Comparison of combined intra-articular and sub-acromial injection with intra-articular injection in adhesive capsulitis

Background: The pain and limitation of shoulder function can disrupt daily activities of patients for months to years. Adhesive capsulitis is considered a self-limiting disease but the duration remains uncertain. The brunt of the disease is focussed on the inflamed joint capsule. On this basis, use of corticosteroid injection is justified. However, injection method is not conclusive. Objectives: To compare clinical benefits of intra-articular injection alone versus combined intra-articular and subacromial injections in management of adhesive capsulitis. Methods: Fifty-nine patients with diagnostic criteria for adhesive capsulitis were included in the study from March 2019 to September 2020. Patients were divided into two groups; patients who underwent intra-articular (IA) injection alone (Group 1) and those who received both intra-articular and sub-acromial (IA+SA) injection (Group 2). The injections were landmark guided. Patients were followed up at three, six, and 12 weeks. Pain was recorded using visual analogue scale (VAS) and subjective function using Constant-Murley score. Results: Twenty-eight patients were included in Group 1 (IA) and 31 in Group 2 (IA+SA). Thirty-six patients were female (18 each in Group 1 and Group 2) and 23 patients were male (Group 1 = 13; Group 2 = 10). In the twelfth week, VAS score was reduced in both the groups. On comparing the mean value of Constant-Murley score between the two groups there is significant difference in value recorded at the sixth and twelfth week. Conclusion: The IA+SA injection provides significant reduction in pain and better function in the short term over the IA injection.

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Repair Integrity and Functional Outcomes Between Knot-Tying and Knotless Suture-Bridge Arthroscopic Rotator Cuff Repair: A Prospective Randomized Clinical Trial

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211002482 ◽

2021 ◽

Vol 9 (4) ◽

pp. 232596712110024

Author(s):

Koray Şahin ◽

Fatih Şentürk ◽

Mehmet Ersin ◽

Ufuk Arzu ◽

Mechmet Chodza ◽

...

Keyword(s):

Rotator Cuff ◽

Constant Score ◽

Knot Tying ◽

Suture Bridge ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Cuff Repair ◽

Group 1

Background: Knot-tying suture-bridge (SB) rotator cuff repair may compromise the vascularity of the repaired tendon, causing tendon strangulation and medial repair failure. The knotless SB repair technique has been proposed to overcome this possibility and decrease retear rates. Purpose: To compare clinical and structural outcomes and retear patterns between the knot-tying and knotless SB techniques. We hypothesized that the knotless technique would result in lower retear rates owing to the preservation of intratendinous vascularity. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 104 patients with full-thickness rotator cuff tears were randomly and prospectively allocated to undergo knot-tying (group 1) or knotless (group 2) SB repair. Clinical outcome measures included range of motion, the visual analog scale (VAS) for pain, and the Constant score for function. Repair integrity was evaluated on magnetic resonance imaging scans using the Sugaya classification. Retears were also classified according to their pattern as type 1 (lateral) or type 2 (medial). Results: Overall, 88 patients (group 1: n = 42 [mean ± SD age, 54.3 ± 9.8 years]; group 2: n = 46 [mean ± SD age, 55.8 ± 8.2 years]) were included in the final analysis. The mean ± SD follow-up period was 25.4 ± 8.3 and 23.3 ± 7.2 months for groups 1 and 2, respectively. From preoperatively to postoperatively, the mean VAS pain score improved significantly in both groups (group 1: from 7.4 ± 1.7 to 1.0 ± 1.7; group 2: from 7.1 ± 1.9 to 1.3 ± 2.0; P < .0001 for both), as did the mean ± SD Constant score (group 1: from 51.7 ± 13.4 to 86.0 ± 11.5; group 2: from 49.4 ± 18.4 to 87.2 ± 14.8; P < .0001 for both). There was no significant difference between the groups for the postoperative VAS or Constant score. The retear rate was not significantly different between the groups (19.0% [8/42] in group 1 and 28.3% [13/46] in group 2; P > .05). There was a significant difference in the type 2 failure rate (75.0% [6/8] in group 1 and 23.1% [3/13] in group 2; P = .03). Conclusion: Both techniques showed excellent improvement and comparable clinical outcomes, and there was no significant difference in retear rates. Consistent with previously published data, the type 2 failure rate was significantly higher with the knot-tying technique. Registration: NCT03982108 ( ClinicalTrials.gov identifier).

