scholarly journals Short Plate with Screw Angle over 20 Degrees Improves the Radiologic Outcome in ACDF: Clinical Study

2021 ◽  
Vol 10 (9) ◽  
pp. 2034
Author(s):  
Kathryn-Anne Jimenez ◽  
Jihyeon Kim ◽  
Jaenam Lee ◽  
Hwan-Mo Lee ◽  
Seong-Hwan Moon ◽  
...  
Keyword(s):  
P Value ◽  
X Rays ◽  
Common Procedure ◽  
Fusion Surgery ◽  
Post Surgery ◽  
Plate Group ◽  
Vas Scores ◽  
Short Plate ◽  
Degenerative Cervical Spine ◽  
Screw Group

Background: Anterior cervical discectomy and fusion surgery is a common procedure for degenerative cervical spine. This describes allospacer and implant-related outcomes, comparing medium plate–low screw angle and short plate–high screw angle techniques. Methods: From January 2016 to June 2019, 79 patients who underwent ACDF were prospectively enrolled. Patients were divided, depending on the plate–screw system used: medium plate–low screw angle (12.3 ± 2.5 to 13.2 ± 3.2 degrees), and short plate–high screw angle (22.8 ± 5.3 to 23.3 ± 4.7 degrees). Subsidence, ALOD, and sagittal cervical balance were analyzed using lateral cervical X-rays. NDI and VAS scores were also evaluated. Results: Age for medium plate–low-angled screw group is 58.0 ± 11.3 years, and 55.3 ± 12.0 in the short plate–high-angled screw group (p-value = 0.313). Groups were comparable in mean NDI (p-value = 0.347), VAS (p-value = 0.156), C2–C7 SVA, (p-value = 0.981), and lordosis angle (p-value = 0.836) at 1-year post-surgery. Subsidence was higher in the medium plate–low-angled screw than in the short plate–high-angled screw (25% and 8.5%, respectively, p-value = 0.045). ALOD is also more common in the medium plate group (p-value = 0.045). Conclusion: Use of a short plate and insertion of high-angled screws (more than 20 degrees) has less chance of subsidence and occurrence of ALOD than the traditional technique of using medium plate and low angle.

scholarly journals Calcaneal Osteotomies in the treatment of Hindfoot Deformities

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Bahman Sahranavard ◽  
Ashish Shah ◽  
Cesar de Cesar Netto ◽  
Ibukunoluwa Araoye ◽  
Parke Hudson ◽  
...  
Keyword(s):  
Heel Pain ◽  
P Value ◽  
Angular Deformity ◽  
Fixation Technique ◽  
Similar Time ◽  
Common Procedure ◽  
Calcaneal Osteotomy ◽  
Significant Difference ◽  
Hindfoot Deformities ◽  
Screw Group

Category: Hindfoot Introduction/Purpose: Calcaneal osteotomy is a common procedure for hindfoot deformities correction. Screw fixation is the most common technique used to stabilize these osteotomies. The clinical decision regarding the number of screws used is frequently based on the surgeon’s experience without sufficient data regarding outcomes and complications. The aim of this study was to compare the outcomes and complications of one versus two screws fixation technique of sliding calcaneal osteotomies. Methods: We reviewed 190 patients (112 female, 78 male) who underwent corrective calcaneal osteotomy for hind-foot angular deformity between 2010-2016. The average age was 48.4 years (18-83), and mean follow-up was 28 weeks (4-150). We divided patients into two groups, according to the number of screws used in the osteotomy fixation (one or two). 85 osteotomies were fixed by one screw and 105 by two screws. We compared both groups regarding incision type, positioning and type of the screws (headed or headless) and complications (non-union, infection, hardware related heel pain). Results: The average time for radiographic union was similar between the groups, around 5.6 weeks (4-10 weeks). Non-unions were not found. The overall Incidence of complications was not significant different in the one screw group compare two screw group (12.7% x 8%, p-value 0.465). Infection rate was similar in both groups (4.7% vs 3.5%, p-value 0.674). There was not significant difference of hardware related heel pain between two groups (15.2% vs 8.5%, p-value 0.149). Similarly, no difference in incidence of hardware related symptoms between patients who used headed screw when comparing with headless screws. Conclusion: Our study compared results in the use of one screw versus two screws fixation technique for sliding calcaneal osteotomies. We found similar time for union. Base of date there was no significant difference of complications, infection, and hardware related heel pain between patients who used one screw when comparing two screws fixation technique for corrective calcaneal osteotomy.

