scholarly journals Endoscopic versus conventional method for partial inferior turbinectomy in chronic hypertrophic rhinitis

2013 ◽  
Vol 2 (2) ◽  
pp. 102-107 ◽  
Author(s):  
Shiwani Rai ◽  
V Sharma ◽  
K Koirala ◽  
AC Sharma
Keyword(s):  
Nasal Obstruction ◽  
Conventional Method ◽  
Controlled Trial ◽  
Inferior Turbinate ◽  
Change Score ◽  
Exact Test ◽  
Endoscopic Method ◽  
Significant Difference ◽  
Chronic Hypertrophic Rhinitis ◽  
Endoscopic Group

Background: The main goal of inferior turbinate surgery is to relieve obstruction while preserving the function of the turbinates as much as possible. Partial inferior turbinectomy (PIT) is an accepted and effective treatment in relieving the nasal obstruction while preserving the turbinate function. The use of endoscope provides complete visualization of the operating field and thus decreases the risk of excessive or inadequate resection. Methods: A prospective single blinded randomized controlled trial was carried out in Department of ENT, Manipal Teaching Hospital, Pokhara, Nepal from September 2008 to March 2010 with an objective to compare between the conventional and endoscopic method of PIT in terms of outcome and post-operative morbidity in chronic hypertrophic rhinitis. Hundred cases were taken and assigned randomly into two groups; i.e. endoscopic PIT and conventional PIT. The post-operative findings were compared between the two groups using Fischer Exact test for proportion and t test for mean. Results: There was 94% improvement in nasal obstruction in conventional group and 100% in endoscopic group at 1 month whereas improvement was 100% in both the groups at 3 months. Though no significant difference was seen statistically yet improvement was more in endoscopic group. There was significant difference in the SNOT 22 change score between endoscopic and conventional method at 1 month and 3 months. Significantly higher rates of post- operative morbidities were seen in case of conventional PIT at 1 month. Conclusion: Endoscopic PIT is better than conventional in terms of improvement in nasal obstruction and decreased postoperative morbidity. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 102-107 DOI: http://dx.doi.org/10.3126/njms.v2i2.8945

A double-blind placebo-controlled trial of perioperative prophylactic antibiotics for elective neurosurgery

1988 ◽  
Vol 69 (5) ◽  
pp. 687-691 ◽  
Author(s):  
Ross Bullock ◽  
James R. van Dellen ◽  
William Ketelbey ◽  
S. Gustav Reinach
Keyword(s):  
Controlled Trial ◽  
Prophylactic Antibiotics ◽  
Risk Of Infection ◽  
Broad Spectrum Antibiotic ◽  
Wound Sepsis ◽  
Double Blind ◽  
Content Type ◽  
Exact Test ◽  
Significant Difference ◽  
To Receive

✓ In this study, 417 patients undergoing “clean” elective neurosurgical operative procedures were randomized to receive a broad-spectrum antibiotic (piperacillin) or placebo given as three perioperative doses, each 6 hours apart. Randomization was carried out by hospital pharmacists, and the investigators remained blinded until the end of the study. Twenty cases were excluded from analysis because either an unforeseen second operation was performed or antibiotic therapy was initiated within 30 days after surgery to treat infection or the risk of infection. Twelve of the 205 patients treated with placebo developed postoperative wound sepsis, and four of the 192 piperacillin-treated patients developed wound sepsis — a statistically significant difference (p < 0.05, Fisher's exact test). Piperacillin thus appeared to reduce the incidence of neurosurgical wound infection in this study.

scholarly journals Anterior Trimming vs Outer Displacement of Inferior Turbinate: A Comparative Study at a Tertiary Care Hospital

1969 ◽  
Vol 11 (3) ◽  
pp. 169-174
Author(s):  
Habib-Ur-Rehman ◽  
Fazal-I-Wahid ◽  
BakhtZada ◽  
Muhammad Javaid ◽  
Naseemul Haq
Keyword(s):  
Comparative Study ◽  
Nasal Obstruction ◽  
Objective Assessment ◽  
Tertiary Care ◽  
Adhesion Formation ◽  
Inferior Turbinate ◽  
Care Hospital ◽  
Female Ratio ◽  
Significant Difference ◽  
Group A