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Growth evaluation in infants with neonatal cholestasis

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032006000400012 ◽

2006 ◽

Vol 43 (4) ◽

pp. 305-309

Author(s):

Camila Carbone Prado ◽

Roberto José Negrão Nogueira ◽

Antônio de Azevedo Barros-Filho ◽

Elizete Aparecida Lomazi da Costa-Pinto ◽

Gabriel Hessel

Keyword(s):

Intrahepatic Cholestasis ◽

Growth Parameters ◽

Neonatal Cholestasis ◽

Medical Visit ◽

Extrahepatic Cholestasis ◽

Significant Difference ◽

Z Scores ◽

The Mean ◽

Group 2 ◽

Group 1

BACKGROUD: Chronic liver diseases in childhood often cause undernutrition and growth failure. To our knowledge, growth parameters in infants with neonatal cholestasis are not available AIM: To evaluate the nutritional status and growth pattern in infants with intrahepatic cholestasis and extrahepatic cholestasis. PATIENTS AND METHODS: One hundred forty-four patients with neonatal cholestasis were followed up at the Pediatric Gastroenterology Service of the Teaching Hospital, State University of Campinas, Campinas, SP, Brazil, in a 23-year period, from 1980 to 2003. The records of these patients were reviewed and patients were classified into two groups, according to their anatomical diagnosis: patients with intrahepatic cholestasis - group 1, and patients with extrahepatic cholestasis - group 2. Records of weight and height measurements were collected at 4 age stages of growth, in the first year of life: 1) from the time of the first medical visit to the age of 4 months (T1); 2) from the 5th to the 7th month (T2); 3) from the 8th to the 10th month (T3); and 4) from the 11th to the 13th month (T4). The weight-by-age and height-by-age Z-scores were calculated for each patient at each stage. In order for the patient to be included in the study it was necessary to have the weight and/or height measurements at the 4 stages. Analyses of variance and Tukey's tests were used for statistical analysis. Repeated measurement analyses of variance of the weight-by-age Z-score were performed in a 60-patient sample, including 29 patients from group 1 and 31 patients from group 2. The height-by-age data of 33 patients were recorded, 15 from group 1 and 18 from group 2 RESULTS: The mean weight-by-age Z-scores of group 1 patients at the 4 age stages were: T1=-1.54; T2=-1.40; T3=-0.94; T4=-0.78. There was a significant difference between T2 X T3 and T1 X T4. The weight-by-age Z-scores for group 2 patients were :T1=-1.04; T2=-1.67; T3=-1.93 and T4=-1.77, with a significant difference between T1 X T2 and T1 X T4. The mean weight-by-age Z-scores also showed a significant difference between group 1 and group 2 at stages T3 and T4. The mean height-by-age Z-scores at the four stages in group 1 were: T1=-1.27; T2=-1.16; T3=-0.92 and T4=-0.22, with a significant difference between T3XT4 and T1XT4. The scores for group 2 patients were: T1=-0.93; T2=-1.89; T3=-2.26 and T4=-2.03, with a significant difference between T1XT2 and T1XT4. The mean height-by-age Z-scores also showed a significant difference between group 1 and group 2 at T3 and T4 CONCLUSION: The weight and height differences between the groups became significant from the 3rd measurement onward, with the most substantial deficit found in the extrahepatic group. In this group, there is evidence that the onset of weight and height deficit occurs between the first and second evaluation stages.

