scholarly journals TIBIAL DIAPHYSEAL FRACTURES;

2017 ◽  
Vol 24 (09) ◽  
pp. 1336-1341
Author(s):  
Sajjad Iqbal ◽  
Hafiz Salman Saeed ◽  
Bushra Aslam ◽  
Iqra Fayyaz
Keyword(s):  
Open Fractures ◽  
P Value ◽  
Type I ◽  
Diaphyseal Fractures ◽  
Segmental Fractures ◽  
Group 2 ◽  
Good Mode ◽  
Transverse Fractures ◽  
Mean Time ◽  
Geometry Of Fractures

Objectives: To evaluate the management of tibial diaphyseal fractures treated byPOP cast versus intramedullary nailing in terms of time of union. Design of study: Randomizedcontrolled trials. Setting: Department of Orthopaedic, Allied / DHQ Hospital, Faisalabad.Duration of Study: Six months (01-08-2013 to 31-01-2014). Materials and Methods: 80patients fulfilling the inclusion and exclusion criteria were included in the study. After laboratoryand radiological assessment, the patients in Group 1 were treated by long leg cast. The patientsin Group 2 were treated with intramedullary interlocking nail. The patients were followed on OPDbasis. Results: 80 patients divided into 2 groups. Each group had 40 patients. Mean age ofpatients was 30.99 ±8.092 years. There were total of 65% males and 35% females in this study.According to geometry of fractures simple transverse fractures were 47.5%, spiral fractureswere 17.5%, oblique fractures were 25% and segmental fractures were 10%. There were 71.25%closed fracture and 28.75% type l open fractures. Mean time of union was 23.86 ± 5.48 weeks ingroup 1 while in group 2, mean time of union was 18.35 ± 4.12 weeks. P-value was 0.001 whichis statistically significant. Conclusion: It is concluded that reamed intramedullary interlockingnailing is a good mode of internal fixation comparing with conservative management of closereduction and POP cast in both close and type I open fractures in terms of union.

scholarly journals Management of displaced transverse fractures of the patella using tension band wiring with or without circumferential cerclage wiring: A comparative study

2019 ◽  
Vol 7 (5) ◽  
pp. 1752
Author(s):  
Zubair A. Lone ◽  
John Mohd ◽  
John Mohd ◽  
Imtiyaz A. Beigh ◽  
Imtiyaz A. Beigh ◽  
...  
Keyword(s):  
Tension Band ◽  
Tension Band Wiring ◽  
P Value ◽  
Fixation Failure ◽  
Non Union ◽  
Recommended Treatment ◽  
Cerclage Wiring ◽  
Group 2 ◽  
Transverse Fractures ◽  
Group 1

Background: Transverse fractures of body of the patella are by far the most common fractures of this bone. Surgical fixation is the recommended treatment in displaced fractures with extensor lag. Although, tension band wiring (TBW) technique is the gold standard for these fractures, few surgeons recommend augmentation with circumferential cerclage wiring to improve the strength of the fixation. We compared the results of the internal fixation of displaced transverse fractures of the patella using TBW and circumferential cerclage wiring with those treated with TBW alone. Methods: We treated 54 displaced transverse fractures of the patella at our institution. We segregated the patients into two groups: Group 1 (n=23) included fractures treated with tension band wiring (TBW) along with augmented circumferential cerclage wiring while as Group 2 (n=31) included fractures treated by TBW alone. Outcome was studied, graded and compared on the basis of knee pain, knee stiffness, quadriceps wasting, loss of flexion and loss of extension. Results: 73.90% patients among group 1 and 70.96% among group 2 showed excellent to good results (P value < 0.1). Fixation failure and need for revision surgery among group 1 and group 2 was found to be 8.69% and 9.67%, respectively (P value < 0.6). Infections and non union occurred among 4.34% patients in group 1 whereas in group 2 it was 6.45% of the patients who encountered the same (P value < 0.6). Conclusions: The use of circumferential cerclage wiring along with tension band wiring for displaced transverse fractures of patella seems to have no added advantage over fixation with tension band wiring alone.Keywords: Patella fracture, Tension band wiring, cerclage wiring 

scholarly journals Comparative study between post-aural and per-meatal approach type-1 tympanoplasty.

