A COMPARATIVE STUDY TO EVALUATE THE OUTCOME OF PONSETI'S TECHNIQUE AND ACCELERATED PONSETI'S TECHNIQUE FOR CORRECTION OF CLUBFOOT

Introduction: Clubfoot is a common congenital deformity with incidence of1-6.8/1000 live births. Ponseti method is currently the gold standard for treatment of clubfoot which conventionally involves weekly plaster changes. A prospective comparative study was carried out at our hospital where we compared one group with weekly plaster change to other group with twice weekly plaster change, using the classical Ponseti protocol of manipulation. A total 50 feet (36 children ), divided into two Methods: groups, were randomly allocated to either Group 1 – 25 feet(accelerated Ponseti) or Group 2 – 25 feet (standard Ponseti). Group 2 underwent serial manipulations and casting once a week and Group 1 received manipulations and castings twice a week. Pirani score was documented at the time of presentation, after each cast, and at the time of removalof nal cast to assess the success of treatment ( Pirani score ≤1). A tota Results: l 43 feet (29 patients) underwent the entire course of treatment, while 7 patients discontinued the treatment during the course of the study. 14 patients, i.e, 21 feet were treated with Accelerated Ponseti Protocol (APP),i.e Group -1, and 15 patients, i.e, 22 feet were treated with Standard Ponseti Protocol (SPP), i.e Group-2. Mean duration of treatment from the rst cast to tenotomy in the accelerated ponseti protocol group was 20.57 ± 4.5 days (ranging from 12 to 29 days), and in standard ponseti protocol group was 39.66 ± 6.9 days (ranging from 29 to 51 days). Conclusion: Both the methods proved to be equally efcacious for the management of clubfoot in our study. However, the accelerated method had an overall shorter treatment duration making it convenient for the parents. As the patient is under direct observation of surgeons, complications, in any, are detected early and easily. Overall, the accelerated technique is more practical, benecial, and equally efcacious as standard ponseti technique, providing a more rapid correction of the deformity.

Download Full-text

Reduction of the Risk of Relapse of Symptoms When Using Esophagoprotector in Patients Requiring Temporary Cancellation of Antisecretory Therapy

Effective Pharmacotherapy ◽

10.33978/2307-3586-2021-17-16-26-30 ◽

2021 ◽

Vol 17 (16) ◽

pp. 26-30

Author(s):

Yu.A. Kucheryavy ◽

◽

P.R. Movtaeva ◽

D.N. Andreev ◽

R.I. Shaburov ◽

...

Keyword(s):

Comparative Study ◽

Underlying Disease ◽

On Demand ◽

Long Time ◽

Prospective Comparative Study ◽

Group 2 ◽

Significant Regression ◽

Risk Of Relapse ◽

Group 1

Objective: to evaluate the effectiveness of an esophagoprotector in reducing the risk of recurrent symptoms of gastroesophageal reflux disease (GERD) in patients who requiring temporary cancellation of therapy with proton pump inhibitors (PPIs). Material and methods. For the prospective comparative study there were selectively chose patients who had been taking PPIs for a long time (at least one month) for the underlying disease and who required temporary discontinuation of antisecretory therapy due to objective medical reasons. The study included patients with endoscopically and/or pH-metrically verified GERD, as well as histologically verified Barrett's esophagus. In the process of randomization of patients, two equal groups were formed, depending on the therapy received at the time of PPI withdrawal: group 1 received antacids on demand, group 2 received antacids on demand, as well as the esophagoprotector Alfasoxx at a dose of 10 ml four times a day (after each meal and at night). The follow-up period was two weeks. The patients recorded episodes of heartburn in their personal diaries. Results. The study included 60 patients (28 men and 32 women). The average age of the examined patients was 43.1 ± 5.3 years. By the end of the two-week follow-up period, the frequency of recurrent symptoms in group 1 was 36.7%, while in group 2 it was 13.3%. The use of the esophagoprotector Alfasoxx contributed to the significant regression of the risk of heartburn recurrence (odds ratio 0.2657; 95% confidence interval (CI) 0.07328-0.9637; p = 0.0438) in comparison with the group of patients who received only antacids in the on-demand mode. When analyzing the population of patients who had relapsed symptoms, it was demonstrated that the average number of heartburn episodes in group 1 was 6.18 (95% CI 4,1930-8,1706), and in group 2 – 4.50 (95% CI 0,7121-8,2879). Conclusion. This prospective comparative study demonstrated that the use of the esophagoprotector Alfasoxx helps to reduce the risk of relapse of GERD symptoms in patients requiring temporary cancellation of PPI therapy.