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Outcomes of coaxial microincision cataract surgery versus conventional phacoemulsification surgery

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v16i3.458 ◽

2019 ◽

Vol 16 (3) ◽

pp. 168-178

Author(s):

Anu Malik ◽

Smruti Ranjan Dethi ◽

Yogesh Kumar Gupta ◽

Alka Gupta

Keyword(s):

Cataract Surgery ◽

Randomized Study ◽

Corrected Visual Acuity ◽

Age Related ◽

Significant Difference ◽

Induced Astigmatism ◽

The Mean ◽

Group 2 ◽

Surgically Induced ◽

Group 1

Aim: To compare surgical parameters and visual outcomes of coaxial microincision cataract surgery (MICS) with standard phacoemulsification. Methods: A prospective randomized study was conducted on 60 eyes of 60 patients with age-related uncomplicated cataract who underwent: standard phacoemulsification surgery (30 eyes) i.e., Group 1, or coaxial MICS (30 eyes) i.e., Group 2. Intraoperative parameters were mean effective phacoemulsification power (EPP), effective phacoemulsification time (EPT), and total volume of balanced salt solution (BSS) used. Best-corrected visual acuity (BCVA) and surgically induced astigmatism (SIA) were evaluated pre- and postoperatively. Results: Mean BCVA at 6 weeks was 0.04 ± 0.07 in Group 1 and 0.05 ± 0.08 in Group 2. No significant difference was observed in SIA between the two groups. Mean EPT was 29.80 ± 3.67 seconds in Group 1 and 31.93 ± 4.08 seconds in Group 2. The mean total EPP in Group 1 was 35.77 ± 5.17%, whereas it was 33.70 ± 3.05% in Group 2. There was a significant statistical difference between mean EPP and EPT in the two groups. Mean total BSS volume used in Group 1 was 128.83 ± 19.81 ml, whereas it was 139.33 ± 13.57 ml in Group 2. Conclusion: Although EPT and BSS volume used were significantly higher in coaxial MICS, the postoperative results of the two techniques were comparable.

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Comparison of Changes in Number of Hyperreflective Dots After İntravitreal Ranibizumab or Dexamethasone İmplant in Patients with Branch Retinal Vein Occlusion

10.21203/rs.3.rs-736656/v1 ◽

2021 ◽

Author(s):

Aylin Karalezli ◽

Sema Kaderli ◽

Ahmet Kaderli ◽

Cansu Kaya ◽

Sabahattin Sul

Keyword(s):

First Year ◽

Intravitreal Ranibizumab ◽

Retinal Layers ◽

Vein Occlusion ◽

Significant Difference ◽

Group 3 ◽

The Mean ◽

Group 2 ◽

Group 1

Abstract Purpose: To compare the effect of intravitreal ranibizumab (IVR) or intravitreal dexamethasone implants (IVD) on regression of hyperreflective dots (HRDs) on optical coherence tomography (OCT) B-scan in patients with branch retinal vein occlusion (BRVO). Methods: 37 eyes of 37 patients with cystoid macular edema who received IVR or IVD and followed up for at least 12 months were included in this study. The patients were divided into three groups according to intravitreal treatment. Group 1 consisted of 12 eyes who received only IVD, group 2 consisted of 10 eyes who received only IVR on a pro re nata and group 3 consisted of 15 eyes who received both IVD and IVR. OCT parameters (CMT, number of HRDs, status of external limiting membrane (ELM) and ellipsoid zone (EZ)) and best-corrected visual acuity (BCVA) were compared between the groups over the follow-up time. HRDs were categorized as HRD in inner retinal layers (from the internal limiting membrane to the inner nuclear layer) or HRD in outer retinal layers (from the outer plexiform layer to the outer border of the photoreceptor layer).Results: There was no significant difference between groups in terms of BCVA, CMT, HRDs in the inner and the outer retinal layers at baseline visit. (p˃0.05 for all) Comparing the baseline values in all groups, a significant decrease was observed in CMT in the first year. (For group 1; p=0.013, group 2; p=0.010; group 3, p<0.001) The BCVA was significantly increased after 1 year in all groups. (p=0.001, p=0.006, p<0.001) The mean number of HRDs in inner and outer retinal layers were significantly decreased in group 1 and group 3. (For group 1; p<0.001, p=0.001, for group 3; p<0.001, p<0.001) However, there was no significant difference in terms of the mean number of HRDs in inner and outer retinal layers for group 2. (p=0.134, p=0.477) At the first year, the number of HRDs in inner and outer retinal layers was significantly lower in group 1 and group 3 than group 2. (For inner HRDs; group 1 vs. group 2 p=0.007, group 2 vs. group 3 p<0.001. For outer HRDs group 1 vs. group 2 p<0.001, group 2 vs. group 3 p<0.001.) The BCVA was higher in group 3 than group 2 at 1year. (p=0.048). There was no significant difference in terms of post-treatment CMT and the number of HRDs between group 1 and group3 in posthoc tests (p=0.621, p=0.876, and p=0.632).Conclusion: The reduction in HRDs at 12 months and better BCVA after IVD intimates that the HRDs should be considered as inflammatory markers in the follow-up of CME in BRVO. Thus, IVD injection could be more appropriate for patients with higher HRDs after BRVO.

