scholarly journals A new technique of epidural and intrathecal catheterization to evaluate pharmacokinetics of epidural administration in dogs: a prospective study

2019 ◽  
Author(s):  
Myoung Hoon Kong ◽  
Jung Eun Kim ◽  
Mi Kyoung Lee ◽  
Chung Hun Lee ◽  
Yeon Joo Lee ◽  
...  
Keyword(s):  
Deep Sedation ◽  
Canine Model ◽  
New Technique ◽  
Treatment Modalities ◽  
Cerebrospinal Fluid Leakage ◽  
Epidural Administration ◽  
Intrathecal Catheter ◽  
Epidural Catheterization ◽  
Epidural Catheters ◽  
A Prospective Study

Abstract Background: Experimental research on animals should be performed before applying new treatment modalities in humans. Among experimental animal models, canine model research is a commonly used method. Injecting drugs into the epidural has also been commonly used in the canine animal model. In canine models, epidural catheters are often inserted into the lumbosacral area during epidural drug injection. Unlike the existing canine model, we describe a new and alternative technique of epidural and intrathecal catheterization to investigate methods of epidural drug administration in dogs. Methods: Twelve adult dogs were used in this study. The epidural procedures were performed with dogs in sternal recumbency under deep sedation. Epidural catheterization was perforemed at the T1-T2 intervertebral space with C-arm fluoroscopy guidance. After confirming the loss of resistance, a flexible epidural catheter was passed cranially to the C2-C3 level. The intrathecal procedures were performed with dogs in lateral recumbency under deep sedation. Intrathecal catheterization was performed through the cisterna magna with the neck slightly flexed. An 18-gauge Tuohy needle was inserted into the subarachnoid space through the atlanto-occipital space. After confirming cerebrospinal fluid leakage without bleeding, a flexible intrathecal catheter was passed caudally to the C2-C3 level. Results: All epidural and intrathecal catheterizations were successfully performed under deep sedation without any complications. Conclusion: The new technique of epidural and intrathecal catheterization in canines is an alternative procedure for investigating epidurally administered drugs.

scholarly journals A new technique of epidural and intrathecal catheterization to evaluate pharmacokinetics of epidural administration in dogs: a prospective study

2019 ◽  
Author(s):  
Myoung Hoon Kong ◽  
Sang Sik Choi ◽  
Jung Eun Kim ◽  
Mi Kyoung Lee ◽  
Chung Hun Lee ◽  
...  
Keyword(s):  
Drug Administration ◽  
Deep Sedation ◽  
Canine Model ◽  
New Technique ◽  
Cerebrospinal Fluid Leakage ◽  
Epidural Administration ◽  
Efficacy And Safety ◽  
Intrathecal Catheter ◽  
Epidural Catheterization ◽  
A Prospective Study

Abstract Background: Compared to the conventional oral or intravenous drug administration, epidural administration of drugs has significantly higher efficacy and safety. Experimental research on animals should be performed before applying to humans. Unlike the existing canine model, we describe a new and alternative technique of epidural and intrathecal catheterization to investigate the efficacy and safety of epidural drug administration in dogs. Methods: Twelve adult dogs were used in this study. The procedures were performed with dogs in sternal recumbency under deep sedation. Epidural catheterization was performed at the T1–T2 intervertebral space with C-arm fluoroscopy guidance. After confirming loss of resistance, a flexible epidural catheter was passed cranially to the C2–C3 level. Intrathecal catheterization was performed through the cisterna magna with the neck slightly flexed. An 18-gauge Tuohy needle was inserted into the subarachnoid space through the atlanto-occipital space. After confirming cerebrospinal fluid leakage without bleeding, a flexible intrathecal catheter was passed caudally to the C2–C3 level. Results: All epidural and intrathecal catheterizations were successfully performed under deep sedation without any complications. Conclusion: The new technique of epidural and intrathecal catheterization in canines is a safe and alternative procedure for investigating the toxicity and pharmacology of epidurally administered drugs.

