scholarly journals CONSERVATIVE MANAGEMENT OF ACUTE LUMBAR DISC HERNIATION WITH ASSOCIATED RADICULOPATHY: A STUDY

Author(s):  
RAPPAI TJ ◽  
SURENDER ◽  
NEERAV PORWAL ◽  
ASHOK KUMAR ◽  
SAPNA CHAUHAN

Objective: Acute disc herniation (DH) is a common cause of low back pain (LBP). It ranks fifth in the category of diseases in terms of cost of hospital care. It has higher indirect costs due to absenteeism from work and disability than any other disease. The present study was performed to assess the clinical outcomes of non-surgically treated LBP patients after 6 months of follow-up. Methods: The present study was prospective study which was performed on 450 lumbar radicular patients visiting the neurosurgery outpatient department having clinical signs and symptoms of acute lumbar DH of less than 3 month duration. Their diagnosis was confirmed by magnetic resonance imaging. The patients were treated conservatively during 6 months. Pain and disability were assessed by visual analog scale (VAS) and Oswestry disability questionnaire, respectively. Results: About 135 (30%) female and 315 (70%) male participated in the study. During the follow-up period, 27 (06%) patients (21 male and 6 female) showed poor response to conservative treatment and motor weakness and underwent surgical intervention. A significant improvement in the VAS Score was seen after 6 months of conservative treatment than initial evaluation of patients (3.12±1.84, 7.1±1.43, p=0.00). Furthermore, significant improvement in disability score of patients was seen in follow-up period (25.82±16.92, 53.66±17.66; p=0.00). Conclusion: Results of our study showed that conservative treatment in patients of acute lumbar DH have significant improvement in pain relief and disability without any notable side effect.

2014 ◽  
Vol 25 (6) ◽  
pp. 571-575 ◽  
Author(s):  
Manoel Brito-Júnior ◽  
Yara Teresinha Correa Silva-Sousa ◽  
João Felipe Bonatto Bruniera ◽  
Carla Cristina Camilo ◽  
André Luis Faria-e-Silva ◽  
...  

This case report describes root canal filling performed over a large S1 ProTaper file fragment in a second mandibular molar with irreversible pulpitis. An S1 ProTaper file was fractured during the instrumentation of the mesiobuccal canal. Approximately 10 mm of file fragment remained in the apical and middle thirds of the canal. The obturation was performed over this fragment using thermomechanically compacted gutta-percha and sealer. Radiographic findings and the absence of clinical signs and symptoms at 3-year follow up indicated successful treatment. Cone-beam computed tomography images revealed absence of periapical lesion and details of intracanal file fragment related to root fillings and apex morphology. In this case, the presence of a large intracanal fractured instrument did not have a negative impact on the endodontic prognosis during the follow up evaluation period.


1987 ◽  
Author(s):  
M Vigo ◽  
A W A Lensing ◽  
F Corbetti ◽  
P R Biondetti ◽  
P Tropeano ◽  
...  

Two hundred and sixtyeight (268) consecutive out-patients with clinical features compatible with deep venous thrombosis (DVT) were referred to our Department for contrast venography, which was carried out according to standard methods, employing 120-160 ml of a non-ionic contrast medium (Iohexol). All side effects probably related to venography were recorded during the test, immediately after its execution, at one day and during long-term follow-up (1 week, 1 month and 6 months), including impedance plethysmography (IPG) evaluation in patients with normal venograms. Eighteen patients (7%) did not undergo venography because of severe edema of the dorsum of the foot (3), impossibility to find a vein (7), patient refusal (1), known hypersensibility to radiopaque dye (4) and allergic reactions after injection of contrast medium (3). Our analysis therefore included 250 patients. Hypersensitivity reaction to the contrast medium following the venography were encountered in 3 patients (1%) of whom two had severe reactions. Pain and tenderness of the foot and calf after the test was observed in 15 patients (6%). No clinical signs and symptoms of pulmonary embolism were observed during and after the procedure and all serum creatine levels, assessed before venography, at day 1 and day 7, remained unchanged. There were 7 instances of contrast extravasation (3%) which did not result in local skin or tissue damage. In none of the patients was there any evidence to suggest the presence of post-venographic phlebitis and no patients with negative venograms developed a positive IPG during the period of follow-up.


2021 ◽  
pp. annrheumdis-2020-218625
Author(s):  
Annemaria C. van Berkel ◽  
Dieuwke Schiphof ◽  
Jan H. Waarsing ◽  
Jos Runhaar ◽  
John M. van Ochten ◽  
...  