Background: Obstruction of nose due to enlargement of inferior turbinate is a very common problem faced by ENT surgeon.In thisstudy a usefultechnique for treatment of inferior turbinate hypertrophy is described.Objective:To determine the surgical outcome and complications ofthe two surgicalprocedures.Material and Methods: This non-randomized comparative study was performed in the Department of ENT, HNS, MTI/LRH,Peshawar, Pakistan, from June 01, 2017 to May 31, 2018. After ethical approval, sample size of 112 was calculated and patientsincluded of both genders fulfilling inclusion criteria. After taking consent patients were equally divided into two groups with nonrandom number table method. Both subjective and objective assessment was carried out and observations were recorded on apredesignedproforma.Data were analyzed using SPSS 20.Results: Total patients were 112,in age range from 16 to 50 years. There were 56(50%) patients in each group.Maleswere 71 andfemale 41withmale to female ratio of 1.7:1 and mean age was 32.92+S.D 10.29 years.Relief from nasal obstruction obtained was94.64% and 92.86% in Group A and B respectively. Headachewas relived 83.34 % and 88.38% in Group A and B respectively. Thecomplications experienced were post operative bleeding, adhesion formation and crusting 2.6%, 3.5% and 1.78% respectively.Statistics showed no significant difference between the two operations (p >0.05).Conclusion: Both trimming and outer displacement of hypertrophied inferior turbinate are effective procedures for relief of nasalobstruction but there was no significant difference betweenthe two techniques interm of outcome and complications.Keywords:Inferiorturbinate, Hypertrophy, Trimming, Outer displacement. Nasal obstruction

scholarly journals The Method and Results of a Treatment Targeting SARS-CoV-2-Activated Inflammasomes

2021 ◽  
Author(s):  
Jong Hoon Lee ◽  
Badar Kanwar ◽  
Chul Joong Lee ◽  
Jenny Balentine ◽  
Asif Khattak ◽  
...  
Keyword(s):  
Controlled Trial ◽  
P Value ◽  
Test Statistic ◽  
Chi Square ◽  
Exact Test ◽  
Pyrin Domain ◽  
Significant Difference ◽  
Chemically Reacting ◽  
Second Period ◽  
Receptor Family

Abstract Background Clinicians considered dapsone administration to treat SARS-CoV-2 inflammasome. Dapsone is helpful in the molecular regulation of Nod-like receptor family pyrin domain-containing 3 (NLRP3).Objective To study the targeting of NLRP3 itself or up-/downstream factors of the NLRP3 inflammasome by dapsone must be responsible for its observed preventive effects, functioning as a competitor.Methods This is a randomized controlled trial (RCT). We set out to use objective criteria of improvement, such as A. a reduction in the FIO2 requirement and B. a decrease in the progression of hypoxia. We treated the patients with standard COVID-19 acute respiratory distress syndrome (ARDS) treatment with dapsone. The RCT results were analyzed.Results ARDS progression was blocked in 17 of 19 total patients at the first period. The 44 (trial 22/ control 22) subjects were analyzed during the second period. The chi-square statistic is 5.1836. The p-value is .02280. (RR 0.21, OR 0.1) Fisher's exact test statistic value is 0.0433. (The result is significant at p < .05) (RR 0.15, OR 0) It is significant at the ARDS onset stage.Conclusion There was a significant difference in dapsone treatment results in the ARDS-onset group. We confirmed that dapsone clinically treated the onset of ARDS by targeting SARS-CoV-2-activated inflammasomes. Like chemically reacting substances, inflammasome and dapsone compete, proving that it is effective in early ARDS. ClinicalTrials.gov Identifier NCT04918914

scholarly journals Effectiveness of Tragacanth Gel Cushions in Prevention of Pressure Ulcer in Traumatic Patients: a Randomized Controlled Trial

