tympanoplasty

Objective: To compare the results of tragal cartilage with perichondrium versus temporalis fascia graft in endoscopic tympanoplasty using underlay technique. Study Design: Comparative prospective study. Place and Duration of Study: Study conducted in Tertiary Care Hospital, Karachi, from Jul 2018 to Feb 2020. Methodology: Overall, 34 patients having permanent unilateral tympanic membrane perforations were included in this study, in whom underlay endoscopic tympanoplasty was performed. Group A patients underwent temporalis fascia graft while group B received a tragal cartilage with perichondrium graft. The success rate between groups was compared in respect of reduction in postoperative air-bone gap and healing of perforation. Results: The success rate of graft was 88% (30/34) in group A and 94% (32/34) in group B after 6 months follow-up, the difference was not found to be statistically significant (p=0.368). Hearing improvement in the form of closure of air bone gap in group A was from 24.52 ± 1.73 dB (decibel) to 13.56 ± 5.67s dB and in group B it was from 19.76 ± 3.47dB to 11.94 ± 3.9dB, the difference was not significant statistically (p=0.333). Conclusion: Keeping in view the results of our study, we conclude that both tragal cartilage with perichondrium and temporalis fascia graft are considered equally successful in endoscopic tympanoplasty.

scholarly journals A Comparative Study on Haemodynamic and Recovery Status in Day-Case Anaesthesia Between Infusion of Propofol, Midazolam, Nalbuphine and Ketamine, Diazepam, Tramadol

2009 ◽  
Vol 21 (1) ◽  
pp. 36-42
Author(s):  
M Masudul Haque ◽  
Md Rabiul Alam ◽  
Md Al Mamun ◽  
Md Mozaffer Hossain ◽  
Md Zahurul Islam
Keyword(s):  
Comparative Study ◽  
Cost Effective ◽  
Combination Group ◽  
Day Case ◽  
Group A ◽  
Prospective Comparative Study ◽  
Case Anaesthesia ◽  
Recovery Status ◽  
Group B ◽  
The Cost

A prospective comparative study was carried out to evaluate haemodynamic and recovery status using infusion of propofol-midazolam-nalbuphine and ketamine-diazepam-tramadol in surgical daycases. Fifty patients of either sex aged within 18-60 years ASA grade I or II requiring routine surgery as day-case basis under GA were selected in Dept of Anaesthesia, CMH, Dhaka during February-May 2006. Cases were randomly divided equally into two groups of 25 each. Group-A received propofolmidazolam- nalbuphine infusion and infusion of ketamine-diazepam-tramadol was used in Group- B for anaesthesia. Haemodynamic parameters, recovery status and home readiness time were monitored and recorded at 10 min intervals. The variations in heart rate, systolic and diastolic BP of both groups were found statistically insignificant (p-values: 0.0524, 0.0513 and 0.0575 respectively). Recovery scores were high in Group-A (p-0.0443) and time for home-readiness were found 242±35 (mean±SD) minutes in Group-A and 367±83 minutes in Group-B (p-0.0329). Drugs used in Group-B were found highly cost effective. It is concluded that by using ketamine, diazepam and tramadol combination (group-B), we can reduce the cost of anaesthesia, which is necessity for majority of patients in our country. On the other hand, propofol, midazolam and nalbuphine combination (group-A), a costlier regime appears suitable for the patients from affluent population. Both the regimes can be practiced with safety.   Journal of BSA, Vol. 21, No. 1, January 2008 36-42

In-line filtration reduced phlebitis associated with peripheral venous cannulation: Focus on cost-effectiveness and patients’ perspectives

2019 ◽  
Vol 21 (2) ◽  
pp. 154-160
Author(s):  
Gianluca Villa ◽  
Rosa Giua ◽  
Timothy Amass ◽  
Lorenzo Tofani ◽  
Cosimo Chelazzi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Vascular Access ◽  
Cost Effective ◽  
Causative Factor ◽  
Control Group ◽  
Previous Trial ◽  
Venous Cannulation ◽  
Group A ◽  
The Cost ◽  
And Control

