scholarly journals A Comparative Study between Endoscopic Dacryocystorhinostomy and External Dacryocystorhinostomy – A Hospital-Based Study

2020 ◽  
Vol 7 (44) ◽  
pp. 2526-2529
Author(s):  
Kanishka Chowdhury ◽  
Sagar Karmakar ◽  
Subhadip Sarkar ◽  
Suman Mukhopadhyay

BACKGROUND Dacryocystorhinostomy (DCR) can be performed via two approaches either external approach or endonasally. Earlier, external approach was preferred but with the recent introduction of endoscopy, the focus has shifted to endoscopic DCR as it is a less invasive procedure. This study was conducted to compare both the approaches. METHODS 50 patients were selected from patients attending eye and ENT OPD of a medical college in Kolkata with complaints of watering and / or discharge or with other features of chronic dacryocystitis e.g., mucocele, pyocele etc. They were then allocated in to two groups, group A (patients who will undergo endo DCR) and group B (patients who will undergo external DCR). Results of both were compared. RESULTS The mean age of study population was 34.34 ± 6.65 yrs. Among the study population, 36 patients (72 %) were female and 14 were male (28 %). Mean age of Group A (i.e. patients subjected to endo DCR) was 34.60 ± 5.72, while that of Group B (patients undergone external DCR) was 34.08 ± 7.58 yrs. Patients had a right sided predilection for DCR operation (66 %). Most common presenting symptom was epiphora (66 %) followed by epiphora with discharge. Mean time taken for the operation was significantly (p < 0.0001) more in group B (117 ± 14.43 mins) compared to that in group A (46.60 ± 8.63 mins). Massive intraoperative bleeding was more common in group B (32 %) compared to that in group A (p = 0.0023). Group B had a significantly higher rate of post-operative complications (56 %) compared to that in group A (p = 0.00085). Group B also had a higher success rate compared to group A; but this difference was not significant. (p = 0.22144). CONCLUSIONS Both the approaches have their own merits and demerits; but both are accepted alternatives, so either approach could be performed depending on the situation. KEYWORDS Endoscopic DCR, External DCR, Epiphora

2015 ◽  
Vol 5 (2) ◽  
pp. 329-331 ◽  
Author(s):  
Laila Helaly ◽  
Md Zakir Hossain Sarker ◽  
MA Mannan ◽  
Md Tafazzal Hossain ◽  
Shafi Ahmed ◽  
...  

Objective : The present prospective randomized clinical trial was carried out to assess whether combined cefepime and amikacin as empirical antibiotic therapy was more effective than combined ceftriaxone and gentamicin in the treatment of febrile neutropenic children with malignant diseases.Material & Methods : The study was conducted in the Pediatric Hematology and Oncology unit of BSMMU over a period of 2 years. (From January 2006 to December 2007) Hospitalised pediatric cancer patients who developed febrile neutropenia following chemotherapy or radiotherapy were the study population. A total 64 cases were consecutively included in the study and were randomly assigned to either cefepime & amikacin group (Group- A) or ceftriaxone & gentamicin group (Group-B). The Group-A received cefepime 1500 mg/m2/dose infused over 15 minutes in two divided doses intravenously(IV) while amikacin was administered as thrice daily dose of 200 mg/m2/dose. Patients of Group-B received ceftriaxone 1500 mg/m2/dose in two divided doses and gentamicin 60 mg/m2/dose thrice daily IV. The therapy was continued until absolute neutrophil counts reached >1000 neutrophils/mm3. The treatment outcome was considered successful if fever resolves within 4 days and does not recur within 7 days of completion of therapy. Of the 64 patients, 13 cases were excluded from the final analysis.Results : Bacteria were isolated from culture in only 16.7% of cases Group-A and 9.5% of group-B. Patients E. coli was the most common isolate found in blood specimen (37%). Following intervention, 90% of cefepime & amikacin group and 85.6% of ceftriaxone & gentamicin group improved absolute neutrophil count to >1000/mm3 of blood. Persistence of fever after start of study drug and duration of antibiotic therapy were significantly less in the former group than those in later group (p = 0.049 and p = 0.004 respectively). Only 1 patient of group B had recurrence of infection within 7 days of treatment completion. The mean duration of hospital stay was less in the former group (7.97 ± 2.61 days) than that in the latter group (11.00 ± 3.42 days) (p = 0.06). Evaluation of final outcome shows that majority (86.6%) of cefepime & amikacin group had successful outcome, while majority of ceftriaxone & gentamicin group (81%) failed to resolve infection with continuation of fever for > 4 days.Conclusion : The study concluded that combined cefepime and amikacin is a better option for empirical treatment of fever and neutropenia in children with malignancies than combined ceftriaxone and gentamicin (p<0.001).Northern International Medical College Journal Vol.5(2) 2014: 329-331


