scholarly journals EVALUATION OF RADIOLOGICAL UNION OF CALVARIA FOLLOWING CRANIOTOMY

2021 ◽  
pp. 1-3
Author(s):  
Majida Begum ◽  
Sudip Kumar Sengupta ◽  
Parvesh Malik ◽  
Debarshi Jana
Keyword(s):  
Observational Study ◽  
Free Flap ◽  
Radiation Treatment ◽  
Fusion Rate ◽  
Clinical Indication ◽  
Fixation Technique ◽  
Non Union ◽  
Number Of Patients ◽  
Postoperative Headache ◽  
Study Population

INTRODUCTION This is an Am bidirectional observational study. Study population is the patients who have undergone craniotomy for any indication in the department of neurosurgery of CH (EC) from September 2016 to Aug 2019. A list of patients who have undergone NCCT/CECT head during their follow up period, due to any clinical indication, drawn. All such patients interviewed and clinically examined for pain at the craniotomy site. AIMS AND OBJECTIVES The incidence of non-union was Correlation between non-union and predisposing factors via primary pathology, fixation technique, age, sex, comorbidities such as DM, TB and radiotherapy. Correlation with postoperative headache MATERIALS AND METHODS Study area Command Hospital Eastern Command. Study population- Patients who have undergone craniotomy for any indication in the department of neurosurgery of CH (EC) from September 2016 to Aug 2019. Sample size is the number of patients who have undergone CT Scan evaluation based on clinical indications in the post operative period. Am bidirectional observational study RESULT AND ANALYSIS We showed that in ICSOL was significantly in higher non union and bad union patients; Head Injury was significantly higher in good union patients. It was found that carcinoma patients were higher in non union and bad union which was statistically significant. Radiation patients were higher in good union which was statistically significant. Present study found that Post-Op Headache was significantly higher in non union and bad union and mean Rate of union was higher in good union. Association of Fixation Technique with Non Union, Good Union and Bad Union was statistically significant. CONCLUSION We can conclude that patients are more likely to have their craniotomy fuse if they did not undergo radiation treatment or have sutures secure the free flap. Craniotomy fusion rates after free flap increases steadily over time, as expected. We were not able to demonstrate that clinical factors such as age, sex, BMI, diagnosis, fixation material, and radiation have an impact on fusion rate when time to fusion was considered.

scholarly journals Trends in the prescription of clozapine in a psychiatric hospital: a 5-year observational study

2017 ◽  
Vol 39 (3) ◽  
pp. 158-164 ◽  
Author(s):  
Gabriela Danielski Niehues ◽  
Alexandre Balestieri Balan ◽  
Vinicius Brum Prá ◽  
Raphaela Santos Pellizzaro ◽  
Paulo Roberto Antunes da Silva ◽  
...  
Keyword(s):  
Observational Study ◽  
Psychiatric Hospital ◽  
Multiple Linear Regression Model ◽  
Study Data ◽  
Clinical Indication ◽  
Number Of Patients ◽  
Proxy Measure ◽  
Icd 10 ◽  
Prescription Rates ◽  
Potential Benefits

Abstract Introduction Clozapine is a well-recognized effective treatment for some patients with treatment-resistant schizophrenia (TRS). Although it has potential benefits and approximately 30% of patients have a clinical indication for clozapine use, prescription rates are low. Objective To evaluate clozapine prescription trends over a 5-year period in a tertiary psychiatric hospital. Methods In this observational study, data prospectively collected by the Medical and Statistical File Service (Serviço de Arquivo Médico e Estatístico) and the Pharmacy Division of Instituto de Psiquiatria de Santa Catarina between January 2010 and December 2014 were summarized and analyzed by investigators blinded to data collection. The number of 100 mg clozapine pills dispensed by the Pharmacy Division to the inpatient units was the outcome and considered a proxy measure of clozapine prescriptions. The number of occupied inpatient unit beds and the number of patients admitted with F20-F29 (ICD-10) diagnoses during the study period were considered to be possible confounders. Results A multiple linear regression model showed that time in months was independently associated with an increase in the number of clozapine pills dispensed by the Pharmacy Division (β coefficient = 15.82; 95% confidence interval 10.88-20.75). Conclusion Clozapine prescriptions were found to have increased during the 5-year period studied, a trend that is opposite to reports from several other countries.

