A single blind controlled study comparing bipolar elecrocautery tonsillectomy to cold dissection method in pediatric age groups

Background: Tonsillectomy is one of the most commonly performed operations in otolaryngology. There are many proven methods of tonsillectomy, including cold dissection and bipolar electrocautery. Objective: To compare bipolar elecrocautery tonsillectomy with cold dissection method in pediatric age groups. Methods: Single blind controlled study to compare bipolar technique against the conventional dissection/snare technique. Results: The average amount of bleeding on electrocautery side was 4.07ml and on the cold dissection side was 14.58 ml. The mean time of operation for electrocautery and cold dissection was 12.04 and 16.57 minutes respectively. On the second post operative day, 35% of the patients complained of pain on the cauterized side, 30% complained of more pain on the dissection side while 35 % experienced equal pain on both sides. Post-operative complication such as hemorrhage was not seen in both the techniques employed. Conclusion: In the present study, bipolar diathermy tonsillectomy had advantages in having less post-operative time and blood loss intraoperatively but patients experience slightly more pain than cold dissection. DOI: http://dx.doi.org/10.3126/hren.v11i3.9651 Health Renaissance 2013;11(3):270-272

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A COMPARISON OF DISSECTION METHOD AND MONOPOLAR TOSILECTOMY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.2.5 ◽

2016 ◽

pp. 30-34

Author(s):

Thanh Thai Le ◽

Duy Nam Dang

Keyword(s):

Postoperative Pain ◽

Outcome Measure ◽

University Hospital ◽

Average Amount ◽

Postoperative Haemorrhage ◽

Advantages And Disadvantages ◽

The Mean ◽

Time Of Operation ◽

Mean Time ◽

Dissection Method

Objective: To compare the dissection and monopolar method of tonsillectomy and evaluate their advantages and disadvantages during surgery and convalescence. Materials and Method: Descriptive, prospective, clinical trial on 76 patients who required tonsillectomy were randomly assigned to have one tonsil removed by dissection - method and the other by monopolar at Hue University Hospital and Hue Central Hospital. Main outcome measure: surgery duration, lost blood, postoperative pain, postoperative haemorrhage, recovering time. Result: The mean time of operation related to dissection-method tonsillectomy was 18,9± 3,7 minutes and in monopolar tonsillectomy was 10,5 ±3,4 minutes. The average amount of bleeding was 13,1 ± 3,8ml and 3,1 ± 2,6ml respectively. Postoperative pain of dissection method with 6,0± 1,3 days and monopolar with 7,8 ± 2,3 days. Postoperative haemorrhage of dissection method with 5,3% and monopolar with 13,2%. Conclusion: Although there are some advantages and disavantages in 2 methods, we should choose dissection method tonsillectomy due to its recovering time. Key words: dissection method, monopolar method

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Acute coronary syndrome: which age group tends to delay call for help?

The Egyptian Heart Journal ◽

10.1186/s43044-020-00124-7 ◽

2021 ◽

Vol 73 (1) ◽

Author(s):

Ahmed Ayuna ◽

Ayyaz Sultan

Keyword(s):

Acute Coronary Syndrome ◽

Time Delay ◽

Local Population ◽

Age Groups ◽

Age Group ◽

Teaching Programme ◽

The Road ◽

Coronary Syndrome ◽

The Mean ◽

Mean Time

Abstract Background Early diagnosis and treatment of ACS can reduce the risk of complications and death. Delay calling for help can increase morbidity and mortality. It is unclear which age group among patients with acute coronary syndrome tend to delay their call for help. Results Our observational retrospective study showed that men and women in their 50s and 40s respectively tend to delay their call for help from symptoms onset. For the former, the mean time delays (590 ± 71.1 min), whereas for the latter it was (1084 ± 120.1 min). Moreover, these groups tend to have a longer time delay between symptoms onset and arrival at the hospital. Among deaths, we observed that the death rate was proportional to the time delay, which is not unexpected. Next step, we plan to perform a qualitative study in the form of questionnaires to target the individuals with a high risk of CVD within these age groups. Conclusion Middle age group of both genders tend to delay their call for help when they experience symptoms of ACS; moreover, regardless of the age, the longer the delay, the higher the mortality rate. The results of this study gave us a better understanding of our local population and will pave the road for a well-structured teaching programme for them to minimise the time delay for calling for help.