Impact of Treatment on Vestibular Schwannoma–Associated Symptoms: A Prospective Study Comparing Treatment Modalities

2021 ◽  
pp. 019459982098656
Author(s):  
Jason H. Barnes ◽  
Neil S. Patel ◽  
Christine M. Lohse ◽  
Nicole M. Tombers ◽  
Michael J. Link ◽  
...  
Keyword(s):  
Vestibular Schwannoma ◽  
Median Number ◽  
Treatment Modalities ◽  
Baseline Survey ◽  
Limited Attention ◽  
Subjective Symptoms ◽  
Prospective Survey ◽  
Significant Difference ◽  
Associated Symptoms ◽  
A Prospective Study

Objective The degree to which various treatment modalities modify vestibular schwannoma (VS)–associated symptoms has received limited attention. The purpose of this study was to determine how different treatment modalities affect subjective symptoms in those presenting with VS. Study Design Prospective survey. Setting Tertiary neurotology referral center. Methods Patients with sporadic VS who received treatment at our institution were prospectively surveyed with a VS symptom questionnaire. Those who completed a baseline survey prior to treatment and at least 1 posttreatment survey were included. The prospective survey evaluated the severity of self-reported symptoms (Likert scale, 1-10), including tinnitus, dizziness or imbalance, headaches, and hearing loss. Results A total of 244 patients were included (mean age, 57 years). The mean duration of follow-up was 2.1 years, and the median number of surveys completed was 2 (interquartile range, 1-3). Seventy-eight (32%) cases were managed with observation, 118 (48%) with microsurgery, and 48 (20%) with radiosurgery. Multivariable analyses revealed no statistically significant difference in the change in tinnitus ( P = .15), dizziness or imbalance ( P = 0.66), or headaches ( P = .24) among treatment groups. Evaluation of clinically important differences demonstrated that microsurgery leads to significant bidirectional changes in headaches. Conclusions Limited prospective data exist regarding the progression or resolution of subjective symptoms in those presenting with VS. This study suggests that tinnitus, dizziness or imbalance, and headaches are unlikely to be significantly modified by treatment modality and generally should not be used to direct treatment choice.

scholarly journals A prospective clinical study of fistula in ano: comparing different treatment modalities in a tertiary care hospital

2019 ◽  
Vol 6 (7) ◽  
pp. 2411
Author(s):  
Hareesh G. S. R. ◽  
Siva Prasad Naik Nenavath
Keyword(s):  
Tertiary Care ◽  
Treatment Modalities ◽  
Prospective Clinical Study ◽  
Care Hospital ◽  
College Hospital ◽  
Common Procedure ◽  
Fistula In Ano ◽  
Low Level ◽  
Complex Fistula ◽  
A Prospective Study

Background: Fistula in ano is one of the common anorectal condition, which is easy to diagnose but difficult to manage because of post-operative complications like incontinence and recurrence. Also numerous procedures have been described for its treatment so as to individualize treatment options.The aim of the study was to assess the efficacy of different treatment modalities in fistula in ano.Methods: This is a prospective study carried out in a tertiary medical college hospital where 75 patients with fistula in ano are analysed for clinical features and surgical modalities compared.Results: Total 75 patients are studied. 82.70% patients presented with discharge in perianal region. Posterior fistulas are seen in 93.30% and anterior in 6.70% patients. 94.70% patients have low level fistula, 84% patients had simple fistula & 16% had complex fistula. 49.30% patients were treated with fistulectomy. 36.0% have undergone fistulotomy. 8.0% had LIFT and 6.7% had SETON. Recurrence is seen in 6.70% of patients.70.70% patients have stayed 4-6 days.Conclusions: Most of the fistulas are simple, posterior and low level fistulas. Fistulectomy is the most common procedure performed. Newer procedures like LIFT and Seton application show promising results with less complications. 

