scholarly journals Comparing the Efficacy of Sinus Irrigation with Traditional Caldwell-Luc Procedure Following Odontogenic Cyst Surgery Involving The Maxillary Sinus

Author(s):  
Niu Gang ◽  
Chen JiaMin ◽  
Wu Ye ◽  
Xie FuPing ◽  
Liu HuangHuang ◽  
...  

Abstract Objective: A large maxillary odontogenic cyst could intrude into the maxillary sinus. The traditional approach following surgery for such a cyst is the Caldwell-Luc procedure However the traditional CDL procedure is associated with more complications and damage of the sinus mucosa. The purpose of this study was to assess a new method with easier operation, which not only prevented postoperative infection but also caused less damage to the maxillary sinus mucosa.Methods: A large odontogenic cyst in the maxillary sinus of 40 patients was diagnosed through radiographic imaging and postoperative histopathology. Twenty patients were treated with maxillary sinus saline irrigation after cyst resection surgery, while 20 patients underwent the traditional Caldwell-Luc procedure. The therapeutic efficacy was evaluated by clinical examination and radiographic imaging; the longest follow-up was 36 months.Results: The postoperative recovery of the 20 patients treated with sinus irrigation. Six patients had mild swelling (30%), 12 had moderate swelling (60%), and 2 had severe swelling (10%); 16 had mild pain (80%), 4 had moderate pain (20%), and 0 had severe pain (0%). Among the 20 patients treated by the Caldwell-Luc approach. Immediately postoperatively, 2 patients had mild swelling (10%), 12 had moderate swelling (60%), and 6 had severe swelling (30%); 10 had mild pain (50%); 6 had moderate pain (30%), and 4 had severe pain (20%). On the second day after surgery, a mild temperature elevation (38.0°C-39.0°C) was noted in 8 patients (40%) treated with the Caldwell-Luc procedure and 1 patient (5%) treated with saline irrigation.Conclusion: Sinus irrigation following large odontogenic cyst surgery involving the maxillary sinus can serve as an alternative to standard CDL and has the advantages of fewer complications, reduced trauma, restoration of the mucosa and more satisfactory results.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Niu Gang ◽  
Chen JiaMin ◽  
Wu Ye ◽  
Xie FuPing ◽  
Liu HuanHuan ◽  
...  

AbstractA large maxillary odontogenic cyst could intrude into the maxillary sinus. The traditional approach following surgery for such a cyst is the Caldwell–Luc procedure. However, the traditional CDL procedure is associated with more complications and damage of the sinus mucosa. The purpose of this study was to assess a new method with easier operation, which not only prevented postoperative infection but also caused less damage to the maxillary sinus mucosa. A large odontogenic cyst in the maxillary sinus of 40 patients was diagnosed through radiographic imaging and postoperative histopathology. Twenty patients were treated with maxillary sinus saline irrigation after surgery, while 20 patients underwent the traditional Caldwell–Luc procedure. The therapeutic efficacy was evaluated by clinical examination and radiographic imaging; the longest follow-up was 36 months. The postoperative reaction was evaluated. There was a statistically significant difference in facial swelling, visual analog scale (VAS) and temperature elevation between the 2 groups. Sinus irrigation following large odontogenic cyst surgery involving the maxillary sinus can serve as an alternative to standard CDL and has the advantages of fewer complications, reduced trauma, restoration of the mucosa and more satisfactory results.


Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2388-2388 ◽  
Author(s):  
Karen C Chung ◽  
Arie Barlev ◽  
Yi Qian ◽  
Susie Jun