2021 ◽  
Vol 28 (01) ◽  
pp. 125-130
Author(s):  
Tahir Hussain Khan ◽  
Ashfaq Hussain Rana ◽  
Sohail A. Malik
Keyword(s):  
Comparative Study ◽  
Tympanic Membrane ◽  
P Value ◽  
Medical College ◽  
Tympanic Membrane Perforations ◽  
Time Period ◽  
Group 2 ◽  
Post Aural Approach ◽  
Mean Time ◽  
Group 1

Objective: To compare the results after tympanoplasty between post-aural and per-meatal approach. Study Design: Comparative study. Setting: Social Security Landhi Hospital, Karachi. Al-Tibri Medical College & Hospital (Isra University Karachi Campus), old thana Malir, Karachi. Period: July 2017 till June 2018. Material & Methods: In this study, 76 Patients of both genders with dry tympanic membrane perforations were included. They were aged between 18 to 40 years. Period of research was one year, study was started since July 2017 till June 2018. Patients were distributed into two groups, group-1 and group-2. 38 patients were included in every group. In group-1, post-aural approach tympanoplasty was done. In group-2, per-meatal approach tympanoplasty was performed. Observed results of both procedures after 1st post-operated day, after 1st post-operated week, after 1st month and after 2nd month post operatively. Variables were intensity of pain, bleeding, PTA (Ac, BC and AB-gap measured by tympanometer) and duration (time period) of surgical procedure. Result: In group-1(post-aural approach tympanoplasty), out of 38 patients, 36 patients had intact grafted tympanic membrane while in group-2 (per-meatal approach tympanoplasty), 37 patients had intact grafted tympanic membrane and 1 patient had residual perforation. Smaller amount of bleeding was noted during surgery and post-operative in group-2, in comparison with group-1. All the dressing gauze were dry in per-meatal approach tympanoplasty group (group-2). Mean time period of surgery was less in per-meatal tympanoplasty (group-2) 65.1 + 3.7 mins and mean time period of post-aural tympanoplasty (group-1) was 82.0 + 5.6 mins. P value was found to be significant i.e. < 0.001. Consumed time period of surgery was also decreased in per-meatal tympanoplasty (group-2). After tympanoplasty, hearing status was also enhanced on PTA in both groups. Post- operatively, it was observed that AB gap was reduced in both groups. On 1st post -operative day, Weber test was done, vibrating sound was heard (lateralized) in post-operated ears which ensured the safety of inner ear apparatus. Conclusion: Results of post-aural and per-meatal tympanoplasty were approximately same but per-meatal approach tympanoplasty is superior as it took shorter amount of time period, minimum post- operative pain and post- operative bleeding.

Clinical and Radiological Changes after use of Alpha-1 Blocker Therapy in Patients of Posterior Urethral Valve with Bladder Neck Hypertrophy

JMS SKIMS ◽  
2009 ◽  
Vol 12 (1) ◽  
pp. 3-7
Author(s):  
Aejaz A Baba ◽  
Bajpai Minu
Keyword(s):  
Bladder Neck ◽  
Posterior Urethral Valve ◽  
Posterior Urethral Valves ◽  
Blocker Therapy ◽  
Urethral Valve ◽  
Novel Method ◽  
Radiological Changes ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

Background: We evaluated the effects of alpha-1 blocker therapy on clinical and radiological abnormalities in patients of posterior urethral valve with bladder neck hypertrophy. Materials and Methods: A total of 74 patients with posterior urethral valves were seen at our department between 2003 and 2007. Out of these 24 had radiological evidence of bladder neck hypertrophy. Those patients with bladder neck hypertrophy who were seen before June 2006 and did not receive alpha-1 blocker (prazocin) therapy after valve ablation were assigned to group 1 (n=10). Group 2 consisted of 14 age matched patients with bladder neck hypertrophy and comparable prognostic factors who received alpha-1 blocker therapy after valve ablation (n=14). Micturating cystourethrography (MCU) was done periodically and a novel method used to calculate bladder neck hypertrophy. Trends in symptoms and radiological changes were evaluated throughout follow-up. Results: Mean patient age at presentation was 3.02±2.68 years in group 1 and 3.12±3.4 years in group 2. Bladder neck hypertrophy decreased from 2.3±1.0 to 2.0±0.5 in a mean time of 52.0 (34-52) weeks in group 1 where as it decreased from 2.2±0.5 to 1.6±0.3 in a mean time of 32.0 (22-52) weeks. Symptomatically patients in group 2 who received alpha-1 blocker therapy after valve ablation were better and had quick resolution of bladder neck hypertrophy. Conclusions: Use of alpha-1 blocker therapy in patients of posterior urethral valve with bladder neck hypertrophy helps in quick resolution of bladder neck hypertrophy. J Med Sci 2009;12(1):3-7.

