scholarly journals Outcome of Type 1 tympanoplasty: An experience at Biratnagar eye hospital in Eastern Nepal

2015 ◽  
Vol 7 (2) ◽  
pp. 55-60 ◽  
Author(s):  
Sanjeev Kumar Thakur ◽  
Sanjay Kumar Singh ◽  
Anwar Afaque ◽  
Nisha Ghimire
Keyword(s):  
Medical Sciences ◽  
Hearing Improvement ◽  
Hearing Outcome ◽  
Type 1 Tympanoplasty ◽  
Younger Age ◽  
History Of ◽  
The Mean ◽  
The Difference ◽  
Graft Success

Background: The history of tympanoplasty is well over a century. Type 1 tympanoplasty is an established procedure worldwide with a variation in the outcome.Aims and Objectives: To analyze the outcome of Type 1 tympanoplasty surgeries in terms of graft success and hearing improvement done at the Ear Department of Biratnagar eye hospital in eastern Nepal and discuss the various factors that might have influenced it.Materials and Methods: Retrospective analysis of records of the cases that underwent Type 1 tympanoplasty from August 2013 to January 2015 was done. The factors analysed were age, gender, the side of the affected ear and the perforation size. Appropriate Statistical test was applied and the results were discussed.Results: A total of 151 cases of type 1 Tympanoplasty were analysed were females had higher frequency than males, with higher incidence at younger age. The mean age of successful cases was 28.53. Females had a better success rate in terms of graft success compared to males. Moderate size perforations had the best outcome of graft success and least were of small size perforations. Of all cases analyzed, hearing improvement was observed in maximum cases.Conclusion: There was no significant influence of age or gender on the hearing outcome. The difference of hearing improvement according to size of perforation was also not significant.Asian Journal of Medical Sciences Vol.7(2) 2015 55-60

scholarly journals Is Allergic Rhinitis a Factor That Affects Success of Tympanoplasty?

2016 ◽  
Vol 59 (1) ◽  
pp. 10-13
Author(s):  
Elif Ersoy Callioglu ◽  
A. Sami Bercin ◽  
Hayati Kale ◽  
Togay Muderris ◽  
Sule Demirci ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Success Rate ◽  
Middle Ear ◽  
Success Rates ◽  
Type 1 Tympanoplasty ◽  
Significant Difference ◽  
Patient Groups ◽  
The Difference ◽  
Graft Success

Objective: The aim of the present study was to investigate the effect of allergic rhinitis on the success of the operation in chronic otitis surgery by using score for allergic rhinitis (SFAR). Materials and Methods: In the present study; 121 patients, who underwent type 1 tympanoplasty were examined retrospectively. SFAR of all patients were recorded. The graft success rates of 26 patients with allergic rhinitis (AR) and 95 patients with no allergic rhinitis group (NAR) were compared. Results: While the graft success rate in NAR group was 89.5%, this rate was 80.8% in the AR group. However, the difference between groups was not statistically significant (p = 0.311). Conclusion: These findings suggest that allergic rhinitis decreases the graft success rate of the pathologies occurring in eustachian tube, middle ear and mastoid although statistically significant difference wasn’t found. Prospective studies with larger patient groups are required in order to evaluate this pathology.

scholarly journals Comparative study of anterior tucking and cartilage support tympanoplasty with respect to graft uptake and hearing outcome

2018 ◽  
Vol 5 (1) ◽  
pp. 69
Author(s):  
Raghunath Shanbag ◽  
J. S. Arunkumar ◽  
M. Sarath Chand ◽  
Santosh S. Garag
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Surgical Techniques ◽  
Chronic Otitis Media ◽  
Hearing Improvement ◽  
Hearing Outcome ◽  
Type 1 Tympanoplasty ◽  
And Cartilage