A Multicentric non-interventional observational study to determine treatment patterns and response of drugs in various stages of breast cancer along with epidemiology

2020 ◽  
Vol 8 (2) ◽  
pp. 71-81
Author(s):  
Mukkamala Durga Niharika ◽  
Shaik Kulsumbi ◽  
Devagiri Anupama ◽  
Tadigiri Vineela Supriya ◽  
Kotari Navya ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Observational Study ◽  
Receptor Expression ◽  
Breast Cancer Patients ◽  
Female Patients ◽  
Life Threatening ◽  
Guntur District ◽  
Study Population ◽  
Hormone Receptor Expression

Cancer is a life-threatening disease which causes to lose cohesiveness and orderliness of normal tissue. These malignant cells can spread to any other organ through blood flow or lymphatic flow and develop malignancy over there; this phenomenon is called metastasis. The aim is to focus on treatment pattern and response of drugs in various stages of breast cancer along with epidemiology. It is a non- interventional multicentric observational study. Female patients confirmed with Breast cancer are included in the study. All the relevant data were collected on a patient demographic form after obtaining informed consent from individual patients. In our study, the mean age of presentation in breast cancer patients was 41.35 years. Further it was found that 40.5% (n = 81) majority-female patients with Breast cancer are from Guntur District and 21.5% (n= 43). The majority of women with Breast cancer have hormone receptor expression of ER+/PR+HER2- was found to be 33% (n= 50). In the study on analyzing comorbidities of the study population, it was noted that 28.5% of women were affected with Diabetes mellitus. In our study, it was found that most of the patients with Breast cancer have been most often prescribed with Adriamycin 27.86%. From these observations, we conclude that late menarche may be one of the etiological causes of breast cancer in women, Invasive carcinoma in situ is the most commonly reported breast cancer in the study. Patients have been diagnosed with breast cancer at their stage 3 of progression, which may be the reason for making it mandatory for more than 50% of patients to undergo 6 to 8 cycles of chemotherapy. Coming to the patterns of drug use, ADRIAMYCIN, CYCLOPHOSPHAMIDE and DOCETAXEL are the three most commonly used single drug and combinational drug therapies among the study population.

scholarly journals Disease course of Neurofibromatosis Type 2; a 30-year follow-up study of 353 patients seen at a single institution

2020 ◽  
Author(s):  
Claire Forde ◽  
Andrew T King ◽  
Scott A Rutherford ◽  
Charlotte Hammerbeck-Ward ◽  
Simon K Lloyd ◽  
...  
Keyword(s):  
De Novo ◽  
Radiation Treatment ◽  
Univariate Analysis ◽  
Age At Onset ◽  
Neurofibromatosis Type ◽  
Neurofibromatosis Type 2 ◽  
Disease Course ◽  
Number Of Patients

Abstract Background Limited data exists on the disease course of Neurofibromatosis Type 2 (NF2) to guide clinical trial design. Methods A prospective database of patients meeting NF2 diagnostic criteria, reviewed between 1990–2020, was evaluated. Follow-up to first vestibular schwannoma (VS) intervention and death was assessed by univariate analysis and stratified by age at onset, era referred and inheritance type. Interventions for NF2-related tumours were assessed. Cox regression was performed to determine the relationship between individual factors from time of diagnosis to NF2-related death. Results Three-hundred-and-fifty-three patients were evaluated. During 4643.1 follow-up years from diagnosis to censoring 60 patients (17.0%) died. The annual mean number of patients undergoing VS surgery or radiotherapy declined, from 4.66 and 1.65 respectively per 100 NF2 patients in 1990-1999 to 2.11 and 1.01 in 2010-2020, as the number receiving bevacizumab increased (2.51 per 100 NF2 patients in 2010-2020). Five patients stopped bevacizumab to remove growing meningioma or spinal schwannoma. 153/353 (43.3%) had at least one neurosurgical intervention/radiation treatment within 5 years of diagnosis. Patients asymptomatic at diagnosis had longer time to intervention and better survival compared to those presenting with symptoms. Those symptomatically presenting <16 and >40 years had poorer overall survival than those presenting at 26-39 years (P=0.03 and P=0.02 respectively) but those presenting between 16-39 had shorter time to VS intervention. Individuals with de novo constitutional variants had worse survival than those with de novo mosaic or inherited disease (P=0.004). Conclusion Understanding disease course improves prognostication, allowing for better informed decisions about care.