Download Full-text

Does the power of the laser devices matter for a successful HoLEP procedure? A prospective comparative study

10.22541/au.161962663.32543778/v1 ◽

2021 ◽

Author(s):

Zafer Tokatli ◽

Mehmet Ferhat ◽

Muhammed Ibis ◽

Gulcin Turkmen Sariyildiz ◽

Atilla Elhan ◽

...

Keyword(s):

Comparative Study ◽

High Power ◽

Antithrombotic Therapy ◽

Functional Results ◽

Holmium Laser ◽

Prospective Comparative Study ◽

Group 2 ◽

Laser Devices ◽

Group 1 ◽

Comparative Manner

Background: To evaluate the efficiency and safety of medium power (MP) holmium laser devices in the enucleation of the enlarged prostate (HoLEP) adenomas compared to high power (HP) laser devices. Methods: Based on the device power used, a total of 120 patients were divided randomly into two groups. While patients in Group 1 were treated with a MP device (50 W) at 39.6-W (2.2J / 18Hz ), patients in Group 2 were treated with HP (100W) device at 42W (1.2J / 35Hz). Peri- and postoperative parameters were well evaluated in both groups with an emphasis on enucleation efficiency and hemoglobin decrease in a comparative manner. Results: Peri- and postoperative parameters as well as functional results were similar in the two groups. The median enucleation efficiency (EE) values in Group 1 and Group 2 were 1.15 (IQR: 0.33-2.2) and 1.11 (IQR: 0.4-2.8), respectively (p=0.775). Hemoglobin decrease values in Group 1 and Group 2 were 1.3 (IQR: 0.1-4) and 1.4 (IQR: 0.4-3.1), respectively (p=0.736). Significant improve in the postoperative functional parameters were noted again in both groups. Conclusion: Our results indicate well that similar to the HP laser devices, effective and safe removal of the enlarged prostate adenomas with MP laser devices (50W) is possible without any technical difficulties, even in patients receiving antithrombotic therapy.

Download Full-text

Functional Outcomes of 24-Hour Thumb Immobilization in Healthy Volunteers: Prospective Comparative Study

Journal of Wrist Surgery ◽

10.1055/s-0037-1598025 ◽

2017 ◽

Vol 06 (03) ◽

pp. 201-205

Author(s):

Raghuveer Muppavarapu ◽

Lyubov Tsytsikova ◽

Poonam Dalwadi ◽

Charles Cassidy ◽

Michael Gottschalk

Keyword(s):

