scholarly journals Comparative study on the effects of pre-operative intranasal steroid spray versus oral steroid on intraoperative bleed in FESS for nasal polyposis

2021 ◽  
Vol 7 (5) ◽  
pp. 782
Author(s):  
Jagannath B. ◽  
Nikitha Pillai ◽  
Bharath Kumar K. L.
Keyword(s):  
Medical Treatment ◽  
Nasal Polyposis ◽  
Oral Steroid ◽  
Time Duration ◽  
Oral Steroids ◽  
Group A ◽  
Surgical Field ◽  
Nasal Steroid ◽  
Group B

<p class="abstract"><strong>Background:</strong> Nasal polyps are associated with chronic inflammation of the nasal cavity and sinus mucosa. Steroids are the main stay of medical treatment. FESS is indicated when medical treatment fails. Bleeding during surgery can impair the surgical field during operation and increase the time duration and risks of complications. Pre-operative corticosteroids help reduce bleeding during surgery. The objectives of the study was to study and compare the effects of pre operative intra nasal steroid spray and oral steroid on intra-operative bleed in FESS for nasal polyposis.</p><p class="abstract"><strong>Methods: </strong>60 patients diagnosed with nasal polyposis were sequentially divided into 2 groups. Group A received intranasal steroid spray and Group B received oral steroid each for 7 days. Patients of both groups underwent FESS under general anaesthesia. Bleeding volume and quality of surgical field were assessed during the procedure to evaluate the effect of pre operative steroids in bleeding in FESS.</p><p class="abstract"><strong>Results: </strong>Majority of our study patients of both the groups had moderate bleed. 33.3% of Group B patients showed the best outcome of surgery with just slight bleeding while 33.3% patients of Group B had moderate to severe bleed. Majority of our study patients (53.3%) had a blood loss of about 50-100 ml, of which 66.7% patients belonged to Group B.</p><p class="abstract"><strong>Conclusions: </strong>Preoperative steroids are truly beneficial. Oral steroids has been found to be relatively better than intra nasal steroid spray in improving symptoms, reducing intra operative bleeding, and in providing better quality of surgical field.  </p><p class="abstract"> </p>

Efficacy of Post-Operative Oral Prednisolone for the Control of Disease in Allergic Fungal Sinusitis

2021 ◽  
pp. 13-17
Keyword(s):  
Study Groups ◽  
Sinus Surgery ◽  
Oral Steroid ◽  
P Value ◽  
Complete Relief ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Oral Steroids ◽  
Group A ◽  
Group B

Background: Ambiguity persists regarding the dosage, frequency, and duration for the use of oral steroids in Allergic Fungal Sinusitis (AFS). Objective: To assess the efficacy of post-operative oral steroid (prednisolone) for the control of disease in Allergic Fungal Sinusitis. Methodology: This was a comparative study, conducted at Bahawal Victoria Hospital, Bahawalpur from January 2019 to March 2019. A total of 40 patients, aged 18 or above with weight over 50 kilograms, having proved Allergic Fungal Sinusitis (AFS) as per criteria defined by Deshazo and Swain, were recruited for this study. All the patients were enrolled within 14 days of excisive sinus surgery adopting endoscopic sinus surgery with or without open methods. Group A (n=20) received oral steroids while Group B (n=20) received a placebo. Patients of both groups also used fluticasone nasal spray and oral itraconazole. Evaluation of all the patients was done at the time of enrollment, 6 and 12 weeks. Data were analyzed by SPSS version 21. Results: Out of a total of 40 patients, 17 (42.5%) were males. After 6 weeks of continuous therapy in both the study groups, 14 (70%) patients of Group A showed complete relief of symptoms in comparison to none in Group B (p-value = 0.001). After 12 weeks of therapy having tapering off in both study groups, all patients in Group A had complete relief of symptoms in comparison to only one (5%) in Group B (p-value = 0.001). Conclusion: Oral steroids of prednisolone, along with inhaled steroids therapy for a minimum of 12 weeks after excisive sinus surgery were found efficacious for the control of disease in patients with Allergic Fungal Sinusitis.

scholarly journals Evaluation on Quality of Life in Patients with Nasal Polyposis Managed with Optimal Medical Therapy

2014 ◽  
Vol 5 (1) ◽  
pp. ar.2014.5.0075 ◽  
Author(s):  
Saleh Khaled Aboud ◽  
Salina Husain ◽  
Balwant Singh Gendeh
Keyword(s):  
Quality Of Life ◽  
Medical Treatment ◽  
Medical Therapy ◽  
Nasal Polyposis ◽  
Optimal Medical Therapy ◽  
Short Course ◽  
Intranasal Steroids ◽  
Oral Steroids