scholarly journals Stapled haemmorhoidopexy versus open haemorrhoidectomy: our initial experience

2017 ◽  
Vol 4 (5) ◽  
pp. 1672
Author(s):  
Mir Mujtaba Ahmad ◽  
Raja Nadeem ◽  
Musharraf Husain ◽  
Irfan Nazir ◽  
Manzoor Ahmad
Keyword(s):  
Hospital Stay ◽  
Operating Time ◽  
P Value ◽  
Stapled Haemorrhoidopexy ◽  
Mean Values ◽  
Post Surgery ◽  
Stapled Haemorrhoidectomy ◽  
Significant Difference ◽  
Vas Scores ◽  
The Mean

Background: Haemorrhoids or ‘Piles’ is a frequently observed disease in surgical practice. Various non-surgical and surgical treatments are available. Open haemorrhoidectomy (Milligan-Morgan) is a widely-used procedure. A recent novel technique called ‘Stapled haemorrhoidopexy’, first described and performed by Italian surgeon Antonio Longo is gaining worldwide recognition for its benefits.Methods: A total of 155 patients between the age group of 20 and 65 years, diagnosed to have grade III or IV haemorrhoids were included in the study, divided into 2 groups, Group 1 undergoing Open haemorrhoidectomy (30 patients) and Group 2 undergoing Stapled haemorrhoidectomy (25 patients). Post operatively patients of both groups were reviewed at the time of discharge, at 7 days after discharge, at 1 month and 3 months post-surgery. The significant difference of the percentages between the two groups was tested using the Chi Square test. The significant difference in the mean values between the 2 groups was tested using the Student’s t- independent test. For all the tests, level of significance was taken as 0.05.Results: In present study, the mean operating time for stapled haemorrhoidopexy was 34.96±7.38 minutes with an average of 20-50 minutes, while with open haemorrhoidectomy, the mean operating time was 44.67±11.83 minutes (p<0.001). The mean VAS scores at 6, 12 and 24 hours with stapled haemorrhoidopexy were 1.79±0.76; 1.83±0.61 and 1.47±0.66, respectively, and with open haemorrhoidectomy, the mean VAS scores at 6, 12 and 24 hours were 2.88±0.88; 2.13±0.82 and 1.91±0.83, respectively. The mean hospital stay for patients with stapled haemorrhoidopexy was 1.96±0.55 days in comparison to the open group where the mean hospital stay was 3.51±0.72 days (P-value<0.001). The time for resumption to routine work was shorter in stapled group 8.61±2.76 as compared to 15.34± 2.12 which was statistically significant (P value <0.001). The mean amount of blood loss during stapled hemorrhoidectomy was statistically less than in open surgery.Conclusions:Stapled Haemorrhoidectomy is less painful with shorter duration of hospital stay and resumption of daily activity is faster than the open haemorrhoidectomy. However, long term follow-up is required to know the recurrence rate in stapled haemorrhoidectomy. 

Pengaruh Terapi Dzikir Terhadap Tingkat Kecemasan Pada Pasien Pre Dan Post Operasi

2019 ◽  
Vol 4 (1) ◽  
pp. 17-29
Author(s):  
Nurlina ◽  
Nursyamsi
Keyword(s):  
Sampling Method ◽  
T Test ◽  
P Value ◽  
Psychological Reactions ◽  
Paired Sample ◽  
Time Treatment ◽  
Post Surgery ◽  
Nursing Services ◽  
Preoperative Stage ◽  
Experimental Group

Postoperative surgery and trauma are stressors that can cause physiological and psychological reactions to the patient. Psychological reactions in the form of anxiety usually arise in the preoperative stage when the patient anticipates surgery and at the postoperative stage because of pain and discomfort, changes in body image and bodily functions. Handling anxiety with spiritual aspects in the form of dzikir therapy is an effort to reduce anxiety levels in patients pre and post surgery. This study used a pre-experimental research design with a one group pre and posttest design study design. The sample of this study was 15 respondents in the experimental group taken by consecutive sampling method. The experimental group received a dzikir therapy 1 time treatment with a duration of 12 minutes. Data collection is done using a questionnaire sheet. Analysis of the data used in this study is univariate and bivariate by using a paired sample t test. The results of the analysis used a statistical test paired sample t test with a level of confidence (α = 0.05). Based on the results of this test, the p value is 0,000, thus p <α (0,000 <0,05). The conclusion of this study is that there is an effect of giving dzikir therapy to the level of anxiety in patients pre and post surgery. Researchers suggest that the results of this study can be used as a reference for application in the scope of nursing services, especially handling anxiety.