Comparative Study ◽

Healthy Volunteers ◽

Functional Outcome ◽

Measurement Information ◽

Dominant Hand ◽

Significant Difference ◽

Patient Reported ◽

Prospective Comparative Study ◽

Group 2 ◽

Group 1

Background Immobilization is often needed for the treatment of wrist and hand injuries. The current best method of immobilization for several types of injuries has yet to be elucidated with little being reported on the functional differences of each type of immobilization. Purpose The purpose of this study is to compare the functional outcome between healthy young volunteers with a 24-hour short arm cast (SAC) versus thumb spica cast (TSC) immobilization. Methods A total of 50 healthy volunteers completed a baseline typing assessment and a Patient-Reported Outcomes Measurement Information System (PROMIS) upper extremity functional scoring assessment. Participants in group 1 were randomly initially assigned to a TSC of their dominant hand followed by an SAC, whereas participants in group 2 were randomly initially assigned to a TSC of their nondominant hand followed by an SAC. The volunteers completed the typing assessment and PROMIS assessment at the end of the 24-hour casting period. Results A total of 50 participants were enrolled in the study with 25 in group 1 and 25 in group 2. There was a 24.3-point difference between the average PROMIS score for participants with SAC compared with participants with TSC (93 vs. 68.7; p = 0.0001). There was a significant difference between the typing speed and accuracy of participants with SAC compared with participants with TSC (p = 0.0001). Conclusion There is a significant difference in functionality of a TSC immobilization versus an SAC immobilization according to the PROMIS functional outcome score and typing speed in a 24-hour casting period. SAC immobilization should be considered to have a possible similar effect in pathologic conditions instead of TSC immobilization given these findings even though a 24-hour period is not enough to provide adequate long-term conclusions. Level of Evidence I, prospective comparative study.

Download Full-text

Scanning Electron Microscopy Analysis of the Anterior Capsulotomy Edge: A Comparative Study between Femtosecond Laser-Assisted Capsulotomy and Manual Capsulorhexis

Journal of Ophthalmology ◽

10.1155/2018/8620150 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Daniele Tognetto ◽

Chiara De Giacinto ◽

Alberto Armando Perrotta ◽

Tommaso Candian ◽

Alessandro Bova ◽

...

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Femtosecond Laser ◽

Comparative Study ◽

Surface Irregularity ◽

Significant Difference ◽

Group 2 ◽

Cut Surface ◽

Scanning Electron ◽

Group 1

Purpose. To compare the capsule edges ultrastructure obtained by two femtosecond laser-assisted cataract surgery (FLACS) platforms and manual continuous curvilinear capsulorhexis (CCC) using scanning electron microscopy (SEM). Setting. Eye Clinic, University of Trieste, Italy. Design. Experimental comparative study. Methods. 150 anterior capsules were collected and divided into three groups as follows: Group 1 (50 capsules) obtained with manual CCC, Groups 2 and 3 (each with 50 capsules) obtained with the Catalys Laser and the LenSx Laser, respectively. All samples were imaged by means of SEM and regularity of the cut surface, and thickness of the capsule edge were evaluated and compared. Results. All femtosecond laser (FSL) capsules were perfectly circular, whereas some alteration of the circular shape was observed in the manual ones. Group 1 showed a smooth and regular capsule edge without any surface irregularity, conversely Groups 2 and 3 showed postage-stamp perforations on the capsule edge. The cut surface irregularity value in Group 2 was 1.4 ± 0.63, while it was 0.7 ± 0.49 in Group 3 (p<0.05). Group 1 had a significantly lower thickness of the capsule edge than the FSL groups (p<0.05). No statistically significant difference in the capsule edge thickness between the FSL groups was found (p=0.244). Conclusions. Despite the presence of slight cut surface irregularities, both FSL capsulotomies showed a better geometry and circularity than the manual ones. Capsulotomy specimens obtained using both FSL capsulotomies showed laser-induced alterations of the capsule edge when compared with smooth and regular edges obtained using manual CCC.

Download Full-text

Accelerated versus conventional Ponseti protocol for the treatment of idiopathic talipes equinovarus deformity: A short term follow up in Iraq

Zanco Journal of Medical Sciences ◽

10.15218/zjms.2021.009 ◽

2021 ◽

Vol 25 (1) ◽

pp. 473-479

Author(s):

Jagar Doski ◽

Berivan Jamal

Keyword(s):