Nasal polyposis (NP) has a great impact on quality of life (QOL) and its management involves a combination of medical therapy and surgery. To the authors' knowledge, no publication has extensively examined NP after optimal medical treatment based on subjective evaluations. The aim of this prospective study was designed to evaluate the QOL in NP patients after (1) a short course of oral steroids, (2) initial 3-month course of macrolide, and (3) long-term treatment with intranasal steroids. A total of 55 patients with grades I and II NP were consecutively treated with oral prednisolone at 25 mg in a single dose for 2 weeks, macrolide at 250 mg daily for the first 3 months, and long-term intranasal steroids. Patients were followed up and evaluated at baseline and 3, 6, and 12 months for QOL measure. At baseline, patients with grade I and grade II NP showed significantly worse QOL scores on all Rhinosinusitis Disability Index domains, particularly for physical function (4.59 ± 1.41) and were significantly higher in social function (3.16 ± 1.17). At 3, 6, and 12 months of treatment, patients showed a significant improvement in all impaired QOL domains compared with baseline after optimal medical therapy (p < 0.05). These results suggest that the optimal medical treatment to improve QOL incorporates medical polypectomy with a short course of oral steroids in addition to macrolide and this can be maintained by long-term intranasal steroid therapy.

scholarly journals Comparison of Endoscopic Sinus Surgery and Continued Medical Treatment Therapy for Refractory Chronic Rhinosinusitis

2021 ◽  
Vol 15 (9) ◽  
pp. 2285-2288
Author(s):  
Sadaf Raffat ◽  
Mustafa . ◽  
Nighat Arif ◽  
Usman Aslam ◽  
M Mubarik Ali ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Treatment ◽  
Chronic Rhinosinusitis ◽  
Medical Therapy ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Group A ◽  
Group B ◽  
Disease Specific

Aim: To compare endoscopic sinus surgery and continued medical treatment in refractory refractory chronic rhinosinusitis (CRS) patients regarding diseases specific quality of life measurement Study design: RCT (Randomized controlled trial) Place and duration of study: Study was conducted at ENT (Ear, nose and throat) department, Railway Hospital Rawalpindi. Study duration was one year (January 2018-Deecember 2018) Methods: A sample size of 22 patients was calculated using WHO calculator. Non probability consecutive sampling was used. A prior ethical approval and consent form was taken. Patients were randomly divided into two groups; Group A was given medical therapy while Group B comprised contain patients in whom medical therapy failed and had undergone endoscopic sinus surgery. Patients were followed for disease specific quality of life scores. Data was analyzed using SPSS version22. Chi-square and t test was applied. P value ≤ 0.05 was considered significant. Results: Total of 22 refractory CRS patients were included in study. There were 10(45.5%) males and 12(54.5%) females. Mean age of refractory CRS patients was 33.4 years±6.2SD. Group A (continued medical therapy) N=11, had significantly high SNOTT -22 scores 60.6±7.1SD as compared to endoscopic sinus surgery 21±3.9SD (p=0.000). Group B (endoscopic sinus surgery) had significantly low endoscopic scores 2.7±0.3SD as compared to group A (continued medical therapy) 7.14±0.53SD (p=0.000). Endoscopic sinus surgery group showed significant reduction in work days lost 17.4±4.9SD as compared to continued medical therapy (Group A) 30.1±2.5SD (p=0.000). Conclusion: Endoscopic sinus surgery is an effective treatment option as compared to continued medical therapy with improved quality of life in refractory CRS patients (with reduced baseline disease specific quality of life). Keywords: Refractory chronic rhinosinusitis, endoscopic sinus surgery, quality of life

Comparison of one-year prognosis of patients classified as chronic critical lower limb ischaemia according to TASC II or European consensus definition in the COPART cohort

VASA ◽  
2015 ◽  
Vol 44 (3) ◽  
pp. 0220-0228 ◽  
Author(s):  
Marion Vircoulon ◽  
Carine Boulon ◽  
Ileana Desormais ◽  
Philippe Lacroix ◽  
Victor Aboyans ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Medical Group ◽  
Consensus Definition ◽  
Transcutaneous Oxygen ◽  
European Consensus ◽  
Group A ◽  
One Year ◽  
Group B