Background: In a previous trial, in-line filtration significantly prevented postoperative phlebitis associated with short peripheral venous cannulation. This study aims to describe the cost-effectiveness of in-line filtration in reducing phlebitis and examine patients’ perception of in-hospital vascular access management with and without in-line filtration. Methods: We analysed costs associated with in-line filtration: these data were prospectively recorded during the previous trial. Furthermore, we performed a follow-up for all the 268 patients enrolled in this trial. Among these, 213 patients responded and completed 6 months after hospital discharge questionnaires evaluating the perception of and satisfaction with the management of their vascular access. Results: In-line filtration group required 95.60€ more than the no-filtration group (a mean of € 0.71/patient). In terms of satisfaction with the perioperative management of their short peripheral venous cannulation, 110 (82%) and 103 (76.9%) patients, respectively, for in-line filtration and control group, completed this survey. Within in-line filtration group, 97.3% of patients were satisfied/strongly satisfied; if compared with previous experiences on short peripheral venous cannulation, 11% of them recognised in-line filtration as a relevant causative factor in determining their satisfaction. Among patients within the control group, 93.2% were satisfied/strongly satisfied, although up to 30% of them had experienced postoperative phlebitis. At the qualitative interview, they recognised no difference than previous experiences on short peripheral venous cannulation, and mentioned postoperative phlebitis as a common event that ‘normally occurs’ during a hospital stay. Conclusion: In-line filtration is cost-effective in preventing postoperative phlebitis, and it seems to contribute to increasing patient satisfaction and reducing short peripheral venous cannulation–related discomfort

CLINICAL OUTCOME AND COST COMPARISON OF CARPAL TUNNEL WOUND CLOSURE WITH MONOCRYL® AND ETHILON®: A PROSPECTIVE STUDY

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 189-192 ◽  
Author(s):  
Anis Dosani ◽  
Sameer K. Khan ◽  
Sheila Gray ◽  
Steve Joseph ◽  
Ian A. Whittaker
Keyword(s):  
Carpal Tunnel ◽  
Wound Closure ◽  
Unit Cost ◽  
Cost Effective ◽  
Cost Comparison ◽  
Absorbable Suture ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
A Prospective Study

This prospective non-randomised two-cohort study compares the use of an absorbable suture (Poliglecrapone [Monocryl]: Group A) and a non-absorbable suture (Polyamide [Ethilon]: Group B) in wound closure after elective carpal tunnel decompression. The primary outcome was scar cosmesis as assessed by the Stonybrook Scar Evaluation Scale (SBSES); the financial cost of wound closure was compared as a secondary outocome. All fifty patients completed follow-up. At six weeks, there was no significant difference in the two groups regarding scar tenderness (p = 0.5), although residual swelling was more evident in the absorbable group (p = 0.2). The mean SBSES score at six weeks was 4.72 in Group A, and 4.8 in Group B (p = 0.3). The unit cost per closed wound of Monocryl was three times than Ethilon (p < 0.05). Ethilon is thus cost-effective without compromising the cosmetic outcome, and we recommend using this as the preferred suture for closure of carpal tunnel wounds.

scholarly journals Comparative study between over underlay with classical underlay techniques of tympanoplasty

2020 ◽  
Vol 6 (5) ◽  
pp. 918
Author(s):  
Prashanth Kudure Basavaraj ◽  
Manjunatha H. Anandappa ◽  
Veena Prabhakaran ◽  
Nishtha Sharma ◽  
Shreyas Karkala
Keyword(s):  
Hearing Loss ◽  
Informed Consent ◽  
Conductive Hearing Loss ◽  
Hearing Threshold ◽  
Chronic Otitis Media ◽  
Success Rates ◽  
Hearing Improvement ◽  
Group A ◽  
Group B ◽  
Conductive Hearing

