Outcome of Endoscopic Sphenopalatine Artery Cauterization for Posterior Epistaxis

Introduction Epistaxis is a common otorhinolaryngology emergency condition. Majority of it is anterior epistaxis which usually improves with conservative management. However, for posterior epistaxis, apart from posterior nasal packing, endoscopic sphenopalatine artery cauterization (ESPAC) is considered an effective measure for its control. Hence, this study was conducted to evaluate the outcome of endoscopic sphenopalatine artery cauterization for posterior epistaxis. MethodsRetrospective medical chart review of patients who underwent endoscopic sphenopalatine artery cauterization for posterior epistaxis from January to December 2018 at Ganesh Man Singh Memorial Academy of ENT-Head & Neck Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. ResultsA total of 31 patients (21 males and 10 females) underwent ESPAC during the one-year period. Twenty-seven of them were unilateral whilst four were bilateral. Four of them rebled, of which two bled within 48 hours and the remaining two after two months. The overall success rate of ESPAC was 87.1% (27/31). ConclusionEndoscopic sphenopalatine artery cauterization is an effective measure to control posterior epistaxis.

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An Evaluation of Potential Inappropriate Prescribing Among Older Persons in Nigeria

Global Journal of Health Science ◽

10.5539/gjhs.v10n11p28 ◽

2018 ◽

Vol 10 (11) ◽

pp. 28

Author(s):

Sule A Saka ◽

Frasia Oosthuizen ◽

Manimbulu Nlooto

Keyword(s):

Logistic Regression ◽

Older Persons ◽

Chart Review ◽

Inappropriate Prescribing ◽

Binary Logistic Regression ◽

University Teaching ◽

Beers Criteria ◽

Retrospective Evaluation ◽

Medical Chart Review ◽

Chi Squared

Potential Inappropriate prescribing (PIP), Drug-Drug interactions (DDI) and polypharmacy are major risk factors for adverse drug reactions among older persons. Although these factors in many cases co-exist in prescriptions to older persons, very few studies have evaluated the inter-relationship between these factors concomitantly. This study aimed to evaluate PIP and DDI and to determine the associations between PIP, DDI, and polypharmacy among Nigerian older persons. This study was a retrospective evaluation of medicine utilization among older persons at Olabisi Onabanjo University Teaching Hospital, Nigeria, using a medical chart review. Older persons aged ≥60 years, with chronic diseases that attended the medical outpatient clinics of the hospital between 1st January and 31st December 2016 were included. Eligible patients’ records were randomly sampled. Information including patients’ demographics, medical and medication histories and current medications were extracted with a checklist. PIP and DDI were evaluated using the 2015 updated Beers Criteria. Associations were determined using Chi-squared test and a binary logistic regression. A total of 352 participants, mean age 69.03±7.35 years were evaluated. According to the Beers Criteria, PIP and DDI among the participants were (124/352, 35.2%) and (20/352, 5.7%) respectively. Majority of the participants (192/352, 54.5%) received polypharmacy. A few participants (12/352. 3.4%) received prescriptions containing PIP, DDI, and polypharmacy concomitantly. DDI was significantly associated with PIP in a logistic regression (OR=0.18, 95%CI=0.05-0.68, p=0.01) and with polypharmacy in a Chi-squared test (OR=3.55, 95%CI=1.16-10.83, p=0.02). This study concludes that PIP, DDI and polypharmacy are interrelated and should be considered when prescribing to older persons.

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Combined Phacoendoscopic Cyclophotocoagulation versus Combined Phacotrabeculectomy in the Management of Coexisting Cataract and Glaucoma: A Comparative Study

Journal of Ophthalmology ◽

10.1155/2018/5149154 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Charles Sing Lok Lau ◽

Jeffrey Chi Wang Chan ◽

Sophia Fei So ◽

Orlando Chia Chieh Chan ◽

Kenneth Kai Wang Li

Keyword(s):

