scholarly journals Clinical Comparison of Diode Laser Assisted “v-Shape Frenectomy” and Conventional Surgical Method as Treatment of Ankyloglossia

Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 89
Author(s):  
Sileno Tancredi ◽  
Paolo De Angelis ◽  
Mario Marra ◽  
Michele Antonio Lopez ◽  
Paolo Francesco Manicone ◽  
...  

(1) Background: Ankyloglossia, or tongue-tie is a condition, in which the tip of tongue cannot protrude beyond the lower incisor teeth because of short frenulum linguae, often containing scar tissue. Limitations of movement are the most important clinical symptoms of this condition, together with feeding, speech, and mechanical problems. (2) Methods: the present study included two groups of patients (group A and group B) including, respectively, 29 and 32 patients (61 patients total), aged from 8 to 12 and presenting ankyloglossia classified according to the Kotlow’s classification. The patients in group A underwent a common surgical procedure. For the patients of group B, a diode laser device (K2 mobile laser, Dentium, Korea) with a micro-pulsed wavelength of 980 ± 10 nm and power of 1.2 watts was used. The post-surgical discomfort of the patients (recording the pain perceived immediately after the end of the anesthesia and during the following week, using the Numeric Rating Scale (NRS) system) and healing characteristics (recorded using the Early Wound Healing Score or EHS) were evaluated. (3) Results: The results shows that the pain in the patients who underwent laser-assisted frenectomy is significantly reduced (p < 0.001) when compared to those who underwent conventional surgical frenectomy, both immediately after surgery (with a reduction in the average NRS of 80.6%) and after the first week (with a reduction in the average NRS of 86.58%). Additionally, in the same patients, an augmentation in the average value of the EHS of 45% was recorded, highlighting significantly (p < 0.001) better quality in the healing of the wound within the 24 h after surgery. Moreover, other advantages observed in the use of laser assisted-frenectomy are the absence of bleeding and, consequently, a clear operative field; no need to use sutures; no need to take painkillers or antibiotics after surgery; and having a faster recovery and less time needed to perform the operation. (4) Conclusions: within the limits of the present study, it seems possible to assert that the laser frenectomy performed using the v-shape technique presents a series of advantages if compared to the conventional surgical method.

Author(s):  
Ashish Patyal ◽  
Anjana Verma ◽  
Madhavi Buddhi

Background: Pain on propofol injection is an unwanted effect which can lead to decreased patient satisfaction. Although many studies have shown that pre-treatment with lidocaine injection is effective in this pain, nevertheless, very few studies have been done  on different concentration and volume of lidocaine, effective of reducing pain significantly. Objective of the current study was to assess and compare the efficacy of intravenous lidocaine with  0.4% and 2% concentration in reducing the incidence and severity of propofol injection pain.Methods: A total of 126 American Society of Anesthesiologist grade I and II patients with age ≥18 years, scheduled for an elective surgery, were enrolled in the study. Patients were randomized into two equal groups of 63 each. Group A (n = 63) received pretreatment with 0.4% lidocaine and group B (n = 63) received 2% lidocaine. Propofol injection pain was measured by using Numeric Rating Scale (NRS) and Withdrawl Response Scale (WRS). Unpaired t test, ANOVA and Chi square test were used for statistical analysis.Results: A statistically significant decrease in the pain was recorded in group A (0.4% lidocaine) as compared to group B (2% lidocaine). Using NRS scale, 12% of patients in group A as compared to 33% patients of group B, experienced pain (p =0.02); while using WRS, 8% patients of group A as compared to 27% group B patients experienced pain (p= 0.04).Conclusions: The pain on injection of propofol is significantly decreased by the use of 0.4% lidocaine in comparison with 2% Lidocaine.


2019 ◽  
Vol 70 (4) ◽  
pp. 1500-1506
Author(s):  
Romina Marina Sima ◽  
Dragos Albu ◽  
Antoniu Cringu Ionescu ◽  
Mihai Dimitriu ◽  
Mihai Popescu ◽  
...  

