The outcome of postoperative paresthesia of inferior alveolar nerve after surgical removal of mandibular third molar using Orthopantomogram (OPG) versus Cone-beam CT

Background: Periapical and Orthopantomogram (OPG) are the most commonly used radiographs for assessment of the relationship of lower 3rd molar roots with the inferior alveolar canal. Panoramic radiographs provide inadequate information of the buccolingual relationship between the roots of the 3rd molar & mandibular canal being two-dimensional (2D) in nature. To verify the relationship in three (3D) dimensions and to make a predictable treatment plan, traditional investigations may be supplemented by using CBCT. Cone-beam computerized tomography (CBCT) is an office-based radiography technique used to assess the three-dimensional relationship of lower 3rd molar roots with inferior alveolar nerve. Patients and methods: This comparative-cross sectional study was conducted at the Department of Oral and Maxillofacial Surgery, Fatima Memorial Hospital (FMH), Lahore from 1st January 2019 till 30th June 2019. A total of 124 patients requiring removal of lower wisdom tooth were enrolled and then divided into two groups (62 in each) randomly. OPG was used for diagnosis of impacted lower 3rd molars in Group A patients while CBCT for diagnosis in Group B patients. A self-designed Performa was used to collect the data and final information was collected after 3 months of follow-up. Data analysis was performed using SPSS 20. A chi-square test was used to compare the postoperative paraesthesia between the OPG group and CBCT group patients. A p-value <0.05 was taken as significant. Results: The occurrence of postoperative paresthesia between the two groups is significantly different; being a low percentage in the CBCT group at 2nd, 7th day and after 3 months follow-up visits with a p-value of 0.019, 0.019, and 0.005 respectively. On 3 months follow up, the distribution of paraesthesia between the two groups is significantly different; 20 patients (32.25%) in OPG group A and those of 7 (11.29%) in CBCT group B experienced paresthesia with a p-value of 0.005. Conclusion: It is better to use CBCT to improve the postoperative paraesthesia for lower third molar surgical extraction.

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Flap design: Comparison of ward’s flap versus modified ward’s flap in surgical extraction of impacted mandibular third molar.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.08.3877 ◽

2019 ◽

Vol 26 (08) ◽

pp. 1323-1327

Author(s):

Ashook Kumar ◽

Anny Memon ◽

Suneel Kumar Panjabi ◽

Salman Shams

Keyword(s):

Postoperative Pain ◽

Third Molar ◽

P Value ◽

Full Thickness ◽

Mandibular Third Molar ◽

Surgical Extraction ◽

Flap Design ◽

Mucoperiosteal Flap ◽

Group A ◽

Group B

To compare the Ward’s Flap Versus Modified Ward’s flap in relation to access, healing & postoperative complications in surgical extraction of mandibular third molar impaction. Study Design: Comparative Cross Sectional. Setting: Department of Oral & Maxillofacial Surgery LUMHS Jamshoro/Hyderabad: Period: March 2017 to November 2017. Materials and Methods: The history, clinical examination and radiographs (OPG and periapical) had done by team of researchers and recorded on proforma. After selection of patient into either group (Group A=Wards Flap, Group B Modified Wards), the surgical extraction was carried out under local anesthesia. For group A, a standard full thickness mucoperiosteal flap (ward’s flap) was raised. The incision was given mesial to the impacted lower third molar. For group B, a standard full thickness mucoperiosteal flap (Modified ward’s flap) was given mesial to second molar. At the end of the surgery, the flap design used for the extraction of impacted lower third molar tooth and the duration of each operation (from the first extraction maneuver to the completion of the last suture), Pain, Swelling and Trismus13 were recorded on the proforma. Every patient was called for follow up on the 3rd day and 7th day. Results: Mean age was found 27.93 years, with range of minimum 20 years and maximum 35 years. Male were found in the majority 72.3%. Majority of the cases 51.5% were found with class B, in class A 37.5% and 10.9% were found with class C. According to the impaction position 50% cases were in class I, and 50% cases were in class II. Preoperative pain measurement was done according VAS, 71.9% patients were found with mild pain, 9.4% were with moderate pain while 18.8% patients were without pain. Modified Wards flap showed good efficacy regarding duration of third molar extraction as compare to Ward’s flap P-value 0.018. Modified ward’s flap had showed less postoperative pain as compare to ward’s flap p-value 0.022. No significant difference was found between both groups on 3rd and 7th postoperative day in Mouth opening. Conclusion: This study concluded that both ward’s flap and modified ward’s flaps showed good efficacy, while duration of surgery and postoperative pain were significantly less in the modified ward’s flaps as compare to ward’s flap. More large sample size studies are required to evaluate more accurate findings.