Long-Term Outcomes after Colton Type I and II Fractures of the Olecranon

2019 ◽  
Vol 13 (1) ◽  
pp. 208-216
Author(s):  
Thord von Schewelov ◽  
Fredrik Hertervig ◽  
Per-Olof Josefsson ◽  
Jack Besjakov ◽  
Ralph Hasserius
Keyword(s):  
Joint Space ◽  
Type I ◽  
Type Ii ◽  
Men And Women ◽  
Radiographic Outcomes ◽  
Fracture Event ◽  
Comminuted Fractures ◽  
Fracture Types ◽  
Transverse Fractures ◽  
Olecranon Fractures

Background: It is unclear if the outcomes differ in different subtypes of olecranon fractures. Objective: Evaluate the outcomes of different Colton types of olecranon fractures, and if outcomes differ in dominant and non-dominant arms and in men and women. Methods: We evaluated primary journals and radiographs in 40 men and 55 women with isolated olecranon fractures and classified fractures according to Colton. Mean 19 years after fracture event, we re-examined subjective, clinical and radiographic outcomes in the former patients, using the uninjured arms as controls. Results: 89% of patients with Colton type I fractures reported at follow-up no subjective differences between the elbows, 84% with type II oblique/transverse fractures and 84% with type II comminuted fractures (p=0.91). The uninjured to former fractured arm differences in elbow range of motion and strength were no different in the 3 fracture types, the proportions of individuals with radiographic elbow degenerative changes were greater in type II than in type I factures (p<0.001), and there were no differences between the proportions of individuals with reduced joint space in the 3 groups (p=0.40). The outcomes were no different if the fractures had occurred in the dominant or non-dominant arms (p=0.43), or in men or women (p=0.43). Conclusion: There were no different outcomes after Colton type I, type II oblique/transverse or type II comminuted fractures, no different outcomes between fractures in dominant or non-dominant arms and no different outcomes in men and women.

scholarly journals P318 Left atrial dysfunction assessed by echocardiography in relation to left atrial fibrosis in patients undergoing ablation for atrial fibrillation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Pilichowska ◽  
J Baran ◽  
P Kulakowski ◽  
B Zaborska
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Systolic Function ◽  
Electrophysiological Study ◽  
Stiffness Index ◽  
P Value ◽  
Group 2 ◽  
Left Atrial Dysfunction ◽  
Left Atrial Fibrosis ◽  
Group 1

Abstract PURPOSE Left atrial (LA) fibrosis is the hallmark of LA remodeling in atrial fibrillation (AF), alters LA function and may predict poor catheter ablation (CA) outcome. LA fibrosis may be assessed invasively using electroanatomical mapping (EAM) during electrophysiological study. The aim was to assess LA function parameters in relation to degree of LA fibrosis derived from EAM in patients with AF. METHODS Patients (pts) n = 39 (79% males, mean age 56+/-10) with non-valvular AF were studied with TTE and TEE before first CA during sinus rhythm. LA strain (LAS) and strain rate (LASR) were analyzed in reservoir (r), conduit (cd) and contractile (ct) phases. The velocities of mitral A, E" and A" were measured with Doppler. E/E" and LA stiffness index - the ratio of E/E" to LASr were assessed. LA appendage flow velocity (LAAv) was measured in TEE. LA volume using biplane area-length method was calculated. The EAM of LA was build using Carto System before CA. Low amplitude potentials area (LAPA) was quantitatively analyzed and expressed as a percentage of LA surface using the cut-off &lt;0.5 mV to detect sites of fibrosis. LA parameters were compared between mild (LAPA &lt;10%) moderate (LAPA 10-40%) and extensive degree of LA fibrosis (LAPA &gt;40%) (table). RESULTS The mean LA volume was 35 ± 11 mL/m². The LAPA ranged from 2 to 78 % of LA surface. Reduced LA function was observed in the LAPA &gt;40% group. Extensive LAPA altered mainly LA compliance parameters. Traditional LA systolic function parameters did not differ in relation to degree of LAPA. CONCLUSION LA compliance is mostly affected by LA fibrosis, thus LA diastolic parameters may be useful in the noninvasive assessment of LA fibrosis. Whether these parameters should be a part of the proper selection of candidates for CA requires further studies. LA function parameters LA parameters Group 1 LAPA &lt;10% n = 13 Group 2 LAPA &gt;10% &lt;40% n = 13 Group 3 LAPA &gt;40% n = 13 P-value Group 1 + 2 vs 3 Mitral A 0.55 ± 0.10 0.55 ± 0.24 0.73 ± 0.32 0.077 A" 9.19 ± 1.74 7.85 ± 1.43 7.92 ± 2.40 0.376 LASr 31.48 ± 4.52 26.48 ± 8.79 19.63 ± 6.76 &lt;0.001 LAScd 17.30 ± 3.05 15.44 ± 6.93 10.91 ± 4.04 0.003 LASct 14.18 ± 5.36 11.05 ± 3.67 8.72 ± 4.78 0.024 LASRr 1.22 ± 0.19 1.24 ± 0.21 0.92 ± 0.20 &lt;0.001 LASRct -1.71 ± 0.46 -1.37 ± 0.34 -1.04 ± 0.33 &lt;0.001 LA stiffness 0.20 ± 0.07 0.34 ± 0.17 0.63 ± 0.29 &lt;0.001 LAAv 0.83 ± 0.18 0.55 ± 0.17 0.60 ± 0.16 0.178