scholarly journals Determination of the Vertical Dimension and the Position of the Occlusal Plane in a Removable Prosthesis Using Cephalometric Analysis and Golden Proportion

2021 ◽  
Vol 11 (15) ◽  
pp. 6948
Author(s):  
Gabriele Cervino ◽  
Sergio Sambataro ◽  
Chiara Stumpo ◽  
Salvatore Bocchieri ◽  
Fausto Murabito ◽  
...  
Keyword(s):  
Vertical Dimension ◽  
Occlusal Plane ◽  
X Rays ◽  
Common Procedure ◽  
Lower Incisor ◽  
Golden Proportion ◽  
The Face ◽  
Removable Prosthesis ◽  
Edentulous Patients

The aim of this study is to demonstrate the use and the effectiveness of cephalometry and golden proportions analysis of the face in planning prosthetic treatments in totally edentulous patients. In order to apply this method, latero-lateral and posterior-anterior X-rays must be performed in addition to the common procedure. Two main concerns for totally edentulous patients are the establishment of the vertical dimension and the new position of the occlusal plane. The divine proportion analysis was carried out by the use of a golden divider. The prosthetic protocol was divided into three steps and a case was selected for better understanding. Referring to the golden relations, if the distance from the chin to the wing of the nose is 1.0, the distance from the nose to eye is 0.618. This proportion is useful and effective in determining the correct prosthetic vertical dimension. The incisal margin of the lower incisor must be positioned between Point A (A) and protuberance menti (Pm) according to the gold ratio 0.618 of the total height A-Pm. Posteriorly the occlusal plane must be placed 2 mm below the divine occlusal plane (traced from the incisal margin of lower incisors to Xi point). A prosthesis made in accordance with cephalometric parameters and divine proportions of the face helps to improve the patient’s aesthetics, function and social personality.

scholarly journals Detecting the Absence of Lung Sliding in Lung Ultrasounds Using Deep Learning

2021 ◽  
Vol 11 (15) ◽  
pp. 6976
Author(s):  
Miroslav Jaščur ◽  
Marek Bundzel ◽  
Marek Malík ◽  
Anton Dzian ◽  
Norbert Ferenčík ◽  
...  
Keyword(s):  
Neural Network ◽  
Deep Learning ◽  
Lung Ultrasound ◽  
Video Recording ◽  
X Rays ◽  
Surgery Complications ◽  
Temporal Dimension ◽  
Sliding Motion ◽  
Post Surgery ◽  
Lung Sliding

Certain post-thoracic surgery complications are monitored in a standard manner using methods that employ ionising radiation. A need to automatise the diagnostic procedure has now arisen following the clinical trial of a novel lung ultrasound examination procedure that can replace X-rays. Deep learning was used as a powerful tool for lung ultrasound analysis. We present a novel deep-learning method, automated M-mode classification, to detect the absence of lung sliding motion in lung ultrasound. Automated M-mode classification leverages semantic segmentation to select 2D slices across the temporal dimension of the video recording. These 2D slices are the input for a convolutional neural network, and the output of the neural network indicates the presence or absence of lung sliding in the given time slot. We aggregate the partial predictions over the entire video recording to determine whether the subject has developed post-surgery complications. With a 64-frame version of this architecture, we detected lung sliding on average with a balanced accuracy of 89%, sensitivity of 82%, and specificity of 92%. Automated M-mode classification is suitable for lung sliding detection from clinical lung ultrasound videos. Furthermore, in lung ultrasound videos, we recommend using time windows between 0.53 and 2.13 s for the classification of lung sliding motion followed by aggregation.

Accuracy of 11 formulae to guide umbilical arterial catheter tip placement in newborn infants

2017 ◽  
Vol 103 (4) ◽  
pp. F364-F369 ◽  
Author(s):  
Wei Ling Lean ◽  
Jennifer A Dawson ◽  
Peter G Davis ◽  
Christiane Theda ◽  
Marta Thio
Keyword(s):  
Gold Standard ◽  
Newborn Infants ◽  
Body Part ◽  
Accurate Method ◽  
Arterial Catheter ◽  
X Rays ◽  
Success Rates ◽  
Common Procedure ◽  
Optimal Position ◽  
Umbilical Arterial Catheter