Visual analogue scale (VAS) is a psychometric scale applied to measure subjective characteristics. The purpose of our study was to evaluate the efficiency of Ulipristal acetate (UPA) compared with Dienogest for endometriomas related pain using VAS. We performed a randomized study on women with symptomatic endometriomas. The study was realized between January 2016�December 2018. The patients were randomized in two groups: Group A- that received UPA in doses of 5 mg daily for 12�13 weeks and Group B that received 2 mg Dienogest for 12�13 weeks. Each group received de VAS (Visual Analogue Scale) questionnaire before and after treatment. 70 women wereincluded in the study with 35 patients for each group. The age the mean age was 30.20 years. For Numeric Rating Scale before treatment in the group with UPA the median value was 6 (CI= 5.26, 6.51) and for group B the median was 5 (CI= 5.13, 5.66). After treatment for group A the median value was 4 (CI= 3.58, 4.29) and for group B the median value 4 (CI= 4.23, 4.6). For FRS before treatment in the group with UPA median value was 6 (CI= 5.87, 6.58) and for the group B median was 6 (CI= 6.16, 6.57). After treatment for group A the median value was 4 (CI= 4.12, 4.73) and for group B the median value 5 (CI= 4.9, 5.06). The pain significantly improved for group A. (p[ 0.05) VAS represent a good method to evaluate the quality of pain for patients with endometriomas. The UPA and Dienogest treatment improve the VAS parameters with better results for UPA in the present study.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Salvatore Gizzo ◽  
Stefania Di Gangi ◽  
Marco Noventa ◽  
Veronica Bacile ◽  
Alessandra Zambon ◽  
...  

Background. Childbirth medicalization has reduced the parturient’s opportunity to labour and deliver in a spontaneous position, constricting her to assume the recumbent one. The aim of the study was to compare recumbent and alternative positions in terms of labour process, type of delivery, neonatal wellbeing, and intrapartum fetal head rotation.Methods. We conducted an observational cohort study on women at pregnancy term. Primiparous women with physiological pregnancies and single cephalic fetuses were eligible for the study. We considered data about maternal-general characteristics, labour process, type of delivery, and neonatal wellbeing at birth. Patients were divided into two groups: Group-A if they spent more than 50% of labour in a recumbent position and Group-B when in alternative ones.Results. 225 women were recruited (69 in Group-A and 156 in Group-B). We found significant differences between the groups in terms of labour length, Numeric Rating Scale score and analgesia request rate, type of delivery, need of episiotomy, and fetal occiput rotation. No differences were found in terms of neonatal outcomes.Conclusion. Alternative maternal positioning may positively influence labour process reducing maternal pain, operative vaginal delivery, caesarean section, and episiotomy rate. Women should be encouraged to move and deliver in the most comfortable position.


2021 ◽  
Vol 71 (5) ◽  
pp. 1764-68
Author(s):  
Amir Sohail ◽  
Ameer Yasser Zaid ◽  
Shizan Hamid Feroz ◽  
Mohammed Saeed ◽  
Syed Khurram Naseer ◽  
...  

Objective: To compare the pain relief efficacy of platelet rich plasma injection with corticosteroid injection in knee osteoarthritis using numeric rating scale. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anesthesia and Pain Management, Combined Military Hospital Peshawar, from Jan 2018 to Dec 2019. Methodology: Total of 310 patients who underwent knee injection for osteoarthritis were included in this study. Patients were divided into two groups; group A and group B comprising of 155 patients each. Patients in group ‘A’ received intra articular corticosteroid injection while patients in group ‘B’ received intra articular platelet rich plasma injection for knee osteoarthritis. Pain assessment via numerical rating score was done at the start of the treatment and at 6 months. Results: In group A female to male ratio was 2.69:1 while in group B the female to male ratio was 2.78:1. Mean age of ‘group A’ was 58.52 ± 11.87 years and that of ‘group B’ was 58.79 ± 11.15 years. Numerical rating score pre-treatment in ‘group A’ vs ‘group B’ was 8.35 ± 1.17 vs 8.42 ± 1.14. While numeric rating scale post treatment in ‘group A’ vs ‘group B’ was 5.74 ± 1.37 vs 4.06 ± 1.19, respectively with p-value of 0.001, which is statistically significant. Conclusion: Patients who received intra-articular platelet rich plasma had significantly more pain relief as compared to patients who received intra-articular steroid on numerical rating score.


2020 ◽  
Vol 2 (1) ◽  
pp. 30-34
Author(s):  
Ummara Qadeer ◽  
Anan Aftab ◽  
Iman Zahra

Objective: To compare whether heat therapy (moist heat pack) is more effective before exercise therapy or after exercise therapy in chronic MSK pain in females. Design Randomized clinical trial study. Methodology: This study is conducted in Abbas institute of medical sciences Muzaffarabad and Muzaffarabad physiotherapy clinic Muzaffarabad.40 female patients with chronic MSK pain are recruited in the study and a questionnaire-based survey was carried out. A self-structured questionnaire is used for demographic details. For screening of chronic MSK pain short form of Orebro pain questionnaire is used. A numeric rating scale in both groups is used to check the intensity of pain. Result: The results showed that between group A and B there was no significant difference. But clinically group B showed more improvement than group A.Both groups showed improvement after treatment. Conclusion: The application of heat therapy (moist hot pack) was found to be more effective after exercises than its use before exercises to improve pain in females with chronic musculoskeletal pain.