Abstract BACKGROUND: MM is the second most common hematalogical malignancy in the U.S. The expansion of myeloma cells in bone, which is characteristic of MM, results in increased osteoclast activity that cause osteolytic lesions, which can lead to spinal cord compression, pathologic fracture, surgery or radiation therapy to bone, and bone pain. Denosumab is a fully human monoclonal antibody that can inhibit bone resorption by reducing the number and activity of osteoclasts by inhibiting RANK ligand, a key mediator of osteoclast activity. The objective of this analysis was to evaluate the pain and HRQoL in patients with MM being treated with denosumab. METHODS: 96 patients with either ≥2 prior treatment regimens and relapsed following a response to any conventional MM therapy (relapsed) or response to the most recent MM therapy and stable M-protein for ≥3 months (PP) were enrolled in a phase 2, multicenter, open-label, single-arm study of denosumab. Patients received 120mg denosumab SC on days 1, 8, 15, and 29 then every 28 days thereafter until disease progression or discontinuation. The Brief Pain Inventory-Short Form (BPI) and Functional Assessment of Cancer Therapy-General (FACT) were assessed at baseline (BL) and prior to treatment on day 1 of each 28-day cycle. BPI “pain at worst in the past 24 hours” scores were categorized as no pain (BPI 0), mild pain (BPI 1–4), moderate pain (BPI 5–6) or severe pain (BPI 7–10). BL and month 3 (relapsed) and month 5 (PP) pain and HRQoL data were analyzed. Longitudinal data regarding pain and HRQoL data were reported at BL and the latest assessment timepoint where <30% of patients had dropped out. RESULTS: 45 patients with relapsed MM (Table 1) and 37 patients with PP MM (Table 2) had BL and ≥1 post-BL assessment. 30% or more patients dropped out after month 3 of treatment in relapsed patients and after month 5 in PP patients. In relapsed patients, 12 (27%), 21 (47%), 8 (18%), and 4 (9%) patients reported no pain, mild pain, moderate pain and severe pain at BL, respectively. In PP patients, 15 (41%), 13 (35%), 5 (14%), and 4 (11%) patients reported no pain, mild pain, moderate pain and severe pain at BL, respectively. 68% and 89% of relapsed and PP patients, respectively, demonstrated improvement or no categorical change in pain. At BL, mean (sd) FACT total scores (0–108, higher score indicating better HRQoL) for relapsed and PP patients were 77.4 (15.3) and 82.5 (11.2), respectively. FACT total scores remained relatively constant in relapsed and PP patients, 77.9 (19.4) and 83.6 (13.3), respectively. In addition, mean change from baseline in FACT domain scores varied between 1.2 to 0.2 in relapsed patients and between 0.3 to 1.1 in PP patients. CONCLUSION: The majority of patients with relapsed and PP MM demonstrated maintenance or improvement in pain and maintenance of HRQoL during treatment with denosumab. These results suggest denosumab may be associated with stabilization of pain and maintenance of HRQoL in patients with MM. Randomized trials are needed to further understand the impact of denosumab on pain and HRQoL in patients with MM. Table 1. “Pain at Worst in the past 24 hours” Category Shift between BL and month 3 in relapsed patients (n=45). Follow-up Pain Category No Pain Mild Moderate Severe TOTAL BL Pain Category No Pain 7 2 2 1 12 Mild 4 10 4 3 21 Moderate 2 3 1 2 8 Severe 0 0 2 2 4 TOTAL 13 15 9 8 45 Table 2. “Pain at Worst in the past 24 hours” Category Shift between BL and month 5 in PP patients (n=37). Follow-up Pain Category No Pain Mild Moderate Severe TOTAL BL Pain Category No Pain 13 2 0 0 15 Mild 4 7 1 1 13 Moderate 1 2 1 1 5 Severe 0 0 2 2 4 TOTAL 18 11 4 4 37


Author(s):  
Jeetendar Valecha ◽  
Syed Mukhtar Ahmed ◽  
Tasghir Nabi ◽  
Mahesh Kumar Mugria ◽  
Siknader Ali Sangrasi ◽  
...  