2019 ◽  
Vol 8 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Javad Shakibamehr ◽  
Mojtaba Rad ◽  
Rahim Akrami ◽  
Mostafa Rad
Keyword(s):  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Controlled Trial ◽  
Daily Basis ◽  
Routine Care ◽  
Group 14 ◽  
Exact Test ◽  
Significant Difference ◽  
Chi Squared ◽  
Skin Redness

Introduction: Pressure ulcer is one of the most common and painful complications in patients admitted to intensive care units (ICUs). This study aimed to compare the effects of tragacanth gel cushions and foam-filled ones on the prevention of pressure ulcers. Methods: This triple-blind, randomized, clinical trial was performed on 94 patients admitted to the ICU of Taleqhani Hospital of Mashhad, Iran. The participants were divided into two groups of tragacanth gel pad and foam (n=47 for each group). Both groups received all the routine care. The participants were examined on a daily basis during a ten-day period. We considered sacral region as the most affected site, and the patients with erythema were excluded from the study. To analyze the data, Chi-squared test, Fisher’s exact test, and t-test were run, using Stata version 12. Results: The data showed significant differences in terms of the incidence of skin redness in the tragacanth gel cushions group and foam cushion group, respectively, 6.84 (1.58) and 5.67 (1.26) days after admission. In addition, in the tragacanth gel cushions group 14 patients (29.7%) did not have skin redness compared with the foam cushion group (8.51%), which indicated a significant difference. Conclusion: This study showed that the use of tragacanth gel cushion is effective in the prevention of pressure ulcers in ICU patients. Cushions filled with tragacanth gel also delayed the onset of erythema. Considering their cost-effectiveness and naturalness, the use of tragacanth gel cushions is recommended to improve the sacral skin health and prevent pressure ulcers.

The Impact of Personal Protection Equipment on Intubation Times

2021 ◽  
pp. 1-5
Author(s):  
Donald Doukas ◽  
Bonnie Arquilla ◽  
Pinchas Halpern ◽  
Mark Silverberg ◽  
Richard Sinert
Keyword(s):  
Health Care Providers ◽  
Controlled Trial ◽  
Size Analysis ◽  
Care Providers ◽  
Personal Protection Equipment ◽  
Study Objective ◽  
Exact Test ◽  
Significant Difference ◽  
Multiple Levels ◽  
The Impact

Abstract Introduction: Hazardous material (HAZMAT) protocols require health care providers to wear personal protective equipment (PPE) when caring for contaminated patients. Multiple levels of PPE exist (level D - level A), providing progressively more protection. Emergent endotracheal intubation (ETI) of victims can become complicated by the cumbersome nature of PPE. Study Objective: The null hypothesis was tested that there would be no difference in time to successful ETI between providers in different types of PPE. Methods: This randomized controlled trial assessed time to ETI with differing levels of PPE. Participants included 18 senior US Emergency Medicine (EM) residents and attendings, and nine US senior Anesthesiology residents. Each individual performed ETI on a mannequin (Laerdal SimMan Essential; Stavanger, Sweden) wearing the following levels of PPE: universal precautions (UP) controls (nitrile gloves and facemask with shield); partial level C (PC; rubber gloves and a passive air-purifying respirator [APR]); and complete level C (CC; passive APR with an anti-chemical suit). Primary outcome measures were the time in seconds (s) to successful intubation: Time 1 (T1) = inflation of the endotracheal tube (ETT) balloon; Time 2 (T2) = first ventilation. Data were reported as medians with Interquartile Ranges (IQR, 25%-75%) or percentages with 95% Confidence Intervals (95%, CI). Group comparisons were analyzed by Fisher’s Exact Test or Kruskal-Wallis, as appropriate (alpha = 0.017 [three groups], two-tails). Sample size analysis was based upon the power of 80% to detect a difference of 10 seconds between groups at a P = .017; 27 subjects per group would be needed. Results: All 27 participants completed the study. At T1, there was no statistically significant difference (P = .27) among UP 18.0s (11.5s-19.0s), PC 21.0s (14.0s-23.5s), or CC 17.0s (13.5s-27.5s). For T2, there was also no significant (P = .25) differences among UP 24.0s (17.5s-27.0s), PC 26.0s (21.0s-32.0s), or CC 24.0s (19.5s-33.5s). Conclusion: There were no statistically significant differences in time to balloon inflation or ventilation. Higher levels of PPE do not appear to increase time to ETI.