2021 ◽  
Vol 93 (2) ◽  
pp. 233-236
Author(s):  
Giovanni Saredi ◽  
Fabrizio I. Scroppo ◽  
Paolo Capogrosso ◽  
Giacomo Maria Pirola ◽  
Lorenzo Capone ◽  
...  

Objective: In this study, we compared postoperative outcomes of patients submitted to varicocele correction under general or local anesthesia at a single center. Methods: All patients underwent varicocele surgical treatment with the Colpi-modified Marmar subinguinal technique. They were managed with either general (Group A) or local with ileo-inguinal and ileo-hypogastric nerves block (Group B) anesthesia. The two groups were compared in terms of timing of discharge and post-operative pain as assessed with the numeric rating scale (NRS) at both rest and movement (NRSm). §Results: Overall, 63 patients were included with a mean (SD) age of 25 years ± 5 yrs. The NRS mean score was significantly lower for Group B during the first 4 days after surgery at both rest and movement (all p < 0.05). Patients receiving local anesthesia showed a faster time to first urination (210 vs. 240 min; p = 0.02), although the time to discharge was comparable between the two groups (250 vs. 250 min). Conclusions: These results suggest that local anetshesia for varicocele surgical treatment is feasible and provide better pain control and faster recovery after surgery.


2018 ◽  
Vol 14 (2) ◽  
pp. 38-40
Author(s):  
N M Shrestha

Background: Urethral stricture and its recurrence is still a major problem in male. Several procedures are present for the treatment of the disease. Lapides introduced the concept of intermittent self dilatation (ISD) which has decreased the incidence of recurrence of urethral stricture if doing properly. The aim of the this study was to report the outcomes of ISD for the treatment of urethral stricture after Filliform follower urethral dilatation (FFUD).Method: This was a prospective comparative study, conducted in the department of surgery, urology unit from March 2013 to February 2016. Total of 49 patients were enrolled and were randomly divided into Group A and Group B. In Group A, all the patients were taught ISD with Nelaton Catheter after FFUD. In group B, all patients underwent only FFUD for urethral stricture. In both groups, Foley's catheter was removed after 2 weeks of FFUD. These patients who had difficulty In passing urine or having lower urinary tract syndrome after removal of catheter, were evaluated for urethral stricture recurrency by clinical symptoms, ultrasonography, urine test for culture and sensitivity, cystoscopy/urethrogram as necessarily.Result: In Group A, 4 patients out of 20(20%)developed urethral stricture recurrency where as in Group B,18 patients out of 23 (78.26%) developed urethral stricture recurrency. Therefore, the rate of urethral stricture recurrence is significantly more in group B than the Group A (p< 0.001).Conclusion: ISD is an effective way for the prevention of urethtral stricture recurrence after FFUD. JNGMC,  Vol. 14 No. 2 December 2016, Page: 38-40


2021 ◽  
pp. 000348942199018
Author(s):  
Kostas Vahtsevanos ◽  
Angelos Chatziavramidis ◽  
Ioannis (Yiannis) Papadiochos ◽  
Georgios Koloutsos ◽  
Anastasios Stefanidis ◽  
...  