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465 No Role for Postoperative Antibiotics in Uncomplicated Appendicitis

British Journal of Surgery ◽

10.1093/bjs/znab134.283 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

N Ayoub ◽

Y Tryliskyy ◽

M K Baig

Keyword(s):

Wound Infection ◽

P Value ◽

Nice Guidelines ◽

Uncomplicated Appendicitis ◽

Perforated Appendix ◽

Group A ◽

Preoperative Antibiotics ◽

Group B ◽

Variable Practice

Abstract Introduction Several studies have shown benefit from use of preoperative antibiotics in reducing postoperative infection after appendectomy as well as efficacy of postoperative antibiotics in complicated appendicitis (defined as perforated appendix or presence of pus in peritoneum). While for uncomplicated appendicitis, several studies showed no benefit from antibiotics postoperatively but there are no clear NICE guidelines till now and so surgeons have different practice based on their preferences. Method This study included patients who had appendectomy for uncomplicated appendicitis in Worthing hospital from 1st July 2019 till 30th June 2020. The end point was 30-day follow up postoperatively for wound infection or collection. Results 90 patients were admitted with uncomplicated appendicitis with age 6-80 years (mean of 31.3). 46 patients (51%) did not receive postoperative antibiotics (group A) and 44 (49%) received postoperative antibiotics (group B) with a variable practice from one dose to 8-day course. postoperatively, only 1 patient (2.1%) in group A developed wound infection requiring drainage while none in group B developed complications (p-value=1). Conclusions Administration of postoperative antibiotics in uncomplicated appendicitis showed no superiority over non-administration. in addition, they add extra cost on NHS. So, their routine use postoperatively is not recommended, however, larger studies are required to confirm this.

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Prediction of Reproductive Success in Multiparous First Service Dairy Cows by Parameters from In-Line Sensors

Agriculture ◽

10.3390/agriculture11040334 ◽

2021 ◽

Vol 11 (4) ◽

pp. 334

Author(s):

Ramūnas Antanaitis ◽

Vida Juozaitienė ◽

Dovilė Malašauskienė ◽

Mindaugas Televičius ◽

Mingaudas Urbutis ◽

...

Keyword(s):

Electrical Conductivity ◽

Blood Parameters ◽

Negative Energy ◽

Hydroxybutyric Acid ◽

Pregnancy Status ◽

Group A ◽

Biochemical Indices ◽

Relationship Of ◽

The Relationship

The aim of the current study was to evaluate the relationship of different parameters from an automatic milking system (AMS) with the pregnancy status of multiparous cows at first service and to assess the accuracy of such a follow-up with regard to blood parameters. Before the insemination of cows, blood samples for measuring biochemical indices were taken from the coccygeal vessels and the concentrations of blood serum albumin (ALB), cortisol, non-esterified fatty acids (NEFA) and the activities of aspartate aminotransferase (AST) and gamma glutamyltransferase (GGT) were determined. From oestrus day to seven days after oestrus, the following parameters were registered: milk yield (MY), electric milk conductivity, lactate dehydrogenase (LDH) and β-hydroxybutyric acid (BHB). The pregnancy status was evaluated using ultrasound “Easy scan” 30–35 days after insemination. Cows were grouped by reproductive status: PG− (non-pregnant; n = 48) and PG+ (pregnant; n = 44). The BHB level in PG− cows was 1.2 times higher (p < 0.005). The electrical conductivity of milk was statistically significantly higher in all quarters of PG− cows (1.07 times) than of PG+ cows (p < 0.05). The arithmetic mean of blood GGT was 1.61 times higher in PG− cows and the NEFA value 1.23 times higher (p < 0.05) compared with the PG+ group. The liver function was affected, the average ALB of PG− cows was 1.19 times lower (p < 0.05) and the AST activity was 1.16 times lower (p < 0.05) compared with PG+ cows. The non-pregnant group had a negative energy balance demonstrated by high in-line milk BHB and high blood NEFA concentrations. We found a greater number of cows with cortisol >0.0.75 mg/dL in the non-pregnant group. A higher milk electrical conductivity in the non-pregnant cows pointed towards a greater risk of mastitis while higher GGT activities together with lower albumin concentrations indicated that the cows were more affected by oxidative stress.

