scholarly journals Comparison of graft uptake in patients undergoing myringoplasty/ tympanoplasty by overlay and underlay procedure.

2019 ◽  
Vol 26 (11) ◽  
pp. 1861-1865
Author(s):  
Muhammad Arshad ◽  
Ambreen Shahnaz ◽  
Madiha Bashir ◽  
Akhtar Zaman

Objectives: To determine which method underlay or overlay has higher results in graft uptake in Tympanoplasty. Study Design: It was experimental study. Setting: it was carried out at ENT Department of Benazir Bhutto Hospital, Rawalpindi. Period: One year from March 2017 to February 2018. Material and Methods: It consisted of a total of 27 patients presenting with chronic otitis media with dry perforation. Two groups of patients were made. Group A had 14 members who undergone underlay technique while the 13 patients in group B undergone overlay technique. Comparison was made on basis of successful graft uptake the main criteria of which was absence of lateralization, atelectasis, blunting or formation of retraction pockets by the end of 6 weeks of follow up. Result: Out of the 27 surgeries, 70.37% of the Myringoplasties were successful. The percent graft uptake came out to be 61.5% with overlay and 78.5% with underlay myringoplasty. In 15 out of the 27 surgeries temporalis fascia was used with a graft uptake rate of 80%, the 12 grafts taken from tragus had a graft uptake rate of 58.33%. Conclusion: Underlay myringoplasty technique has higher results than overlay myringoplasty technique.

2016 ◽  
Vol 23 (03) ◽  
pp. 246-250
Author(s):  
Yousaf Jan ◽  
Waqas Ahmad ◽  
Shaukat Hussain ◽  
Muhammad Shah ◽  
Ahmad Din

Objectives: To evaluate and compare the effect of aspiration plus methylprednisone injection versus surgical excision of the dorsal wrist ganglions in terms of resolution,complications and recurrence. Study Design: Prospective study. Setting: Surgical wardHayatabad Medical Complex, Peshawar. Period: June 2009 to December 2011. Methodology:After taking permission from ethical and research committee. Included patients were all adult ofboth gender with dorsal wrist ganglion. Patients with cancer, bleeding disorders and diabeteswere excluded from the study. The patients were divided in two groups: Group A includedpatients for aspiration and injection treatment, while Group B included patients underwentsurgical excision. All the patients were followed for complete resolution of ganglion, anycomplications of treatment and recurrence within one year. Follow up arranged at 7th day, 1,3, 6 and 12 months. Results: Total of 80 patients was included in the study. Out of 80, 65%(n=52) were females while 35% (n=28) were males. The mean age was 26.37±5.62 years.Group A and group B patients had overall success rates of 75% and 95%, with recurrence of25% and 5% in group A and group B respectively. In methylprednisolone group, mild pain wasreported by 70% (n=28), while in the surgical excision group, all the patients experienced mildto moderate pain postoperatively which necessitated oral analgesics for few days. Conclusion:Surgical excision is superior to injection-aspiration method for dorsal wrist ganglion treatmentbecause of high success and low recurrence rate. As injection-aspiration treatment


Vascular ◽  
2019 ◽  
Vol 27 (5) ◽  
pp. 518-523 ◽  
Author(s):  
Gergana T Taneva ◽  
Marco V Usai ◽  
Georgios A Pitoulias ◽  
Giovanni Torsello ◽  
Martin Austermann ◽  
...  