<p class="abstract"><strong>Background:</strong> Tympanic membrane perforation in chronic otitis media exposes the middle ear mucosa to exogenous source of infection and also produces conductive hearing loss. To overcome this problem various surgical techniques of tympanoplasty using different graft materials have been tried with varying degrees of success rate. The purpose of this study was to compare anterior tucking and cartilage support tympanoplasty with respect to graft uptake and hearing outcome.</p><p class="abstract"><strong>Methods:</strong> This prospective study comprised of 50 consecutive patients with chronic otitis media of tubo tympanic type during October 2015 to September 2017, which were divided into two groups. Group A (25 patients) underwent type 1 tympanoplasty with anterior tucking method, Group B (25 patients) underwent type 1 tympanoplasty with cartilage support. The primary result was measured in view of graft uptake &amp; hearing capacity outcome at 6 months post operatively by performing pure tone audiometry.  </p><p class="abstract"><strong>Results:</strong> In anterior tucking tympanoplasty group out of 25 patients, the graft uptake was good in 22 patients and 23 patients showed good improvement in hearing, while in cartilage support tympanoplasty group all the 25 patients the graft uptake was good and all showed good hearing improvement postoperatively. In our study both the groups have significant hearing improvement and in cartilage support tympanoplasty results were better.</p><p class="abstract"><strong>Conclusions:</strong> The aim of tympanoplasty is to treat middle ear and tympanic membrane defects. In this study we subjected the patients for anterior tucking and cartilage support tympanoplasty for two different groups respectively and both methods showed significant hearing improvement.</p>

Incidence of postural headache after lumbar puncture requiring epidural blood patch: Effects of needle caliber; 2-year experience

2021 ◽  
pp. 197140092110006
Author(s):  
Warren Chang ◽  
Ajla Kadribegic ◽  
Kate Denham ◽  
Matthew Kulzer ◽  
Tyson Tragon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lumbar Puncture ◽  
Conservative Management ◽  
Epidural Blood Patch ◽  
Female Gender ◽  
Regional Hospital ◽  
Younger Age ◽  
Blood Patch ◽  
History Of ◽  
The Difference

Purpose A common complication of lumbar puncture (LP) is postural headaches. Epidural blood patches are recommended if patients fail conservative management. Owing to a perceived increase in the number of post-lumbar puncture headaches (PLPHs) requiring epidural blood patches at a regional hospital in our network, the decision was made to switch from 20 to 22 gauge needles for routine diagnostic LPs. Materials and methods Patients presenting for LP and myelography at one network regional hospital were included in the study. The patients were contacted by nursing staff 3 days post-procedure; those patients who still had postural headaches after conservative management and received epidural blood patches were considered positive cases. In total, 292 patients were included; 134 underwent LP with 20-gauge needles (53 male, 81 female, average age 57.7) and 158 underwent LP with 22-gauge needles (79 male, 79 female, average age 54.6). Results Of 134 patients undergoing LP with 20-gauge needles, 15 (11%) had PLPH requiring epidural blood patch (11 female, 3 male, average age 38). Of 158 patients undergoing LP with 22-gauge needles, only 5 (3%) required epidural blood patches (all female, average age 43). The difference was statistically significant ( p < 0.01). Risk factors for PLPH included female gender, younger age, lower body mass index, history of prior PLPH and history of headaches. Conclusion Switching from 20-gauge to 22-gauge needles significantly decreased the incidence of PLPH requiring epidural blood patch. Narrower gauge or non-cutting needles should be considered in patients with risk factors for PLPH, allowing for CSF requirements.

scholarly journals Analysis of a continuous 24-hour glycemic curve by the symmetrization method

2009 ◽  
Vol 55 (1) ◽  
pp. 3-7
Author(s):  
A V Dreval ◽  
B P Kovachev ◽  
E G Starostina ◽  
I V Misnikova ◽  
O. A Dreval
Keyword(s):  
Diabetes Complications ◽  
Glycosylated Hemoglobin ◽  
Self Control ◽  
Statistical Monitoring ◽  
Symmetrization Method ◽  
Daily Dose ◽  
Glycemic Indices ◽  
History Of ◽  
The Mean

The study included 18 patients (10 females and 8 males) with a not less than 2 year-history of type 1 diabetes (T1D), who had received insulin therapy since its diagnosis was established. The patients ’ mean age was 32.9± 13.0 years; the mean duration of TID was 15.1+11.5 years; the mean daily dose of insulin was 40.1+16.0 units; the mean level of glycosylated hemoglobin (HbAJ was 9.4±2.1% (the normal value 4.4-4.9%). The glycemic curve symmetrization method proposed for statistical analysis of glycemic self-control is also quite suitable for the statistical monitoring of a continuous daily glycemic curve. The high and low glycemic indices calculated from the symmetrized glycemic data correlate well with the level of HbAk and with the duration of hypoglycemia and hyperglycemia and hence they may be used as additional criteria for a risk of diabetes complications. The criteria, calculated from the symmetrized data of glycemia for the risk of hyper- and hypoglycemia, adequately reflect the behavior of a continuous glycemic curve and may be used as integral indices of the efficiency of glucose-reducing therapy in clinical practice.