Objective: To determine the effectiveness of mobilizations along with hot therapy versus mobilizations for the management of chronic neck pain due to over usage of smart phones among young. Materials and Methods: This interventional clinical trial was conducted at OPD, Institute of Physiotherapy & Rehabilitation Sciences (IPRS) in Liaquat University Medical and Health Sciences Jamshoro (LUMHS). All the individuals from LUMHS Jamshoro including students, age 18-35 years and either of gender were included. All the individuals were divided in two groups (group A and group B). Cases of group A were underwent management of mobilization with hot therapy and cases of group B underwent only mobilization management. Outcome was observed in the terms of decrease the pain during work, reading and sleeping. All the data was recorded via study proforma. Results: Total 64 individuals were studied. Mean age was 26.2+4.2 years in group A and 28.6+5.3years. Males were in majority in both groups. According to the pain assessment on movement, mild pain was in 18.8%, moderate pain was 50.0%, severe pain was in 12.5% and very severe pain was in 18.85 of the patients of group A. However in group B most of the patients 93.8% had mild pain and 6.2% patients had severe pain, while no any patients with moderate pain and very severe pain was found in group B. After treatment pain was more decreased in patients of group A as pain during work, reading and sleeping was significantly higher in only mobilizations treatment group as compared to those underwent mobilizations with hot therapy treatment, p-values were quite significant. Conclusion: It was concluded that the treatment of mobilization with Hot pack was more effective than treatment only mobilization.


2021 ◽  
Vol 12 (1) ◽  
pp. 454-464
Author(s):  
Abdul wahid ◽  
Muhammad Arsalan Ali Sajid ◽  
Ambreen Muzaffar ◽  
Muhammad Zohaib Hussain

Back ground: study was conducted to determine the frequency of plantar fasciitis among three different universities students due to improper shoes. It was cross-sectional study. Plantar fasciitis is the inflammation of plantar fascia; plantar fascia is a thick connective tissue that forms the medial arch of foot. Improper shoes cause constant pressure and irritation on plantar fascia that leads to inflammation. When someone wears improper shoes, pronation activity of the foot decreased and it can lead to plantar fasciitis. Objective: The objective of study was to determine the frequency of plantar fasciitis due to improper shoes among three different universities students. Material and Methods: Study was cross-sectional and the data was collected from university students. Data was collected by using questionnaire and by applying statistical procedures results were concluded. Results: There were the following results in this study as, 35.5% participants without pain, 45% with mild pain, 16% with moderate pain and 3.6% with severe pain. There were 84% participants with single etiology, 13% participants with multiple etiology and 3% participants with nerve entrapment. There were 31 participants with no pain, 49 participants with mild pain, 11 participants with moderate pain and 2 participants with severe pain between ages 20-25 years. And between ages 26-30 there were 29 participants with no pain, 27 with mild pain, 16 with moderate pain and 4 participants with severe pain. Conclusion: Study concluded that 55.6% participants were between ages of 20-25 years. 54.4% participants were females, 59.2% participants were with no pain, 84% participants were with single etiology that is plantar fasciopathy. There were mostly participants suffered with mild pain and only 3.6% participants showed response with severe pain. There were mostly participants suffered with single etiology and the number of affected participants with plantar fasciitis slightly increased with age.


2019 ◽  
Vol 27 (3) ◽  
pp. 156-159
Author(s):  
Alexandre Tadeu do Nascimento ◽  
Gustavo Kogake Claudio ◽  
Pedro Bellei Rocha ◽  
Juan Pablo Zumárraga ◽  
Olavo Pires de Camargo

ABSTRACT Objective: To evaluate the outcomes of patients that underwent arthroscopic surgery for lateral epicondylitis (LE), after failed conservative treatment. Methods: One hundred four patients with LE treated with arthroscopic debridement of the extensor carpi radialis brevis (ECRB) tendon were enrolled in this retrospective study. They were evaluated using Disabilities of the Arm, Shoulder and Hand (DASH) score, Visual Analogue Scale (VAS) and Short Form Health Survey (SF-36) scale. Mean age at surgery was 46.9 years. Duration of symptoms was 2.1 years (range: 6 m to 10 yrs.). Mean follow-up was 34.4 months (range: 6 to 68 m). Results: Mean postoperative scores were: 20.67 points on the DASH; 1.8 points on the VAS at rest, with 48 cases (46%) without pain, 40 (38%) with mild pain, 13 (13%) with moderate pain and 4 (4%) with severe pain; 4.7 points on the VAS in activity, with 21 (20%) without pain, 21 (20%) with mild pain, 35 (34%) with moderate pain and 27 (26%) with severe pain; and SF-36 was 66.8 points. Of the 23 patients who practiced sports regularly or with higher physical demand from the upper limbs, 17 (74%) were able to return to the same activity at the same level. No significant complications were observed postoperatively, except for 3 (2.8%) cases of postoperative superficial infection. Conclusion: Surgical treatment with arthroscopy for recalcitrant LE is effective and safe, presenting positive outcomes in the studied patients. Level of evidence IV, Case Series.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19636-e19636
Author(s):  
Maricarmen Alfaro ◽  
Raquel Baldeos ◽  
Beatriz Rosales ◽  
Maria Berenguel ◽  
Alfredo Aguilar