scholarly journals Microdebrider-Assisted Turbinoplasty and Submucosal Diathermy for Inferior Turbinate Hypertrophy: A Randomized Clinical Trial

2020 ◽  
Vol 24 (4) ◽  
pp. 390-394
Author(s):  
Muhammad Arshad ◽  
Ahmed Hasan Ashfaq ◽  
Muhammad Tayyab Rasheed ◽  
Mahwash Khawaja ◽  
Muhammad Nadeem Langove ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Nasal Obstruction ◽  
Sleep Disturbances ◽  
Inferior Turbinate ◽  
P Value ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Inferior Turbinate Hypertrophy

ABSTRACT Background: Nasal obstruction is a common presenting problem which can lead to symptoms like sleep disturbances, mouth breathing, oral cavity dryness. Hypertrophied inferior turbinate is a common cause of nasal obstruction. Microdebrider assisted turbinoplasty and submucosal diathermy are widely used methods for patients who fail to respond to medical therapy to relieve obstruction. The aim of the study was to compare two methods in terms of relief of nasal obstruction, reduction in sneezing and post-operative complications. Material & Methods: This randomized clinical trial was conducted at ENT Department, Benazir Bhutto Hospital Rawalpindi, Pakistan for one year from 01-03-2018 to 28-02-2019. One hundred and twenty patients were randomized to into either MAT and SMD groups each with 60 patients. Nasal obstruction symptom evaluation score system (NOSE) was used to access relieve from obstruction and sneezing. SPSS 22, online chai square and fisher exact test calculators were used to analyze the data. Results: Two groups were comparable for age and gender. After 3 months of treatment, all patients in MAT group and 51 patients in SMD group were completely relieved from obstruction. At two weeks follow up 37(61.57%) patients in MAT group had grade 0 obstruction compared with 14 (23.33%) in SMD group and this difference was significant (p value .000). at one month follow up 55 (91.67%) patients in MAT while 46 (76.67%) had completely relieved obstruction and this difference was significant ( p value .024). Not all patients showed reduction in sneezing in both groups. 37 patients in MAT and 25 patients in SMD group had completely relieved from sneezing at third month follow up with MAT group showing significantly more patients with sneezing reduced at one month follow up. Crust formation was most seen complication in both groups, more with SMD group at two weeks follow up which responded to treatment alkaline nasal douches and crust removal.   Conclusion: MAT gives better in terms of nasal obstruction relieved, reduction in sneezing and less complications than SMD  procedure. KEYWORDS: Microdebrider; Diathermy; Turbinates; Nasal obstruction  

Early change in 18-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) to predict response to preoperative systemic therapy (PST) in HER2-negative primary operable breast cancer: Translational breast cancer research consortium (TBCRC008).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10509-10509 ◽  
Author(s):  
Roisin M. Connolly ◽  
Jeffrey P Leal ◽  
Matthew P. Goetz ◽  
Zhe Zhang ◽  
Xian C Zhou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fdg Pet ◽  
Controlled Trial ◽  
Response Assessment ◽  
Complete Response ◽  
Response To Therapy ◽  
Exact Test ◽  
Standardized Uptake Values ◽  
Positron Emission ◽  
Significant Difference