scholarly journals Frequency detection of BRAF V600E mutation in a cohort of pediatric langerhans cell histiocytosis patients by next-generation sequencing

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shunqiao Feng ◽  
Lin Han ◽  
Mei Yue ◽  
Dixiao Zhong ◽  
Jing Cao ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Langerhans Cell Histiocytosis ◽  
Mutation Screening ◽  
Langerhans Cell ◽  
Braf V600e ◽  
P Value ◽  
Type I ◽  
Next Generation ◽  
Mutation Status ◽  
Generation Sequencing

Abstract Background Langerhans cell histiocytosis (LCH) is a rare neoplastic disease that occurs in both children and adults, and BRAF V600E is detected in up to 64% of the patients. Several studies have discussed the associations between BRAF V600E mutation and clinicopathological manifestations, but no clear conclusions have been drawn regarding the clinical significance of the mutation in pediatric patients. Results We retrieved the clinical information for 148 pediatric LCH patients and investigated the BRAF V600E mutation using next-generation sequencing alone or with droplet digital PCR. The overall positive rate of BRAF V600E was 60/148 (41%). The type of sample (peripheral blood and formalin-fixed paraffin-embedded tissue) used for testing was significantly associated with the BRAF V600E mutation status (p-value = 0.000 and 0.000). The risk of recurrence declined in patients who received targeted therapy (p-value = 0.006; hazard ratio 0.164, 95%CI: 0.046 to 0.583). However, no correlation was found between the BRAF V600E status and gender, age, stage, specific organ affected, TP53 mutation status, masses close to the lesion or recurrence. Conclusions This is the largest pediatric LCH study conducted with a Chinese population to date. BRAF V600E in LCH may occur less in East Asian populations than in other ethnic groups, regardless of age. Biopsy tissue is a more sensitive sample for BRAF mutation screening because not all of circulating DNA is tumoral. Approaches with low limit of detection or high sensitivity are recommended for mutation screening to avoid type I and II errors.

scholarly journals In Vitro Effects of Sulforaphane on Interferon-Driven Inflammation and Exploratory Evaluation in Two Healthy Volunteers

Molecules ◽  
2021 ◽  
Vol 26 (12) ◽  
pp. 3602
Author(s):  
Elena Genova ◽  
Maura Apollonio ◽  
Giuliana Decorti ◽  
Alessandra Tesser ◽  
Alberto Tommasini ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Supportive Therapy ◽  
P Value ◽  
Type I ◽  
Interferon Signature ◽  
Interferon Stimulated Genes ◽  
Immune System Activation ◽  
In Vitro Effects

Interferonopathies are rare genetic conditions defined by systemic inflammatory episodes caused by innate immune system activation in the absence of pathogens. Currently, no targeted drugs are authorized for clinical use in these diseases. In this work, we studied the contribution of sulforaphane (SFN), a cruciferous-derived bioactive molecule, in the modulation of interferon-driven inflammation in an immortalized human hepatocytes (IHH) line and in two healthy volunteers, focusing on STING, a key-component player in interferon pathway, interferon signature modulation, and GSTM1 expression and genotype, which contributes to SFN metabolism and excretion. In vitro, SFN exposure reduced STING expression as well as interferon signature in the presence of the pro-inflammatory stimulus cGAMP (cGAMP 3 h vs. SFN+cGAMP 3 h p value < 0.0001; cGAMP 6 h vs. SFN+cGAMP 6 h p < 0.001, one way ANOVA), restoring STING expression to the level of unstimulated cells. In preliminary experiments on healthy volunteers, no appreciable variations in interferon signature were identified after SFN assumption, while only in one of them, presenting the GSTM1 wild type genotype related to reduced SFN excretion, could a downregulation of STING be recorded. This study confirmed that SFN inhibits STING-mediated inflammation and interferon-stimulated genes expression in vitro. However, only a trend towards the downregulation of STING could be reproduced in vivo. Results obtained have to be confirmed in a larger group of healthy individuals and in patients with type I interferonopathies to define if the assumption of SFN could be useful as supportive therapy.