Background: Frey’s syndrome is a well-known complication of parotid surgery; its prevention may be achieved by the use of an interpositional barrier between the overlying flaps and the exposed parenchymal bed of parotid gland. The aim of this study was to retrospectively evaluate clinical outcomes with and without the interpositional placement of a porcine dermal collagen graft (PDCG) for prevention of syndrome occurrence. Methods: We conducted a 20-year retrospective study including the patients who had undergone “formal” (superficial, total, or subtotal) parotidectomies for benign pathologies. The inclusion criteria also involved patients that were (i) regularly monitored about clinical symptoms related to syndrome, and (ii) examined with Minor starch-iodine test. The severity of the diagnosed syndrome was retrospectively evaluated according to the grading score system of Luna-Ortiz. To assess group differences in terms of the extent of dissection in operating sites, we estimated the tumor and histological specimen volumes using the available dimensions. Results: We included 73 patients who had undergone 76 formal parotid surgeries. The surgical sites were divided into 2 groups: (1) Group A consisted of 44 sites that were reconstructed with a SMAS flap, and (2) Group B, comprised 32 sites where a PDCG was additionally applied as an artificial preventive barrier. At a mean follow-up of 26.3 months, a significantly lower incidence of clinically diagnosed Frey’s syndrome was found after the use of dermal collagen interpositional barrier ( P = .031). Specifically, subjective symptoms were reported at an incidence of 31.8% in Group A and 6.7% in Group B. Minor’s test was positive at an incidence of 59.09% in Group A and 21.87% in Group B ( P = .004, 95% CI). Severe Frey’s syndrome was observed in 31.82% of the patients of Group A and in 3.12% of the patients of Group B ( P = .002, 95% CI). Since there were no statistical significant differences between the volumes of the removed tumors and the excised histological specimens, the extent of dissection was not proved to influence the occurrence of Frey’s syndrome in the compared groups, Conclusion: Porcine dermal collagen is a safe, practical, and useful means for parotid reconstruction, since it seems to contribute in prevention of Frey’s syndrome when increased amount of glandular tissue has to be removed. Additional randomized controlled studies with bigger samples are required to better assess the PDCG use in parotid surgery.


2020 ◽  
pp. 63-68
Author(s):  
Phat Ho Tan ◽  
Tam Vu Thi Minh ◽  
Trong Huynh Nguyen Dang ◽  
Phuong Tran Nhat Thi Anh ◽  
Ngan Tran Thi Kim ◽  
...  

Background: Hepatic encephalopathy is an important evidence that confirms impairment of liver function, may occur in about 40% of cirrhotics. Data about efficacy of rifaximin plus lactulose in the treatment of Vietnamese patients was still limited. This study aimed to determine the precipitating factors and to access the efficacy of lactulose plus rifaximin in overt hepatic encephalopathy. Patients and Methods: The prospective single-blind randomized controlled trial, 43 cirrhotics with overt hepatic encephalopathy without portal systemic shunting addmitted to gastroenterology department of Cho Ray Hospital from March 2019 to August 2019, were randomized into two groups (group A lactulose plus rifaximin 1.100 mg/day, n = 21; and group B only lactulose; n = 22). All patients were recorded for onset factors, clinical characteristics and assessing the recovery of hepatic encephalopathy. Results: The mean age of patients in this study was 54.8 ± 12.1 years (the ratio of male to female patients is 4.38 : 1). The leading cause of cirrhosis was alcohol (39.5%). The most common clinical symptoms were jaundice (83.7%), spider naevi (41.9%) and ascites (37.2%). The most common triggers were infection (51.2%), gastrointestinal bleeding (37.2%) and constipation (25.6%). The percentage of patients with complete improvement after treatment with lactulose plus rifaximin was 81% compared to 63.6% in the lactulose-treated patients only (95% CI: 0.539 - 1.147, p value = 0.206). Conclusion: Our data revealed that common triggers of hepatic encephalopathy were infections, gastrointestinal bleeding and constipation. The combination of lactulose plus rifaximin was more effective than rifaximin alone in the treatment of overt hepatic encephalopathy. Key words: hepatic encephalopathy, precipitating factor, lactulose, rifaximin


Author(s):  
Priti A. Mehendale ◽  
Mayur T. Revadkar

Background: There is evidence regarding beneficial use of Transcutaneous Electrical Nerve Stimulation (TENS) on post Lower Segment Caesarean Section (LSCS) incision pain. However, efficacy of different types of TENS following C section pain has not yet been explored adequately.Methods: 96 women who had recently undergone LSCS were included for the study. The subjects were in the age group of 20 to 40 years (25.84±3.96); having pain intensity 4 or more on Numerical Pain Rating Scale (NPRS). They were divided into three groups by random allocation method; namely Group A: Acupuncture (Low/Motor) TENS, Group B: Conventional (High/Sensory) TENS and Group C: Control group. Group A and B received specific type of TENS twice a day for 15 minutes. Control group C did not receive any TENS intervention. All subjects received standard post-operative medications and physiotherapy. Pain intensity was recorded on NPRS pre and post intervention.Results: Both Acupuncture TENS and Conventional TENS significantly decreased post-operative pain intensity as compared to control group (p value <0.0001).Conclusions: Both, acupuncture and conventional TENS are equally effective in reducing post LSCS incision pain at a strong and non-painful intensity.


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