Success Rate ◽

Surgical Procedures ◽

Surgical Intervention ◽

Operation Time ◽

Macula Edema ◽

One Year ◽

The One ◽

Significant Cataract ◽

Cystoid Macula Edema

Purpose. To compare the surgical outcome of combined phacoemulsification and endoscopic cyclophotocoagulation (phacoECP) versus combined phacoemulsification and mitomycin C-augmented trabeculectomy (phacoTbx) in patients with coexisting glaucoma and visually significant cataract. Methods. A retrospective review of 89 eyes of 89 patients who received phacoECP (N=49) and phacoTbx (N=40) was carried out at a tertiary eye center in Hong Kong. The minimum follow-up period was 6 months. Criterion of success was reduction of IOP at least 30% or absolute IOP of 15 mmHg or below without (complete success) or with (qualified success) antiglaucomatous medication. Results. PhacoTbx had more reduction of antiglaucomatous medication (4 vs 1, P<0.001). At postoperative year one, there was more IOP reduction for phacoTbx than phacoECP (8 mmHg vs 3 mmHg, P=0.012). The one-year complete success rate was also higher for phacoTbx (46.2% vs 8.2%, P<0.001), while qualified success was comparable between the 2 groups (74.4% vs 73.5%, P=0.925). Operation time was shorter for phacoECP (37 vs 73 minutes, P<0.001). The number of postoperative follow-up visits was less (6 vs 11.5, P<0.001) for phacoECP. Additional surgical procedures were more common in phacoTbx (55% vs 0%, P<0.001). There was no postoperative cystoid macula edema, hypotony, or endophthalmitis reported in both groups. Conclusions. PhacoECP is significantly less effective than phacoTbx in reduction of both IOP and number of antiglaucomatous medications for patients with medically uncontrolled glaucoma and cataract. Its complete success rate is also significantly lower than that of phacoTbx. With its comparable qualified success, shorter operation time, less number of postoperative visits, and secondary surgical intervention, phacoECP may still have a role in very selected cases.

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Health Impact of Community-Based Water Treatment Systems in Honduras

Journal of Anthropology ◽

10.1155/2011/929860 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Jeffery Deal

Keyword(s):

Water Treatment ◽

Health Impact ◽

Test Results ◽

Community Based ◽

Medical Chart Review ◽

Access To Water ◽

One Year ◽

The One ◽

Initial Results ◽

Protozoan Species

This paper provides a followup on a previous report in this journal on the health impact of providing access to water treatment and flush toilets to region of Honduras. Significant reductions were found in the one-year incidence of positive test results for the three protozoan species tested. This finding combined with the previously reported ethnographic and medical chart review data provides compelling evidence that such interventions significantly reduce the disease load from waterborne pathogens within this population. Furthermore, the finding that initial results are significantly different, even in the initial round of testing, if individuals who are not followed up are eliminated from the analysis has profound methodological implications which warrant further investigation and demonstrates the need for precise definitions of community in future studies.

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Nonsurgical Management of Apical Root Perforation Using Mineral Trioxide Aggregate

Case Reports in Dentistry ◽

10.1155/2021/5583909 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Omar Alzahrani ◽

Faisal Alghamdi

Keyword(s):

Success Rate ◽

Mineral Trioxide Aggregate ◽

Apical Part ◽

Success Rates ◽

Nonsurgical Management ◽

Gutta Percha ◽

Tissue Healing ◽

Root Canal Retreatment ◽

One Year ◽

The One

This study illustrates a conservative approach to nonsurgical management of apical root perforation in maxillary first molars. A patient was referred for retreatment of a maxillary left first molar. Her chief complaint was dull pain while biting in her maxillary left first molar. Periapical radiography showed radiolucency related to the mesiobuccal root and overextended gutta-percha through a perforation in the apical part of the distobuccal root. A CBCT scan was acquired and revealed the location and size of the apical perforation. The clinical examination showed that the tooth has been endodontically treated and the canals were filled, tender to percussion and palpation. Thus, the nonsurgical root canal retreatment was done and the perforation site was repaired by using mineral trioxide aggregate (MTA). At the one-year follow-up, after the management of apical root perforation, we observed periapical tissue healing and no pain due to percussion and palpation, without any clinical/radiological signs or symptoms. The prognosis of this case has a higher success rate with the development of new materials such as MTA. The MTA not only can seal the site of the perforation but also has the ability to induce calcification. Many factors can contribute to the success rate of perforated cases, including time, size, and location of the perforation. With the use of this material and good tools like a microscope, there are those with having higher chances of repair and eventually higher success rates.

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Role of Contact with Tuberculous Patients in Cases of Tuberculous Cervical Lymphadenitis.