scholarly journals Postoperative bisphosphonate do not significantly alter the fusion rate after lumbar spinal fusion: a meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jun Mei ◽  
Xiaoxu Song ◽  
Xiaoming Guan ◽  
Dou Wu ◽  
Junjie Wang ◽  
...  
Keyword(s):  
Bone Formation ◽  
Spinal Fusion ◽  
Meta Analysis ◽  
Fusion Rate ◽  
Lumbar Spinal Fusion ◽  
Fusion Surgery ◽  
Number Of Patients ◽  
Cage Subsidence ◽  
Lumbar Spinal

Abstract Background To evaluate the effect of postoperative BP treatment on improving the fusion rate after lumbar spinal fusion surgery by performing a meta-analysis of randomized controlled trials (RCTs) and other comparative cohort studies. Methods A comprehensive search of PubMed, EMBASE, the Web of Science, and the Cochrane Central Register of Controlled Trials was performed for RCTs and other comparative cohort studies on the effect of BP treatment on improving the fusion rate after lumbar spinal fusion surgery. The primary outcome measures were the number of patients with bone formation grades A, B, and C at 12 months of follow-up; fusion rates at 12 and 24 months of follow-up; vertebral compression fracture (VCF) at 12 and 24 months of follow-up; pedicle screw loosening at 24 months of follow-up; and cage subsidence, the Oswestry disability index (ODI), and the visual analogue score (VAS) at 12 months of follow-up. The final search was performed in July 2020. Results Seven studies with 401 patients were included. Compared with the placebo, BP treatment did not significantly alter the number of patients with bone formation grades A, B, and C, or the VAS at the 12-month follow-up or the fusion rates at the 12- and 24-month follow-ups. In addition, compared with the placebo, BPs significantly reduced the risks of VCF at the 12- and 24-month follow-ups, pedicle screw loosening at the 24-month follow-up, and cage subsidence and the ODI at the 12-month follow-up. Conclusions Postoperative BPs do not clearly improve bone formation and the fusion rate, but they reduce VCF, cage subsidence, and loosening of pedicle screws after lumbar fusion surgery compared with the control treatment.

scholarly journals 662 MICROVASCULAR MYOCUTANEOUS AND CUTANEOUS FREE FLAP RECONSTRUCTION FOR PATIENTS WITH TERMINAL ESOPHAGOSTOMY AFTER COMPLICATED ONCOLOGICAL ESOPHAGUS RESECTION

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Lukas Pölsler ◽  
Jaroslav Presl ◽  
Christian Brandtner ◽  
Alexander Gaggl ◽  
Jörg Hutter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Free Flap ◽  
Treatment Options ◽  
Graft Function ◽  
Oral Intake ◽  
Artificial Nutrition ◽  
Severe Problem ◽  
Promising Alternative ◽  
Number Of Patients

Abstract   Persisting anastomotic leak after oncological esophagectomy is a severe problem associated with high mortality and morbidity. Unfortunately, treatment options with promising results are scarce especially when conventional operative and endoscopic methods have failed. Due to limitation of oral intake and need for artificial nutrition quality of life is reduced. Microvascular myocutaneous and cutaneous free flap (MFF) reconstruction could be a promising alternative. Methods This retrospective cohort study presents seven patients treated between March 2017 and November 2020 at our surgical department, with terminal esophagostomy after complicated oncological esophagus resection without further feasible treatment options. All Patients received anastomotic MFF reconstruction. We have examined postoperative outcomes, complications according to Clavien-Dindo-Classification and patient contentment with a questionnaire. Additionally, we described important procedure related facts. Results The included seven male patients had median age of 65.15 years (range: 48–75). MFF function was adequate in six out of seven patients, graft rejection appeared in one patient. Five patients initially had good results, surgical revision was performed in one patient to ensure graft function. Postoperative complications appeared in 6/7 patients (Table 1). Mean duration of inpatient care was 63 days (Range: 24–156). At time of evaluation, one patient has died cancer related. No more additional nutrition was needed in 3/6 patients with adequate graft function. The majority of patients reported an improved quality of life compared to preoperatively. Conclusion MFF free flap can be a safe and feasible treatment option for patients with terminal esophagostomy after complicated oncological esophagus resection without further treatment options or in patients with complicated postoperative course with complex combined defects. The renewed ability of oral food intake results in a significant improvement of quality of life for the patients. No procedure related mortality was observed. Number of patients with regained ability of oral intake is encouraging.

scholarly journals Regional differences in reasons for consultation and general practitioners’ spectrum of services in Northern Germany – Results of a cross-sectional observational study