Aim To evaluate the performance of two different flexible devices, the balloon-expandable BeGraft stent as on-label chEVAR use with the Endurant (Medtronic, Santa Rosa, USA) stent graft compared to the self-expandable off-label employment of Viabahn (Gore Flagstaff, Arizona, USA). Methods All patients treated for pararenal aortic pathologies between 2008 and 2017 using Endurant II (Medtronic, Santa Rosa, CA, USA) abdominal endograft in combination with Viabahn (Gore, Flagstaff, AZ, USA) or BeGraft (Bentley, Hechingen, Germany) at our institution were retrospectively analyzed. Patients were divided into two groups according to the employed chimney graft, namely Viabahn (group A) and BeGraft (group B). The primary endpoint was the incidence of type IA endoleak at one month and last follow-up. Secondary endpoints included reintervention rates, primary patency of the chimney graft, and need for additional placement of bare metal stents also known as relining. Results A total of 27 patients (mean age: 76 years) were treated with overall 47 chimney grafts. In particular, 11 patients received 21 Viabahn and 16 patients underwent placement of 26 BeGraft stents. Mean follow-up was 14.3 ± 9.0 months for group A and 13.0 ± 13.7 for group B, p = .451. The mean chimney graft length was 85.1 ± 38.9 mm for group A and 34.9 ± 9.8mm for group B ( p < .001). The oversizing rate at the proximal sealing zone was significantly higher in group B (Group A: 23.1 ± 16.5% vs. Group B: 33.6 ± 7.6%, p = .007). The primary patency rates were similar between groups ( p = .250). The subgroup analysis showed a significantly higher early (9–42.9% vs. 2–7.7%, p = .005) and at last CT follow-up (5–23.8% vs. 0–0.0%, p = .011) type IA endoleak, higher primary relining (14–66.7% vs. 5–19.2%, p = .001) and reintervention rates (5–23.8% vs. 0–0.0%; p = .011) for group A chimney stent grafts. Conclusions Both chEVAR combinations displayed similar patency rate, showing the BeGraft-Endurant composition less need for relining and fewer one-year type IA endoleak and reintervention rates in the subgroup analysis.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 825-825
Author(s):  
Dmitriy Zamarin ◽  
Manisha Bhutani ◽  
Danielle Chimento ◽  
Sergio Giralt ◽  
Nikoletta Lendvai ◽  
...  

Abstract Abstract 825 BACKGROUND: Autologous stem cell transplantation (ASCT) is a widely used therapeutic option in first line treatment of multiple myeloma (MM). However, many patients eventually relapse. While precise knowledge of relapse and progression (R/PD) patterns would be important to generate evidence based surveillance recommendations after ASCT, such data is limited in the literature, especially in the era following the introduction of the free light chain assay. The purpose of this study is to examine the patterns of post-ASCT relapse and to derive evidence based recommendations for optimal surveillance of patients. METHODS: We performed a retrospective analysis on 258 patients with MM who underwent ASCT within one year of diagnosis at MSKCC between 2000 and 2010, as part of first line therapy. We used the IMWG standard criteria for serologic and clinical R/PD. We first determined for all patients the date of serologic R/PD. Patients identified as having serologic R/PD were further examined to determine whether clinical (anemia, renal failure, hypercalcemia, development of soft tissue lesions), radiologic (skeletal survey) or urinary R/PD had anteceded serologic R/PD. Several groups of patients were derived and further analyzed in terms of relapse patterns and adequacy of follow up. RESULTS: Among 258 patients, 173 were determined to have serologic R/PD at a median of 19.2 months post-transplant. Among these patients, on the dates of their serologic R/PD, 17 (9.8%) had concurrent overt symptomatic evidence of clinical/radiologic R/PD (Group A symptomatic R/PD), while 156 (90.2%) were found to have isolated asymptomatic serologic R/PD without apparent evidence of concomitant clinical/radiologic R/PD (Group B asymptomatic R/PD). Group A included patients with distinct and sometimes coinciding clinical characteristics (poor risk cytogenetics with aggressive disease (n=3), leptomeningeal relapse (n=1), soft tissue relapse (n=4) and acute severe anemia at relapse (n=3)); patients with IgA gammopathy (n=5); and patients considered to have inadequate serologic follow up intervals (range of follow up interval between date of serologic R/PD and prior serologic testing 149 to 245 days) (n=6). Upon further examination of group B, 44 patients had radiologic imaging at the time of serologic R/PD (within 4 weeks following the date of serologic R/PD). Fourteen among them (32%) had evidence of new bone lesions. Among all 173 patients with serologic R/PD, 83 patients had a skeletal survey within one year prior to the date of serologic R/PD. Only 3 (3.6%) had evidence of radiologic R/PD anteceding serologic R/PD. All 3 patients were considered to have had inadequate serologic follow up interval (Range 208 to 252 days). Abnormal urine immunofixation (UIF) anteceded serologic R/PD in 5 out of 41 (12%) patients tested who had achieved CR post transplant. In these patients the abnormal UIF anteceded the serologic R/PD by a mean of 2.4 months. Abnormal UPEP anteceded serologic R/PD by 1.9 months in only 1 out of 40 (2.5%) patients tested who had achieved less than CR post transplant. CONCLUSIONS: Based on the results of this analysis, several conclusions can be drawn: 1) The vast majority of R/PD in patients with MM are asymptomatic R/PD detected first by serologic studies. A small percentage of patients (those with aggressive cytogenetics, specific relapse types including soft tissue, severe cytopenia, and IgA gammopathy) will have symptomatic R/PD with overt concomitant evidence of clinical and/or radiologic R/PD at the time of serologic R/PD; 2) Among patients who have apparent asymptomatic R/PD, a significant percentage will have evidence of skeletal lesions and therefore imaging should be recommended in these patients; 3) In the absence of serological R/PD, routine surveillance screening with yearly skeletal surveys cannot be recommended based on this analysis since this test was not useful in any of the analyzable patients in whom it was obtained; 4) Aside from few patients in CR whose relapse may be detected earlier by UIF (with probably no clinical benefit), all patients with multiple myeloma whose disease progresses will have serologic R/PD at the time of progression and follow up limited to serologic testing may well be sufficient for monitoring patients with MM post transplant. Disclosures: No relevant conflicts of interest to declare.