ObjectiveTo explore the natural course of hip osteoarthritis (OA) in a population of first-time presenters with hip complaints.MethodsData were collected at baseline and after 2, 5, 8 and 10 years on participants from the Cohort Hip and Cohort Knee study with early symptomatic hip OA. Descriptive statistics were used to analyse the natural course of the hip complaints with respect to clinical signs and symptoms, physical functioning and radiographic osteoarthritis (ROA) features.ResultsIn total, 588 participants were included with hip complaints and 86% completed the 10-year follow-up. The 10-year follow-up showed that 12% (69 participants) underwent hip replacement (HR), an increase of ROA of the hip (Kellgren and Lawrence score≥2) from 19% to 49%, and an increase in clinical hip OA according to the American College of Rheumatology criteria from 27% to 43%. All Western Ontario and McMaster Osteoarthritis Index subscales and physical activity remained on average constant during the 10-year follow-up for those who did not undergo an HR. The use of pain medication increased from 43% at baseline to 50% after 10 years.ConclusionOne out of nine participants with early hip problems received an HR during the 10-year follow-up. Prevalence of clinical hip OA and hip ROA increased steadily during the 10-year follow-up. Overall, we observed more hip OA, but fewer or stable complaints with respect to clinical signs and symptoms, and physical functioning. So it could be cautiously concluded that after 10 years, first-time presenters with hip complaints either received an HR or their symptoms remained stable.


2021 ◽  
Vol 9 (7) ◽  
pp. 1393-1397
Author(s):  
Bindu K.T ◽  
Shobhana M. C. ◽  
Prema P. E

A non-randomized controlled trial was carried out in 40 participants with intervention for 15 days and a follow up of 7 days. Clinical signs and symptoms of raktārśaḥ were assessed before and after the intervention and after fol- lowing up, by using the subjective parameters scale including, Frequency of bleeding, Nature of bleeding, Change in colour of the mucosa of pile mass, Character of defecation and Period of straining. Grñjanaka pēya along with a therapeutic protocol in raktārśaḥ has shown significant positive changes in subjective parameters like frequency of bleeding (p<0.01 level), nature of bleeding (p<0.01 level), changes in the mucosa, period of straining and char- acter of defecation after the 15 days of intervention in the study group. Keywords: Raktārśaḥ, Gr̥ ñjanaka pēya, Therapeutic dietary protocol, Subjective parameters


Author(s):  
Nikola Grubor ◽  
Igor Ignjatovic ◽  
Boris Tadic ◽  
Marjan Micev ◽  
Vladimir Milosavljevic ◽  
...  

Abstract Myoid angioendothelioma (MA) represents an extremely rare nonhaematopoietic proliferation of the spleen. MA is a rare, benign, vascular tumour that consists of vascular elements and arranged stromal cells. Due to an absence of specific clinical signs and symptoms, MA is considered challenging to diagnose. Although the radiological presentation can indicate the vascular nature of the tumour, the diagnosis of MA is almost exclusively obtained from the use of histopathology after surgical excision and immunohistochemistry of the tissue. Due to its completely unclear biological behaviour and relationship with other primary and secondary tumours, the only effective therapy for MA is splenectomy and a regular postoperative follow-up. Herein, we report a case of a 26-year-old male patient with nonspecific abdominal pain and a radiologically detected tumour of the spleen who underwent a laparoscopic splenectomy. Histopathologic and immunohistochemical examinations confirmed a myoid angioendothelioma of the spleen.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Xinbo Wu ◽  
Guoxin Fan ◽  
Xin Gu ◽  
Xiaofei Guan ◽  
Shisheng He

Objective.To describe the two-level percutaneous endoscopic lumbar discectomy (PELD) technique in transforaminal approach for highly migrated disc herniation and investigate its clinical outcomes.Methods.A total of 22 consecutive patients with highly migrated lumbar disc herniation were enrolled for the study from June 2012 to February 2014.Results.There were 12 males and 10 females, with a mean age of 41.1 (range 23–67) years. The mean follow-up period was 18.05 (range 14–33) months. According to the modified MacNab criteria, the clinical outcome at the final follow-up was excellent in 14, good in 6, and fair in 2 patients and the satisfactory rate (excellent and good) was 90.9%. The improvements in VAS and ODI were statistically significant. One patient had recurrent herniation in 18 months after the first surgery and underwent open discectomy. One patient showed symptoms of postoperative dysesthesia (POD), but the POD symptom was transient and partial remission was achieved in two months after conservative treatment.Conclusion.Two-level PELD in transforaminal approach can be a safe and effective procedure for highly migrated disc herniation.