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Comparable Efficacy of Terbinafine and Itraconazole in the Treatment of Tinea Pedis

Bangladesh Journal of Medicine ◽

10.3329/bjmed.v21i2.13615 ◽

2013 ◽

Vol 21 (2) ◽

pp. 74-79

Author(s):

Md Abdul Wahab ◽

Mohammad Jamal Uddin ◽

Biswas Shahen Hassan ◽

Md Zafrul Islam ◽

Ishrat Bhuiyan ◽

...

Keyword(s):

Fungal Infection ◽

Tinea Pedis ◽

Comparable Efficacy ◽

P Value ◽

Mycological Cure ◽

Efficacy Analysis ◽

Group A ◽

Group B

Background: Tinea pedis (athlets foot) is the most common fungal infection. Relapse is common in tinea pedis and may be result of recurrence following inadequate treatment or reinfection. Objective: To evaluate the comparable efficacy of terbinafine and itraconazole in the treatment of tinea pedis. Methods: 120 patients of tinea pedis confirmed by KOH microscopy were included in the study. The study was carried out in three different Hospitals and Private Chambers for a period of 3 years from July 2006 to June 2009. Mean age of the patients was 40.28±10.23. The patients were devided into 2 equal group:A & B. Group- A was given terbinafine 250 mg/day and group-B was given intraconazole 200 mg/day for 2 weeks. Results: Follow up 2 weeks after cessation of therapy revealed clinical and mycological cure of 93.3% in terbinafine group and 86.6% in itraconazole group. Conclusion: Efficacy analysis revealed that terbinafine is superior than itraconazole in the treatment of tinea pedis (P value 0.224). DOI: http://dx.doi.org/10.3329/bjmed.v21i2.13615 Bangladesh J Medicine 2010; 21: 74-79

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Evaluation of the Relationship between Mandibular Third Molar and Mandibular Canal by Different Algorithms of Cone-beam Computed Tomography

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1609 ◽

2014 ◽

Vol 15 (6) ◽

pp. 740-745

Author(s):

Mojdeh Mehdizadeh ◽

Navid Ahmadi ◽

Mahsa Jamshidi

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Inferior Alveolar Nerve ◽

Third Molar ◽

Mandibular Canal ◽

Cross Sectional Study ◽

Cone Beam ◽

Cross Sectional ◽

Mandibular Third Molar ◽

The Relationship

ABSTRACT Objectives Exact location of the inferior alveolar nerve (IAN) bundle is very important. The aim of this study is to evaluate the relationship between the mandibular third molar and the mandibular canal by cone-beam computed tomography. Study design This was a cross-sectional study with convenience sampling. 94 mandibular CBCTs performed with CSANEX 3D machine (Soredex, Finland) and 3D system chosen. Vertical and horizontal relationship between the mandibular canal and the third molar depicted by 3D, panoramic reformat view of CBCT and cross-sectional view. Cross-sectional view was our gold standard and other view evaluated by it. Results There were significant differences between the vertical and horizontal relation of nerve and tooth in all views (p < 0.001). Conclusion The results showed differences in the position of the inferior alveolar nerve with different views of CBCT, so CBCT images are not quite reliable and have possibility of error. How to cite this article Mehdizadeh M, Ahmadi N, Jamshidi M. Evaluation of the Relationship between Mandibular Third Molar and Mandibular Canal by Different Algorithms of Cone-beam Computed Tomography. J Contemp Dent Pract 2014;15(6):740-745.

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COMPARISON OF THE EFFICACY OF ANTIBIOTIC-STEROID AND ICHTHAMMOL GLYCERINE WICK IN TREATMENT OF ACUTE OTITIS EXTERNA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-3.4556 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S612-16

Author(s):

Maryam Khan ◽

Kamran Ashfaq Ahmed Butt ◽

Naeem Riaz ◽

Zaheer Ul Hassan ◽

Attique Ahmed ◽

...