2008 ◽  
Vol 15 (01) ◽  
pp. 81-86
Author(s):  
MUHAMMAD NAWAZ ◽  
MUHAMMAD SULTAN ◽  
QAISAR HANIF ◽  
Muhammad Sadiq

Purpose: To compare the results of standard dacryocystorhinostomy with the results ofdacryocystorhinostomy done with silicon tube stentting of the lacrimal canaliculi. Study design: This is a hospitalbased, prospective, comparative and interventional study. Setting: Department of Ophthalmology, Allied HospitalPunjab Medical College Faisalabad. Period: January 2006 to December 2006. Methods: Twenty seven patients ofchronic dacryocystitis fulfilling the inclusion criteria were selected and divided in two groups. Group A consisted of 15patients who underwent standard dacryocystorhinostomy and Group B consisted of 12 patients who underwentdacryocystorhinostomy along with intubation of the lacrimal canaliculi with silastic tubes. All the patients were followedup for at least six months post-operatively. Success of the procedure, defined as the symptomatic relief of epiphoraand infection was assessed at the end of follow-up period. Results: Of the total 27 patients of chronic dacryocystitis23 (85%) were female and 4(15%) were male. The mean age of the patients was 45 years. The success of theprocedure was recorded in 14 (93.33%) patients in group-A and in 10 (83.33%) patients in group B. Quite a few andsimple complications were recorded during the study period. Conclusions: 1. Standard externaldacryocystorhinostomy is a simple and cost effective procedure forthe management of chronic dacryocystitis. 2. Silicontube stentting of the lacrimal canaliculi does not have any extra advantage in the management of chronic dacryocystitiswithout canalicular obstruction.


2015 ◽  
Vol 8 (1) ◽  
pp. 1-4
Author(s):  
NK Mohindroo ◽  
Harjitpal Singh

ABSTRACT A prospective study on 50 cases of chronic dacryocystitis was done to see outcome of management by endoscopic dacryocystorhinostomy (DCR) in Indian population and to look for its advantages or disadvantages over external-DCR. Effect of mitomycin-C was also evaluated in endoscopic DCR cases. Dacryocystitis was diagnosed on the basis of clinical examination by doing regurgitation test and lacrimal syringing. These patients were divided into two groups: group I consisted of those 25 subjects who were planned for endonasal endoscopic DCR and group II of those 25 subjects who underwent external-DCR in ophthalmology department. Of all the cases, maximum number of cases was in the age group of 21 to 35 years, 27 (54%) cases, 88% were females and 12% were males. External-DCR required a relatively longer surgical duration of an average 65 minutes as compared to 35 minutes for endonasal DCR. Average hospital stay for patient in group I was 3 days and it was 7 days in group II. There were minimal intraoperative complications in endoscopic procedure as compared to external-DCR group. Average follow-up was 6 months. Primary success rate was 96% in both the groups. Thus, it was concluded that both the procedures represent good alternatives for the treatment of primary nasolacrimal sac or duct obstruction or chronic dacryocystitis, endoscopic DCR having advantage of less complications and less traumatic. Mitomycin-C was found to be helpful in reducing fibrosis. How to cite this article Singh H, Mohindroo NK. Comparative Study of Endonasal Endoscopic Dacryocystorhinostomy and External Dacryocystorhinostomy. Clin Rhinol An Int J 2015;8(1):1-4.


2018 ◽  
Vol 26 (1) ◽  
pp. 29-34
Author(s):  
Harikesh Sharma ◽  
Ajay Mallick

Introduction Common cause for failure of endonasal dacryocystorhinostomy is closure of the intranasal ostium usually due to granulation tissue formation. Attempts have been made to improve the success rate of lacrimal surgery by using different methods like using balloon catheters, lasers and antimetabolites. This study aims to see change in success rate with and without the use of using Mitomycin-C in endonasal Dacryocystorhinostomy (DCR) surgery. Materials and Methods Sixty patients of acquired chronic dacryocystitis with nasolacrimal duct blockage, in the age group of 11-50 yrs were taken for study. Patients were alternatively divided into two groups A & B (30 patients in each group). Endoscopic dacryocystorhinostomy with Mitomycin-C application was performed in Group A and without Mitomycin-C application in Group B patients. Subjective assessment for symptomatic improvement and objective analysis obtained from results of syringing. The result data was subjected to Student’s t test and x2analysis. Result Age of patients varied from 11 to 50 yrs. The male to female ratio was 7:8 in group A while 2:3 in group B. The commonest age group was between 21 -30 years in both the groups. After 12 month follow up the success rate was 93% in both the groups. The results between the groups were found to be statistically not significant (p>0.05). Conclusion Mitomycin C was used in this study to assess its efficacy in improving the results of endoscopic DCR. Mitomycin C did not have significant effect on the outcomes of endoscopic DCR surgery for chronic dacryocystitis.