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Comparison between dissection method and coblation technique in tonsillectomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194934 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1607

Author(s):

Shreyas S. Joshi ◽

Vinayak Raikar

Keyword(s):

Chronic Tonsillitis ◽

P Value ◽

Safe Procedure ◽

Duration Of Surgery ◽

The Mean ◽

Operative Recovery ◽

Dissection Technique ◽

Cold Dissection ◽

Dissection Method

Background: The objective of the present study was to compare the dissection method and coblation technique in tonsillectomy in patients of chronic tonsillitis.Methods: This is prospective study in which 40 patients of chronic tonsillitis in age group of 5-12 years were selected in this study. Patients were blinded with regards to technique used to remove tonsils. 20 patients underwent tonsillectomy by cold dissection method and 20 with coblation method. In both techniques, duration of surgery and amount of blood loss were recorded and compared. Results: In our study, the mean operative time from giving incision to achieving complete haemostasis for dissection method was 42.9 minutes and that for coblation technique was 34 minutes. The amount of blood lost on an average by dissection method was 51.8 ml, and by coblation technique was 22.3 ml. This difference was found to be statistically significant. Pain was evaluated by visual analogue scale. The data recorded from two groups was put to statistical analysis and ‘p’ value was calculated using independent t-test. The mean pain score for coblation technique averaged over 10 days was 2.72 and was 4.84 for dissection technique.Conclusions: We can conclude that coblation tonsillectomy is an easy to learn safe procedure with significant advantages in terms improving the quality of post-operative recovery compared to that following the cold dissection technique. But cost effectiveness of dissection method outweighs benefits of coblation at present in Indian scenario.

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Evaluation of Sports-Related Concussion in Children (5–12) and Adolescents (13–18)

Neurology ◽

10.1212/01.wnl.0000801848.01575.87 ◽

2021 ◽

Vol 98 (1 Supplement 1) ◽

pp. S12.3-S13

Author(s):

James Pate ◽

Ian Cummins ◽

Kasey Cooper ◽

James Mooney ◽

Marshall Chandler McLeod ◽

...

Keyword(s):

Demographic Data ◽

Skull Fracture ◽

Age Groups ◽

Child And Adolescent ◽

Return To Play ◽

Specific Outcome ◽

The Mean ◽

New Diagnosis ◽

Mean Time

ObjectiveThe objective of this study was to examine the association between sport/non-sport concussions as well as age and time to recovery after concussion diagnosis in children and adolescents.BackgroundThere is an ongoing debate between policy makers and medical specialists on when is the appropriate time to allow children to begin playing contact sports. This dilemma is important because sports are incredibly prevalent in our child and adolescent population today. There is still significant debate if age at time of concussion diagnosis is associated with long term affects and time to recovery.Design/MethodsOf the 725 patients who received a diagnosis of concussion at Children's of Alabama (COA) from 2018 to 2019, 350 patients were included for retrospective cohort review based on documented recovery data defined as follow up appointment PRN (as needed) or begin return to play protocol. 221 patients were lost to follow up while 7 were excluded for concomitant skull fracture. Recovery time, patient demographic data, symptoms severity score, and injury characteristics were then analyzed for each patient.ResultsOverall, the mean time of recovery after new diagnosis of any concussion was 87.2 days. The mean time to documented recovery in sports-related concussion was 82.6 days compared to 98.5 days in non-sports related concussion. Of note, both the 5–12 and 13–18 age groups had the same mean time to recovery at 87 days.ConclusionsSports related concussion showed decreased mean time to recovery compared to non-sports related concussion. Also, age did not play a factor in time to recovery as there was no difference in the 2 age groups. This data, along with the NCAA-DOD Care Consortium showing repetitive head injury during early adolescence is unrelated to brain health as measured by specific outcome measures, has the potential to provide valuable information for future policy on child and adolescent sports.