2020 ◽  
Vol 33 (2) ◽  
pp. 76-84
Author(s):  
Md Ismail Hossain ◽  
Md Nahid Khurram Choudhury ◽  
Md Shamsul Alam ◽  
Shahnaz Sultana Beauty ◽  
Farid Uddin

Context: LSTR 3 Mix MP therapy is one of the procedures for the management of nonvital tooth with periapical lesion. The principle of this therapy is the complete sterilization of the total pulp canal space, thereby healing of the periradicular lesion.  Objectives: To assess the clinical and radiological outcome of ‘Lesion sterilization and Tissue Repair’ (LSTR) for endodontic treatment of nonvital teeth with periapical lesion.  Materials and Methods: This descriptive, observational study allocated 40 nonvital teeth with periapical lesion treated by LSTR 3 Mix MP Therapy. In study subjects, a mixture of Metronidazole, Ciprofloxacin and Minocycline (3 Mix) in a proportion of 1:1:1 in ointment (Macrogol mixed with propylene glycol: MP) was placed at the orifice of the root canal or the bottom of pulp chamber after gaining access in the pulp chamber and removal of necrotic pulp, then sealed with Glass Ionomer cement and further reinforced by composite resin. The protocols for follow up examination were 3, 6 and 12 months post operatively. At the time of follow up examination a standard follow up chart was maintained.  Results: Out of 40 cases, in 29 cases had good responses both clinically and radiologically and 8 patients came back with some complications. Out of these 8 patients, 6 patients had uncertain outcome and in 2 patients it was unacceptable.  Conclusion: LSTR 3 mix MP therapy reduced clinical signs and symptoms successfully in teeth with periapical lesion and radiological improvement of the periapical index was also noted. TAJ 2020; 33(2): 76-84


2020 ◽  
Vol 33 (1) ◽  
pp. 25-30
Author(s):  
Md Ismail Hossain ◽  
Monira Parveen ◽  
Md Nahid Khurram Choudhury ◽  
Tasnim Wakia ◽  
Farid Uddin ◽  
...  

Background: Root canal Therapy is one of the procedures for the management of nonvital tooth with periapical lesion. The principle of this therapy is the complete sterilization of the total pulp canal space thereby healing of the periradicular lesion. Objectives: This experimental study assessed the clinical and radiological outcome of root canal treatment for nonsurgical management of nonvital teeth with periapical lesion. Materials and Methods: A total number of 40 infected teeth with periapical lesion were treated by conventional root canal treatment. Irritants from the root canal system was removed by mechanical instrumentation( Crown down Technique), chemical irrigation with NaOCL and by using Calcium Hydroxide as intracanal medicaments and fluid tight obturation both apically and coronally resulting repairs of inflamed periradicular tissues. The protocol for follow up examination will be 3, 6 and 12 months post operatively. At the time of follow up examination a standard follow up chart will be maintained. Results: Among 40 cases 32 cases could be treated as acceptable as their responses were good both clinically and radiologically and 5 patients came back with some complications among them 3 cases were uncertain and 2 cases were unacceptable. Conclusion: It was concluded that conventional root canal treatment reduced clinical signs and symptoms successfully in teeth with periapical lesion and radiologically. TAJ 2020; 33(1): 25-30


1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 203-206 ◽  
Author(s):  
Y. Kinoshita ◽  
T. Terada ◽  
Y. Tanaka ◽  
H. Yokote ◽  
M. Tsuura ◽  
...  

Three patients with vertebral arteriovenous fistulae are described. Transarterial embolization by microcoils and balloons was used in each case and the fistula was completely occluded in one case immediately after embolization. Another two cases with partial obliteration of the fistula were followed and showed complete occlusion of the fistula after a one year follow-up. After embolization of the fistula, each patient improved in clinical signs and symptoms and showed no complications. Transarterial embolization for vertebral arteriovenous fistula is a safe and effective treatment.


Author(s):  
Marzieh Maddah ◽  
Mohammad Reza Fazlollahi ◽  
Reza Shiari ◽  
Farhad Shahram ◽  
Setareh Mamishi ◽  
...  

Chronic granulomatous disease (CGD) is a rare genetic disorder of neutrophil activity, resulting in increased rate of recurrent infections with catalase–positive bacteria and fungi, as well as various autoimmune diseases such as sarcoidosis, rheumatoid arthritis, and discoid and/or systemic lupus erythematosus. Few reports have reported lupus erythematosus (LE) in patients with X–linked CGD (XL-CGD) and carriers, and very few in autosomal recessive CGD (AR-CGD). Here, we present 5 patients with CGD developing LE at different ages to emphasize on the importance of appropriate follow–up and treatment in patients with CGD with clinical signs and symptoms of autoimmune diseases and even in those with negative serologic results.


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