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the over underlay tympanoplasty technique with classical underlay tympanoplasty in terms of hearing impairment, graft acceptance and complications.</p><p class="abstract"><strong>Methods:</strong> 60 patients of chronic otitis media, mucosal, inactive, aged between 16-60 years who presented to ENT OPD with small, medium, large and subtotal perforations having mild to moderate conductive hearing loss were included in the study. After taking informed consent, patients were randomly divided into 2 groups containing 30 patients each. In group A, graft was placed medial to the handle of malleus and medial to the annulus (underlay technique), while in group B, graft was placed lateral to the handle of malleus and medial to the annulus (over underlay technique). Both groups were reviewed after 6 months. Pre-operative and post-operative air bone gap were compared. Surgery was considered successful based on post-operative graft uptake, hearing improvement and maintenance of middle ear space.  </p><p class="abstract"><strong>Results:</strong> In group A, re-perforation was seen in 8 cases (26.7%) whereas only 3 cases (10%) in group B had re-perforation. Medialization was noted among 4 patients in group A (13.3%), and was absent in group B. Lateralization was absent in both the groups. Post-operative hearing threshold in group A was 6.2±4.56 dB and in group B was 11.45±7.38 dB.</p><p class="abstract"><strong>Conclusions:</strong> Over underlay tympanoplasty is a safer technique as compared to classical underlay, showing lower rates of re-perforation or medialization and a significant improvement in hearing. Hence over-underlay is an effective method, having higher success rates.</p>

scholarly journals Comparison of marsupialization under nasal endoscopy versus Lacrimal probing for treatment of congenital dacryocystoceles: a report of 40 cases

2019 ◽  
Author(s):  
Yanhui Cui ◽  
Peng Sun ◽  
Lixing Tang ◽  
Chengyue Zhang ◽  
Qian Wu ◽  
...  
Keyword(s):  
Success Rate ◽  
Reoperation Rate ◽  
Nasal Endoscopy ◽  
Efficacy And Safety ◽  
Group A ◽  
Group B

Abstract Introduction This study was performed to compare the efficacy of marsupialization under nasal endoscopy versus Lacrimal probing in the treatment of congenital dacryocystocele. Methods Forty neonates (43 eyes) diagnosed with congenital dacryocystoceles were divided into Group A (nasal endoscopic marsupialization) and Group B (Lacrimal probing). The patients were followed up for 1 year after surgery. The efficacy, incidence of complications, and reoperation rate were compared between the two groups. Results The male:female ratio was 25:15 patients (27:16 eyes). In Group A, the success rate was 100%, the incidence of complications was 5%, and the reoperation rate was 0%. In Group B, the success rate was 90%, the incidence of complications was 20%, and the reoperation rate was 30%. Conclusion Compared with Lacrimal probing, marsupialization under nasal endoscopy provides greater efficacy and safety for congenital dacryocystoceles.

scholarly journals Antibiotic usage rates in bacterial versus nonbacterial diseases: a new way to monitor hospital-acquired infections in children: a retrospective case analysis

2020 ◽  
Vol 7 (11) ◽  
pp. 2176
Author(s):  
Jayendra R. Gohil ◽  
Chintu C. Chaudary ◽  
Sheena D. Sivanandan
Keyword(s):  
Antibiotic Usage ◽  
Retrospective Case ◽  
Hospital Acquired Infections ◽  
Group A ◽  
Added Benefit ◽  
Reduction Of Mortality ◽  
Group B ◽  
The Cost ◽  
Hospital Acquired ◽  
Selection Of

Background: While treating children, the selection of antibiotics, when indicated, should be from the point of its effectiveness, safety, suitability, and cost. However, this flow of action does not take place in all cases. Aim of the study was to assess the antibiotic usage in admitted children and mortality.Methods: The case records between January to July 2012 in children wards was evaluated for the use of antibiotics. Patients were grouped into; group A- ‘must use' antibiotic in all, and group B- where antibiotics are not indicated.Results: There were 1852 admissions, including 719 Thalassemia cases. Antibiotic usage was 63% in 1133 cases after excluding thalassemia. Out of 1133 cases, 423 were in group A and 710 cases were in group B. In group B the antibiotic usage was 41%. The mortality was 6.6% and 4.8% in group A and B. Inside group B, mortality was 5.9% versus 4.0% in those administered versus not administered, antibiotics.Conclusions: There was no increase in mortality in patients in whom antibiotics were not prescribed, and no added benefit of prescribing antibiotics was observed in nonbacterial group B disease patients. The mortality was similar in both the groups. In nonbacterial group B, the antibiotics did not offer any advantage in the reduction of mortality, but increased the cost of the treatment, and possibly the chance of development of drug resistance and adverse events. When analysing the hospital antibiotic usage, only the nonbacterial diseases should be considered to get a true picture of the inappropriate prescription of antibiotics.

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