A PROSPECTIVE STUDY TO COMPARE THE EFFICACY OF THREE TREATMENT MODALITIES ON BENIGN BREAST DISEASE VIZ. EVENING PRIMROSE OIL (EPO), DANAZOLAND CENTCHROMAN

2021 ◽  
pp. 22-24
Author(s):  
Abhishek Chaudhary ◽  
Prem Prakash ◽  
Yasir Tajdar ◽  
Nadeem Ahmad
Keyword(s):  
Prospective Study ◽  
Premenopausal Women ◽  
Breast Disease ◽  
Treatment Modalities ◽  
Breast Pain ◽  
Medical Sciences ◽  
Evening Primrose ◽  
Cancer Breast ◽  
Breast Lumps ◽  
A Prospective Study

Background: Breast pain among women, with or without lump is common complaint and a cause of signicant anxiety and fear of breast cancer. Breast feeding is additionally one of the reasons for non-cyclic pain, brocystic breast disease is otherwise called broadenosis. Material and Methods:This is prospective study in the Department of General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, Bihar. Conclusion: Centchroman is a selective anti estrogen effective in the treatment of brocystic disease. Centchroman is effective in reducing the sizes of breast lumps, providing relief from mastalgia and in curing cyclical and noncyclical breast pain in the premenopausal women.

scholarly journals Thymomodulin in association with antifungal drugs in the therapy of cats with disseminated cutaneous sporotrichosis: a prospective study

2021 ◽  
Vol 51 (6) ◽  
Author(s):  
Gustavo Soares Forlani ◽  
Risciela Salardi Alves de Brito ◽  
Jéssica Paola Salame ◽  
Angelita Reis Gomes ◽  
Fábio Raphael Pascoti Bruhn ◽  
...  
Keyword(s):  
Survival Rate ◽  
Body Condition ◽  
Body Condition Score ◽  
Clinical Signs ◽  
Time Frame ◽  
Antifungal Drugs ◽  
Treatment Modalities ◽  
Condition Score ◽  
Group 2 ◽  
A Prospective Study

ABSTRACT: Feline sporotrichosis is a relevant mycose in veterinary medicine due to its severity and zoonotic potential and the fact that it can be difficult to treat. The immune status of the animal exerts influence on the prognosis of the disease and determines its clinical outcome. This study evaluated the efficacy of the immunomodulatory thymomodulin as an adjunct to antifungal therapy in cats with disseminated sporotrichosis; thymomodulin was used in association with itraconazole (ITL) and potassium iodide (KI) to treat this fungal disease in the feline patient. Thirty-one cats (n=31) diagnosed with disseminated cutaneous sporotrichosis were divided into two groups as follows: Group 1 (G1) (n=16), which included those animals that were treated with thymomodulin in association with ITL and KI, and Group 2 (G2) (n=15) which had pacientsthat received ITL and KI only. The response to different treatment modalities was assessed, considering the survival rate, time frame for the lesions to respond to therapy, and clinical improvement or deterioration according to a body condition score system. Animals from G1 had a survival rate of nearly 100% (93.6%) that was approximately twice higher than the survival rate of those animals from G2 (53%). Moreover, patients from G1 had a significantly better prognosis, improved body condition, and shorter time for remission of the extra cutaneous clinical signs (p<0.02). Our findings showed that the association of thymomodulin with ITL and KI improves the prognosis of cats with disseminated cutaneous sporotrichosis.

scholarly journals A study on faciomaxillary trauma in a tertiary care hospital: a prospective study

2018 ◽  
Vol 6 (1) ◽  
pp. 51
Author(s):  
T. Chenthil Sivamuthu
Keyword(s):  
Alcohol Abuse ◽  
Road Traffic ◽  
Tertiary Care ◽  
Treatment Modalities ◽  
Common Denominator ◽  
Care Hospital ◽  
Management Options ◽  
Chest Injuries ◽  
The Common ◽  
A Prospective Study