Ponseti Method ◽

Congenital Talipes Equinovarus ◽

Talipes Equinovarus ◽

The Mean ◽

Congenital Talipes ◽

The Difference ◽

Group 2 ◽

Accelerated Protocol ◽

Group 1

Background and objective: The accelerated protocol of Ponseti method was suggested to shorten the period of treatment of the conventional one for the cases of talipes equinovarus deformity. This study aimed to compare the accelerated protocol of Ponseti method in the treatment of clubfoot deformity with the conventional one. Methods: A prospective comparative study was conducted for infants less than six months with congenital talipes equinovarus deformity. The patients were randomized to either Group 1 (casts changed every week, conventional protocol of Ponseti method) or Group 2 (twice weekly, accelerated one). Pirani score was used to assess the severity of the deformity at presentation, at time of last cast removal, and at the last follow up visit (6th months). Results: The patients included were 48 cases with 79 feet. Group 1 (39 clubfeet) had a mean Pirani score of 5.6 (± 1.15) at presentation, which dropped to 0.47 (± 0.41) when the last cast was removed. In Group 2 (40 clubfeet), it dropped from 5.57 (± 0.83) to 0.77 (± 0.01). The result of each treatment protocol was significant, but the difference between them was not significant. Five cases (three patients aged more than three months) of Group 2 needed eight casts to reach an acceptable position of correction. The difference between the mean number of casts applied in Group 1 (5.09) and Group 2 (5.82) was statistically not significant. However, the difference between the mean number of days spent in the cast was significant. The complications occurred in 12 out of 79 feet, with no statistically significant difference between both groups. Conclusion: The accelerated protocol of Ponseti method for treating clubfoot deformity is as effective and as safe as the conventional one. It shortens the time required to complete the treatment program. Those who present lately (beyond the age of three months) may require an additional number of casts. Keywords: Clubfoot; Congenital talipes equinovarus; Ponseti; Accelerated; Cast.

Download Full-text

The impact of the early tenotomy of Achilles tendon on the length and results of congenital clubfoot severe forms treatment

Vojnosanitetski pregled ◽

10.2298/vsp170815167r ◽

2019 ◽

Vol 76 (8) ◽

pp. 795-801

Author(s):

Zoran Rakonjac

Keyword(s):

Achilles Tendon ◽

Negative Impact ◽

Ponseti Method ◽

Congenital Clubfoot ◽

Results Of Treatment ◽

Analysis Of Results ◽

Group 2 ◽

The Impact ◽

Group 1 ◽

Female Subjects

Background/Aim. In this paper we present our modification of the Ponseti method which we have been using for the treatment of severe forms of congenital clubfoot since 2007. The aim of this paper was to determine, on the basis of the analysis of results, the impact of the early tenotomy of the Achilles tendon on the length and results of treatment of severe forms of congenital clubfoot. Methods. The study was prospective and lasted from 2007 to 2016 year. It was implemented in the Clinic for Children's Surgery Banjaluka. The Group 1 consisted of the subjects treated by the modified Ponseti method in the period of 9 years (2007?2016). There were a total of 30 subjects (52 feet). There were 20 (67%) of male and 10 (33%) of female subjects. There were 22 (77%) subjects with bilateral and 8 (27%) with unilateral deformity. The Group 2 consisted of the subjects treated by the classic Ponseti method in the period of 9 years (2007?2016). There were a total of 32 subjects (52 feet). There were 26 (81%) of male and 6 (19%) of female subjects. There were 20 (63%) of subjects with bilateral and 12 (37%) with unilateral deformity. We used the Pirani score for: classification of deformity according to the severity, monitoring of results of the correction, determination of indication for tenotomy of the Achilles tendon and for the analysis of results of the treatment. Results. The total length of treatment in the Group 1 was from 6 to 9 weeks (mean = 6.71 ? 0.871), and in the Group 2 from 9 to 12 weeks (mean = 9.92 ? 0.882) (r = 0.86; p = 0.001). There was no difference in the results of the treatment (?2 = 2.372 df = 2 n = 52 p = 0.936. Conclusion. Applying early tenotomy of Achilles tendon in the treatment of severe forms of congenital club foot significantly shortens the duration of treatment and has no negative impact on the results of treatment.