BackgroundUmbilical arterial catheter (UAC) insertion is a common procedure in the neonatal intensive care unit (NICU). Correct placement of the tip of the UAC at first attempt minimises handling of the infant and reduces the risk of infection and complications. We aimed to determine the accuracy of 11 published formulae to guide UAC placement.MethodsThis was a one-year prospective observational study in a tertiary NICU. Clinicians used their preferred formula for UAC insertion, with X-rays performed immediately post-procedure to check the tip position. Birth weight and measurements included in the 11 formulae were recorded within 48 hours. The gold standard insertion distance was defined as the distance from the abdominal wall to the mid-descending aorta, at T8 level on X-ray (range T6–T10). Insertion length using the 11 formulae was calculated and compared with this gold standard distance.ResultsOne hundred and three infants were included, with median (IQR) gestational age and weight of 28 (26–33.5) weeks and 980 (780–2045) g, respectively. The predicted value of the 11 formulae to place the UAC in correct position ranged from 51.0% to 73.8%. Formulae that involved direct body part measurements showed the highest predicted success rates, smallest mean difference from T8 and narrowest limits of agreement using the Bland-Altman method.ConclusionSuccess rates for accurate UAC placement are highest when formulae that involve body measurements are used. However, even the most accurate method would result in more than 25% of UACs needing manipulation to achieve an optimal position.

scholarly journals Investigating a Newly Developed Educational Orthopedic Application for Medical Interns in a Before-after Quasi-clinical Trial Study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahla Daliri B.O. ◽  
Hassan M. Majd ◽  
Ali Moradi
Keyword(s):  
Clinical Trial ◽  
Medical Knowledge ◽  
Correlational Analysis ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Final Exam ◽  
Vas Scores ◽  
Medical Interns ◽  
Exam Scores

Abstract Background In COVID 19 era, the literature on e-learning, or particularly m-learning, has considerably increased focusing on the subject of medical knowledge transfer. Considering the importance of orthopedic knowledge for general practitioners and the inadequacy of the orthopedics internship duration in Mashhad University of Medical Sciences (MUMS), we have developed and investigated a smartphone orthopedic educational application named “Orthobox”. Methods In a quasi-clinical before-after trial study, we investigated the benefits of Orthobox application for medical interns attending MUMS orthopedic departments. A total of 120 students (64 and 56 students in control and case groups respectively) were recruited. The application consists of five main parts of medication, common order samples, common prescriptions, cast and splint types, and educational movies. Students who passed the course without getting access to the application (control group) and students who were also using application during the course (case group) were defined, and comparison was done between them objectively through final exam score comparison and subjectively through Visual Analogue Scale (VAS) questionnaire score comparison. Besides, using case group students’ activity report provided by the application panel, correlational analysis was done on their amount of activity on each of the main parts of the application and the corresponding question exam and VAS score separately. Results The case group of the study generally achieved higher final exam scores, mainly on Order question score (P value<0.001). Total VAS scores were also greater in case group (P value =0.001). It has also been identified that there is a notable positive trend between student’s amount of usage of the application and their final exam scores through correlational analysis. This correlation was not significant about students’ application visit numbers and VAS scores. Conclusion These results suggest that m-learning has got the potential to improve students’ medical knowledge and skills by organizing must-to-learn content specified for intern students of orthopedics on one hand, and cause more satisfaction in students about their education on the other hand. Trial registration This study was not registered because it is a quasi-clinical trial study. Level of evidence Level III (Evidence obtained from well-designed controlled trials without randomization (i.e. quasi-experimental).

scholarly journals A COMPARISION OF POSTERIOR CAPSULAR OPACITY FORMATION UPTO 1 YEAR IN PATIENTS WITH SMALL INCISION CATARACT SURGERY WITH FOLDABLE INTRAOCULAR LENS AND PHACOEMULSIFICATION WITH THE SAME INTRAOCULAR LENS

2020 ◽  
pp. 173-176
Author(s):  
Kinjal Rathod ◽  
Kinjal Trivedi ◽  
Snehal Nayi ◽  
Somesh Aggarwal
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Nd:Yag Laser ◽  
Visual Outcome ◽  
Posterior Capsular Opacification ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Common Procedure ◽  
Age Related