2019 ◽  
Author(s):  
Ingmar Schäfer ◽  
Heike Hansen ◽  
Thomas Ruppel ◽  
Dagmar Lühmann ◽  
Hans-Otto Wagner ◽  
...  
Keyword(s):  
Observational Study ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Training ◽  
Practice Trial ◽  
Cross Sectional ◽  
Federal States ◽  
German Federal States ◽  
Number Of Patients ◽  
Individual Consultation

Abstract Background Among other factors, the patients’ consultation reasons and GPs’ spectrum of services determine the process and outcome of the medical treatment. So far, however, there has been little information on differences in reasons for consultation and GPs’ services between urban and rural areas. Our study’s goal was thus to investigate these factors in relation to the regional location of GPs’ practices. Methods We conducted a cross-sectional observational study based on standardised GP interviews in a quota sampling design. All counties and independent cities within a radius of 120 km around Hamburg were divided into three regional categories (urban area, environs, rural area) and stratified proportionally to the population size. Differences in the number of reasons for consultation and services were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the German federal states and administrative districts. Differences in individual consultation reasons and services were identified by logistic regression via stepwise forward and backward selection. Results Primary care practices in 34 of the 37 selected administrative districts (91.9%) were represented in the dataset. In total, 211 GPs were personally interviewed. On average, GPs saw 344 patients per month with a slightly higher number of patients in rural areas. They reported 59.1 ± 15.4 different reasons for consultation and 30.3 + 3.9 different services. There was no statistically significant regional variation in the number of different consultation reasons, but there was a broader service spectrum by rural GPs (ß=-1.42; 95% confidence interval -2.75/-0.08; p=0.038) which was statistically explained by a higher level of medical training. Additionally, there were differences in the frequency of individual consultation reasons and services between rural and urban areas. Conclusion GPs in rural areas performed more frequently services usually provided by medical specialists in urban areas. This might be caused by a low availability of specialists in rural areas. The association between medical training and service spectrum might imply that GPs compensate the specific needs of their patients by completing advanced medical training before or after setting up a medical practice. Trial registration The study was registered in ClinicalTrials.gov (NCT02558322).

scholarly journals Metabolic syndrome in alopecia areata: an observational study at a tertiary care center

2021 ◽  
Vol 7 (5) ◽  
pp. 647
Author(s):  
Subrata Kumar Das ◽  
Saptadipa Das
Keyword(s):  
Metabolic Syndrome ◽  
Observational Study ◽  
Alopecia Areata ◽  
Care Center ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Center ◽  
Cross Sectional ◽  
Laboratory Parameters ◽  
Number Of Patients

<p class="abstract"><strong>Background:</strong> The aim was to evaluate the parameters of metabolic syndrome (MS) in patients of alopecia areata and to investigate the possibility of an existing relationship between MS and alopecia areata (AA).</p><p class="abstract"><strong>Methods:</strong> This cross-sectional observational study included 50 patients with AA who attended OPD of department of dermatology at a tertiary care center during a period of 1 year. Clinical and laboratory parameters were noted in each patient.<strong></strong></p><p class="abstract"><strong>Results:</strong> This study included 50 patients with AA (33 males and 17 females). In the present study maximum number of patients belonged to the age group 20-30 years with 23 patients, followed by 30-40 years with 17  patients. Most of the study subjects, 17 were college students and number of employees were 15. Out of 50 patients 44  had patch(es) and 2 patient had alopecia totalis. In this study out of 50 patients, 38 had mild AA, 7 had AA and 5 patients had severe AA. No significant derangement of clinical and laboratory parameters of MS observed in patients of AA.</p><p class="abstract"><strong>Conclusions:</strong> In the present study we did not observe any significant derangement of clinical and laboratory parameters of  MS  in patients of alopecia areata.</p>

scholarly journals The prevalence of gastroesophageal reflux disease and its association with various risk factors in a tertiary care centre in West Bengal

2021 ◽  
Vol 9 (3) ◽  
pp. 780
Author(s):  
Anant Parasher ◽  
Kunal Ranjan
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Urban Areas ◽  
West Bengal ◽  
Past History ◽  
Tertiary Care ◽  
Time Interval ◽  
Number Of Patients ◽  
Study Population

