Topiramate and Pregabalin in Lumbar Radicular Pain. Is Topiramate a better option?

Abstract Objective: To compare the efficacy of two anticonvulsant drugs topiramate and pregabalin on lumbar radicular pain and to find out whether topiramate is a better option or not. Study design: Experimental study. Place and Duration: Department of Neurosurgery, Combined Military Hospital Lahore. January 2020 - March 2020. Patients and Methods: 60 patients of both gender divided in two groups of 30 each were included. Patients were assessed based on subjective impairment scale of oswestry disability index. Maximum score was calculated in percentage with higher score pointing to greater disability. Both drugs were given in low starting once daily dose, 75 mg for pregabalin and 25 mg for topiramate for two weeks followed by twice daily dose for two more weeks in patients not getting pain relief. Results: Male to female ratio of 4:1 in both groups. Age range of 27-77 years (41.5+12.45) for pregabalin and 22-74 years (41.6+14.6) for topiramate group. Baseline demographics and pre drug pain measurement index were identical amongst two groups. Oswestry disability index was 49.2+18.3 pre drug and post drug 41+16.4 for pregabalin (p<0.01). For topiramate it was 43.6+37.9 pre drug and 37.9+17.3 post drug (p <0.01). Conclusion: Both pregabalin and topiramate are effective in radicular pain management, and topiramate is not better but still a viable option as an alternative to pregabalin.

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Frequency of Patients Passing an Impacted Esophageal Meat Bolus by Conservative Method Alone

Esculapio ◽

10.51273/esc20.2516311 ◽

2020 ◽

Vol 16 (03, july 2020-Septmber 2020) ◽

Author(s):

Ghulam Murtaza ◽

sarwat Hassan Syed ◽

Mohammad Qamar Nasir ◽

Damish Arsalan ◽

Muhammad Awais Amin ◽

...

Keyword(s):

Conservative Management ◽

High Frequency ◽

Clinical Suspicion ◽

Barium Swallow ◽

Single Intravenous Dose ◽

Demographic Information ◽

Food Bolus ◽

Female Ratio ◽

Age Range ◽

Male To Female

Objectives: To determine the frequency of patients passing the impacted esophageal meat bolus by conservative management Methods: After obtaining permission from ethical committee of Hospital,a total of 62 patients meeting the study criteria were recruited in the study which was conducted in Department of Otorhinolaryn-gology, Services Hospital, Lahore. Demographic information (name, age, gender, contact) was also obtained. Patients with clinical suspicion of impacted esophageal food bolus of age 20-50 years of either gender were included. Patients with known esophageal abnormalities like stricture, web or growth on either barium swallow or esophagogastroduodenoscopy, peptic ulcer and GERD were excluded. After taking informed written consent from each patient, single intravenous dose of buscopan 20mg was given to each patient. Each patient was followed by the researcher himself for 24 hours to assess the passage of food bolus. Results: 20-50 years was the age range in our study, with mean age being 34.10± .63 years. Majority of the patients 32 (51.61%) were between 20 to 35 years of age. Out of 62 subjects, 37 (59.68%) were male, 25 (40.32%) were females with male to female ratio 1.5:1. In our study, Frequency of patients passing the impacted esophageal meat bolus by conservative management was found in 51 (82.26%) patients. Conclusion: This study concluded that there is a high frequency of patients passing the impacted esophageal meat bolus by conservative management. Keywords: Esophagus, foreign body, conservative management.

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OUTCOME OF DACRYOCYSTORHINOSTOMY WITH OR WITHOUT SILICON INTUBATION IN PRIMARY NASOLACRIMAL DUCT OBSTRUCTION

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2011.1.2.55-59 ◽

1969 ◽

Vol 1 (2) ◽

pp. 55-59

Author(s):

Haroon Rashid ◽

Faizur Rahman ◽

Abid Naseem ◽

Arshad Iqbal.