Journal of Nepal Medical Association ◽

10.31729/jnma.570 ◽

2004 ◽

Vol 43 (152) ◽

pp. 79-82

Author(s):

D K Baskota ◽

RCM Amatya ◽

RP Shrivastav ◽

BK Sinha

Keyword(s):

Communicable Disease ◽

Disease Process ◽

Neck Surgery ◽

Cross Sectional Study ◽

University Teaching ◽

Cervical Lymphadenitis ◽

Cross Sectional ◽

History Of ◽

One Year

A prospective, analytical and cross-sectional study to find out the role of contact with tuberculous patientsduring the process of development of Tuberculous Cervical Lymphadenitis was currently carried out in theDepartment of ENT- Head & Neck Surgery of Tribhuvan University Teaching Hospital Kathmandu, Nepal.Altogether 103 cases of histopathologically confirmed cases of Tuberculous Cervical Lymphadenitis of morethan six weeks of duration were included in the study during the period of one year from March, 2000 toFebruary, 2001.History of contact with tuberculous patients in the past during the development of the disease process wasfound to be positive in 19(18.4%) of the 103 cases. In rest of the 84 cases history of contact with tuberculouspatients was found to be negative (81.6%).The result of this study so far indicates that there is a minimal role of contact with tuberculous patients forthe development of tuberculous cervical lymphadenitis. Although tuberculosis is known as a chroniccommunicable disease, in our study majority cases of Tuberculous Cervical Lymphadenitis did not give anyhistory of contact with tuberculous patients in the past.Key Words: Tuberculous cervical lymphadenitis, tuberculous patients, communicable disease.

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Prevalence of Post Tonsillectomy Haemorrhage at a Tertiary Care Centre in Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.5831 ◽

2021 ◽

Vol 59 (234) ◽

Author(s):

Prashant Tripathi ◽

Rohita Bajracharya ◽

Kunjan Acharya ◽

Bijaya Kharel ◽

Yogesh Neupane ◽

...

Keyword(s):

Chart Review ◽

Tertiary Care ◽

Neck Surgery ◽

Sleep Apnoea ◽

University Teaching ◽

Care Centre ◽

Recurrent Tonsillitis ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Obstructive Sleep

Introduction: Tonsillectomy is one of the common ENT surgical procedures. Post-tonsillectomy haemorrhage remains a frequent complication which can be potentially life-threatening. The objective of the present study was to calculate the prevalence of haemorrhage following a tonsillectomy at a tertiary care centre. Methods: It was a descriptive cross-sectional study performed by medical chart review of the patients who underwent tonsillectomy from January 2018 to December 2019 at the department of ENT- Head and Neck Surgery of Tribhuvan University Teaching Hospital. Ethical approval was obtained from the institutional review committee (Ref:-282(6-11) E2 076/077). Convenient sampling method was used. All patients of any age who had tonsillectomy for recurrent tonsillitis or tonsillar hypertrophy with or without obstructive sleep apnoea and no missing information on chart review were included in the study. Data were entered in MS-Excel 2007 and analyzed in rate and percentage. Results: Ten (5.18%) out of a total of 193 patients who underwent tonsillectomy had a post tonsillectomy haemorrhage. All 10 (100%) were adults patients, operated for recurrent tonsillitis, and used electrocautery. It was common in male patients 7 (70%). All of the haemorrhages was between a third and sixth postoperative day and were mild in severity. Conclusions: The prevalence of post-tonsillectomy haemorrhage was high at our centre during the study period of two years. It was common in adults, males and surgery done for recurrent tonsillitis using electrocauterization.

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Resources: Internet Resources for the Independent Medical Evaluator – 2007

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2007.julaug02 ◽

2007 ◽

Vol 12 (4) ◽

pp. 4-7

Author(s):

Christopher R. Brigham ◽

Jenny Walker

Keyword(s):

Head Trauma ◽

Clonic Seizure ◽

Acute Subdural Hematoma ◽

Orbital Fracture ◽

Orbital Wall ◽

First Occurrence ◽

One Year ◽

The One ◽

Neurological Injuries ◽

Medial Orbital Wall

Abstract Rating patients with head trauma and multiple neurological injuries can be challenging. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, Section 13.2, Criteria for Rating Impairment Due to Central Nervous System Disorders, outlines the process to rate impairment due to head trauma. This article summarizes the case of a 57-year-old male security guard who presents with headache, decreased sensation on the left cheek, loss of sense of smell, and problems with memory, among other symptoms. One year ago the patient was assaulted while on the job: his Glasgow Coma Score was 14; he had left periorbital ecchymosis and a 2.5 cm laceration over the left eyelid; a small right temporoparietal acute subdural hematoma; left inferior and medial orbital wall fractures; and, four hours after admission to the hospital, he experienced a generalized tonic-clonic seizure. This patient's impairment must include the following components: single seizure, orbital fracture, infraorbital neuropathy, anosmia, headache, and memory complaints. The article shows how the ratable impairments are combined using the Combining Impairment Ratings section. Because this patient has not experienced any seizures since the first occurrence, according to the AMA Guides he is not experiencing the “episodic neurological impairments” required for disability. Complex cases such as the one presented here highlight the need to use the criteria and estimates that are located in several sections of the AMA Guides.