Introduction: Cataract is most common cause of curable blindness worldwide and cataract surgery is most common procedure performed in ophthalmology. Posterior capsular opacification (PCO) is most common complication after cataract surgery which is usually treated with Neodymium-doped: Yttrium Garnet (Nd:YAG) laser posterior capsulotomy or occasionally with a surgical capsulotomy. The incidence and severity of PCO correlates to the type of surgical technique, IOL optic edge designs and IOL materials. Material and Methods: 70 eyes of 64 patients operated for age related cataract were studied in this prospective interventional study. Phacoemulsification was done in 35 eyes and SICS in 35 eyes with hydrophobic single piece biconvex foldable intraocular lens. Patients were followed up at 1, 3, 6, 9 and 12 months for the development of PCO. Clinically significant PCO (loss of 2 or more lines of Snellen’s visual acuity chart) was treated with Nd:YAG laser capsulotomy. Results: The overall incidence of PCO was 22.85%. Amongst the patients who developed PCO, SICS and phacoemulsification was performed in 62.5% and 37.5% patients respectively. Result was statistically significant with p value <0.05 using z test. On first postoperative day, patients operated with phacoemulsification had better visual acuity than SICS. Conclusion: Phacoemulsification can provide early and better visual outcome than SICS and has lower incidence of PCO formation which may be due to difference in irrigation and aspiration and less disruption of blood aqueous barrier than SICS. PCO can be reduced by atraumatic surgery and thorough cortical clean up and capsular polishing.

scholarly journals Patient satisfaction after mini-incision brachioplasty

2016 ◽  
Vol 25 (4) ◽  
pp. 254-257
Author(s):  
Ahmed Hassan El-Sabbagh
Keyword(s):  
Patient Satisfaction ◽  
Patient Education ◽  
Type Ii ◽  
Common Procedure ◽  
Post Surgery ◽  
Question Survey ◽  
Mini Incision

Brachioplasty is a common procedure performed by plastic surgeons, with type II brachioplasty being the most regularly performed procedure in the clinic. This study evaluates patient satisfaction after mini-incision brachioplasty using a five-question survey. We administered the survey to 26 patients six months after they had undergone mini-incision brachioplasty to correct type II deformity. Most of the patients considered the improvement by surgery acceptable (53.8%), while 84.6% reported a decrease of at least two clothing sizes post-surgery. More than half (57.7%) were satisfied with body symmetry following surgery, while 69.2% accepted the resultant scar. However, only 30.8% would recommend this type of operation without reservations. The results of this study indicate that adequate patient education prior to mini-incision brachioplasty is key to optimal patient satisfaction.

Evaluation of the Efficacy of Liposomal Bupivacaine in Total Joint Arthroplasty

2019 ◽  
pp. 089719001987257
Author(s):  
Francis J. Zamora ◽  
Rani P. Madduri ◽  
Ashmi A. Philips ◽  
Nancy Miller ◽  
Mini Varghese
Keyword(s):  
Knee Arthroplasty ◽  
Pain Control ◽  
Standard Of Care ◽  
P Value ◽  
Opioid Use ◽  
Post Surgery ◽  
Likert Score ◽  
Average Pain ◽  
Hip And Knee Arthroplasty ◽  
The Difference

Background: Appropriate pain control is one of the cornerstones necessary to promote positive clinical outcomes. A new bupivacaine liposomal formulation was designed to extend its analgesic effect for up to 72-hours post-surgery, reportedly leading to significant opioid-sparing. Method: Retrospective and prospective chart review conducted in a 178-bed academic institution between January 2013 to December 2013 and August 2014 to November 2014, in 115 patients that receive hip and knee arthroplasty. The primary outcome was the measurement of average daily pain score on post-operative days 1 and 2. Secondary outcomes included length of stay, overall opioid use post-surgery and pain control satisfaction using Press-Ganey® scores. Results: The average pain scores in the HCl group were 4.64 and 4.38 (Likert score: 0-10) for POD 1 and POD 2, compared to 4.72 POD 1 and 4.2 POD 2 in the liposome group (POD 1: p = 0.413; POD 2: p = 0.303). The difference in LOS for knee arthroplasty was statistically significant [HCl group: 1.94 days (± 0.66) versus liposome group: 2.27 days (±0.77) p-value = 0.038)] favoring the standard of care. For hip arthroplasty or bilateral knee arthroplasty the differences in LOS were not statistically significant ( p = 0.052 and p = 0.484 respectively). 93% of the patients in the HCl group, pain was well controlled, versus 88.5% in the liposome group with similar oxycodone IR use among groups. Conclusion: Liposome bupivacaine did not offer a notable benefit compared to the HCl formulation in our study.

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