scholarly journals Management of scope-induced type I duodenal perforations: Over-the-scope clip versus surgery

2021 ◽  
Author(s):  
Amol S. Dahale ◽  
Siddharth Srivastava ◽  
Sundeep Singh Saluja ◽  
Sanjeev Sachdeva ◽  
Ashok Dalal ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Delayed Diagnosis ◽  
Oral Intake ◽  
Standard Of Care ◽  
Duodenal Perforation ◽  
Type I ◽  
Over The Scope Clip ◽  
Group 2 ◽  
Duodenal Perforations ◽  
Surgical Group

Abstract Background Scope-induced duodenal perforation is a life-threatening complication and surgery remains the standard of care. With the advent of over-the-scope clip (OTSC), scope-induced perforations are increasingly managed conservatively, though there is no study comparing this form of non-surgical treatment with surgery. We aimed to compare OTSC and surgery in the management of scope-induced perforation of the duodenum. Methods We retrospectively collected data of scope-induced duodenal perforation patients. Perforations identified and treated within 24 h of procedure were analyzed. Factors analyzed were spectrum, etiology, baseline parameters, perforation size, outcome, comorbidities, and duration of hospital stay. Results A total of 25 patients had type I duodenal perforations, out of whom five were excluded due to delayed diagnosis and treatment. Of the twenty, eight were treated with OTSC placement while the rest underwent surgery. Age was comparable and the majority were females. Baseline parameters and comorbidities were similar in both the groups. The median size of perforation was 1.5 cm in both the OTSC group and the surgical group. All patients were treated with standard of care according to institutional protocols. Patients in the OTSC group were started orally after 48 h of OTSC placement, while in the surgery group median time to oral intake was 7 days. Two patients in the surgical group died while there was no mortality in the OTSC group (p = 0.48). Median hospital stay was shorter in the OTSC group (2 days vs. 22 days, p = 0.003). Conclusions OTSC is a feasible and better option in type I duodenal perforations with a shorter hospital stay.

Does Presurgical Nasoalveolar Molding Have a Long-Term Effect on Nasal and Upper Airway Dimensions?

2020 ◽  
pp. 105566562098023
Author(s):  
Ashwina S. Banari ◽  
Sanjeev Datana ◽  
Shiv Shankar Agarwal ◽  
Sujit Kumar Bhandari
Keyword(s):  
Upper Airway ◽  
P Value ◽  
Airway Patency ◽  
The Mean ◽  
Group 2 ◽  
Acoustic Pharyngometry ◽  
Nasoalveolar Molding ◽  
Area And Volume ◽  
Group 1

Objectives: To compare nasal and upper airway dimensions in patients with cleft lip and palate (CLP) who underwent nasoalveolar molding (NAM) with those without NAM during infancy using acoustic pharyngometry and rhinometry. Materials and Methods: Eccovision acoustic pharyngometry and rhinometry (Sleep Group Solutions) was used for assessment of mean area and volume of nasal and upper airway in patients with complete unilateral CLP (age range 16-21 years) treated with NAM (group 1, n = 19) versus without NAM (group 2, n = 22). Results: The mean nasal cross-sectional areas and volume were higher in group 1 compared to group 2 on both cleft ( P value <.001) and noncleft side ( P value >.05). The mean area and volume of upper airway were also significantly higher in group 1 compared to group 2 ( P value <.05). Conclusions: Nasoalveolar molding being one of the first interventions in chronology of treatment of patients with CLP, its long-term outcome on nasal and upper airway patency needs to be ascertained. The results of the present study show that the patients with CLP who have undergone NAM during infancy have better improvement in nasal and upper airway patency compared with those who had not undergone NAM procedure. The basic advantages of being noninvasive, nonionizing and providing dynamic assessment of nasal and upper airway patency make acoustic pharyngometry and rhinometry a diagnostic tool of choice to be used in patients with CLP.

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