Download Full-text

Topical Nitroglycerine Versus Lateral Sphincterectomy for Fissure in Ano: A Hospital Based Comparative Study

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v16i2.24875 ◽

2018 ◽

Vol 16 (2) ◽

pp. 40-43

Author(s):

Bimarsh Adhikari ◽

Sunil Kumar Yadav ◽

S. N. Gupta

Keyword(s):

Comparative Study ◽

College Teaching ◽

Pain Reduction ◽

Lateral Sphincterotomy ◽

Female Ratio ◽

Benign Condition ◽

Number Of Patients ◽

The Mean ◽

Group 2 ◽

Group 1

Background: Anal fissure is a common benign condition presenting as severe pain, constipations and bleeding per rectum. It is defined as longitudinal tear or defect in anal canal skin. Surgical treatment of this conditions requires hospital admission and complications, like bleeding, infection and to its severe extent continence disturbances. That warrants a new treatment modality as pharmacological sphincterotomy i. e topical GTN (glycerine trinitrate) whose effects are reversible, cost effective and simple. Objective: The objective is to compare the effectiveness of topical GTN over lateral sphincterotomy in terms of pain management and healing of fissure. Method: This was a comparative study carried out in the department of Surgery at Nepalgunj Medical College, Teaching Hospital. Two groups were created and 25 patients in each group were put randomly. First group (Group 1) used topical GTN whereas second group(Group 2) underwent lateral sphincterotomy for treatment of fissure. The two groups were reassessed at 4 and 8 weeks for pain and fissure healing. Result: Total number of patients was 50. Each group consisted of 25 patients. The male to female ratio in group 1 was 1:1.5 and in group 2 it was 1: 1.8. In group 1 patients after 4 weeks of application of GTN pain reduced from the mean of 80±15 at the time of presentation to 50±9.27. When these patients were seen after 8 weeks, the pain reduction on VAS was nil in 21 patients out of 25. In group 2 the mean score fell from 75±15 to 20±10 after 4 weeks and at 8weeks 23 out of 25 patients didn't have any pain. It was observed that the pain reduction and healing were faster in group 2 patients when evaluated after 4 weeks (p=0.0029). but at the end of 8 weeks both group patients were similar in terms of pain reduction and healing of fissure (p=.28). Conclusion: According to study local GTN application is as effective as lateral sphincterotomy with cost effectiveness, simple with tolerable side effect and no continence disturbances.

Download Full-text

Comparative study of laparoscopic hernia repair versus open hernia repair

Journal of Nobel Medical College ◽

10.3126/jonmc.v7i2.22303 ◽

2018 ◽

Vol 7 (2) ◽

pp. 30-34

Author(s):

Rohit Prasad Yadav ◽

Dipendra Thakur ◽

Bashu Dev Baskota ◽

Amit Kumar Shah ◽

Kaushal Samsher Thapa ◽

...

Keyword(s):

Hernia Repair ◽

Comparative Study ◽

Hospital Stay ◽

Laparoscopic Hernia Repair ◽

Fatty Tissue ◽

Duration Of Surgery ◽

Group 2 ◽

Lower Pain Score ◽

Open Hernia Repair ◽

Group 1

Background: Hernia is the abnormal exit of an organ or fatty tissue, such as the bowel, through the weak wall of the cavity in which it normally resides. Repair of inguinal hernia is common surgical procedures. This study aims to compare between laparoscopic and open hernia repair. Method: Study is non randomized comparative study. Study includes 76 patients who had undergone surgery for hernioplasty. Among them 38 undergone laparoscopic hernioplasty and 38 undergone open hernioplasty from June 2016 to August 2018. Results: Mean hospital stay was 2.95 days in group 1 and 4.03 in group 2 .VAS was found to be 2.45 in group 1 and 5.71 in group 2 which is significantly low in group 1 patients with p<0.001. Duration of surgery is more in group 1 with mean duration of 94.08 minutes comparing to group 2 with mean duration of 43.55 minutes (with p<0.001). Conclusion: Laparoscopic hernia repair offers advantages over open repair in terms of less hospital stay and lower pain score for patient not contraindicated for general anesthesia and complicated hernia.