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Arthroscopic Bankart repair with knotless suture anchors: A comparison of the permanent and absorbable types

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1177/2210491720953595 ◽

2020 ◽

Vol 27 (2) ◽

pp. 202-207

Author(s):

Abdulrahman D Algarni

Keyword(s):

External Rotation ◽

Shoulder Function ◽

Bankart Repair ◽

Suture Anchors ◽

Glenohumeral Instability ◽

Arthroscopic Bankart Repair ◽

Significant Difference ◽

Functional Scores ◽

Group 2 ◽

Group 1

Aim: The aim of this study was to compare the clinical outcomes of arthroscopic Bankart repair (ABR) using two types of knotless suture anchors (KSAs) in patients with post-traumatic recurrent anterior glenohumeral instability (AGHI). Methods: Thirty-two patients underwent an ABR using KSAs: a permanent KSA (PushLock) and an absorbable counterpart (BioKnotless). There were 16 patients in each group. Pre-and post-operative assessment for shoulder function using the American Shoulder and Elbow Surgeons and Constant–Murley scores, recurrence of instability, post-operative limitation of external rotation (ER) and ability to return to pre-injury level were recorded in both groups. Results: Both groups displayed significant improvements in functional scores ( p < 0.0001) without a significant difference between the groups. Of the 32 patients, 9.4% had recurrence of instability (one re-dislocation in group 1 and two symptomatic subluxations in group 2). Return to pre-injury level occurred in 87.5% and 81.3% of group 1 and group 2, respectively. There was 2° to 3° loss of ER after ABR in both groups; the difference between the groups was not significant ( p = 0.45). Conclusion: ABR for recurrent AGHI using a permanent or absorbable KSA offers comparable successful outcomes; no significant statistical difference was found.

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Changes in the Rate of Postoperative Flexor Tendon Rupture in Patients with Distal Radius Fractures

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s242483552050054x ◽

2020 ◽

Vol 25 (04) ◽

pp. 481-488

Author(s):

Rui Hirasawa ◽

Eichi Itadera ◽

Seiji Okamoto

Keyword(s):

Distal Radius ◽

Tendon Rupture ◽

Flexor Tendon ◽

Major Complication ◽

Significant Difference ◽

Flexor Tendon Rupture ◽

Tendon Ruptures ◽

The Mean ◽

Group 2 ◽

Group 1

Background: Flexor tendon rupture is a major complication after volar locking plating for distal radius fracture (DRF). Few studies have investigated changes in the rate of postoperative flexor tendon rupture in patients with DRFs. The present study aimed to investigate the changes in the rate of postoperative flexor tendon rupture and to assess plate placement and reduction positions. Methods: We retrospectively reviewed patients in whom more than 24 months had passed since DRF surgery. The patients were interviewed by telephone. Forty-nine patients (50 fractures; 2007–2009) from institution A were included in group 1 and 81 patients (84 fractures; 2013–2016) from institution B were included in group 2. The DRF surgery method was similar between the two groups. The rate of flexor tendon rupture, Soong classification grade, and radiological index (i.e., volar tilt [VT], radial inclination [RI], and ulnar variance [UV]) were statistically investigated in both groups. Results: Patient epidemiology was not significantly different between the two groups. The flexor tendon rupture rates were 2% and 0% in groups 1 and 2, respectively, without a significant difference. With regard to the Soong grade, 44 fractures were grade 2 and 6 were grade 1 in group 1, whereas 18 were grade 2, 38 were grade 1, and 28 were grade 0 in group 2, with a significant difference (p < 0.05). With regard to the radiological index, the mean VT values were 5° and 11° in groups 1 and 2, respectively, with a significant difference (p < 0.05). However, RI and UV showed no significant difference. Conclusions: Plate placement and reduction positions, which are risk factors for flexor tendon ruptures after DRFs, have improved recently when compared with previous findings. With these changes, the rate of flexor tendon rupture is presumed to have decreased.