A STUDY OF MORPHOLOGY AND GROSS ANOMALIES IN FULL-TERM PLACENTAE

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
M Pranay Kumar ◽  
Shaik Arshad Rajmohammad
Keyword(s):  
Gas Exchange ◽  
Fetal Development ◽  
Cerebellar Hypoplasia ◽  
Medical Sciences ◽  
Morphological Variations ◽  
Pathologic Evaluation ◽  
Area Of Interest ◽  
History Of ◽  
The Mean ◽  
Gross Examination

Background: Placenta is an important connecting organ between the mother and fetus. It provides nutrition, gas exchange, waste removal, immune support, and endocrine functions. Since variations of the placenta result in effects on fetal development and neonatal survival it is the area of interest to be studied by anatomists, pathologists, and obstetricians. We in the current studied the placental morphology, variations, and abnormalities of the human placenta. Methods: The samples comprised of a collection of placentae in the Department of Anatomy of Prathima Institute of Medical Sciences, Karimnagar. Samples were collected after delivery, placentae were mopped to remove any clotted blood, and then weighed with 10 cm of the umbilical cord. The specimen is fixed in 10% formalin immediately over 24-48 hours and then subjected to thorough gross examination. Results: Out of n=60 placentae studied the mean weight of the placenta was found to be highest at 38 weeks of gestation with a mean surface area of 964.46 cm2 and mean weight of 463.75 Kgs. N=49(81.67%) were normal maternal conditions and history of abortions and pre-eclampsia was in n=2 cases each and oligohydramnios in n=3 cases. Among the fetal abnormalities Anencephaly, Macrostomia, MS/TS/Cerebellar hypoplasia, and holoprosencephaly with single nostril was found in n=1(1.67%) cases each. Conclusion: Examination of the placenta performed in the delivery room provides information that may be important to the care of both mother and infant. The findings of this assessment should be documented in the delivery records. The placenta should be submitted for pathologic evaluation if an abnormality is detected. Keywords: Placenta, Morphological Variations, Anencephaly, oligohydramnios, Macrostomia.

Incidence and prognosis of patients with spinal metastasis as the initial manifestation of malignancy

2019 ◽  
Vol 101-B (11) ◽  
pp. 1379-1384 ◽  
Author(s):  
Jin-Sung Park ◽  
Se-Jun Park ◽  
Chong-Suh Lee
Keyword(s):  
Surgical Treatment ◽  
Spinal Metastasis ◽  
Spinal Disease ◽  
Primary Malignancy ◽  
Initial Manifestation ◽  
Kaplan Meier ◽  
History Of ◽  
The Mean ◽  
The Difference

Aims This study aimed to evaluate the incidence and prognosis of patients with spinal metastasis as the initial manifestation of malignancy (SM-IMM). Patients and Methods We retrospectively reviewed the electronic medical records of 338 patients who underwent surgical treatment for metastatic spinal disease. The enrolled patients were divided into two groups. The SM-IMM group included patients with no history of malignancy whose site of primary malignancy was diagnosed after the identification of spinal metastasis. The other group included patients with a history of treatment for primary malignancy who then developed spinal metastasis (SM-DTM). The incidence of SM-IMM by site of primary malignancy was calculated. The difference between prognoses after surgical treatment for SM-IMM and SM-DTM was established. Results The median follow-up period was 11.5 months (interquartile range (IQR) 3.2 to 13.4) after surgical treatment. During the follow-up period, 264 patients died; 74 patients survived. The SM-IMM group consisted of 94 patients (27.8%). The site of primary malignancy in the SM-IMM group was lung in 35/103 patients (34.0%), liver in 8/45 patients (17.8%), kidney in 10/33 patients (30.3%), colorectum in 3/29 patients (10.3%), breast in 3/22 patients (13.6%), prostate in 3/10 patients (30%), thyroid in 4/8 patients (50%), and ‘other’ in 28/88 patients (31.8%). On Kaplan–Meier survival analysis, the SM-IMM group showed a significantly longer survival than the SM-DTM group (p = 0.013). The mean survival time was 23.0 months (95% confidence interval (CI) 15.5 to 30.5) in the SM-IMM group and 15.5 months (95% CI 11.8 to 19.2) in the SM-DTM group. Conclusion Of the 338 enrolled patients who underwent surgical treatment for spinal metastasis, 94 patients (27.8%) underwent surgical treatment for SM-IMM. The SM-IMM group had an acceptable prognosis with surgical treatment. Cite this article: Bone Joint J 2019;101-B:1379–1384.