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EFFECTS OF SPRAYING 2,4-D AMINE ON COCCINELLID LARVAE

Canadian Journal of Zoology ◽

10.1139/z60-035 ◽

1960 ◽

Vol 38 (2) ◽

pp. 285-288 ◽

Cited By ~ 24

Author(s):

Jean B. Adams

Keyword(s):

Age Groups ◽

The Mean ◽

Main Effects ◽

Mean Time

When coccinellid larvae in six different age groups were sprayed with 2,4-D amine and then confined in glass vials, two main effects were seen: first, mortality was increased four times in all age groups; and secondly, the mean time to pupation increased in all age groups except the 1-day-old larvae.

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Extension block technique for mallet fractures: a comparison of one and two dorsal pins

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193416647725 ◽

2016 ◽

Vol 41 (7) ◽

pp. 701-706 ◽

Cited By ~ 2

Author(s):

U. Akgun ◽

T. Bulut ◽

E. C. Zengin ◽

M. Tahta ◽

M. Sener

Keyword(s):

Controlled Study ◽

Randomized Controlled ◽

Outcome Scores ◽

Level 3 ◽

The Mean ◽

Group 2 ◽

Mean Time ◽

Extensor Lag ◽

Group 1

The aim of this study was to compare the clinical and radiological outcomes of one or two dorsal pins for extension blocking of mallet fractures. We treated 36 mallet fractures with the extension block technique. A single pin was used in 19 fractures (Group 1) and two pins in 17 fractures (Group 2). The mean age was 33.6 years and the mean follow-up time was 12.2 months. All patients were assessed by the Crawford outcome score. Extensor lag and other complications were noted. All fractures united with a mean time of 6.0 weeks (4–9) in Group 1, and 6.1 weeks (4–7) in Group 2. We obtained 74% and 71% excellent and good outcome scores in Group 1 and in Group 2, respectively. The final extension lag was 6° in Group 1, and 7° in Group 2. No difference was found between the two groups in terms of clinical outcomes, radiological values and complications. Level 3 non-randomized controlled study.

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MP006: Review of clinical presentation and trajectory of patients with a diagnosis of primary brain tumour in a pediatric tertiary centre

CJEM ◽

10.1017/cem.2016.147 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S68-S68

Author(s):

J. Abou-Diab ◽

S. Gouin ◽

I. Bouhout ◽

A. Carret

Keyword(s):