Keyword(s):

Experimental Study ◽

Otitis Externa ◽

The Other ◽

Military Hospital ◽

P Value ◽

Similar Response ◽

Quasi Experimental ◽

Group A ◽

Group B

Objective: To compare the efficacy of steroid antibiotic wick with Ichthammol Glycerol wick in the management of Acute Otitis Externa in terms of tenderness and clearance of discharge/debris. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Out Patient department of Combined Military Hospital Peshawar and Hayatabad Medical Complex Peshawar, from May to Nov 2018. Methodology: A total of 250 patients were included and divided into two groups of 125 each. After necessary suction clearance topical Ciprofloxacin/Dexamethasone (Cipotec-D) wick was placed in auditory canal of group A patients and topical Glycerol/Ichthammol wick was placed in group B. Follow up visits were done on 3rd and 7th day of starting the treatment. Results: Group A patients responded better in terms of tenderness (88%) however both groups had similar response in terms of discharge reduction (7.2% vs 6.4%). In terms of efficacy neither of the treatment proved more efficacious compared to the other (p-value 0.058). Conclusion: While steroid antibiotic wick is significantly more efficient in terms reducing tenderness, in terms of overall efficacy and discharge reduction Ichthammol/glycerol is equally effective.

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Ilioinguinal Neurectomy and Chronic Post-Operative Pain After Inguinal Hernia Repair

10.52916/jcbi214005 ◽

2020 ◽

pp. 1-7

Author(s):

Aliya Ishaq ◽

Muhammad Shadab Khan ◽

Mariya Ishaq ◽

Ayesha Saba ◽

Turab Pishori

Keyword(s):

Inguinal Hernia ◽

P Value ◽

Third Wave ◽

Brisk Walking ◽

Healthcare Facilities ◽

Nerve Preservation ◽

Post Operative Pain ◽

Group A ◽

Group B

Objective: This study aims to determine the effect of preservation /division of ilioinguinal nerve in patients undergoing lichenstein hernioraphy on severity of chronic post operative pain as well well as presence /absence of groin numbness. Method: A randamised control trial was conducted for a period of six months on 60 patient fulfilling inclusion criteria who underwent lichenstein hernioraphy at general surgery department of Liaquat National university hospital Karachi , Pakistan. Result: A total of 60 patients undergoing elective inguinal hernia mesh repair were Included in study and divided in two groups with 30 patients each. Only male patients were included in the study as female gender was one of the exclusion criteria so gender stratification was no considered. Patients between 17 to 77 yrs of age were included in study and randomly divided in two groups. Mean age of population in group A is 42.96 +/- 17.76 an in group B is 54.23 +/- 15.0. The minimum age of the patient in Group A is 17 years and maximum age is 73 years whereas minimum age of the patient in Group B is 20 years and maximum age is 77 years. 45.9% Patients in group A (Nerve preservation group) have right inguinal hernia. 54.0%% Patients in group B (Nerve Division group) have right inguinal hernia. 56.5%% Patients in group A (Nerve Preservation group) have left inguinal hernia. 43.4% Patients in group B (Nerve Division group) have left inguinal hernia. Chronic groin pain while different physical activities and groin numbness in nerve preservation and nerve division group was assessed at three and six months follow ups in all patients of the study population. 3% of the patients from nerve preservation group had mild pain during climbing stairs at three and six months follow up and the P-Value was 0.313 which is statistically not significant. 10% of the patients from nerve division group and 50% patients from nerve preservation group had pain during brisk walking at three months follow up and the P-Value was 0.001 which is statistically significant. 23% of the patients from nerve division group and 60% patients from nerve preservation group had pain during brisk walking at six months follow up and the P-Value was 0.004 which is statistically significant. 13.3% patients from nerve preservation group had moderate pain during brisk walking at three months follow up while none of the patient from nerve division group had pain and P-Value was 0.038 which is statistically significant. 6.6% of the patients from nerve preservation group had moderate pain during brisk walking at six months follow up while none of the patient from nerve division group had pain and p-value was 0.150 which is statistically in significant. 20% of the patients from nerve division group and 30% of the patients from nerve preservation group had mild groin numbness at three months follow up with P-Value of 0.371 which is statistically in significant. 33.3% of the patients from nerve division group and 30% of the patients from nerve preservation group had groin numbness at six months follow up with a p-value of 0.781 which is statistically in significant. Conclusion: Prophylactic ilioinguinal neurectomy during Lichtenstein tension free inguinal hernia repair decreases the incidence of exertional chronic post operative pain as compare to the nerve preservation group. However the cutaneous neurosensory disturbance/groin numbness between the two groups has no difference in term of outcome. In order to prepare ourselves from a expected third wave of Covid-19, we should not repeat mistakes that we made during previos waves. We should refrain ourselves from dismantling our enhanced healthcare facilities, there should not be any sorts of shortage of oxygen , hospital beds, and drug that we have already witnessed. We must have an aggressive containment measure comprising of a really strong and pro-active surveillance system. This can be achieved by increasing the capacity of the existing surveillance system by identifying active cases early. We must ensure that we should follow “social vaccine” of proper masking, avoid indoor gatherings, and proper sanitization. Our vaccination programme needs a boost. We should vaccinate a large section of people before any third wave hits us. The more we vaccinate, the better prepared we are. As medical professionals, it must be ensured that proper scientific protocol must be implemented while handling Covid-19 cases. And last but not the least efforts must be made to fill up vacancies seen in our public health system, especially for frontline healthcare workers. As it is anticipated that the young children are more vulnerable to the forthcoming third wave, efforts are to be sought in order to start vaccination of the younger children in our country. Trials for which has already been started in India and across the world. Till the time vaccine is made available, the resources are to be mobilized to build up healthcare facilities catering the vulnerable age group in this third wave such as building up of more paediatric wards, paediatric ICU’s , training of healthcare personals in handling the emergencies for expected third wave .In addition to these efforts , more and more paediatric covid care centers must be set up at various parts of the country. Equally important is making arrangements for rehabilitation centers for the orphans. Countries like US, Singapore and UAE have already started vaccinating the children in age group between 12 to 15 years with Pfizer-BioNTech Covid vaccine. It’s a high time that the government in India must consider for allowing “expedited approval pathway” to the companies like Pfizer for their Covid-19 vaccine for children. All these combined efforts from everyone may ensure that the country and world may remain well equipped against these subsequent waves of this deadly virus and pave the path of the triumph in the near future.