Background: Gastroesophageal Reflux (GER) is the regurgitation of gastric contents and acid into the esophagus. Frequent and abnormal amounts of reflux leads to Gastroesophageal reflux disease (GERD) which causes symptoms like heartburn, regurgitation, and /or other complications. In view of absence of any data on the prevalence of GERD from this part of India, the current population based study was conducted to study the prevalence of GERD and its association with various risk factors.Methods: In this community based prospective cross-sectional observational study, 500 patients from rural and urban areas of West Bengal were included during the one year period from July 2014 to June 2015.Results: Out of a total of 500 patients studied, the percentage of patients with GERD in our study population was found to be 31.3%. Out of 292 males enrolled for the study, number of patients with GERD was 66 (22.6%) as compare to females where the same was found to be 43.26% (90/208). The majority (68.2%) of patients had mild GERD, 18.5% had moderate GERD whereas only 13.3% of patients had severe GERD.Conclusions: The percentage of patients with GERD in our study population was found to be 31.3%. It was observed to be significantly associated with increasing Body Mass Index (B.M.I), smoking, the female gender, a sedentary lifestyle, dinner to bed-time interval of ≤2 hours, chronic NSAID use, and a past history of abdominal surgery.

A STUDY ON OUTCOME OF MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS (MIPO) IN EXTRA ARTICULAR FRACTURE OF DISTAL 1/3RD TIBIA.

2021 ◽  
pp. 106-111
Author(s):  
Vaibhav Vaibhav
Keyword(s):  
Soft Tissue ◽  
Average Duration ◽  
Tibial Fractures ◽  
Categorical Variables ◽  
Minimal Risk ◽  
Distal Tibial Fractures ◽  
Non Union ◽  
Articular Fractures ◽  
Number Of Patients ◽  
Duration Of Surgery

BACKGROUND: Fractures of the distal tibia can be challenging to treat because of the limited soft tissue, the subcutaneous location, and poor vascularity. There is a considerable debate regarding the best method for treating distal tibial fractures. In present study we have treated distal tibial fractures using MIPPO technique OBJECTIVES: To evaluate the functional outcome following use of MIPO technique in lower 1/3rd fractures of tibia. MATERIAL AND METHODS: This is a longitudinal follow up study. In this study a total of 30 patients with fracture distal 1/3rd tibia admitted to CMRI hospital will be selected for treatment with MIPO technique according to inclusion and exclusion criteria. All patients were reviewed in CMRI Hospital and radiographs (Tibia AP and lateral views) obtained after surgery and then at 1 month, 3 months and nally at 6 months. From 5 weeks onwards symptoms and functions will be assessed using the scoring system of Olerud and Molander(1984). Statistical analysis of categorical variables was expressed as number of patients and percentage of patients and continuous variables are expressed as descriptive statistics. The statistical software SPSS version 20 has been used for the analysis. RESULTS: The age of patients ranged from 22-65 years. Fracture was most common in 4th and 5th decade of life. Average mean age was 44.03±10.74yrs. In this study majority of 17(56.7%) patients were male and there were 13(43.3%) were female. Road Trafc accident (RTA) was the main cause to produce lower end tibia fractures (83.3%) in our study. In this study right side (60%) was involved more than left (40%). In this study only 3 (10%) patients had open grade 1 injury. Majority of patients 27 (90%) had closed injury. In our study 66.67% (20) of patients had associated injuries and 33.33% patients had no associated injury. Average injury operation interval in this study was 3.27±1.53 days. Average no. of plate holes were 10.50±1.72. Average duration of hospital stay in this study was 10.07±2.75 days. Average duration of surgery in this study was 88.03±16.36 minutes. In this study 26 patients (86.7%) had no early post-op complications and 4 (13.3%) had complications. 3 patients (10%) had delayed wound healing and 1patient (3.3%) had supercial infection of suture lines. There was 1 non-union and majority of patients 21(70%) took 20-25 weeks for union. 7(23.4%) patients took less than 20 weeks and 1(3.33%) patient took more than 25 weeks. Average time of union in this study was 21.17±2.17 weeks. Average time of weight bearing was 17.72±1.91 weeks in this study. Most frequent late complication seen was swelling with frequency of 7 followed by stiffness and pain. 1 patient had malunion and 1 patient had non-union. In this study there were 28(93.3%) patients which showed union, 1 (3.3%) patient showed coronal malunion and 1(3.3%) had non-union. There were 21 patients (70 %) with excellent result, 7 patients (23.3%) with good result and 2 patients (6.7%) with fair result in our cases of study. Average clinical Olerud & Molander score was 81.17±16.07 in this study. CONCLUSION: The satisfactory functional results and lack of soft tissue complications suggest that this method should be considered in peri-articular fractures. Biological xation of complex fractures gives stable as well as optimal internal xation and complete recovery of limb function at an early stage with minimal risk of complications.

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