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Catheter-directed foam sclerotherapy treatment of saphenous vein incompetence

VASA ◽

10.1024/0301-1526/a000174 ◽

2012 ◽

Vol 41 (2) ◽

pp. 120-124 ◽

Cited By ~ 11

Author(s):

Asciutto ◽

Lindblad

Keyword(s):

Saphenous Vein ◽

Short Term ◽

Foam Sclerotherapy ◽

Results Of Treatment ◽

Ulcer Healing Rate ◽

Complete Obliteration ◽

Ceap Classification ◽

One Year ◽

The One

Background: The aim of this study is to report the short-term results of catheter-directed foam sclerotherapy (CDFS) in the treatment of axial saphenous vein incompetence. Patients and methods: Data of all patients undergoing CDFS for symptomatic primary incompetence of the great or small saphenous vein were prospectively collected. Treatment results in terms of occlusion rate and patients grade of satisfaction were analysed. All successfully treated patients underwent clinical and duplex follow-up examinations one year postoperatively. Results: Between September 2006 and September 2010, 357 limbs (337 patients) were treated with CDFS at our institution. Based on the CEAP classification, 64 were allocated to clinical class C3 , 128 to class C4, 102 to class C5 and 63 to class C6. Of the 188 patients who completed the one year follow up examination, 67 % had a complete and 14 % a near complete obliteration of the treated vessel. An ulcer-healing rate of 54 % was detected. 92 % of the patients were satisfied with the results of treatment. We registered six cases of thrombophlebitis and two cases of venous thromboembolism, all requiring treatment. Conclusions: The short-term results of CDFS in patients with axial vein incompetence are acceptable in terms of occlusion and complications rates.

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Regional household poverty and mobility analysis – a transition probability approach

Nierówności społeczne a wzrost gospodarczy ◽

10.15584/nsawg.2020.3.15 ◽

2020 ◽

Vol 63 (3) ◽

pp. 286-302

Author(s):

Damian Mowczan ◽

Keyword(s):

Transition Probability ◽

General Level ◽

Transition Matrices ◽

Equivalent Unit ◽

Central Statistical ◽

Per Capita ◽

Probability Matrices ◽

General Mobility ◽

One Year ◽

The One

The main objective of this paper was to estimate and analyse transition-probability matrices for all 16 of Poland’s NUTS-2 level regions (voivodeship level). The analysis is conducted in terms of the transitions among six expenditure classes (per capita and per equivalent unit), focusing on poverty classes. The period of analysis was two years: 2015 and 2016. The basic aim was to identify both those regions in which the probability of staying in poverty was the highest and the general level of mobility among expenditure classes. The study uses a two-year panel sub-sample of unidentified unit data from the Central Statistical Office (CSO), specifically the data concerning household budget surveys. To account for differences in household size and demographic structure, the study used expenditures per capita and expenditures per equivalent unit simultaneously. To estimate the elements of the transition matrices, a classic maximum-likelihood estimator was used. The analysis used Shorrocks’ and Bartholomew’s mobility indices to assess the general mobility level and the Gini index to assess the inequality level. The results show that the one-year probability of staying in the same poverty class varies among regions and is lower for expenditures per equivalent units. The highest probabilities were identified in Podkarpackie (expenditures per capita) and Opolskie (expenditures per equivalent unit), and the lowest probabilities in Kujawsko-Pomorskie (expenditures per capita) and Małopolskie (expenditures per equivalent unit). The highest level of general mobility was noted in Małopolskie, for both categories of expenditures.

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From Scarcity to Abundance: Achieving Quality-Assured Mass Higher Education

Online Learning ◽

10.24059/olj.v15i2.181 ◽

2011 ◽

Vol 15 (2) ◽

Author(s):

Peter P. Smith

Keyword(s):

Higher Education ◽

Knowledge Economy ◽

Good Practice ◽

The United States ◽

The Other ◽

Secondary System ◽

Mass Higher Education ◽

Post Secondary ◽

One Year ◽

The One

The United States is in a bind. On the one hand, we need millions of additional citizens with at least one year of successful post-secondary experience to adapt to the knowledge economy. Both the Gates and Lumina Foundations, and our President, have championed this goal in different ways. On the other hand, we have a post-secondary system that is trapped between rising costs and stagnant effectiveness, seemingly unable to respond effectively to this challenge. This paper analyzes several aspects of this problem, describes changes in the society that create the basis for solutions, and offers several examples from Kaplan University of emerging practice that suggests what good practice might look like in a world where quality-assured mass higher education is the norm.

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