Background: We compared one-year amputation and survival rates in patients fulfilling 1991 European consensus critical limb ischaemia (CLI) definition to those clas, sified as CLI by TASC II but not European consensus (EC) definition. Patients and methods: Patients were selected from the COPART cohort of hospitalized patients with peripheral occlusive arterial disease suffering from lower extremity rest pain or ulcer and who completed one-year follow-up. Ankle and toe systolic pressures and transcutaneous oxygen pressure were measured. The patients were classified into two groups: those who could benefit from revascularization and those who could not (medical group). Within these groups, patients were separated into those who had CLI according to the European consensus definition (EC + TASC II: group A if revascularization, group C if medical treatment) and those who had no CLI by the European definition but who had CLI according to the TASC II definition (TASC: group B if revascularization and D if medical treatment). Results: 471 patients were included in the study (236 in the surgical group, 235 in the medical group). There was no difference according to the CLI definition for survival or cardiovascular event-free survival. However, major amputations were more frequent in group A than in group B (25 vs 12 %, p = 0.046) and in group C than in group D (38 vs 20 %, p = 0.004). Conclusions: Major amputation is twice as frequent in patients with CLI according to the historical European consensus definition than in those classified to the TASC II definition but not the EC. Caution is required when comparing results of recent series to historical controls. The TASC II definition of CLI is too wide to compare patients from clinical trials so we suggest separating these patients into two different stages: permanent (TASC II but not EC definition) and critical ischaemia (TASC II and EC definition).

A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth
Keyword(s):  
Medical Science ◽  
Frozen Shoulder ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Animal Kingdom ◽  
Shoulder Joints ◽  
Group A ◽  
Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

Joint involvement influences quality of life in systemic lupus erythematosus patients

Lupus ◽  
2020 ◽  
pp. 096120332097903
Author(s):  
Francesco Natalucci ◽  
Fulvia Ceccarelli ◽  
Enrica Cipriano ◽  
Carlo Perricone ◽  
Giulio Olivieri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Joint Involvement ◽  
Systemic Lupus ◽  
Median Disease Duration ◽  
Group A ◽  
Musculoskeletal Manifestations ◽  
Group B

Introduction Joint involvement represents the major determinant in quality of life (QoL)in Systemic Lupus Erhytematosus (SLE) patients. However, QoLhas been generally evaluated by non-specific questionnaires. We evaluated the relationship between SLE musculoskeletal manifestations and QoL, assessed by LupusQoL. Methods Patients with joint involvement (group A) were compared with those without this feature (group B). Disease activity was assessed by SLEDAI-2k in the whole population, while DAS28 and swollen to tender ratio were applied to assess joint activity. LupusQoL was administered to all the patients. Results Group A included 110 patients [M/F 8/102; median age 49 years (IQR 13), median disease duration 156 months (IQR 216)], group B 58 [M/F 11/47; median age 40 years (IQR 15), median disease duration 84 months (IQR 108)].We found significanlty lower values in all the LupusQoL domains except for one (burden to others) in group A in comparison with group B. A significant correlation between DAS28 values and all the LupusQoL domains in group A was found; only three domains correlated with SLEDAI-2k. Conclusions SLE-related joint involvement significantly influences disease-specific QoL. DAS28 better correlated with LupusQoL domains in comparison with SLEDAI-2k, confirming the need for specific musculoskeletal activity indices.

scholarly journals Influence of Lead on the Interpretation of Bone Samples with Laser-Induced Breakdown Spectroscopy

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Abdolhamed Shahedi ◽  
Esmaeil Eslami ◽  
Mohammad Reza Nourani
Keyword(s):  
Plasma Temperature ◽  
Laser Induced Breakdown Spectroscopy ◽  
Plasma Parameters ◽  
Time Duration ◽  
Laboratory Rats ◽  
Breakdown Spectroscopy ◽  
Laser Induced Breakdown ◽  
Group A ◽  
Atomic Lines ◽  
Group B

This study is devoted to tracing and identifying the elements available in bone sample using Laser-Induced Breakdown Spectroscopy (LIBS). The bone samples were prepared from the thigh of laboratory rats, which consumed 325.29 g/mol lead acetate having 4 mM concentration in specified time duration. About 76 atomic lines have been analyzed and we found that the dominant elements are Ca I, Ca II, Mg I, Mg II, Fe I, and Fe II. Temperature curve and bar graph were drawn to compare bone elements of group B which consumed lead with normal group, group A, in the same laboratory conditions. Plasma parameters including plasma temperature and electron density were determined by considering Local Thermodynamic Equilibrium (LTE) condition in the plasma. An inverse relationship has been detected between lead absorption and elements like Calcium and Magnesium absorption comparing elemental values for both the groups.