Background: Faciomaxillary injuries are increasing in incidence in Tirunelveli district due to the increasing number of vehicles on the street which are inadequate and due to assault. The common denominator in both these situations is alcohol abuse. This study aims to assess the incidence, causative factors and management options of Faciomaxillary trauma.Methods: Around 50 case of faciomaxillary injuries admitted in the Department of Plastic surgery, TVMCH were taken up for study. The cases were studied for age, sex, personal habits, mode of injury, associated injuries, involved bones and type of fracture, clinical features, treatment modalities, and complications.Results: Road Traffic Accident (RTA) was the most common cause. Males aged 20-30 were the most commonly involved. Alcohol abuse and Intoxication was the most common antecedent event. Associated head, limbs and chest injuries were common. Mandible was the commonest bone to be fractured followed by zygoma, maxilla and nasal bones. ORIF and IMF was the common surgery performed.Conclusions: Alcohol abuse is the leading cause of faciomaxillary injuries. Educating the public about the traffic rules and the ill effects of drunken driving will go a long way to prevent these injuries.

scholarly journals Percutaneous fully endoscopic surgical management of the ruptured epidural catheter: Rescue of the young anesthesiologist from his dilemma

2020 ◽  
Author(s):  
Weijun Kong ◽  
Guangru Cao ◽  
Dexing Liu ◽  
Qian Du ◽  
Yiyong Wei ◽  
...  
Keyword(s):  
Back Pain ◽  
Adverse Events ◽  
Epidural Catheter ◽  
Operation Time ◽  
Endoscopic Technique ◽  
Cerebrospinal Fluid Leakage ◽  
Vas Score ◽  
Medical Disputes ◽  
Before And After ◽  
Epidural Catheters

Abstract Background Epidural nerve block and analgesia are basic operation techniques for anesthesia. Epidural catheter rupture and partial retention are adverse events and rare complications of epidural catheterization technology. The probability of occurrence when applied by young doctors is high. Removal of the residual catheter by conventional surgery causes more trauma and bleeding, slows recovery, and causes medical disputes. These events also challenge the growth of young doctors. Some hospitals have almost eliminated this operation technique. All surgical patients undergo intubation and general anesthesia, which greatly wastes medical resources and increases patient costs. Objective To analyze the efficacy and safety of removing the residual dural catheter by a percutaneous endoscopic technique and discuss the clinical technique and precautions. Methods This was a retrospective analysis of 7 patients with ruptured epidural catheters treated in our department from October 2015 to October 2019 using the percutaneous spinal endoscopic technique to remove the remaining epidural catheter. The operation time, intraoperative bleeding volume, surgical complications, and neurological symptoms before and after surgery were recorded. The Self-Rating Anxiety Scale (SAS) was used to assess the anxiety level of the anesthesiologist and the patient before and after the catheter removal operation, and the postoperative low back pain VAS score was recorded. Results The remaining epidural catheter was successfully removed from all 7 patients. The operation time was 54.14 ± 14.45 (32–78) minutes, and the intraoperative blood loss was 9.134 ± 3.078 (5–15) ml. There were no cases of dural damage, cerebrospinal fluid leakage, sensorimotor dysfunction of the lower limbs, or bowel dysfunction. The anxiety symptoms of the patient and the anesthesiologist disappeared after removal of the residual epidural catheter. The patients' postoperative back pain VAS score was 0 to 2 points. Conclusion Percutaneous spinal endoscopy is a safe and effective minimally invasive technique for removing residual epidural catheters. It causes less trauma and less bleeding, allows a faster recovery, and has a low cost. It does not affect the recovery of patients from other surgical operations and reduces both medical risks and medical costs. At the same time, it avoids or reduces the occurrence of medical disputes and eliminates the pressure on young anesthesiologists regarding similar adverse events.

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