e19636 Background: Assessing pain in nonverbal, especially agonic cancer patients is a great challenge. In the absence of self-report, measurement of pain could be difficult and patient`s behavior could be useful. The aim of this work was to evaluate the Pain Assessment Behavioral Scale (PABS) in cancer agonic patients. Methods: PABS scale was used to evaluate 118 cancer patients enter in agony. Pain levels was categorized according to PABS score in Mild Pain (score 1-3), Moderate Pain (score 4-5), Severe Pain (score>6). We correlated levels of pain with age, sex, cancer metastatic site or active tumor localization with the ANOVA, Chi square or Fisher tests when were appropriated. A P<0.05 was considered significant. Results: Fifty two patients (44.1%) were male and 66 female (55.9%). The median age was 74 (Standar Deviation [SD]:13.1; Range: 30-94). Most frequent primary tumors were colorectal (16%), lung (11%), Pancreas (9.3%), Breast (8.5%), lymphomas (6.8%), prostate (6.8%) and gastric (5.6%) cancer. Involvement of primary active tumor or active metastases was present in lung (22%), Central Nervous System (CNS) (13.6%), liver (22%), and bone (7.6%). The median of PABS score was 5 (SD=1.25; range: 2 – 8). Seven cases had mild pain (5.9%), 105 moderate pain (89%) and 6 severe pain (5.1%). There was no correlation of pain levels with age (P=0.420), sex (P=0.098), active tumor or metastatic involvement of lung (P=0.321), CNS (P=0.972), Liver (P=0.575) or bone (P=0.529). Conclusions: In our experience, PABS scale is a useful tool to evaluate pain in agony cancer patients. We found no correlation between active tumor or metastatic localization with the intensity of pain.


2019 ◽  
Vol 4 (1) ◽  
pp. 634-638
Author(s):  
Karuna Shrestha ◽  
Rajeev Shah ◽  
Srijana Sapkota

Introduction: Otitis externa is a common painful condition presents with generalized infection of external auditory canal, typically reveals erythema and edema of the skin. Aural packing plays an important role in relieving the pain and edema. For packing, either we impregnated with 10% Ichthammol glycerine or steroid-antibiotic ointment. Objective: To compare the efficacy of 10% Ichthammol Glycerine pack with steroid-antibiotic ointment pack for relieving the pain in acute otitis externa. Methodology: A prospective, non-randomized clinical trial was carried out in 94 patients at Birat Medical College and Teaching Hospital, Biratnagar, Nepal from February 2018 to July 2018. Patients diagnosed with acute otitis externa were included in this study, where 47 patients were treated with 10% IG pack and remaining 47 patients treated with a combination steroid antibiotic ointment pack. Before aural packing was carried out, pain was assessed using visual analogue scale (VAS). Both groups of patients were evaluated after 48 hours for assessment of pain. Results: The total number of patients included in this study was 94. Among them 41 (43.6%) were male and 53(56.4%) were female where male and female ratio was 1:1.29. Majority of the patients were below 40 years (83%). Treatment with steroid-antibiotic ointment pack had significant reduction in pain after 48 hours post treatment, none of them had severe pain, 4(8.5%) had moderate pain remaining and 43(91.4%) had only mild pain. Whereas in patients treated with 10% IG pack 1(2.1%) had severe pain, 14(29.7%) had moderate pain and 32(68%) had mild pain. There was statistically significant decrease in pain with steroid-antibiotic pack. Conclusions: Both treatment modalities are effective but this study showed steroid-antibiotic ointment pack, the combined therapy is more effective than 10% IG pack for relieving the pain in acute otitis externa.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 796.2-796
Author(s):  
P. G. Conaghan ◽  
L. Abraham ◽  
P. Graham-Clarke ◽  
L. Viktrup ◽  
J. C. Cappelleri ◽  
...  