Keyword(s):

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Interventional Study ◽

Female Ratio ◽

Duct Obstruction ◽

Number Of Patients ◽

Silicon Tube ◽

Complications Rate ◽

Age Range ◽

Male To Female

Objectives: The objective of the study was to compare the outcome of Classical Dacrocystorhinostomy(DCR) alone or with Slicon intubation in patients of primary nasolacrimal duct obstruction.Study design: This is a randomized prospective interventional study performed at Saidu Teaching Hospitalform from 1st January'2006 to 31st December 2006.Material and methods: Diagnosis of nasolacrimal duct obstruction was made on basis of history, clinicalexamination, regurgitation test and syringing of the nasolacrimal passage. Patients were selected byconvenient sampling and were randomized to two groups, for DCR with and without Silicon tube. Silicontube was removed after 4 months of surgery. Patients were followed up to 6 months.Results: Total number of patients was one hundred. Fifty (50%) patients were operated with siliconintubation and 50 (50%) without silicon intubation. Male to female ratio was 1:1.27.Age range was 15 yearsto 80 years. Mean, median and mode ages were 42.54, 47 and 30 years respectively. Eleven patients werelost from the study at various stages and were not included in the results of the study. The complicationsnoted were silicon tube loss in 2 cases, silicon tube displacement in 3 cases and DCR failure in 4 cases.Among the failure, 2 cases belonged to each group with and without silicon intubation.Conclusions: We conclude that the complications rate with and without silicon intubation is the same inprimary nasolacrimal duct obstruction. It is therefore, recommended that silicon intubation may not benecessary in such cases.Key words: DCR, Intubation, NLD Obstruction.

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Effectiveness of Liraglutide in Type II Diabetes Mellitus Management: Experience in Emirati Patients

Clinical Medicine Insights Endocrinology and Diabetes ◽

10.4137/cmed.s31756 ◽

2015 ◽

Vol 8 ◽

pp. CMED.S31756 ◽

Cited By ~ 1

Author(s):

Nasrullah K. Ghuman ◽

Loai M. Saadah ◽

Majdi S. Al Najjar ◽

Duha Y. Shaheen ◽

Shady I. AM ◽

...

Keyword(s):

Standard Form ◽

Type Ii Diabetes Mellitus ◽

Military Hospital ◽

Patient Visit ◽

Female Ratio ◽

P Values ◽

Patients Âgés ◽

Male To Female ◽

Univariate Analyses

Objective To measure effectiveness of liraglutide in reducing glycated hemoglobin (HbA1C), weight, and systolic blood pressure (SBP) in Emirati patients. Design A retrospective cohort study. Setting Endocrinology clinic in a 300-bed military hospital. Patients A total of 152 patients who qualified for liraglutide between September 21, 2012, (first patient visit) and May 5, 2014 (last patient visit). Methods Team collected demographic and clinical data using a standard form. Data keeper performed univariate analyses to measure the effect of liraglutide in reducing the three outcomes of interest; namely, HbA1C, weight, and SBP. Results One hundred patients had at least the first visit in the clinic and 98 patients came for a second follow-up visit while on the medication. Adherence of clinicians to the internal criteria for prescribing liraglutide was 92%. Patients' ages were 47.9 ± 11.7 years. Male-to-female ratio was almost 1:1. Overall, in the paired analyses, HbA1C decreased from first to second visits (8.7 ± 1.9 vs. 7.6 ± 1.8, P < 0.0001) and remained unchanged in subsequent visits (eg, in visit 3, HbA1C was 7.4 ± 1.8). Patients lost an average of 1.3 kg between the first and second visits (99.3 ± 19.3 vs. 98.0 ± 19.5, P = 0.0003). The reduction in SBP between visits 1 and 2 was less (130.9 ± 15.8 vs. 129.9 ± 16.5, P = 0.5896). ANOVA yielded a significant reduction in HbA1C at 4 months and 6 months ( P values < 0.05). SBP dropped by about 3.6 mmHg and weight by about 2.3 kg ( P values > 0.05). Conclusions Liraglutide is effective in reducing HbA1C, weight, and to a lesser extent, SBP in Emirati patients.

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Diagnostic Accuracy of Rapid Diagnostic Kits Test for Diagnosis of Malaria

10.53350/pjmhs2115102826 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2826-2828

Author(s):

Muhammad Ahsan Zafar ◽

Sidra Khalid ◽

Talha Munir

Keyword(s):