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Orthosiphon versus Placebo in Nephrolithiasis with Multiple Chronic Complaints: A Randomized Control Trial

Evidence-based Complementary and Alternative Medicine ◽

10.1093/ecam/nem141 ◽

2009 ◽

Vol 6 (4) ◽

pp. 495-501 ◽

Cited By ~ 7

Author(s):

Amorn Premgamone ◽

Pote Sriboonlue ◽

Srinoi Maskasem ◽

Wattana Ditsataporncharoen ◽

Bungornsri Jindawong

Keyword(s):

Myofascial Pain ◽

White Blood Cells ◽

Analog Scale ◽

Significant Difference ◽

Before And After ◽

The Mean ◽

Randomized Control ◽

Group 2 ◽

Primary Measure ◽

Group 1

Nephrolithiasis in the communities of Northeast Thailand frequently presents with multiple chronic health complaints, i.e. myofascial pain, back pain, dyspepsia, arthralgia, headache, fatigue, frank paresthesia, dysuria and any of these aggravated by purine-rich food (PRF). We assessed the efficacy of Orthosiphon in treating subjects with at least two active symptoms and negative for urine white blood cells. Subjects were randomly allocated to two groups. Crude extract of Orthosiphon given in a capsule (equivalent to 1.6–1.8 g of dried leaves of Orthosiphon) two times a day to Group 1 (n= 36) and a placebo to Group 2 (n= 40) for 14 days. The medication for each subject was packed and its code kept secret until the data analysis. Both groups were asked not to consume any of 25 purine-rich foods (PRFs) during treatment. The primary measure was the reduced sum of active severity symptoms as recorded using the visual analog scale before and after therapy (i.e. on day 7 and 14). The data on 76 subjects were processed. The mean of the total scores (95% CI) of the symptoms in each group were decreased significantly (P< 0.001); 185.6 (153.3, 218.0) to 94.7 (58.2, 131.2) in the Orthosiphon group and 196.1 (164.4, 227.8) to 89.6 (62.8, 116.5) in the placebo group. When comparing between groups, no statistically significant difference was found. The mean consumption in PRFs was significantly decreased (P< 0.001) in both groups; however, Orthosiphon did not have additional benefit over placebo at 7 and 14 days of treatment during which they reduced these foods.

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Effects of Acupuncture on the Symptoms of Anxiety and Depression Caused by Premenstrual Dysphoric Disorder

Acupuncture in Medicine ◽

10.1136/acupmed-2013-010394 ◽

2013 ◽

Vol 31 (4) ◽

pp. 358-363 ◽

Cited By ~ 15

Author(s):

Fabiana Carvalho ◽

Kelly Weires ◽

Márcia Ebling ◽

Maristela de Souza Rabbo Padilha ◽

Ygor Arzeno Ferrão ◽

...

Keyword(s):

Rating Scales ◽

Premenstrual Dysphoric Disorder ◽

Randomised Clinical Trial ◽

Sham Acupuncture ◽

Anxiety And Depression ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Single Blind ◽

Group 1

Objective The objective of this investigation was to evaluate the effects of acupuncture and sham acupuncture on the symptoms of anxiety and depression brought on by premenstrual dysphoric disorder (PMDD). Methods In a single-blind randomised clinical trial, 30 volunteers with PMDD were assigned alternately to group 1 (acupuncture) or group 2 (sham acupuncture), and completed an evaluation of symptoms of anxiety and depression using the Hamilton Anxiety (HAM-A) and Hamilton Depression (HAM-D) Rating Scales. The procedure was performed twice a week for two menstrual cycles, for a total of 16 attendances for each participant. Results Before the intervention the mean HAM-A and HAM-D scores did not differ between groups. Following the intervention symptoms of anxiety and depression were reduced in both groups; however, the improvement was significant in group 1 compared to group 2, as shown by a mean reduction in HAM-A scores of 58.9% in group 1 and 21.2% in group 2 (p<0.001). The reduction in the mean HAM-D scores was 52.0% in group 1 and 19.6% in group 2, resulting in a significant difference (p=0.012). Conclusions The results suggest that acupuncture could be another treatment option for PMDD patients.