Background:Symptomatic osteoarthritis (OA) leads to functional limitations and loss of independence. OA management focuses on pain relief and preserving physical function using non-pharmacologic and pharmacologic therapy. Additionally, patients commonly manage OA pain by avoiding activities that exacerbate their pain. Informal care, i.e. assistance from an unpaid caregiver, plays a major role in the total care provided to patients with chronic diseases like OA.Objectives:To evaluate how OA pain severity affects physical functioning and the subsequent need for assistance with mobility and daily activities in 5 EU countries: France, Germany, Italy, Spain and UK.Methods:Data were drawn from the Adelphi OA Disease Specific Programme (2017-18), a point-in-time study of physicians and their OA patients. Patients rated their average pain intensity over the last week on a 0-10 scale (0 = no pain; 10 = worst possible pain) and were then categorised into mild (0-3), moderate (4-6) and severe (7-10) pain groups. Patients also provided an assessment of their physical function (0-10 WOMAC scale where higher scores indicated greater functional impairment), impact on mobility, whether caregiver assistance was required, daily activities requiring caregiver assistance and home modifications made due to their OA. Physicians also rated patients’ functioning on a 0 to 10 scale (0 = fully functional; 10 = completely impaired). Comparisons among pain severity groups were made using chi-squared tests and analysis of variance.Results:The analysis included 1750 OA patients: 24% mild pain (n=413); 47% moderate pain (n=822); 29% severe pain (n=515). The patients were predominantly women (58%) and had a mean (SD) age of 65.6 (11.5).Increased pain severity was associated with greater functional impairment scores as reported by patients (WOMAC scores: mild pain=2.1; moderate pain=4.1; severe pain=5.9) and physician-rated functional impairment (mild pain=3.5; moderate pain=4.3; severe pain=5.6). Mobility was impacted for 78% of patients with severe pain (vs. 41% mild; 63% moderate) and the need for a walking aid such as a walking stick or walking frame increased with worsening severity; wheelchair assistance was needed for 7% of severe patients (compared with <1% of mild or moderate patients). Furthermore, 31% of patients with severe pain reported having to modify their home due to their OA (vs. 11% mild; 18% moderate [p<0.001]), typically adapting their bathroom (23%) or fitting a stairlift (6%).The need for assistance from a caregiver to help with daily activities was associated with an increase in patients’ pain (9% mild; 20% moderate; 42% severe [p<0.001]). For most patients this was an immediate family member, however, the proportion of patients paying for professional care also increased with severity (1% mild; 2% moderate; 7% severe). Taking the patient to work or doctor’s appointments; help with shopping; preparing/cooking meals and help with travelling out of the home were most frequently reported activities needing caregiver assistance.Conclusion:In this study of European patients, increased pain severity was associated with greater functional impairment and impact on mobility as expected; however, this study highlights the substantial need for assistance with daily activities as well as modifications to the home. The unseen costs to the patient with moderate to severe OA pain are significant.Disclosure of Interests:Philip G Conaghan Consultant of: AbbVie, BMS, Eli Lilly, EMD Serono, Flexion Therapeutics, Galapagos, GSK, Novartis, Pfizer, Speakers bureau: AbbVie, Eli Lilly, Novartis, Pfizer, Lucy Abraham Shareholder of: Pfizer, Employee of: Pfizer, Peita Graham-Clarke Shareholder of: Eli Lilly and Co, Employee of: Eli Lilly and Co, Lars Viktrup Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Joseph C Cappelleri Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Craig Beck Shareholder of: Pfizer, Employee of: Pfizer, Andrew G Bushmakin Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Niall Hatchell: None declared, Emily Clayton: None declared, James Jackson: None declared


Author(s):  
Moshiur Rahman Khasru ◽  
Fariha Haseen ◽  
Md Moniruzzaman Khan ◽  
Radia Naz ◽  
Tangila Marzen ◽  
...  