Diagnostic Accuracy ◽

Gold Standard ◽

Female Ratio ◽

Diagnostic Kits ◽

Negative Results ◽

Malaria Antigen ◽

The Mean ◽

Sensitivity Specificity ◽

Age Range ◽

Male To Female

Objective: To assess the diagnostic accuracy of rapid diagnostic kits test for diagnosis of malaria taking microscopy as gold standard Methodology: A total of 375 cases with age range 18-65 years of either gender as suspected for malaria were included in the study. We excluded all those cases already taking anti-malarial drugs. The study was conducted at Chughtais Lahore Lab, Lahore. Required blood sample were obtained following aseptic measures. Malaria RDT SD Bioline Malaria Antigen Pf/Pan (Catalogue No. 05FK60, Standard Diagnostics Inc, Hagal-Dong, Korea, from now on referred as “SD RDT”) was used. Patients were labeled as positive or negative on the basis of reports from hematology department assessed by microscopy and patients were labeled as positive or negative Results: The mean age of the patients was 41.84±13.44 years, male to female ratio of the patients was 1.01:1. The sensitivity, specificity, and diagnostic accuracy of the RDT for diagnosing malaria was 96.79%, 96.28% and 96.53% respectively taking microscopy as gold standard Conclusion: Rapid diagnostic kits is very useful reliable test with high diagnostic accuracy for diagnosis of malaria taking microscopy as gold standard Keywords: Microscopy, Rapid Diagnostic kits, Malaria,

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Drug Abuse Deaths in Glasgow in 1992 — A Retrospective Study

Medicine Science and the Law ◽

10.1177/002580249503500306 ◽

1995 ◽

Vol 35 (3) ◽

pp. 207-212 ◽

Cited By ~ 16

Author(s):

Marie T Cassidy ◽

Michael Curtis ◽

Gillian Muir ◽

John S Oliver

Keyword(s):

Retrospective Study ◽

Drug Abuse ◽

Place Of Residence ◽

Female Ratio ◽

Drug Deaths ◽

The Family ◽

Family Home ◽

Age Range ◽

High Degree ◽

Male To Female

A survey of 62 drug deaths in Glasgow showed a wider age range than expected (16–49), a high male to female ratio (44:18) and, where mode of employment had been recorded, a high degree of unemployment (91%). The majority of deaths occurred near centres of known supply. Although a number occurred in the family home, a large proportion were not at the place of residence. In only two cases was morphine detected alone. The majority of the deaths were from combinations of drugs, primarily with benzodiazepines.

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Tracheostomal Stenosis after Laryngectomy: Incidence and Predisposing Factors

Otolaryngology ◽

10.1016/s0194-5998(95)70112-5 ◽

1995 ◽

Vol 113 (3) ◽

pp. 242-247 ◽

Cited By ~ 26

Author(s):

Mark K. Wax ◽

B. Joseph Touma ◽

Hassan H. Ramadan

Keyword(s):

Suture Line ◽

University Hospitals ◽

West Virginia University ◽

Female Ratio ◽

Stenosis Rate ◽

Plastic Type ◽

Minimal Rate ◽

Good Technique ◽

Age Range ◽

Male To Female

Laryngectomy for carcinoma of the larynx has been performed since it was first described in 1880. Since that time the complication of tracheostomal stenosis has plagued both surgeons and patients. The reported incidence of tracheostomal stenosis ranges from 4% to 42%. At West Virginia University Hospitals from 1976 to 1994, 106 patients undergoing laryngectomies on the head and neck oncology service were analyzed. The charts of patients treated before 1991 were reviewed retrospectively; a prospective analysis was initiated in 1991. Only patients with a minimum of 6 months of follow-up were included in this study. The male-to-female ratio was 3:1, with an age range of 28 to 86 years (mean, 58 years). The overall rate of stenosis was 28.4%. The incidence of tracheostomal stenosis was higher in women (46.4%) than in men (21.6%) ( p < 0.05). Since 1991 a plastic type of closure was used in 25 patients. The stenosis rate was 0% in these patients. Before 1991 a bevel or circle technique was used, with stenosis rates of 33% and 75%, respectively ( p < 0.05). Infection at the site of the stoma, fistula, steroid use, neck dissection, pectoralis major myocutaneous flap usage, primary tracheoesophageal puncture, and radiotherapy did not correlate with an increased incidence of stenosis. The most important factor in prevention of stomal stenosis after laryngectomy is attention to detail while forming the stoma. With good technique and a plastic-type closure to break up the suture line, a minimal rate of stenosis should be encountered.