Revealing the history of infectious disease epidemics through phylogenetic trees

1995 ◽  
Vol 349 (1327) ◽  
pp. 33-40 ◽  
Keyword(s):  
Phylogenetic Trees ◽  
Viral Transmission ◽  
Human Populations ◽  
Viral Sequence ◽  
Immunodeficiency Virus ◽  
History Of ◽  
The Difference ◽  
Disease Epidemics ◽  
Hiv 1

Phylogenetic trees play an increasing role in molecular epidemiology, where they have been used to understand the forces that shape patterns of viral sequence diversity. Phylogenetic trees can also be used to trace the dynamics of viral transmission within populations. Case studies document the worldwide spread of Human Immunodeficiency Virus type 1 (HIV -1) and hepatitis C virus (HCV). Despite similarities between these viruses, especially in their transmission routes, they are shown to have very different epidemiological histories. A possible reason for the difference is that HCV has coexisted longer with human populations.

Acupuncture and Gastric Acid Studies

1979 ◽  
Vol 07 (04) ◽  
pp. 356-361 ◽  
Author(s):  
Joseph O. A. Sodipo ◽  
J. M. Falaiye
Keyword(s):  
Duodenal Ulcer ◽  
Pain Relief ◽  
Gastric Acid ◽  
Acid Output ◽  
Symptomatic Relief ◽  
Ulcer Group ◽  
History Of ◽  
Basal Acid ◽  
The Mean ◽  
The Difference

The effects of therapeutic acupuncture on gastric acid secretion on pain relief in chronic duodenal ulcer patients were studied. Ten adult Nigerian patients with clinical, endoscopic as well as radiological evidence of duodenal ulcer constituted the "Ulcer Group". Four other patients who gave history of dyspepsia formed the "Dyspeptic Group". Pentagastrin stimulation test was performed on all subjects pre- and post-acupuncture therapy. The classical Chinese acupuncture loci were employed. The mean Basal Acid Output (BAO) in the duodenal ulcer group was markedly reduced from 4.04 ±1.01 mMols/hour to 1.05±2.5mMols/hour. The mean Maximal Acid Output (MAO) was lowered from 34.72±13.81 mMols/hour to 15.34±4.01 mMols/hour. The difference was statistically significant (P<0.001). It is more probable, therefore, that the relief of pain is attributable to the therapeutic inhibition of gastric hyperacidity in our patients. Thus, though pain relief has been previously demonstrated in response to acupuncture, the results of this investigation have gone further to show that acupuncture achieves symptomatic relief through therapeutic gastric depression in duodenal ulcer patients.

scholarly journals Shortening of the Symptom-Free Period in Rhesus Macaques Is Associated with Decreasing Nonsynonymous Variation in theenv Variable Regions of Simian Immunodeficiency Virus SIVsm during Passage

1998 ◽  
Vol 72 (9) ◽  
pp. 7494-7500 ◽  
Author(s):  
P. J. Spencer Valli ◽  
Vladimir V. Lukashov ◽  
Jonathan L. Heeney ◽  
Jaap Goudsmit
Keyword(s):  
Simian Immunodeficiency Virus ◽  
Rhesus Macaques ◽  
Envelope Gene ◽  
Nucleotide Substitutions ◽  
Variable Regions ◽  
Immunodeficiency Virus ◽  
The Mean ◽  
The Difference ◽  
Nonsynonymous Variation