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BREAST ABSCESS;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.01.484 ◽

2017 ◽

Vol 24 (01) ◽

pp. 89-94

Author(s):

Muhammad Umar Javed ◽

Sidra Aleem ◽

Sheraz Jamil Asif ◽

Javed Iqbal

Keyword(s):

Needle Aspiration ◽

P Value ◽

Breast Abscess ◽

Group A ◽

Mean Size ◽

Duration Of Disease ◽

Recurrent Breast ◽

Group B ◽

Incision Drainage

Objectives: To compare the recurrence rate between incision drainage andmultiple needle aspiration for breast abscess treatment. Study Design: Randomized ControlledTrial. Setting: Department of General Surgery, Bahawal Victoria Hospital, Bahawalpur. StudyDuration: 29th September 2015 to 29th June 2016. Materials & Methods: A total of 60 femalepatients with breast abscess of <2 cm in size and of duration <2 weeks between 20 to 40 yearsof age were included. Patients with multiple breast abscesses, recurrent breast abscesses andcomplicated abscesses were excluded. The patients were randomized into Group A (incisionand drainage) & Group B (needle aspiration), by using lottery method. Follow up was done forup to 7 days and recurrence was noted. Results: The mean age of patients in group A was30.83 ± 5.67 years and in group B was 31.53 ± 5.73 years. Mean duration of disease was 7.58± 2.83 days. Mean size of abscess was 0.86 ± 0.43 cm. Recurrence was found in 07 (23.33%)patients in group A (incision drainage) while in 21 (70.0%) patients in group B (multiple needleaspiration) with p-value of 0.000 which is statistically significant. Conclusion: The recurrencerate is less after incision & drainage as compared to multiple needle aspirations for treatingbreast abscess.

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COMPARISION OF CEMENTED VERSUS UNCEMENTED HEMIARTHOROPLASTY OF THE HIP.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.07.3527 ◽

2019 ◽

Vol 26 (07) ◽

pp. 1057-1061

Author(s):

Dr. Hafiz Salman Saeed ◽

Farhad Alam ◽

Muhammad Yousaf ◽

Iqra Fayyaz

Keyword(s):