Brain Tumour ◽

Brain Tumours ◽

Clinical Presentation ◽

Age Groups ◽

Nausea And Vomiting ◽

Primary Brain Tumour ◽

Clinical Presentations ◽

The Mean ◽

Mean Time ◽

Symptoms And Signs

Introduction: Recognition of life-threatening conditions, such as brain tumours, remains a challenge among pediatric patients. Few studies have described the implication of initial presentation, clinical evolution and healthcare system factors in diagnosis delay of brain tumours in children. We aimed to determine the clinical presentation patterns and health care trajectory of children with a diagnosis of primary brain tumour. Methods: A retrospective chart review in a pediatric university-affiliated hospital was conducted. Participants were all patients less than 18 years of age diagnosed with a brain tumour by neuroimaging between Jan 2003 and Dec 2014. Data were extracted from an institutional tumour registry and medical records. Results: From the registry, 288 patients were identified. The mean age at time of diagnosis was 7.44 ± 0.29 years. Most tumours were infra-tentorial (55%) and had astrocytic origin (29%). The majority (35%) had consulted only once prior to diagnosis, while 14% had consulted at least 4 times prior to diagnosis. The mean time between the onset of symptoms and diagnosis was 147 ± 19 days. The mean time between symptoms onset and first consultation was 84 ± 14 days. The most frequent symptoms and signs at onset and diagnosis were respectively: headache (44% vs 59%, p<0.01), nausea and vomiting (31% vs 58%, p<0.01) and abnormalities of gait (10% vs 32%, p<0.01). 129 patients (45%) were diagnosed in an Emergency Department (ED). Symptoms and signs that differed significantly for those diagnosed in an ED were: headache (71% vs 42%, p<0.01), nausea and vomiting (73 % vs 32%, p<0.01), lethargy (26% vs 9%, p<0.01), weight loss (15% vs 3%, p<0.01), irritability (9% vs 0%, p<0.01) and endocrine abnormality (2% vs 8%, p=0.02). Clinical presentations of infants up to one year of age (14%) differed from other age groups. They presented mostly with growth abnormality (46%), macrocephaly (40%), irritability (40%), development abnormalities (18%) and sun-setting eyes sign (10%). Conclusion: In this large comprehensive cohort, we have found that the diagnosis of primary brain tumours is most frequently made in the ED. Different clinical presentations have been identified and varied between different settings of diagnosis and different age groups.

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Role of tamsulosin in patients undergoing ESWL for renal and ureteric stones

International Surgery Journal ◽

10.18203/2349-2902.isj20205881 ◽

2020 ◽

Vol 8 (1) ◽

pp. 201

Author(s):

Gyan Prakash Singh ◽

Sabyasachi Panda ◽

Pradeepta Kumar Panda

Keyword(s):

Clearance Rate ◽

Controlled Study ◽

Control Group ◽

Stone Size ◽

Analgesic Requirement ◽

Stone Clearance ◽

Complete Clearance ◽

The Mean ◽

And Control ◽

Mean Time

Background: To determine the effect of tamsulosin, as adjunctive medical therapy on the outcome of extracorporeal shock wave lithotripsy (ESWL) for solitary renal and ureteric calculi.Methods: From January 2017 onwards, a prospective, randomized controlled study was conducted in patients with solitary renal or ureteral calculus measuring less than 20 mm undergoing ESWL. The study group (n=62) received 0.4 mg of tamsulosin daily till stone clearance or a maximum period of 12 weeks and control group (n=58) received ESWL only. Parameters assessed were stone size, composition, location, stone clearance, mean time to clearance, analgesic requirement, steinstrasse, need for hospitalization and/or auxiliary procedures.Results: There was no difference between the 2 groups with regards to age, stone size, location or composition. The complete clearance rate for renal stones was 62.7% and 36.5% (p=0.004) and for ureteric stone was 89.4% and 58.8% (p=0.03) in study and control groups, respectively. The control group had a higher rate of clinically insignificant residual fragments (CISF i.e. <3 mm), 12.9% versus 35.4% (p=0.002). There was no significant difference in the mean time to stone clearance (p=0.07) or in the incidence of steinstrasse formation (p=0.12). The mean analgesic requirement (p=0.01), need for auxiliary procedures and hospitalization (p=0.03) was significantly was higher in the control group.Conclusions: Tamsulosin increase the complete clearance rate and decrease the incidence of CISF. It also reduces analgesic requirement, need of additional procedures and hospitalization rate and might be useful as a routine adjunctive therapy following ESWL.