Comparison of montelukast and mometasone furoate in the prevention of recurrent nasal polyps

2011 ◽  
Vol 6 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Erkan Vuralkan ◽  
Cem Saka ◽  
Istemihan Akin ◽  
Sema Hucumenoglu ◽  
Binnur Uzmez Unal ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Nasal Spray ◽  
Peripheral Blood ◽  
Nasal Polyposis ◽  
Mometasone Furoate ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Snot 22

Background: The aim of our study was to compare the effects of montelukast and mometasone furoate nasal spray on the postoperative course of patients with nasal polyposis. Patients and methods: Fifty patients diagnosed with nasal polyposis between March 2006 and August 2007 were included in the study. All patients underwent bilateral endoscopic sphenoethmoidectomy and were randomized postoperatively into two groups. Group A ( n = 25) received 10 mg montelukast per day and group B ( n = 25) received 400 µg mometasone furoate nasal spray twice daily. All patients were followed up for 6 months. Sino-Nasal Outcome Test (SNOT)-22 scores, polyp grades, computerized tomography (CT) scores (Lund–Mackay), eosinophils in peripheral blood and polyp tissue were evaluated before and after surgery. Results: There was a significant reduction in SNOT-22 scores in both groups throughout the study period. There was a significant difference in the recurrence rate between both groups with a marginal advantage of mometasone furoate nasal spray. Eosinophils in peripheral blood were found to be effective on the recurrence rate ( p < 0.05). Conclusions: In conclusion, both drugs seem to have a complementary action and further studies are needed to determine which patients should receive which treatment.

Comprehensive Nursing can Relieve the Negative Emotions of Patients undergoing Breast Cancer Resection and Reduce Postoperative

2021 ◽  
Vol 7 (5) ◽  
pp. 4234-4243
Author(s):  
Xiaoxia Lv ◽  
Lihua Wang ◽  
Yan Zhai
Keyword(s):  
Breast Cancer ◽  
Postoperative Complications ◽  
Quality Score ◽  
Cancer Resection ◽  
Upper Limb Function ◽  
Sf 36 ◽  
Group A ◽  
Group B ◽  
Nursing Quality

To explore the effect of comprehensive nursing on adverse emotions and postoperative complications of breast cancer patients undergoing mastectomy. Altogether 180 patients who received treatment in our hospital from May 2017 to May 2019 were selected as the research participants and divided into group A and group B. Among them, 100 cases in group A received comprehensive nursing, 80 cases in group B received routine nursing. The surgical indications, upper limb function, serum NGF, TK1 and CA15-3 expression level, VAS score, SAS, SDS score, quality of life SF-36 score were detected, and the incidence rate of postoperative complications and nursing quality score were compared. Compared with group B, group A had less postoperative bed time, intraoperative blood loss, length of hospital stay, better recovery of upper limb function, lower expression levels of serum NGF, TK1 and CA15-3, lower VAS score, SAS and SDS score, higher quality of life SF-36 score, lower incidence of postoperative complications and higher nursing quality score. Comprehensive nursing can relieve the negative emotions of patients undergoing breast cancer resection and reduce the incidence of postoperative complications.

Comparison of Post-Operative Quality of Life between Vaginal Hysterectomy and Abdominal Hysterectomy

2021 ◽  
Vol 15 (7) ◽  
pp. 1801-1803
Author(s):  
Nazia Sajjad ◽  
Sara Qadir ◽  
Rukhsana Kasi ◽  
Tayyaba Rasheed ◽  
Fozia Unar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vaginal Hysterectomy ◽  
Controlled Trial ◽  
Abdominal Hysterectomy ◽  
Study Group ◽  
Randomized Controlled ◽  
Group A ◽  
Group B ◽  
Satisfactory Quality

Objectives: To compare the frequency of satisfactory quality of life between vaginal hysterectomy and abdominal hysterectomy. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Obstetrics and Gynecology, Niazi Medical & Dental College, Sargodha from 1st April 2020 to 31st December 2020. Methodology: Ninety patients were comprised and they were divided in two groups; group A (vaginal hysterectomy) and Group B (abdominal hysterectomy) were performed. Hysterectomies (vaginal or abdominal) were performed by consultant gynecologist having experience at having least 5 years). Results: Mean age of the patients was 49.82±3.207 years, mean age of the patients of group A was 49.82±3.193 years and mean age of the patients of group B was 49.82±3.256 years. Satisfactory quality of life was noted in 38 (84.44%) patients of study group A and 29 (64.44%) patients of study group B. Statistically significant (P = 0.051) difference between the frequency of satisfactory quality of life between the both groups was noted. Conclusion: Results of this study reveals that post hysterectomy quality of life found more satisfactory in vaginal hysterectomy group as compared to abdominal hysterectomy group. Insignificant association of post hysterectomy quality of life with age group, marital status, parity and socio-economical status was found. Findings of this study also revealed that post hysterectomy satisfactory quality of life is not associated with education of the patients. Key words: Hysterectomy, Quality of life, abdomen, vagina, WHO, Uterus

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