2021 ◽  
Vol 15 (8) ◽  
pp. 2043-2045
Author(s):  
Tahir Hamid ◽  
Muhammad Rizwan Qadir ◽  
Ahmad Raza Nsar ◽  
Rizwan Saleem ◽  
Abdur Rehman ◽  
...  

Aim: To compare partial nail avulsion followed by matricectomy either with phenol (80-88%) or with electro cautery for Stage 2 & 3 ingrown toenails for early and late postoperative complications. Methods: This study was conducted at department of surgery Nawaz Sharif social security teaching hospital Lahore for one year from 01-01-2018 to 31-12-2018. One hundred patients full filling inclusion criteria were included in the study and divided into two equal groups A and B. Partial nail avulsion done in both groups followed by chemical matricectomy with phenol (80-88%) in group A and patients in group B matricectomy done with electrocautry. Results: The mean age in group A is 19.7± 8.08 years and in group B is 20.20± 6.9 years, both groups comparable p-value (0.74).In early post-operative complications in group A 17(34%) patients and 14(28%) patients in group B experienced mild pain p-value is (0.66). 6(12%) of group A patients and 6(12%) of group B patients experienced moderate pain p-value (01). 1(2%) of group A patient and 2(4%) of group B patients experienced severe pain p-value (01). 02(4%) patients of group A and 02(4%) patients of group B had serous discharge p-value(01). 1(2%) of group B patients have purulent discharge, however, no patients in group A patients have purulent discharge p-value (01). 1(2%) patients of group A and 2(4%) patients of group B had recurrence at three months follow up p-value (01). 2(4%) patients of group A and 4(8%) patients of group B had recurrence at six months follow up p-value (0.68). Conclusion: Partial nail avulsion followed by matricectomy either with Phenol 80-88% or with electrocautry are comparable in early and late complications. Keywords: Ingrown toenails, partial matricectomy


2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Wu Shanshan ◽  
Du Xinfang ◽  
Yu Shuihong ◽  
Lai Kecong ◽  
Qi Jinjin ◽  
...  

Abstract Background In this study, we aim to determine the hepatic pathological changes in HBV DNA-negative chronic Hepatitis B (CHB) patients after 12-month antiviral therapy. Methods Blood routine indicators including platelet count (PLT) and white blood cell (WBC) were determined. The coagulation function was evaluated by determining the prothrombin time (PT) and prothrombin time activity (PTA), together with the HBV DNA quantification and alpha fetoprotein (AFP). The virology data included hepatitis B surface antigen (HBsAg)/antibodies against hepatitis B surface antigen (anti-HBs), hepatitis B e antigen (HBeAg)/antibodies against hepatitis B e antigen (anti-HBe) and antibodies against hepatitis B core antigen (anti-HBc) were tested. Pathological assay was performed to the liver puncture tissues. Based on the HBV DNA data in the 12-month follow-up of the cases that received anti-viral therapy during this time, the experimental group was divided into group A (HBV DNA negative at the baseline level, HBV DNA negative after 12 months, N = 79) and group B (HBV DNA negative at the baseline level, HBV DNA turning to be positive after 12 months, N = 13). Statistical analysis was performed on the each test index of the two groups. Results The inflammation grade of group A showed significant improvement after 12-month treatment (P < 0.05). The pathological inflammation grade of group B was increased after one year, and the liver function indices and the PTA (P < 0.05) levels were all increased. Pathological results indicated that the proportion of disease progression in group A was decreased after 12-month follow-up while that proportion was increased in group B. Significant differences were noticed in AFP levels between the patients with progression in group A and those with progression in group B. Conclusion Negative HBV DNA does not mean a controlled hepatitis B. Hepatitis B patients transferred to HBV DNA positivity during the anti-viral therapy are easily to show disease progression, and then special attention should be paid to the HBV DNA monitoring. Meanwhile, close monitoring to the changes of liver function, PTA and AFP levels may help to detect changes on the disease in a timely manner.