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Frequency of Retinoblastoma at Lady Reading Hospital, Peshawar, Pakistan

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v12i3.301 ◽

1970 ◽

Vol 12 (3) ◽

pp. 140-143

Author(s):

Zafar Iqbal ◽

Tariq Muhammad Saeed

Keyword(s):

Demographic Data ◽

Treatment Options ◽

Late Presentation ◽

Group V ◽

Female Ratio ◽

Fellow Eye ◽

Bilateral Retinoblastoma ◽

Male Preponderance ◽

Age Range ◽

Male To Female

Aim: To ascertain the demographics, clinical features, and treatment options for children with retinoblastoma. Methods: This was a hospital-based cohort study of all children with retinoblastoma presenting from 1 January 2008 to 31 December 2008. Demographic data, presenting features, family history, and findings identified during examination were recorded for each patient. The tumours were classified using the Reese- Ellsworth classification system. Documentation of the tumours included examination under anesthesia, ultrasound B- scan, and computed tomography scan as well as histopathological reporting of enucleated eyes.Results: Twenty seven new patients with retinoblastoma were identified and 36 eyes were affected, with a bilaterality rate of 33%. The frequency was 4.1, with a bimodal peak of presentation of younger than 1 yearand 4 years. The mean age at diagnosis was 3.2 years (SD, 2.5 years; range, 3 months to 8 years). Most of the patients were boys, (59%) and most were in the age range of 1 to 5 years (66%). There was a male preponderance (5:1) amongst patients younger than 1 year and the male to female ratio was equal (1:1) in the 1 to 5 years age range. Leukocoria was the main presentation in 38% of eyes and 19% presented with proptosis. Enucleation/exenteration was performed for 17 unilateral eyes (94%) and 5 bilateral eyes (27%) with group V disease. Groups I and II tumours (n = 1 and n = 7 for unilateral and bilateral eyes, respectively) were treated conservatively with cryotherapy or chemotherapy alone or in combination. The commonest treatment for bilateral disease was enucleation of 1 eye and chemotherapy for the fellow eye (22%). Radiotherapy was advised for patients with histopathological evidence of optic nerve involvement (25%).Conclusions: Retinoblastoma usually affects infants and children younger than 5 years, with no sexual or racial predilection. One-third of patients demonstrate bilaterality, with leukocoria as the commonest presenting feature and proptosis as a feature of late presentation. In bilateral retinoblastoma, primary enucleation of one eye with conservative chemotherapy and/or cryotherapy of the fellow eye is advocated.

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Decreased Morbidity and Mortality from Intestinal Ascariasis: Experience of a Single Center

Journal of Paediatric Surgeons of Bangladesh ◽

10.3329/jpsb.v2i2.19551 ◽

2014 ◽

Vol 2 (2) ◽

pp. 73-78

Author(s):

Md. Akbar Hossain Bhuyian ◽

Md. Abdullah Al Farooq ◽

Md. Minhajuddin Sajid ◽

MA Mushfiqur Rahman ◽

Md. Momtazul Hoque ◽

...

Keyword(s):

Pediatric Surgery ◽

Surgical Complication ◽

Morbidity And Mortality ◽

College Hospital ◽

Female Ratio ◽

Medical College ◽

Biliary Ascariasis ◽

Open Surgical Procedure ◽

Age Range ◽

Male To Female

Background: Ascariasis is a common gastrointestinal infestation worldwide. It affects more children who live in poor hygenic condition. Pediatric surgeons are supposed to manage related surgical complications of ascariasis.Objective: To evaluate the recent pattern of occurrence of intestinal and biliary ascariasis with morbidity and mortality related to it.Materials and Methods:Study design: Retrospective study.Period of study: Study was conducted between Jan 2006 - Dec 2011 (total 06 years).Place of study: This study was carried out in the department of Pediatric Surgery, Chittagong Medical College Hospital (CMCH), Chittagong; Bangladesh.Study Subjects: Patients admitted and diagnosed as intestinal (1591) and biliary (181) ascariasis in the department of Pediatric surgery, CMCH were evaluated.Results: A total of 1772 patients were admitted with surgical complication of ascariasis. Among them 1591 (89.78%) patients were diagnosed as intestinal ascariasis and 181 (10.22%) patients as biliary ascariasis. Age range was 6 months to 12 years with mean age of 6 years for intestinal ascariasis. Biliary ascariasis presented between 3 years to 12 years with mean age of 7 years. Male (1060) suffered more than female (531). Male to female ratio was 2:1 for intestinal ascariasis while females (120) suffered more than male(61) in biliary ascariasis ( ratio 2: 1). Total 231 surgery both elective and emergencies were done.Discussion: Most of the patients (52-81% ) were treated by endoscopic removal of worm from common bile duct. Some patients (15 - 31 %) were treated successfully by conserevative approach. Only a few patients needed open surgical procedure. No patient had died from biliary ascariasis and death from complications of intestinal ascariasis reduced from 20% to 4% over the last 6 years.Conclusion: There has been a reduced number of disease burden over the last few years from ascariatic and biliary ascariasis.DOI: http://dx.doi.org/10.3329/jpsb.v2i2.19551