ABSTRACT During six blood passages of simian immunodeficiency virus SIVsm in rhesus macaques, the asymptomatic period shortened from 18 months to 1 month. To study SIVsm envelope gene (env) evolution during passage in rhesus macaques, the C1 to CD4 binding regions of multiple clones were sequenced at seroconversion and again at death. Theenv variation found during adaptation was almost completely confined to the variable regions. Intrasample sequence variation among clones at seroconversion was lower than the variation among clones at death. Intrasample variation among clones from a single time point as well as intersample variation decreased during the passage. In the variable regions, the mean number of intrasample nonsynonymous nucleotide substitutions decreased from the first passage (5.26 × 10−2 ± 0.6 × 10−2 per site) to the fifth passage (2.24 × 10−2 ± 0.4 × 10−2 per site), whereas in the constant regions, the mean number of intrasample nonsynonymous nucleotide substitutions differed less between the first and fifth passages (1.14 × 10−2 ± 0.27 × 10−2 and 0.80 × 10−2 ± 0.24 × 10−2 per site). Shortening of the asymptomatic period coincided with a rise in theKs/Ka ratio (ratio between the number of synonymous [Ks] and the number of nonsynonymous [Ka] substitutions) from 1.080 in passage one to 1.428 in passage five and mimicked the difference seen in the intrahost evolution between asymptomatic and fast-progressing individuals infected with human immunodeficiency virus type 1. The distribution of nonsynonymous substitutions was biphasic, with most of the adaptation ofenv variable regions occurring in the first three passages. This phase, in which the symptom-free period fell to 4 months, was followed by a plateau phase of apparently reduced adaptation. Analysis of codon usage revealed decreased codon redundancy in the variable regions. Overall, the results suggested a biphasic pattern of adaptation and evolution, with extremely rapid selection in the first three passages followed by an equilibrium or stabilization of the variation between env clones at different time points in passages four to six.

scholarly journals Evaluation of multiple risk factors involved in the development of Diabetic Retinopathy

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Syeda Birjees Anwar ◽  
Naveed Asif ◽  
Syed Abid Hassan Naqvi ◽  
Sidra Malik
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Family History ◽  
Positive Family History ◽  
Family History Of Diabetes ◽  
Duration Of Diabetes ◽  
Multiple Risk Factors ◽  
History Of ◽  
The Mean ◽  
The Difference

Objective: To determine the role of hypertension, hyperlipidemia, smoking and positive family history of diabetes and hypertension in the development of diabetic retinopathy. Methods: This prospective cohort study was conducted at the Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi over 2 years period from June 2014 to June 2016. One hundred consecutive diabetic patients with no signs of diabetic retinopathy and good glycemic control (HbA1c<6.5%) were registered by non-probability convenient sampling after taking written informed consent. They were evaluated for hypertension, hyperlipidemia and smoking status. These patients were then followed 6 monthly for 2 years to look for the development of diabetic retinopathy. Results: The mean age of the patients was 50.72±9.29 years and there were 57 (57%) male and 43 (43%) female patients. Majority (82%) of the patients had NIDDM. The mean duration of diabetes was 8.31±6.83 years. 11% of the patients were smoker, 37% were hypertensive, 6% had hyperlipidaemia, 62% had family history of diabetes and 30% had family history of hypertension. At the end of follow-up, 9 (9.0%) patients had diabetic retinopathy. The frequency of diabetic retinopathy increased with increasing age of the patient; however, the difference was statistically insignificant. A comparatively higher frequency of diabetic retinopathy was also seen in patients with IDDM and those with positive family history of diabetes and hypertension yet again, the difference was statistically insignificant. Also, no significant difference was noted among male and female genders and smokers vs. non-smoker. However, the frequency of diabetic retinopathy increased significantly with increasing duration of diabetes. It was also higher among those with hypertension and hyperlipidemia. Conclusion: Higher patient age (≥50 years), increasing duration of diabetes (≥20 years), insulin dependent diabetes mellitus, hypertension, hyperlipidemia, and positive family history of diabetes and hypertension were found to be associated with increased frequency of diabetic retinopathy. How to cite this:Anwar SB, Asif N, Naqvi SAH, Malik S. Evaluation of multiple risk factors involved in the development of Diabetic Retinopathy. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.279 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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