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Ultrasound Guided Popliteal Nerve Block For Various Ankle & Foot Surgeries

Indian journal of applied basic medical sciences ◽

10.48165/ijabms.2021.233704 ◽

2021 ◽

Vol 23 (2) ◽

pp. 39-57

Author(s):

Dipti Anandani ◽

Manisha Kapdi ◽

Bhakti Rajani

Keyword(s):

General Anaesthesia ◽

Nerve Block ◽

Age Groups ◽

Neurological Complications ◽

Ultrasound Guided ◽

Nerve Blocks ◽

The Mean ◽

Ultrasonographic Guidance ◽

Time Required ◽

Mean Time

Background: Ankle& foot surgeries are very common surgeries in various age groups like young & geriatric as well as in patients with comorbidities. Popliteal nerve block is one of multimodal Anaesthesia & analgesia for same. we have used ultrasound guided block to prevent complications &precise volume at a site for improving Characteristics of block. Aims of study: To study the technique of giving popliteal nerve blocks with ultrasonographic guidance and evaluate it in terms of: No of attempts, Time required for sensory and motor blockade, Quality of Intra operative analgesia, Duration for post-operative analgesia, Supplementation required in form of sedo analgesia/general anaesthesia & Complications encountered. Methods: We performed ultrasonography guided popliteal nerve block in 60 adult patients of ASA grade I/II/III undergoing foot and ankle surgeries. The volume of drug used was 20ml consisting of Lignocaine (1.5%) 10ml and Bupivacaine (0.5%) 10ml; Results: The mean time taken to conduct the block was 4.3±1.4 mins. The mean time taken for sensory onset was 3.8±1.1 mins. The mean time taken for motor onset was 7.0± 1.4 mins. The mean time taken for completing the surgery was 39.2±5.0 mins. The mean time taken for complete motor regression was 143.8±13.5 mins. The mean time taken for complete sensory regression was 184.8± 16.8 mins. The patients first complained of pain at the mean time of 239±22.4 mins. The patients have stable haemodynamic parameters: pulse rate, SBP, DBP throughout the operation. Failure of block was seen in 4 patients where supplementation in the form of Injection Midazolam 1mg IV and Injection Fentanyl 50microgm IV was given in 2 patients and general anaesthesia was given in 2 patients. No other neurological complications were noticed in our study. Conclusion: ultrasound guided Popliteal nerve block is safe& effective block for various ankle &foot surgeries.

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A Randomized Controlled Trial Comparing Er:YAG Laser and Rotary Bur in the Excavation of Caries - Patients' Experiences and the Quality of Composite Restoration

The Open Dentistry Journal ◽

10.2174/1874210601812010443 ◽

2018 ◽

Vol 12 (1) ◽

pp. 443-454 ◽

Cited By ~ 4

Author(s):

Roxana Sarmadi ◽

Elin Viktoria Andersson ◽

Peter Lingström ◽

Pia Gabre

Keyword(s):

Er:Yag Laser ◽

Controlled Trial ◽

Laser Technique ◽

Laser Method ◽

The Mean ◽

Time Required ◽

Mean Time ◽

Caries Lesions ◽

Single Blind

Objective: The aim of this study was to evaluate patients´ experiences of two excavation methods, Er:YAG laser and rotary bur and time required by the methods as well as objective assessments of quality and durability of restorations over a two-year period. Methods: A prospective, single-blind, randomized and controlled investigation was performed. Patients aged 15 to 40 years with at least two primary caries lesions, which had been radiographically assessed as of the same size, were recruited. In each patient, one cavity was excavated using rotary bur and one using Er:YAG laser technique. The time required for excavations and, where applicable, local anaesthesia, was measured during the treatments. Patient experiences were measured using questionnaires. The quality and durability of restorations were assessed over a two-year period in accordance with modified Ryges criteria and radiographs. Twenty-five patients (mean age 22.6 years) participated in the study. In total, 56 cavities were included of which 28 were treated with Er:YAG laser and 28 were treated with a rotary bur. Results: The patients associated the laser method with less discomfort. The mean time for excavation by laser was three times longer than by rotary bur (13.2 min vs. 4.3 min, P<0.0001). Over a two-year period, no statistically significant differences with regard to quality or durability could be seen between the restorations associated with the methods. Conclusion: The Er:YAG laser technique was more time-consuming than the rotary bur. Despite this, the laser technique caused less discomfort and was preferred as an excavation method by patients.

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