COVID-19 pandemic is now a great headache for the world population. Respiratory symptoms are the main presentation of COVID-19. However, musculoskeletal pain, headache, loss of taste and smell sense, and neurological manifestations may occur. Identification of patterns of musculoskeletal pain, fatigue and physical health status in COVID-19 is crucial. In this cross sectional study, a total 380 individuals with COVID-19 were recruited from the population following selection criteria. Pain varied widely in hip, neck, leg and calf muscles, back and spine, shoulder, arms and hand, and other parts of the body among the respondents. Inconstant, among respondents of younger age group (aged ≤50 year), 37.59% had moderate pain, 6.77% had severe pain, 13.91% had mild pain, and 41.17% had no pain. On the other hand, among older respondents (aged >50 year) 47.37% had moderate pain, 25.44% had severe pain, 13.15% had mild pain, and 14.03% had no pain. The differences between two groups was statistically significant (p<0.05). However, there was no difference in frequency of pain between males and females. Those respondents who had pain was reported having physical health worse than the average compared to that of those who had no pain. BSMMU J 2021; 14 (COVID -19 Supplement): 1-7


2017 ◽  
Vol 13 (1) ◽  
pp. 97
Author(s):  
Sahurrahmanisa Sahurrahmanisa ◽  
Kenanga Marwan Sikumbang ◽  
Istiana Istiana

Abstract: Postoperative pain is a complex pain response which often occurred in post-operative patient. Effective pain management is conducted by giving preemptive analgesia, preventive analgesia and multimodal. The purpose of this study was to analyze the effect combination of paracetamol 325 mg and codeine 10 mg in a patient with ORIF inferior extremity. This was an observational analytic study with a cross sectional method and 32 respondents were included by consecutive sampling method. The result of this study, in group with the combination of paracetamol and codeine there are 4 respondents (25.0%) of mild pain, 12 respondents (75.0%) of moderate pain, and there’s none had severe pain, and the group without combination therapy there’s no mild pain, 7 respondents (43.8%) of moderate pain, and 9 respondents (56.2%) of severe pain. The statistic analyses with Kolmogorov Smirnov p-value <0.05, it can be concluded that in this study a combination of paracetamol and codeine are effective as a preemptive analgesia. Keywords: postoperative pain, preemptive analgesia, visual analog scale (VAS), paracetamol, codeine Abstrak: Nyeri pasca bedah merupakan respon nyeri yang sering dirasakan pasien setelah pembedahan dengan respon yang kompleks. Penanganan nyeri yang efektif dilakukan dengan pemberian analgesia preemptif, analgesia preventif, dan analgesia multimodal. Tujuan penelitian ini untuk menganalisi efek kombinasi parasetamol 325 mg dan kodein 10 mg sebagai analgesia preemptif pada pasien dengan ORIF ekstremitas bawah. Penelitian ini menggunakan rancangan observasional analitik cross sectional dengan teknik consecutive sampling didapatkan 32 sampel. Hasil penelitian, pada kelompok yang diberikan kombinasi parasetamol dan kodein sebanyak 4(25.0%) nyeri ringan, 12 (75.0%) nyeri sedang dan tidak didapatkan nyeri berat, sedangkan pada kelompok yang tidak diberikan kombinasi parasetamol dan kodein tidak ditemukan nyeri ringan, sebanyak 7 (43.8%) nyeri sedang dan 9 (56.2%) nyeri berat. Analisa statistik menggunakan Komogorov Smirnov didapatkan perbedaan yang signifikan antara kedua kelompok dengan nilai p value < 0,05 sehingga dapat disimpulkan pada penelitian ini kombinasi parasetamol dan kodein dapat digunakan sebagai analgesia preemptif. Kata-kata kunci: nyeri paska bedah, analgesia preemptif, visual analog scale (VAS) , parasetamol, kodein.


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