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Quality of life of tinnitus patients with and without hearing loss

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20205616 ◽

2020 ◽

Vol 7 (1) ◽

pp. 11

Author(s):

Oluyomi S. Ayodele ◽

Segun Segun-Busari Segun-Busari ◽

Kayodele H. Omokanye ◽

David A. Dunmade ◽

Emmanuel F. Ologe

Keyword(s):

Quality Of Life ◽

Hearing Loss ◽

Pure Tone Audiometry ◽

Female Ratio ◽

Age Range ◽

The Relationship ◽

Male To Female ◽

Significant Health ◽

Moderate Hearing Loss

Background: Tinnitus is a common, irritating and often disturbing symptom. It poses big challenge to the patients’ management and affects their quality of life (QoL). Tinnitus is one of the most common otological symptoms associated with hearing loss. The aim of the study was to determine the quality of life of adult tinnitus patients and the effect presence of hearing loss has on the quality of life.Methods: All consenting adults presenting with tinnitus with or without associated hearing loss were recruited. Sociodemographic information, clinical assessment, pure tone audiometry (PTA) and QoL assessment with Tinnitus Functional Index (TFI) were carried out. The data collected were analysed and results were presented in tables and simple chart. Results: The age range of participants was between 18 and 80 years with a mean age of 51.94 years±17.41. Male to female ratio was 1:1.4. The relationship between tinnitus and associated hearing loss was statistically significant with moderate hearing loss found as commonest. Sensorineural hearing loss was the commonest type found. Tinnitus was mostly described as a big problem. The relationship between the TFI scores and presence of hearing loss as well as degree of hearing loss was statistically significant.Conclusions: Tinnitus has a significant health burden which tends to increase with co-existing hearing loss. PTA assessment and measurement of QoL should be advocated as routine for tinnitus patients no matter the cause of tinnitus and also especially among those with self-professed normal hearing.

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Angiographic characteristics of contralateral asymptomatic eyes in acute Central serous chorio-retinopathy in an Asian population

Asian Journal of Medical Sciences ◽

10.3126/ajms.v10i1.21111 ◽

2018 ◽

Vol 10 (1) ◽

pp. 33-37

Author(s):

Rajya L Gurung ◽

Afaque Anwar

Keyword(s):

Serous Retinal Detachment ◽

Asian Population ◽

Systemic Steroid ◽

Asian Studies ◽

Female Ratio ◽

Number Of Patients ◽

Acute Central Serous Chorioretinopathy ◽

Angiographic Evidence ◽

Age Range ◽

Male To Female

Background: Acute Central serous chorioretinopathy (CSCR) is characterised by an idiopathic circumscribed serous retinal detachment, usually confined to the central macula. Aims and Objective: We aimed to analyse the angiographic characteristics of contra-lateral asymptomatic eyes of patients presenting with acute CSCR in an Asian population. Materials and methods: This is a retrospective study of 70 consecutive patients presenting with acute CSCR who underwent detailed fundus evaluation and fluorescein angiography within 1 year period. Results: Fluorescein angiograms of 70 patients were analysed . Male to female ratio was 10.66 : 1. The age range of patients was ( 24-54 ) years , median 37 years and mean age 38.37 years with standard deviation 6.78 . Active tobacco use was found in 34 (48.6%) eyes and systemic steroid use in 2 (2.8%) eyes. Majority, 48 (34.3% ) of symptomatic and all 70(100% ) of contralateral asymptomatic eyes had presenting best corrected visual acuity ( BCVA ) of ≥ 20/60. All 70 (100%) of symptomatic eyes had angiographic evidence of leakage in comparison to only 25(35.7%) of contralateral asymptomatic eyes. Multi-focal leakage was seen in 21 (30%) of symptomatic eyes and 6(8%) of asymptomatic eyes , inkblot leakage pattern being the most common in seen in 57 (81.4%) of symptomatic and 16 (22.8%) of asymptomatic eyes. The most common site of leakage was central seen in 62 (88.5%) of symptomatic eyes and 19 (27.1%) of contralateral asymptomatic eyes. Conclusion: The findings in our study was comparable to other Asian studies. A considerable number of patients had angiographic evidence of CSCR in the contralateral asymptomatic eye.

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