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.


2019 ◽  
Author(s):  
Ehab M. Moawad ◽  
Ahmed A. Abd Elghany ◽  
Amr A. Gab-Alla ◽  
Osama M. Elbassiouny ◽  
Mohsen S. Badawy

Abstract Background The study aimed to assess the role of intraoperative mitomycin-C (MMC) application during hyperopic LASIK correction (+1.00 D to +6.00 D) by examining topographic corneal changes and incidence of regression over a one-year follow-up period. Methods This comparative randomized control study included 136 eyes of 68 hyperopic patients divided into two groups; Group A included 68 eyes of 34 patients that had LASIK with the application of 0.02% MMC for 10 seconds on the stromal bed after excimer laser treatment, and group B included 68 eyes of 34 patients that had LASIK without MMC application. Uncorrected distance visual acuity (UDVA), refraction, keratometry and topography were recorded at 1st week and 1st, 3rd, 6th, and 12th months postoperation. Predictability and treatment efficacy were also recorded at the end of the follow-up period. Results Better predictability was noted in group A than in group B at the 6 month and 12 month follow-up visits, with a mean cycloplegic refraction SE of +0.5 ± 0.31 D in group A and +0.67 ± 0.39 D in group B at the 6 month visit, and +0.63 ± 0.37 D in group A and +0.89 ± 0.48 D in group B at the 12 month visit. The efficacy of the treatment at the end of the follow up period was better in group A than in group B. Group A showed fewer topographic corneal changes than group B. Conclusions Intraoperative MMC application during hyperopic LASIK achieves better predictability and efficacy and induces fewer topographic changes and lower regression rate of hyperopia during the first postoperative year. Trial registration: the Pan African Clinical Trial Registry PACTR201901543722087, on 29 January 2019.


2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S552-55
Author(s):  
Saleem Asif Niazi ◽  
Shahzad Maqbool ◽  
Yousra Riaz ◽  
Zafarullah Khan ◽  
Shafaq Zaman ◽  
...  

Objective: To determine the efficacy of permeatal ednoscopic myringoplasty, in inactive (mucosal) COM regarding, graft take and hearing improvement. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Department, Pak Emirates Military Hospital, Rawalpindi, from Aug 2019 to Feb 2020. Methodology: This was conducted on a sample size of n=100. Patients having inactive (mucosal) COM with dry central small, medium and large perforations were included. Patients were divided in to three groups on the basis of age, group A 15-30 years, group B 31-45 years and group C 46-60 years. All the patients underwent per-meatal endoscopic myringoplasty, without raising the tympano-meatal flap, under general anesthesia. Patients were followed up over a period of six months. Graft take was assessed by microscopy. Hearing was assessed by Pure Tone Audiometry (PTA) with improvement in air bone gap to 15db as primary end point. Data was collected on structured performa. Data was analyzed using SPSS version 17. Results: In this study, 33 (33%) were males and 67 (67%) were females. Age ranged 15-60 years. Out of 5 patients lost to follow up. A total of 95 completed their follow up. Based on age of the patients, in group A, successful graft take was 100%. In group B, it was 91% & in group C it dropped to 46%. On the basis of tympanic membrane perforation size, the graft success rate in small perforations was 94.8%; in medium sized perforations it was 86.8% and in large sized perforations of tympanic membrane it was........


EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
H Santos ◽  
M Santos ◽  
I Almeida ◽  
H Miranda ◽  
C Sa ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Portuguese Registry of Acute Coronary Syndromes Background Acute coronary syndrome (ACS) and atrial fibrillation (AF) are common diseases in developed countries and in some cases, the first episode of AF can occur during the ACS. A stressful event like an ACS can be a trigger for AF, being important to realize its impact and prognosis in the short and long term. Objective Evaluate the impact and prognosis of new-onset AF in ACS. Methods Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-4/09/2019. Patients were divided into two groups: A – patients without new-onset AF, and B – patients that presented new onset of AF. Were excluded patients without a previous cardiovascular history or clinical data during the admission and the follow-up period. Logistic regression was performed to assess if new-onset AF in ACS was a predictor of major adverse cardiac events and mortality. Kaplan-Meier test was performed to establish the survival rates and re-admission for one year of follow up. Results 9687 patients suffered ACS and had follow-up at 1 year, 9264 in group A (95.6%) and 423 in group B (4.4%). Both groups were similar regarding dyslipidemia, diabetes mellitus, previous coronary artery disease, multivessel disease after the cardiac catheterization. Group A had more smokers (28.2 vs 17.8%, p &lt; 0.001) and left ventricular ejection fraction (LVEF) &gt;50% (69.2 vs 45.1%, p &lt; 0.001). On the other hand, group B was elderly (67 ± 14 vs 75 ± 12, p &lt; 0.001), female (26.9 vs 34.0%, p &lt; 0.001), arterial hypertension (70.5 vs 77.5%, p = 0.005), was more admitted directly to the cat lab (12.5 vs 17.7%, p = 0.002), ST-segment elevation myocardial infarction (40.2 vs 49.9%, p &lt; 0.001), Killip-Kimball classification &gt; I (12.8 vs 34.8%, p &lt; 0.001) and hybrid revascularization (0.7 vs 2.4%, p = 0.002). Logistic regression revealed that new-onset of AF in ACS patients was a predictor of congestive heart failure (odds ratio (OR) 1.75, p &lt; 0.001, confidence interval (CI) 1.47-2.09), cardiogenic shock (OR 3.08, p &lt; 0.001, CI 2.37-4.01), sustained ventricular tachycardia (OR 2.29, p &lt; 0.001, CI 1.61-3.25) and intrahospital mortality (OR 1.99, p &lt; 0.001, CI 1.51-2.63). Nevertheless, new-onset of AF was not associated with re-infarction (p = 0.361), mechanical complications (p = 0.319), atrioventricular block (p = 0.574), stroke (p = 0.131) and cardiac arrest (p = 0.060) during the hospitalization for ACS. Mortality rates at one year of follow-up showed significant differences, p &lt; 0.001, between the two groups (Figure 1). Similar results were found concerning re-admission for all causes, p = 0.021 (Figure 2), on the other causes, re-admission for cardiovascular causes do not reveal to be significant, p = 0.515. Conclusions New-onset of AF in ACS was a predictor of congestive heart failure, cardiogenic shock, sustained ventricular tachycardia and intrahospital mortality. AF was associated with higher mortality rates and re-admission for all causes at one year follow up.


2019 ◽  
Vol 34 (9) ◽  
pp. 604-610
Author(s):  
Sergio Gianesini ◽  
Erica Menegatti ◽  
Maria Grazia Sibilla ◽  
Diana Neuhardt ◽  
Elisa Maietti ◽  
...  

Objectives Comparison of a flush sapheno-popliteal junction ligation versus a mini-invasive foam sclerotherapy-assisted ligation. Methods Forty-eight chronic venous disease patients underwent sapheno-popliteal junction flush ligation (group A). Forty-one patients underwent small saphenous vein ligation by means of mini-invasive incision with foam sclerotherapy of the popliteal stump (group B). Results At 4.1 ± 3.3 years mean follow-up, sapheno-popliteal junction recurrence was detected in four patients of group A (4/48; 8.3%) and in two cases of group B (3/41; 7.3%) ( P= ns). Mean procedural time was 36 ± 11 minutes versus 21 ± 6 minutes ( p<0.0001). A mild post-operative paresthesia lasting more than 24 h was reported in 6.3% (3/48) of group A versus 2.4% (1/41) ( p<0.009) of group B. At one-year check-up, Aberdeen Varicose Vein Questionnaire significantly improved in both groups with no significant difference between group A and B. Conclusions Foam-assisted mini-invasive sapheno-popliteal ligation represents a time and clinical-effective option, associated with a decrease in post-operative paresthesia risk.


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