2017 ◽  
Vol 4 (9) ◽  
pp. 2920
Author(s):  
Jahangir Sarwar Khan ◽  
Raheel Ahmad

Background: Laparoscopic cholecystectomy (LC) a minimal invasive procedure is regarded as gold standard for gallstone disease for many years. With increase learning curve of surgeons, the incidence of complications of this procedure decreases significantly. The purpose of study was to compare the experiences of Laparoscopic cholecystectomy performed.Methods: It was a retrospective cohort study conducted in Surgical Department, Rawalpindi Medical College and author's surgical clinic. From 1st January 1998 to 31st December 2014. Total 3000 patients of Laparoscopic cholecystectomy were divided into 2 groups. First 1500 cases (operated between January 1998 to December 2007) in Group A and next 1500 cases (operated between January 2008 to December 2014) in Group B. Preoperative diagnosis, intraoperative findings and injuries especially incidence of CBD injuries with post-operative complications and their management were evaluated.Results: Out of 3000 cases 2585 (86.1%) were females and 415 (13.8%) were males. Total 18 (0.6%) cases had CBD injury during LC. 17 cases were in group A which decreased significantly to 1 case in Group B. Mean operative time was 30 minutes. Wound infection remained the most common postoperative complication.Conclusions: In our setup, the burden of laparoscopic cholecystectomy for symptomatic gallstones have increased with very low incidence of complications.


2019 ◽  
Vol 27 (2) ◽  
pp. 161-166
Author(s):  
Bijan Basak ◽  
Kaustuv Das Biswas ◽  
Subhradev Biswas ◽  
Ankit Choudhary

Introduction Although external DCR was considered to be the Gold Standard treatment for NLD obstruction, endoscopic DCR appears to give comparable results,  with the advantage of the absence of external facial scar and no disruption of the medial palpebral ligament or the angular facial vessels. This study aims to evaluate the outcome of endoscopic dacryocystorhinostomy (DCR) and compare with the outcome of external DCR, based on data available on literature search. Materials and Methods In this prospective, longitudinal, interventional study, 67 cases of chronic dacryocystitis were operated endoscopically from January 2017 to December 2018. All patients were documented about detailed medical and operative history, thorough medical check up including ocular and ENT examination. Level of obstruction of nasolacrimal duct (NLD) was diagnosed by lacrimal syringing and probing. Surgery was performed under local anaesthesia except in uncooperative patients where general anaesthesia was used. 0˚ & 30˚ endoscopes were used in surgery. The surgical outcomes and complications were recorded, analyzed and compared to those of external DCR from available literature.   Results The overall success rate of endoscopic DCR was 94.7%, which is closely comparable to external DCR. Conclusion Endoscopic DCR is an effective and safe alternative to external DCR, with comparable results and better patient satisfaction.


2020 ◽  
Vol 21 (2) ◽  
pp. 105-110
Author(s):  
Md Shawkat Alam ◽  
Sudip Das Gupta ◽  
Hadi Zia Uddin Ahmed ◽  
Md Saruar Alam ◽  
Sharif Muhammod Wasimuddin

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110


1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
S. Samra ◽  
M. Habeb ◽  
R. Nafae

Abstract Background A few people infected by the coronavirus become seriously ill, while others show little to no signs of the symptoms, or are asymptomatic. Recent researches are pointing to the fact that the ABO blood group might play an important role in a person’s susceptibility and severity of COVID-19 infection. Aim of the study: try to understand the relationship between ABO groups and COVID-19 (susceptibility and severity). Results A total of (507) patients were included in this study. The study population was divided based on the ABO blood group into types A+, A−, B+, AB, O+, and O−. Blood group A was associated with high susceptibility of infection: group A, 381 (75.1%); and less common in group O, 97 (19.2%), group B, 18 (3.5%), and group AB, 11 (2.2%). The severity of COVID-19 infection was common in non-blood group O where (20 (7.1%), 4 (26.7%), 2 (11%), and 1 (9%) in type A+, A−, B+, and AB, respectively), while in type O 3.1%. And mechanically ventilated patients were 22 (5.9%), 2 (13.4%), 2 (11.1%), and 1 (1%). Mortality was high in blood groups A and B, 16 (4.37%) and 1 (5.5%), respectively, while in blood group O, it was 1%. Conclusion The incidence, severity, and mortality of COVID-19 were common in non-blood group O. While blood group O was protected against COVID-19.


KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 21-24
Author(s):  
Md Abdus Salam ◽  
Md Mahbub Alam ◽  
Rezwan Ahmed ◽  
Md Sultan Mahmud

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24


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