Download Full-text

Efficacy of Trigger Point Injections in Patients with Lumbar Disc Hernia without Indication for Surgery

Asian Spine Journal ◽

10.4184/asj.2018.12.2.232 ◽

2018 ◽

Vol 12 (2) ◽

pp. 232-237 ◽

Cited By ~ 2

Author(s):

Bahar Dernek ◽

Levent Adiyeke ◽

Tahir Mutlu Duymus ◽

Akın Gokcedag ◽

Fatma Nur Kesiktas ◽

...

Keyword(s):

Comparative Study ◽

Trigger Point ◽

Lumbar Disc ◽

Exercise Program ◽

Home Exercise ◽

Home Exercise Program ◽

Oral Medications ◽

Prospective Comparative Study ◽

Vas Scores ◽

Group 1

<sec><title>Study Design</title>Prospective comparative study.</sec><sec><title>Purpose</title>To investigate the efficacy of gluteal trigger point (TP) injections with prilocaine in patients with lumbosacral radiculopathy complaining of gluteal pain.</sec><sec><title>Overview of Literature</title>TP injections can be performed using several anesthetic agents, primarily lidocaine and prilocaine. While several studies have used lidocaine, few have used prilocaine.</sec><sec><title>Methods</title>A total of 65 patients who presented at the polyclinic with complaints of lower back pain with lumbar disc herniation (based on physical examination and magnetic resonance imaging) and TPs in the gluteal region were included in this prospective comparative study. Group 1 comprised 30 patients who were given TP injections, a home exercise program, and oral medications, and group 2 comprised 35 patients who were only treated with a home exercise program and oral medications. The patients' demographic data, Oswestry Disability Index (ODI) scores, and Visual Analog Scale (VAS) scores were recorded, and these data were evaluated at 1- and 3-month follow-ups.</sec><sec><title>Results</title>The ODI and VAS scores of both groups significantly decreased initially and at the follow-up examinations, but the decreases were more marked in group 1.</sec><sec><title>Conclusions</title>We obtained better results with TP injections than only a home exercise program and oral medications in patients with radiculopathy and TPs in the gluteal region.</sec>

Download Full-text

Loose knots and surgical site infections in abdominal surgeries (clean-contaminated and contaminated wounds)

International Surgery Journal ◽

10.18203/2349-2902.isj20212705 ◽

2021 ◽

Vol 8 (7) ◽

pp. 2050

Author(s):

Napa Madhusudhan ◽

R. Prabhakar

Keyword(s):

Wound Closure ◽

Surgical Site Infections ◽

Considerable Proportion ◽

Intravenous Antibiotics ◽

Vertical Mattress ◽

Prospective Comparative Study ◽

Group 2 ◽

Clean Contaminated ◽

Secondary Wound Closure ◽

Group 1

Background: Surgical site infections (SSIs) are associated with high healthcare costs and worsen the post-operative course of a considerable proportion of general abdominal surgical patients. SSIs raise the risk of post-operative morbidity and mortality, necessitating hospitalization, intravenous antibiotics, and potentially surgical reintervention. The aim of the study was to compare the outcome of intermittent loose knots and the conventional vertical mattress suturing in patients undergoing abdominal surgeries.Methods: This prospective comparative study was done in patients undergoing emergency abdominal surgeries for any cause. Patients were divided into 2 groups- (a) group 1 (45 patients): intermittent loose knots between conventional vertical mattress sutures; (b) group 2 (45 patients): conventional vertical mattress suturing.Results: In this study, 31% of patients were in the 41-50 years age group, 53.3% of patients were male. Among various abdominal surgery opted, laparotomy was the most commonly performed procedure (47%). In this study, group 1 patients shown a decrease in wound gap, secondary wound closure and delayed wound approximation than group 2 patients.Conclusions: Loose knots in between conventional vertical mattress sutures are better than conventional vertical mattress suturing in terms of wound gap, secondary wound closure and delayed wound approximation.

Download Full-text