Controlled Trial ◽

P Value ◽

Orthopaedic Department ◽

Residual Pain ◽

Uncemented Hemiarthroplasty ◽

Group A ◽

The Mean ◽

Group B ◽

Trial Setting

The objective of this study was to compare the mean residual pain after cemented versus uncemented hemiarthroplasty of hip. Study Design: Randomized Controlled Trial. Setting: Orthopaedic Department, Allied Hospital, Faisalabad. Period: September 2016 to October 2017. Materials and Methods: Total 150 patients were admitted in orthopedic Department of Allied Hospital Faisalabad according to inclusion & exclusion criteria. After taking informed written consent, all patients were divided into two groups randomly. Cementedhemiarthroplasty was done in Group A patients and uncemented hemiarthroplasty was done in group B patient. All procedures were done by surgeon who has minimum 5yrs post fellowship experience. Monthly Follow up was done and residual pain was noticed at the end of 6th month. All the data was analyzed by using SPSS version 20.0. Results: In this study, in Group-A the patients between 65-75 years of age were 57.33% (n=43) and between 76-85 of age were 42.67% (n=32). In Group B the patients between 65-75 years of age were 56%(n=42) and between 76-85 years were 44% (n=33). The mean+sd was calculated and it is 73.49+4.99 years in Group-A patients and 73.73+4.74 years in Group-B patients. In Group A, males were 61.33% (n=46) and female were 38.67% (n=29). In Group B, males were 57.33% (n=43) and female were 42.67% (n=32). When we compared the residual pain after cemented versus uncemented hemiarthroplasty of the hip, it shows 1.69+0.35 in Group-A patients and 2.62+0.30 in Group-B patients. When we calculated p-value it was 0.0001 showing a significantdifference. Conclusion: It is concluded that residual pain in cemented hemiarthroplasty is lower than uncemented hemiarthroplasty.

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Short-term outcome of Manual Thrombus Aspiration for patients Undergoing Primary PCI for Acute STEMI Showing LargeThrombus burden

QJM ◽

10.1093/qjmed/hcaa041.028 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M N Penjameen ◽

E M Elfekky ◽

R R Elias ◽

A I Nassar

Keyword(s):

Systolic Function ◽

P Value ◽

Primary Pci ◽

Thrombus Aspiration ◽

Culprit Lesion ◽

Short Term ◽

St Segment ◽

Group A ◽

Group B

Abstract Background Thrombus aspiration (TA) might have a potential role in STEMI patients with heavy thrombus burden. The objective of several prospective trials whether routine TA in STEMI patients, contributes to a reduced mortality. After the first promising results, mainly based on the single center (TAPAS trial), results of the largest randomized trials to date (TASTE) study and (TOTAL) study, have not shown any significant differences in all-cause mortality, re-hospitalizations or stent thrombosis after a maximum of one-year follow-up period Objectives The aim of this prospective study is to study the in-hospital & short term out-come of using manual thrombus aspiration in STEMI patients undergoing primary PCI & showing large thrombus burden. Results The study included 209 patients referred to (CCU) of (Ain Shams University hospitals) with diagnosis of STEMI, who had under-gone primary PCI, with evidence of heavy thrombus burden . All the patients received DAPT, 99% had received GPIIbIIIa antagonists. The patients were divided into 2 groups: group (A) included 73 patients, who had under-gone manual thrombus aspiration followed by PCI to culprit lesion +/- other vessels & and group (B) included 136 patients, who had under-gone primary PCI of culprit lesion+/- other vessels, using the standard technique, without thrombus aspiration, within the period from 11/2016 till 7/2018(21 months),and they were followed up during hospital stay & for one month following hospital discharge. No stents were used in 13.7% of group (A), but no stents were used on 3.7% of group (B) (p value= 0.007). TIMI III flow had been achieved in 94.5% of group (A), 80.1% of group (B)(p value = (0.020) . MBG 3 had been achieved in 82.2% of group (A), 58.1% of group (B) . ST-segment resolution > 70% had been achieved in 8.2% of group (A), that hadnot been achieved in group (B) (p value =0.003). Mortality(among MACE) was the only event detected (p value 0.026). Follow up MACE were statisticalLy significant results (p value=0.022) . Statistically highly significant results regarding, LV systolic function EF %, p vaue= 0.001, had been achieved . Conclusion In STEMI patients with evidence of heavy thrombus burden, a strategy of manual aspiration thrombectomy is valuable in reducing index hospitalization mortality, and 1 month follow-up rates of mortality, TIMI flow, better MBG, ST-segment resolution, in addition to left ventricular systolic function .

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