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Effects of eliminating tension by means of epineural stitches: a comparative electrophysiological and histomorphometrical study using different suture techniques in an animal model

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2011000300019 ◽

2011 ◽

Vol 69 (2b) ◽

pp. 365-370 ◽

Cited By ~ 4

Author(s):

J Bustamante ◽

M Socolovsky ◽

R S Martins ◽

J Emmerich ◽

M G Pennini ◽

...

Keyword(s):

Test Results ◽

Motor Action ◽

Nerve Suture ◽

Group 4 ◽

Significant Difference ◽

Group 3 ◽

The Mean ◽

Group 2 ◽

Human Nerve ◽

Group 1

Epineural stitches are a means to avoid tension in a nerve suture. We evaluate this technique, relative to interposed grafts and simple neurorraphy, in a rat model. METHOD: Twenty rats were allocated to four groups. For Group 1, sectioning of the sciatic nerve was performed, a segment 4 mm long discarded, and epineural suture with distal anchoring stitches were placed resulting in slight tension neurorraphy. For Group 2, a simple neurorraphy was performed. For Group 3, a 4 mm long graft was employed and Group 4 served as control. Ninety days after, reoperation, latency of motor action potentials recording and axonal counts were performed. Inter-group comparison was done by means of ANOVA and the non-parametric Kruskal-Wallis test. RESULTS: The mean motor latency for the simple suture (2.27±0.77 ms) was lower than for the other two surgical groups, but lower than among controls (1.69±0.56 ms). Similar values were founding in both group 1 (2.66±0.71 ms) and group 3 (2.64±0.6 ms). When fibers diameters were compared a significant difference was identified between groups 2 and 3 (p=0.048). CONCLUSION: Good results can be obtained when suturing a nerve employ with epineural anchoring stitches. However, more studies are needed before extrapolating results to human nerve sutures.

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Comparison of the results of percutaneous nephrolithotomy in different age groups

International Surgery Journal ◽

10.18203/2349-2902.isj20185013 ◽

2018 ◽

Vol 5 (12) ◽

pp. 3888

Author(s):

Ali Borekoglu ◽

Ibrahim Atilla Aridogan ◽

Mutlu Deger ◽

Onur Karsli ◽

Volkan Izol

Keyword(s):

Blood Transfusion ◽

Percutaneous Nephrolithotomy ◽

Preoperative Evaluation ◽

Control Group ◽

Perioperative Bleeding ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

And Control ◽

Group 1

Background: Evaluation of feasibility, safety and effectiveness of percutaneous nephrolithotomy (PCNL) in different age groups.Methods: Between July 1997-October 2012, 233 patients who were 65 years old and older were included in this study. These patients were divided into two age subgroups used in gerontology research. Group 1 was defined as patients 65-74 years old, Group 2 was older than 74 years old. Data from patient records, including demographic characteristics, preoperative evaluation, operative details, and complications were retrospectively analyzed and compared with control group data.Results: The mean age of 233 patients was 69.7±4.6 years. The mean operative times for Group 1, group 2 and the control group were 76.2±47.3mins, 92.9±47.6mins, 77±44mins, respectively and there was no statistically significant difference between groups 1 and 2 and the control group (p>0.05). Twenty-eight of the 233 patients (12%) needed blood transfusion due to perioperative bleeding. The transfusion rates of groups 1 and 2 were 11.3% and 16.7%, respectively. There was no statistically significant difference between the study groups and control group for blood transfusion rates (p>0.05). There was no statistically significant difference in complications between the study and control groups (p>0.05).Conclusions: In geriatric patients, stone-free rates, transfusion rates and other operation parameters are similar to younger populations when experienced surgeons perform PCNL. Despite comorbidities and decreased body reserve, PCNL can be performed without a significant increase in complications in different ages.

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