10509 Background: PST allows for improved surgical outcomes and response assessment without compromising long term outcomes. PST is an attractive model for assessing surrogate markers of response to therapy. We hypothesized that changes in tumor standardized uptake values corrected for lean body mass (SUL) max on FDG- PET by cycle 1 day 15 (C1D15) of therapy would predict pathological complete response (pCR) to PST in women with stage 2-3, grade 2-3, HER2-negative breast cancer. Methods: TBCRC008 is a multicenter placebo-controlled trial that investigates pCR following 12 weeks of preoperative carboplatin and albumin-bound paclitaxel with or without vorinostat. FDG-PET followed by tumor biopsies were performed at baseline and C1D15. We correlated % reduction in SULmax on FDG-PET (PERCIST 1.0; Wahl RL, J Nuc Med 2009) with pCR (no invasive cancer in breast/axilla). We compared % reduction in SULmax between responders (pCR) and non responders (no pCR) using nonparametric Wilcoxon rank sum test. We explored association of % reduction in SULmax at pre-specified cutoff with response using Fisher’s exact test and logistic regression. We correlated baseline, C1D15, and % change in Ki67 at C1D15 with pCR. Results: Accrual is complete. Of 62 women enrolled (10/2009-11/2011), 40 have completed study PST and surgery (median age 47.5 [range 30-68], ER-positive 67%). Overall pCR was 26%. In an intent to treat analysis (n=39), we observed a significant difference in median % reduction in SULmax between responders vs not (66.6% vs 32.4%, p <0.001). We observed a higher proportion of reduction in SULmax ≥ 60% in responders vs not (80% vs 3.5%, p <0.001). The differences in baseline, C1D15 and % change in Ki67 were not significant between responders and non-responders. Conclusions: Change in SULmax on FDG-PET 15 days after initiating PST was significantly greater in patients with pCR versus no pCR. Future studies will determine whether altering therapy based on early changes in SULmax will improve pCR. Unblinded data from all participants will be presented at the meeting.

Degloving of the inferior turbinates: pilot study to assess the effectiveness of a new technique in turbinate reduction

2003 ◽  
Vol 117 (11) ◽  
pp. 866-870 ◽  
Author(s):  
E. B. Chevretton ◽  
C. Hopkins ◽  
I. M. Black ◽  
P. Tierney ◽  
N. C. Smeeton
Keyword(s):  
Pilot Study ◽  
Nasal Obstruction ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Inferior Turbinate ◽  
Nasal Symptoms ◽  
Postnasal Drip ◽  
Nasal Inspiratory Peak Flow ◽  
A New Technique ◽  
Inferior Turbinate Hypertrophy

A pilot study to assess the safety and efficacy of ’degloving’ of the inferior turbinate is described. This prospective study reports on the effectiveness of the technique in 37 patients with nasal obstruction due to inferior turbinate hypertrophy. Both objective and subjective measurements of nasal patency were made pre-operatively, and repeated at six weeks, six months and two years post-operatively using nasal inspiratory peak flow rates, saccharin clearance time and an end referenced visual analogue scale to record nasal symptoms.There was a significant improvement in the peak inspiratory flow at six weeks (96.4 to 151.2 l/min) and at six months (148.4 l/min), which was sustained at two years (117.1 l/min, p<0.001). There was an overall improvement in patient satisfaction with nasal symptoms (23.4 to 76.7, 76.8 and 66.8 at six weeks, six months and two years, p<0.001) and a decrease in the sensation of nasal obstruction (71.9 to 21.5, 32.9 and 29.8, p<0.001), which was also sustained. Rhinorrhoea was reduced, and sense of smell increased across the group, but the improvements did not reach statistical significance. The results for postnasal drip and saccharin clearance did not show a significant change over the period of the study. There were no haemorrhagic complications in the group studied.This pilot study demonstrates a new surgical technique for reduction of the inferior turbinates, that yields significant improvement in nasal obstruction, an acceptably low complication rate and is well tolerated by patients. A randomized controlled trial is being planned.

scholarly journals THE EFFECTIVENESS OF TRIPLE-DOSE ALBENDAZOLE IN COMPARISON WITH MEBENDAZOLE FOR THE TREATMENT OF TRICHURIASIS IN CHILDREN

2019 ◽  
pp. 104-107
Author(s):  
SALEHA SUNGKAR ◽  
FANNY P. IRMAWATI ◽  
ROSE A. HASWINZKY ◽  
YASMINE A. DWINASTITI ◽  
SRI WAHDINI ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Reduction Rate ◽  
Wilcoxon Test ◽  
Cure Rate ◽  
Exact Test ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Before And After ◽  
Egg Reduction Rate ◽  
Triple Dose

Objective: Trichuriasis is difficult to treat with single-dose anthelmintic. Although a higher cure rate (CR) can be achieved by treatment with triple-dose albendazole and mebendazole, the results of studies are inconsistent. This study aimed to evaluate the effectiveness of triple-dose albendazole and mebendazole in treating trichuriasis. Methods: A randomized controlled trial was conducted in a primary school in the Pandeglang District, Banten Province, Indonesia in July–August, 2018; 382 children were recruited. Stools were collected and examined microscopically using the Kato–Katz method to identify Trichuriasis eggs. Children positive for Trichuris trichiura were randomized and divided into two groups. One was given a triple dose of 400 mg albendazole and the other a triple dose of 500 mg mebendazole. On day 14 after treatment, stools were reexamined to calculate CR and the egg reduction rate (ERR). Data were analyzed using SPSS version 20. Results: The prevalence of soil-transmitted helminth infection was 42%, and that of trichuriasis and ascariasis was 25.1% and 29.8%. There was a significant difference (Wilcoxon test, P<0.01) in the intensity of infection before and after intervention. Both groups showed high values of CR (mebendazole: 95.2%, albendazole: 85.4%; Fisher’s exact test, P = 0.125) and ERR (mebendazole: 99%, albendazole: 96%; Mann–Whitney test, P = 0.110). There was no significant difference in CR and ERR between the two groups. Conclusion: Triple-dose albendazole was as effective as triple-dose mebendazole in treating trichuriasis.

scholarly journals Does addition of craving management tools in a stop smoking app improve quit rates among adult smokers? Results from BupaQuit pragmatic pilot randomised controlled trial.

2019 ◽  
Author(s):  
Aleksandra Herbec ◽  
Lion Shahab ◽  
Jamie Brown ◽  
Harveen Kaur Ubhi ◽  
Emma Beard ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Point Prevalence ◽  
Management Tools ◽  
Exact Test ◽  
Significant Difference ◽  
Continuous Abstinence ◽  
Randomised Controlled

Introduction: Delivery of craving management tools (CMTs) via smartphone applications (apps) may improve smoking cessation rates, but research on such programmes remainslimited, especially in real-world settings. This study evaluated the effectiveness of adding CMTs in a cessation app (BupaQuit).Methods: The study was a two-arm pragmatic pilot parallel randomised controlled trial, comparing a fully-automated BupaQuit app with CMT with a control app version withoutCMT. A total of 425 adult UK-based daily smokers were enrolled through open online recruitment (February 2015-March 2016), with no researcher involvement, and individually randomised within the app to the intervention (n=208) or control (n=217). The primary outcome was self-reported 14-day continuous abstinence assessed at 4-week follow-up. Secondary outcomes included 6-month point-prevalence and sustained abstinence, and app usage. The primary outcome was assessed with Fisher’s exact test using intent to treat with those lost to follow-up counted as smoking. Participants were not reimbursed.Results: Re-contact rates were 50.4% at 4 weeks and 40.2% at 6 months. There was no significant difference between intervention and control arms on the primary outcome (13.5% vs 15.7%; p=0.58;RR=0.86, 95% Confidence Interval (CI)=0.54-1.36) or secondary cessation outcomes (6-month point prevalence: 14.4% vs. 17.1%, p=0.51;RR=0.85, 95%CI=0.54-1.32; 6-month sustained: 11.1% vs 13.4%, p=0.55,RR=0.83,95%CI=0.50-1.38). Bayes factors supported the null hypothesis (B[0, 0,1.0986]=.20). Usage was similar across the conditions (mean/median logins: 9.6/4 vs. 10.5/5; time spent: 401.8/202s vs. 325.8/209s).Conclusions: The addition of craving management tools did not affect cessation, and the limited engagement with the app may have contributed to this.

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